Home birth

Planning for a home birth

Planning for a home birth is a positive option for women who:

• are healthy during pregnancy and at the onset of labour
• are pregnant with one baby
• begin labour naturally between 37 and 42 weeks of pregnancy
• baby's head is positioned downwards
• have no previous obstetric complications that might affect this pregnancy or birth

What are the benefits of a home birth?

• A familiar environment - you do not need to leave your home, and can labour in comfortable surroundings. This may help you feel more relaxed and in control during the birth.
• The midwife will come to your home and provide labour care.
• Your birth partner will be with you in your own home.
• You are less likely to have medical interventions when you labour at home.
• You don't have to travel to hospital in labour and you can get straight into your own bed after you give birth.
• Women who have a home birth report a positive birth experience.

What are the disadvantages of a home birth?

• A situation may arise where the midwife will recommend transfer to hospital. This may be because you need more pain relief, there are concerns about you or your baby, or if you decide you would like to go to hospital.
• If the midwife has concerns about you or your baby, they will recommend transferring you to hospital.
• Transferring to hospital in the later stages of labour can sometimes be distressing or traumatic, and potentially have a negative impact on your labour and birth experience.
• Depending on where you live in the Highlands, waiting for an ambulance and travel time to Raigmore Hospital could take an extended period of time. Your midwife will discuss approximate transfer times.

Who will look after you at your home birth?

You will be looked after by a team of midwives who are on-call. There is a chance that you may not know any of the midwives.

Depending on the time of day or if you have a long labour, the midwives may need to hand over to the next team of midwives on-call.

The on-call rota for your home birth will start when you reach 39 weeks of pregnancy. Evidence shows that the majority of women do not start their labour before 39 weeks. However, if you had your previous baby/babies before 39 weeks, then we will start the on-call rota earlier. This can be discussed between you and your midwife.

Your midwife will have a home birth discussion with you and your birth partner at home. This discussion is important so that you can make an informed decision. She will talk to you about:

• the possible risks
• reasons for transfer
• transfer time to Raigmore
• how to call the on-call midwife

Your midwife can help and advise you on what to prepare for your home birth.

Home birth if this is your first baby

Having a home birth for your first child offers advantages of a relaxed, familiar environment and means you're less likely to need interventions such as an epidural, episiotomy or assisted birth.

However, some risks increase slightly and you're more likely to need to transfer to an obstetric hospital during labour, or immediately after the birth. The Birthplace study found that if this your first baby, there is a 45% chance of needing to be transferred from home to hospital. This can still be a positive experience and you'll be cared for all the way.

If home birth is your preferred choice, your midwife will discuss this option with you and provide all the information you need to make the right decision for both you and your baby.

Considerations

Home birth requires a bit of extra preparation as you need to create the birth environment you wish for:

• If you want to use a birth pool, these can be rented or bought.
  • Think about the weight of them on your flooring.
  • Also consider protecting your flooring and furnishings.
  • Think about the responsibility of filling the pool and maintaining the temperature.
• How will you organise child care and pet care during the labour and birth?
• Epidurals are not available at home but you can use gas and air, TENS and relaxation techniques.
• Have plenty of sheets and towels available for you and baby.
• Stock up well on refreshments for you and your birth supporters.