Did you know you have the right to choose where you give birth?
Many of us assume that when we have a baby, we will give birth in a hospital. That’s probably because it’s what we see on TV most of the time, through dramas or documentaries about maternity hospitals. Our society has medicalised the process to the point it has become assumed that a safe birth means a hospital birth; something that must take place under the watchful eye of a medical team and with all the drugs and assistance readily available. It’s also the most common experience of our friends, family and colleagues. Babies are born in hospital, because that’s just the way it is.
Well, not quite. In the majority of cases, there are three options available to you.
Option 1 – Hospital Birth
Most births take place in hospital. Your midwife or GP will be able to tell you which hospitals have a maternity service in your area. You can, however, choose to go to a different hospital if you prefer. It’s worth checking out how the Care Quality Commission rates your local maternity service and if you’re not happy, you can look at alternatives.
An obvious advantage of a hospital birth is having direct access to the full spectrum of pain relief and medical care should you or your baby need it. You are, however, statistically more likely to experience an epidural, episiotomy or instrumental delivery if you have your baby in hospital.
Option 2 – Birth Centre / Midwife-led Unit.
Birth Centres are often described as a half-way house between a hospital birth and a home birth. They are staffed by midwives (not doctors) and can either be a standalone unit or attached to a hospital.
Everyone I know who has given birth in a Birth Centre (including myself) has been really positive about their experience. A lot of people say they are a bit like comfortable hotel rooms; often having a birth pool, soft lighting, relaxing wall art and active birthing equipment designed to help you stay mobile during labour. You do need to consider, however, that certain types of pain relief, such as an epidural, will not be available to you in a Birth Centre and if you would like to receive that additional level of support, you would need to transfer to a hospital. If your Birth Centre is attached to a hospital then this is often as simple as being wheeled through a set of doors into a different part of the building; but if you’re in a standalone unit, you’ll need to take into account the transfer time.
Some Birth Centres will not accept those with a “high risk” pregnancy but each case should be considered individually. So even if you are considered “high risk” and you want to have your baby in a Birth Centre, it’s well worth discussing your position with the Centre and asking them to explain to you why you and/or your baby are at high risk of harm if you give birth without the support of an obstetric hospital team. There may be ways that the risks involved can be safely managed and you might find that a Birth Centre attached to a hospital will be able to accommodate you more safely than perhaps a standalone Birth Centre.
Option 3 – Home Birth
The main advantage of home birth is that you are in your most familiar, comfortable surroundings, helping you to feel more calm and relaxed during labour. If you have other children, they can stay with you and your partner will not be restricted in the time they spend with you (which they may well be in hospitals, particularly since COVID-19). There is evidence to say that you have lower levels of intervention during a home birth and also if it’s not your first baby, giving birth at home is as safe as giving birth in a Birth Centre or in a hospital, which is rather reassuring.
As with Birth Centres, you will have water and gas and air available to you throughout labour, but if you would like any additional pain relief, you would need to be transferred to hospital during your labour. This would also be the case if you or baby needed additional support or care. When I chose a homebirth for our daughter we lived within 5 minutes of a major maternity hospital, so I felt really comfortable being at home. Had I been an hour away, I may have felt different. It’s a personal choice and one to think through carefully with your family and care providers.
So as you can see – in the vast majority of cases, you do have a choice about where to have your baby. Talk to your midwife about your options and what feels right to you in your individual circumstances. If they recommend a particular place for birth and you disagree, ask why they recommend it – they should be able to provide you with evidence to support what they say.
I would whole-heartedly encourage you to visit your local hospital and Birth Centre to see for yourself. Many will offer online videos if it is not possible to be shown around in-person. Being able to visualise yourself in the place you hope to give birth is a powerful tool.
One of the core principles of hypnobirthing is to provide you with the confidence to make informed choices about the care you and your baby receive. If you are not happy with the advice you are receiving or do not feel that you are being listened to, speak to the Head of Midwifery at your local hospital or contact an organisation such as Birthrights.