Hospital, birth centre or home?
Hospital, birth centre or home?

Where you choose to give birth can have a big impact on your birth experience. Generally the more relaxed you feel, the easier your labour will be. So you'll need to think about where you'll feel most comfortable - and that might not be in a hospital.

The Government recently announced plans to give women more choice on where they have their babies - including more access to home births.

Check out our interactive Good Birth Guide before you decide. All you need to do is type in your postcode to access full information about the standards and services on offer in your local area.

So whether you opt for a hospital birth with hi-tech facilities on hand if you need them, a more homely approach at a birthing centre, or whether you think you'd prefer a home birth, here's how to get the birth you want.

Hospital


Around 95% of mums have hospital births, where there's a range of Pain Relief available, such as epidurals, as well as instant access to emergency treatment. Many first-time mums feel daunted by the thought of birth and feel safer in hospital.
But a hospital birth doesn't have to be hi-tech. You can still have an active, natural birth and there are many hospital-based midwives who are keen to support you and help you have one. Many hospitals offer birthing pools - although if you go into labour at a busy time, you may find the pool is already in use.
‘If you're worried about coping with pain or things going wrong, a hospital birth may give you peace of mind,' says Angela Hewett, community midwife at Leeds Teaching Hospitals Trust and midwifery lecturer at Leeds University.
‘But it doesn't suit everyone. Some women feel anxious in a hospital environment - and that can slow down contractions, making labour longer and intervention more likely.'
You're also unlikely to have one-to-one midwife care, and there may not be as much privacy as you'd like.
Of course, you may not have much choice. If you've had complications in the pregnancy or a difficult birth in the past, a hospital birth is probably the best choice.
But do your homework. If there are several hospitals in your area, check out their services via our Good Birth Guide, then visit them and see where you feel most comfortable.
Be clear about the type of birth you want - draw up a birth plan and choose a birth partner who can speak on your behalf if necessary.

Choose a hospital birth if...


  • You want a range of pain relief options, including an epidural.
  • You've had complications during pregnancy. If you're having twins, a hospital birth is recommended.
  • You've had a difficult delivery in the past.

Birth Centre


If you're not sure about a hospital birth, you could think about having your baby in a birth centre. These are run by midwives and are ideal if you want a more homely experience, but with the added security of having a medical team on hand.
Birth centres are often attached to, or near, hospitals, so if there's a problem or medical emergency, you can easily be transferred. It's free to have your baby at an NHS birth centre, but there are private centres, too.
‘Birth centres focus on making the birth as natural as possible, with the use of birthing pools and movement,' says Angela. ‘They're decorated to look more like a home, and you're likely to have the same midwife throughout the birth.'
Pain Relief, however, is limited to gas and air and sometimes pethidine and you're unlikely to be able to have an epidural. If you want to have your baby in a birth centre, your pregnancy needs to be low-risk, with no complications.
Demand for birth centres is high, so there may not be a room available when you go into labour (for obvious reasons you can't book!), so make sure you have an alternative location in mind just in case things don't go to plan on the day.

Choose a birth centre if...


  • You'd really prefer a more homely atmosphere.
  • You want a more natural delivery.
  • You'd prefer one-to-one care.
  • You don't want an epidural.

Home birth


If you've had a straightforward pregnancy and are keen to have a natural birth, you could have your baby at home. Around 2% of women opt for a home birth.
‘If you're in a home environment and you're relaxed, labour can be less stressful,' says Angela Hewett. ‘In my experience, women don't tend to need as much pain relief during a home birth.'
If you choose a home birth you'll have two midwives with you, and you'll be able to have gas and air and pethidine - although you'll need to order these beforehand. You can also hire a birthing pool.
Remember that birth tends to be a messy business. So if you're especially house-proud, this might not be the best option, although the midwives will usually do a thorough clean-up job afterwards!
‘Sometimes it's the dads who are most anxious about a home birth,' says Angela, ‘so try to get them involved. Remind your partner that one of the best things about a home birth is he won't have to be separated from you and your baby after the birth.'
It's your right to have a home birth, as long as it's medically safe, but you may still have to make a case for one, especially if your GP is not particularly supportive. In a recent survey by the National Childbirth Trust, 71% of women said home birth was not discussed as a positive option during their pregnancy, yet 43% said they would consider giving birth at home if their midwife or GP said it was safe.
For more info, call the Association for Improvements in the Maternity Services on 0870 765 1433 or visit www.aims.org.uk. Or call the National Childbirth Trust (NCT) on 0870 444 8709 or see www.nct.org.uk.

Choose a home birth if...


  • Your pregnancy has been straightforward.
  • You want a natural birth in a familiar setting.
  • You'd prefer to avoid medical intervention such as an epidural.
Babyexpert.com 26/06/2007 08:30:00
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