FAQs on home birth

This article covers the following FAQs about home birth:

Can I have a home birth?

How does home birth compare to other options for birth?

Do I have a right to a home birth?

When is home birth not advised?

Is a home birth safe?

Is my home suitable?

Why choose a home birth?

Further information

The majority of home births occur after a normal, healthy pregnancy, with one baby who is head-down. In fact, home birth is increasingly common for first babies.

Can I have a home birth?

Some experts have said that a first labour is particularly suitable for home birth because they are generally longer and - if it does not progress smoothly - there will be plenty of time to transfer to hospital.

If you fall into a higher risk category, home birth may still be an option, but talk to your midwife so that you can weigh up the pros and cons for your individual situation.

Many women in the following groups, for instance, have considered the risks and benefits and made an informed decision to give birth at home:

• previous difficult birth or heavy bleeding after the birth,
• previous caesarean section,
• over 42 weeks' gestation (you may be offered the choice of induction of labour, and if you accept, this will only be done in hospital),
• moderately raised blood pressure,
• anaemia (low iron count),
• fifth or subsequent baby and/or
• breech (bottom- or feet-first) baby and twin births - it is rare for these to happen at home but they can - usually under the care of independent midwives who specialise in such situations.

It's always important to make the decision that feels right to you.

How does home birth compare to other options for birth?

In deciding where to give birth, you may find the results of the Birthplace Study 2011 from the National Perinatal Epidemiology Unit (NPEU) useful. The results provide parents with detailed, up-to-date information about the four different places for planning birth. (The results are specific to England). The study compares planning to use a ‘midwifery unit’ or birth centre with planning a hospital birth. It also compares planning to have a home birth with planning for a hospital birth.

The main focus of the study is outcomes for women who are ‘low risk’, i.e. those who are healthy, with a straightforward pregnancy, no previous obstetric complications that might affect this pregnancy. The study finds that there are positive reasons for considering planning to use a birth centre or to have a home birth.

Do I have a right to a home birth?

There is no simple answer to this very question. Certainly nobody can make you go into hospital to have your baby – it is not against any law to have your baby at home. But what most women want to know is whether they have a right to maternity services at home – in other words, does the health authority have an obligation to provide a midwife to attend a home birth?

The Nursing and Midwifery Council in its statement says ‘Should a conflict arise between service provision and a woman’s choice for place of birth, a midwife has a duty of care to attend her... Withdrawal of a home birth service is no less significant to women than withdrawal of services for a hospital birth.’

Your health authority is legally obliged to provide emergency care, although it cannot be forced by law to provide a home birth service. So if a woman insisted on staying at home and called the hospital when in labour then they would do their utmost to provide a midwife to go to her home to care for her.

This is not the way most women would like their care in labour to be organised. If you are living in an area where you cannot, during your pregnancy, get the maternity services to support your choice to have a baby at home, get in contact with one of the supervisors of midwives from the hospital, or the community midwifery manager. In most areas, midwives are supportive of a woman’s choice to have her baby at home and will try hard to provide a home birth service.

When is home birth not advised?

A safe home birth is not possible if you have a full placenta praevia or low lying placenta (placenta covering the cervix), or your baby is in a transverse lie (sideways across the womb) because these births require a caesarean section. Many women also choose a hospital birth if they have severe health problems, or their baby is likely to need medical attention immediately after birth, for example, if the baby is premature.

In certain situations, some professionals will advise you to give birth in hospital, while others may be willing to support you at home.

If your midwife does not consider you a good candidate for home birth, ask her to go through the reasons with you to help you weigh up the pros and cons for yourself. If you have questions or need support, contact your local NCT home birth support group by calling 0300 330 0770 and the Association for Improvements in the Maternity Services to explore your options.

Is a home birth safe?

There has always been debate about the safety of home birth and you can read more about the facts in our article here.

Is my home suitable?

It doesn’t matter if your home is small, untidy or in need of decorating. The important thing is that you feel comfortable there. Your midwife can discuss how long it would take an ambulance to reach you in an emergency, and any access concerns. She will also discuss with you what you will need for a home birth.

Why choose a home birth?

Women may plan a home birth because they:

• feel safer at home,
• have had a previous positive birth experience in hospital, and now feel confident about birth at home,
• dislike being in hospital,
• are worried about the effect of a hospital environment on their labour,
• want to keep birth normal and avoid interventions,
• want to reduce the risk of infection,
• don’t want to be separated from older children,
• want more than one birth partner,
• want to avoid overnight hospital stay without partner,
• hope to use a birth pool and cannot be sure that this will be possible in hospital,
• want privacy,
• want to feel more in control,
• want continuity of care, with a midwife they know attending the birth, and/or
• have had a previous negative experience in hospital, and don't want to repeat this.

Ultimately, the decision to have your baby at home is yours but it always helps to have support and information in making that choice.

Further information

The results of the Birthplace study were released in December 2011 and provide useful information for parents about their choice of place of birth.

NCT's helpline offers practical and emotional support in all areas of pregnancy, birth and early parenthood: 0300 330 0700. We also offer antenatal courses which are a great way to find out more about birth, labour and life with a new baby. Other NCT resources include:

• ‘Homebirth All you need to know’ leaflet available from NCT shop.
• ‘Mums the Word’ DVD available from NCT shop.
• 'Daddy Cool' DVD available from NCT shop.
• NCT's shared experiences register, which enables mothers to talk to other women who have had similar experiences. Call 0300 330 0770 or email enquiries@nct.org.uk.
• Local NCT homebirth support groups. Call 0300 330 0770 or email enquiries@nct.org.uk.

If you would like to read more about the evidence on the safety and other advantages and disadvantages of home birth, the following are good resources:

The Home Birth Reference Site provides information and opinions about home birth, for parents who think that it might be the right choice for them, and for health professionals looking for resources. 

BirthChoiceUK provides information on choosing maternity care to help parents make the right choice for them.

• MIDIRS and NHS Centre for Reviews and Dissemination (1999), Place of Birth.
• Rediscovering birth by Sheila Kitzinger
• Birth your way by Sheila Kitzinger
• Home birth: A practical guide by Nicky Wesson
• Choosing a home birth by Beverley Lawrence Beech
• Midwives and home birth, MC Circular 8/2006