Research shows that if your pregnancy has been straightforward and you are not considered high risk it is just as safe to have your baby at home as in hospital. With a hospital birth you are more likely to end up with interventions, and you have a greater risk of infection. Even if taken to hospital during labour, you are still less likely to end up with a caesarean section than someone booked for a hospital birth.
The biggest advantage of having your baby at home is being in a familiar, comfortable environment with none of the elements of uncertainty and fear that can inhibit labour in a hospital. You have the freedom to move around as you wish, and to have as many people with you as you choose - or you may just prefer the privacy, knowing that members of staff are not going to walk through the door. Women who have a home birth are more likely to feel in control and relaxed than those who give birth in hospital.
Preparing for a home birth
If you choose to have your baby at home, your midwife will generally bring the delivery equipment to your house at around 37 weeks and leave it there. There is little preparation involved in a home birth but there are a few things that you can do to make things easier.
Things you can do
Have a list of contact numbers to hand for when labour starts, for example, your midwife's mobile number or the telephone number of the community midwife's office (the local labour ward should be able to contact the community midwife if you cannot get through). There are also a number of other sensible preparations you can make before you go into labour:
- Walk around your house to see how you can use the furniture during labour. Ideally you want to remain upright and walking around. Try putting a cushion on a table and leaning over it, or leaning on the kitchen worktop. Is it the right height? Can you adapt and use what is around you?
- An adjustable reading lamp will be useful when the midwife checks your perineum afterwards to see whether you need any stitches. You could also have a torch handy for the same purpose.
- If you have other children, it is useful to have someone to take care of them, just in case you have to be transferred into hospital, rather than having to wake them up and take them to stay elsewhere once your contractions have started. You need to know that they are being looked after in order to stay relaxed.
- Find some plastic sheeting, (for example, a ground sheet or an old shower curtain) to protect your mattress or carpet. Old sheets or towels can also be useful.
- Pack a bag for the hospital 'just in case'.
Options for pain relief
Choosing to have a home birth makes a huge difference to women's ability to cope with the contractions. Because of this, and the one-to-one care that they get from the midwife, many women find that they do not need pain relief when they have a home birth. Most women use what is around them - they walk around, listen to music, eat and drink, and generally stay relaxed, which is the secret of staying in control of your labour.
Many women, whether at home or in hospital, find a soak in a warm but not hot bath to be a great source of pain relief but some drugs can be used at home.
- You can use gas and air (Entonox) to take the edge off the pain. Your midwife will bring some canisters to your home and you can breathe it through a mouthpiece or a facemask.
- Some doctors will prescribe meptazinol or pethidine, for the midwife to give you. However, some midwives are reluctant to use this at home because it makes the baby drowsy.
- Alternatively, you could hire a TENS (transcutaneous electrical nerve stimulation) machine, which works by blocking the pain impulses and encouraging your body to produce natural pain relievers. Check with your midwife whether she will be able to bring one with her or whether you should hire one.
Midwives are trained and equipped to deal with emergencies should they occur. However if there are signs that all is not well during labour, your midwife may decide to transfer you to hospital.
You should discuss any reasons that she might have for doing this beforehand. They would include:
- Your baby showing signs of distress during labour, including opening his bowels
- Very slow progress of the labour
- Any bleeding during labour
- High blood pressure
- Signs of infection.