By Nicola Evans, Clinical Negligence Solicitor at Neil Hudgell Solicitors
With a baby on the way, you want to be sure that you are safe and prepared for your new child’s arrival. Whilst most women give birth in a hospital, giving birth at home is gaining popularity in the wake of the NHS’ announcement that home births are a healthy alternative to obstetric units.
If you are a couple planning a home birth, here is the information you need to know to be sure of your rights and options.
Deciding to have a home birth
Recognise your risks
Home births can be a healthy, safe way for a mother to give birth, so long as you are at low risk of complications. Around 45% of women fit into the “extremely low risk of complications” category. Your pregnancy is considered low risk if:
• your pregnancy is straightforward
• you are in good health
• you have no serious health conditions (pregnancy-related or otherwise)
However, there are further factors to consider. Your chance of complications during birth may rise if you are over the age of 35, overweight, or have high blood pressure. It is important to discuss your personal risks to ensure you are making the safest choice that is right for you.
Your right to choose
Assessing your risk is something to discuss with your GP or midwife before your expected due date. From this discussion, they may inform you that you are not an ideal candidate for home birth, or that you might be more prone to complications and would be safer giving birth in an obstetric unit. Despite these recommendations, they cannot refuse to give you care, should you choose to have a home birth against their advice. You have the right to choose where you would prefer to give birth.
Organising a home birth
It’s important to make it known to your midwife or GP that you want to have a home birth. This way, they can record it in your maternity notes and prepare you accordingly.
Private midwives charge between £2,000 and £4,500, and will help you through pregnancy, labour and birth. Whilst this may be too high a cost for some, others find it useful to have someone on call at all times throughout their pregnancy. Should this be an avenue you want to explore, you can find more information here.
A private midwife isn’t a necessity, and an NHS midwife is equipped to deal with a home birth. There have been rare cases of staff shortages, where a maternity unit may ask that you travel to the hospital. By insisting on your preferred choice of a home birth, however, a midwife is required to travel to your home.
What do I need?
When you pass 32 weeks of pregnancy, you’ll want to start thinking about the items you’ll need during labour. Eleanor from Neighbourhood Midwives says “from a practical perspective, home birth requires very little equipment” – all you really need is:
• clean towels
• a change of bed linen
• waterproof covers for furniture or bed
• an optional birth pool which you or your partner will need to set up by filling with water when labour begins
During the birth
Once in labour, you can contact your NHS or private midwife, who will arrive to support your labour and birth. It is also recommended that you have at least one birthing partner to assist with tasks like getting fresh towels.
Planning pain relief for your home birth is something you can organise with your midwife. Whilst an epidural can only be administered in hospital, Entonox (gas and air) and Pethidine (a form of opiate) are both available for use in a home birth and will be given by the midwife.
• Entonox, just as you would receive in hospital, has a calming effect
• Pethidine is effective for pain relief in early labour, though is less effective in later labour during stronger contractions.
These would both be administered in hospital in a normal labour.
The pain relief you opt for during labour is something that can be discussed with your midwife prior to the birth, during which you can discuss the benefits, and possible risks of side effects.
Aftercare to expect
Immediately after birth
If the birth has led to any tears, your midwife will more than likely be able to deal with these, rather than needing to move you to hospital. The only occasions where transferring may be necessary, is if the placenta doesn’t remove itself, or if you have particularly bad tears. These problems are both rare, but will mean that you will need to go to hospital to be treated.
Once the midwife is happy, they will take care of the necessary health, weight and other checks, and will give you the birth certificate. When they’re happy that everything is settled and you’re comfortable, they will leave you with your baby.
You’ll receive a health visit between ten to fourteen days after the birth, where the midwife will hand over to the health visitor. This will consist of questions about you and the baby, checking the baby’s health and talking to you about immunisation. There will be further checks at six to eight weeks, between nine months and a year, and a final between two and two and a half years.