Home Birth Info
Home birth is a safe, sensible choice. Planning a home birth keeps your options open, reduces your chance of interventions, and has benefits for your birth, you as a birthing woman, and your partner.
On this page you can find information about:
Equipment midwife brings
How to get a home birth if your midwife is not supportive
If you want more information please message or email me, or join the Luton and Dunstable home birth facebook group I run. It is for Luton and Dunstable, but others welcome too.
I run workshops on home birth, and on vbac (vaginal birth after caesarean), and I have a free hbac e-course (home birth after caesarean.
I have an e-course about home birth, specifically for partners. Answering your questions, and giving you practical tips: Home birth FAQs for partners
Safety of home birth
There are now many, many studies showing that planned home birth is at least as safe as planned hospital birth, and results in fewer interventions.
This article explains the history of home birth in the UK and why home birth got such a bad rap. Several reasons, including: data lumped together planned and unplanned home births; assumptions in 1970 Peel report.
In 2019 a systematic review and meta analysis of all the recent research concluded: "among low risk women who intend to give birth at home when labour starts there is no increase in perinatal and neonatal mortality or morbidity compared to similarly low risk women who intend to give birth in a hospital. There were no differences between intended home and intended hospital groups in other neonatal outcomes including NICU admission, Apgar scores, and the need for resuscitation."
The UK Birth Place study 2015 looked at outcomes by place of birth for 64,000 babies born to 'low risk' mothers in 2010, including my youngest.
It found that birth in any setting is extremely safe, with perinatal mortality rates extremely low.
It found that there were much fewer interventions for home birth, and other midwife led settings, compared with the traditional labour ward (aka obstetric unit). Remember, this was comparing low risk with low risk. They only difference was the intended place of birth.
The UK Birth Place study found there was no difference in 'poor outcomes' for second and subsequent births, but a increased chance with first babies. See picture.
This caused some midwives and doctors to recommend birth centres or hospital for the first baby.
I asked one of the researchers of the Birth Place study, on twitter, why there was a difference in outcomes between home and standalone birth centres. She said that she didn't know, but that midwives working at standalone birth centres reported greater levels of confidence than community midwives generally, and that areas that had high community midwife confidence levels in doing home births had lower transfer rates.
Since the Birth Place study was published in 2011, there have been further studies, including the systematic review and meta analysis mentioned at the top of the page, and this one from the Netherlands. Both the systemic review and the meta analysis had higher numbers of women than the birth place study so are better able to compare neonatal death and morbidity. Both concluded there was no difference between home and hospital for mortality and morbidity for first timers, but that planned home births had fewer interventions (comparing low risk with low risk in each case).
Reasons for transfer
All births, that start spontaneously, are home births. Planned hospital births have planned transfers and planned home births don't. You transfer only if you need to. Transfer from home to hospital is not a failure. It is just what happens sometimes. The most common reason for transfer is for slow labour. There is something about transferring in that often gets baby on the way, whether it is the large step into the ambulance that creates room in the pelvis for the baby to turn, or move down, or that the woman stops 'trying' for the duration of the ambulance ride. Many babies are born shortly after transfer. Transfer is not a bad thing. Sometimes labour does need help.
It is really common to worry about needing to transfer, and it can be helpful to know the most common reasons, and to see that very few of them are emergencies. From looking at the transfer rates you can also see how few transfer for more pain relief. Home birth helps birth be less painful.
These statistics are for 'low risk' women. For higher risk women the reasons are in the same proportions, but in some situations more transfer.
These are the most common reasons. There are a whole lot of other reasons that were less than 0.5%, and really varied. If you want to see them all they are in this report on the Birthplace study, on pages 66-67.
The percentages are for all the women who planned home birth. So for first timers, 11% of all the home births transferred because of slow first stage, which was a quarter of all the transfers.
High risk doesn't mean 'high risk', it means 'higher risk'. A high risk of snow tomorrow is not 0.5%. That is a low risk of snow. But if there is a 0.5% chance/risk of snow in Aberdeen and a 0.01% chance/risk of snow in London. Aberdeen has a higher risk of snow, but not a high risk.
Women with a label of 'high risk' are usually advised to give birth on a consultant led obstetric unit (aka labour ward). However it is your decision to make. High risk labels in maternity care cover a huge range of situations, and I cannot look at them all here. An adjunct study to the main Birthplace study looked at 'high risk' women, and found that "The risk of 'intrapartum related mortality and morbidity' or neonatal admission for more than 48 hours was lower in planned home births than planned OU births." and "The babies of 'higher risk' women who plan birth in an OU appear more likely to be admitted to neonatal care than those whose mothers plan birth at home, but it is unclear if this reflects a real difference in morbidity."
There were two more studies on high BMI and vbac (vaginal birth after caesarean), which both make great reading. Home birth is associated with much lower levels of intervention.
You are balancing your unique situation. The benefits of home birth, the benefits of hospital birth, the additional risks of hospital birth, plus other things. In the end it is your decision.
If you want support to access home birth if you are considered 'higher risk', please drop me an email.
Also check out my free hbac e-course.
What you need to get ready
I will be adding to this section soon.
Here are some links to the UK Birth Place Study
This is the decision tool for parents: http://www.nhs.uk/Conditions/pregnancy-and-baby/Documents/Birth_place_decision_support_Generic_2_.pdf (In my webinar I address the issue of the tiny but higher chance of 'poor outcomes' for babies when first birth is at home. Can't be because of being at home because standalone midwife led units don't have the same stats and have no better access to medical equipment than at home. Most likely because of the lack of experience of midwives doing home births.)
Birth Place website: https://www.npeu.ox.ac.uk/birthplace
place of birth and vbac: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5014182/
BMI and outcomes http://onlinelibrary.wiley.com/doi/10.1111/1471-0528.12437/abstract
This is research from the Netherlands (2015) looking at outcomes over 10 years (400,000 women) comparing low risk women giving birth at home or hospital. It found there was no difference in outcomes for babies, including first timers.
The Business of Being Born - documentary by Rikki Lake https://www.youtube.com/watch?v=xk-ApG4Rw1U&list=PLtB9LXUsSoXIxIBb2iKKqCtN3L2-yXxDD&index=1&t=1681s
Here's a clip from the movie showing Marsden Wagner "If you want a humanised birth the best thing you can do is to stay the hell out of the hospital."
Mybirth.tv Lots of home birth videos filmed by midwife turned filmmaker, Bernie Bos, mostly for cable TV shows 'Home Grown Babies' and 'Home Birth Diaries' includes vbacs at home and other 'outside of guidelines' home births, and also transfers. https://www.youtube.com/watch?v=eljsrpgiC6k&list=PLcfqjj6yoqap2HeuBvdUwDbU6iY2ouwtR
www.which.co.uk/birth-place useful interactive tool for thinking through your options, plus stats on every hospital.
www.homebirth.org.uk especially the section: can I still have a home birth if ...
www.sarawickham.com lots of useful links to research with commentary. Especially good for high bmi, older women, going past due dates.
Please email if you would like more information, other information, or simply a bit of moral support.