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6 reasons for booking a home birth - even if you plan to go to hospital

Of course home birth is not for everyone but there are some advantages to booking one even if you plan to give birth in hospital.

1. You might like it

Booking a home birth keeps your options open. It is much easier to say 'I'd like to go to hospital now' than to be in hospital and turning around and saying 'Actually I'd like a home birth.' (Though it is possible and I know it has been done.) You don't have to stay at home but at least you've got that option. Areas that have caseloading midwifery schemes (where community midwives are given caseloads of women for whom they not only do the antenatal and postnatal care but also attend the birth) often leave the decision of where to give birth till the woman is in labour. If all is going well and she's happy, they stay at home; if she wants to go to hospital, they go in. No drama.

2. It helps you to stay at home longer

Staying at home as long as possible is one of the things you can do to reduce your chance of ending up with a caesarean. This can be really challenging. The urge to go in, to be where you are going to give birth, to be where the midwives are can be overwhelming. The whole 'when do I go in' thing is stressful - especially for partners. If you plan a home birth then the midwife will come to you. Her support can give you confidence to keep going at home and then she can help you decide when and if you want to go in. Some areas actually offer a 'domino' scheme (which stands for DOMicillary IN and Out) where the community midwife attends you at home in labour, helps you decide when to go in, and then is your midwife in hospital.

3. You get one to one care

Research has overwhelmingly shown that one to one care from a midwife during labour massively improves outcomes for you and your baby. And it is not just that they will not be looking after one or two other women in labour, but because they are in your house, looking after you, they won't be off checking stocks, replying to emails, inputting data etc. When you go to hospital they may be your midwife in labour, or, if not, you will get really good care because you were the women who planned the home birth but ended up in hospital. Many midwives will go out of their way to make it as homely and relaxed as possible.

4. Reduces your chance of having a caesarean by 75%

All the research that has shown the improved outcomes for women having home births, actually looks at where they planned to give birth, rather than where the birth actually occurred. Planning to give birth at home is what makes the difference (stay at home longer, individualised care, more relaxed, better environment for labour hormones to flow). Women who plan to give birth at home also use less pain relief, are less likely to tear or be cut, less likely to haemorrhage, and are much less likely to have an assisted birth, even if they go to hospital. Your baby is more likely to have a higher APGAR score at birth and breastfeeding is likely to go easier. If this is your second baby you have a 96% chance of a straightforward birth if you plan a home birth (compared to 70% planned hospital birth) (From UK Birth Place Study comparing low risk with low risk).

5. It's your first baby

Some people say you should have your first baby in hospital because you don't know what will happen, but that's precisely why you should plan to give birth at home. Planning a home birth puts yourself in the best position for all to go well. How the first birth goes has an impact on any subsequent births. So reducing your chance of a caesarean or assisted birth means you have more options next time around. The huge UK Birth Place Study, comparing low risk women found that planning a home birth with your first baby gives you a 67% chance of a straightforward birth (i.e. no intervention) compared to just 46% with a planned hospital birth. Your chance of having an emergency caesarean is almost halved with a planned home birth (9% vs 16%). Remember this is comparing low risk women; the only difference between the two is where they planned to give birth. The study did show a small increase to the tiny chance of poor outcomes for babies with planned home birth for first timers, but there wasn't the same increase for stand alone midwifery units, and they don't have any better provisions or access to interventions so it wasn't the low tech aspect of home births that was the problem. No further research has yet been done why the difference. It is up to you to balance the benefits and risks.

6. All births are home births

All births that start spontaneously are home births, just some have preplanned transfers. You spend large amounts of time in labour at home whether you are planning a home or hospital birth. With a planned hospital birth there's a tendency to be holding on, treading water, till it's time to go in. Planning a home birth means you prepare for it and are ready to cope with it. You might put up some sparkly lights or try out different surfaces to lean on. And doesn't that sound a much nicer way to start your labour? Hopefully then, by the time you go in you'll be in such a flow your baby will just pop out, or even before you go in. And then you get all the other advantages of a home birth - your own bath, your own bed, partner doesn't have to leave, and you can celebrate with champagne and takeaway!

If you'd like to find out more about your options here's a link to the Birth Place Study decision support guide and the original research.

For more info about home birth go to the home birth reference site .

I'm a doula and antenatal teacher in Bedfordshire, UK. I run antenatal masterclasses and pregnancy retreats. More details on my website.

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