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Can I have a home birth with midwives from a different hospital?

This is a question I have just had in my inbox.

And the short answer is yes!

A lot of people think it is not possible, including midwives, but it is.

It does depend on your geography, if you have another trust that can physically cover your area. And also, why you don't want care from the midwives who would normally cover home birth in your area. I am guessing it is either because they are not being supportive of home birth, or you are worried because there might not be a midwife available, or because you have not had a good experience with them.

You cannot request care from another trust because they have a home birth team and yours doesn't.

Not supportive of home birth

If your midwife is not being supportive of home birth, you may find that if you contact the head of midwifery this changes. Write and ask to be assigned to a midwife who is more supportive of home birth. And you can expect to be supported in a home birth, irrespective if it within trust guidelines or not. It is your right to plan a home birth. If, after exploring this avenue, then you still feel unsupported, then you can go to another trust.

"I requested to go under a home birth team that don’t cover my area usually because the hospital that I should be under refused me a home birth with my second as they "don’t do that". They accepted me as two of the midwives actually live very near to me, even though they work in a slightly different area. I had to drive 15 miles to all appointments pre and post natal but they did a home birth for me! Amazing experience!"

If you are being told that it is not hospital policy for someone in your situation to have a home birth (vbac, twins, etc) or you are 'not allowed' a home birth, that is not a good enough reason. You are the person giving birth. It is your baby. You are legally entitled to chose where you give birth. Many women/birthing people have home births 'outside of guidelines'.

Again, contact the head of midwifery, tell her you are planning a home birth; it is your informed decision (full stop, don't need to explain - or simply say 'as you'll understand); and ask her to put it in your notes.

Worries about midwives not being available, or no home birth service

If you are worried about not having a midwife available on the day, then address this with your trust first. Contact the head of midwifery and ask them for an escalation plan for that situation, and that may include contacting a neighbouring trust or independent midwife. It is very reasonable to insist on having cover for a home birth. "I am not prepared to put myself and my baby at increased risk of a hospital birth."

"I have anxiety and planning a home birth was essential in reducing that, and helping me feel in control. One of my biggest fears was not having a midwife available on the day. Initially the hospital just said it would depend if they had enough midwives, but my doula suggested contacting Birthrights and they wrote to the hospital recommending an escalation plan. I am so glad I did this as when I went into labour there wasn't midwives available. My partner reminded the midwife on duty about the plan and we ended up with a midwife from a neighbouring trust."

I also recommend that you write to the head of the trust, and copy in Birthrights, AIMS, your local Healthwatch, and your local MVP (maternity voices partnership). Home birth is seen as a 'nice extra', not a strategic essential. We need to raise our voices so that home birth is taken more seriously. As a statement on home birth from the old Nursing and Midwifery Council said,

"Withdrawal of a home birth service is no less significant to women than withdrawal of services for a hospital birth."

Negative previous experience

If it is the third situation, then yes, I have known of a couple of people who have had their home births covered by a different trust because of this reason. The first step would be to contact the head of midwifery of the trust you want to get your care from, or the next nearest one to you, and explain that you don't want care from the hospital that would cover you, but want a home birth. Explain that your anxiety/trauma would make it impossible for you to relax and birth with midwives from there. That you understand that this is an exceptional request, but you have specific reasons for not wanting their care, based on previous experience.

You need to have all your care transferred to the hospital that the midwives work for.

"I live less than a mile from my local hospital but I had such an awful experience with my first I just didn't want anything to do with them. I had had a 'birth afterthoughts' meeting, but they just gaslighted me. At my booking appointment I asked for a planned caesarean but the midwife didn't think that would be 'allowed'. So I contacted Cathy, Chilled Mama, for support. She said I could contact a neighbouring hospital about a elective caesarean. When I jokingly said "I wish I could have a home birth with them." Cathy said to ask them. And they said yes! I was over the moon. I had the most wonderful, healing home birth. And the midwives were so supportive and positive."

Should you need to transfer to hospital in labour you can request that you are not taken to x hospital. And this should be respected. But obviously if time is imperative to safe life then you would be taken to the nearest.

"I had a fast home birth with my fourth. He needed a check up after birth and we were happy to go to hospital for that. But I didn't want to go to my local hospital because of my previous experience. I still had a complaint ongoing. I told my midwife and she was great. She told the paramedics and sorted it all out for me. I thought it would be difficult but it wasn't."

Get support

You can get further support in requesting maternity care from a different trust by contacting Birthrights UK. They are a charity run by lawyers who specialise in helping people get the maternity care they need. Just email or call them.

Your local Maternity Voices Partnership and Healthwatch should also be able to support you and advocate for you.

I can also help you draft letters. If it doesn't work out, or you decide to stick with your local midwives I can advise you on how to get them to listen to you and create a bespoke plan, backed by the head of midwifery. I have helped a number of women get better care the next time around, including making complaints, changing midwife, not having antenatal appointments, and lots of having home births outside of guidelines. Just ask. I offer support by email/messages for free.

Have you had midwifery care from a different trust? Are you experiencing a similar situation? I'd love to hear from you.

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