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Where to give birth – Observations by Katharine Graves

More often than not, the automatic choice for most women is to give birth in a birth centre. They think they are getting the best of both worlds; it is less medicalised than a delivery ward but doesn’t have the perceived risks of giving birth at home.   At home you get one-to-one care often from a known midwife which is generally agreed to be the gold standard of care. You get exactly the same, or even better, medical support at home, but in hospital you lose out on some of the fundamental benefits of home. This study contradicts the generally held assumption that hospital is safer, and it has important information and the facts for all women to be aware of in the decision-making process.

Being fully informed

A little-known fact that is important in the decision-making process of ‘where to give birth’ is the increased stress from week 40-41.5 that occurs when women are booked into some birth centres. After this time, she is no longer allowed to go to the birth centre so may be desperate to get the baby out. She is more likely to agree to a sweep which itself can have knock on effects and associated risks. As the study demonstrates, homebirths have been shown to be safer for women. But why is this the case?

Instinct and feeling safe

Being at home, arguably, a mother’s “safe” place, will facilitate labour to progress more comfortably and efficiently than in a hospital environment, which also includes a birth centre. Often labours progress quicker and have less medical intervention (such as assisted deliveries) when they take place at home as it is instinctively where we feel safe.

In preparation you need to make sure you have good information and plan carefully.  Instinct is the most powerful factor when it comes to giving birth. You will have a midwife with you, just for you, who will call a second midwife for the actual birth. A midwife who has chosen to support women at home is generally one who is more supportive of a normal birth and likely to give more women centred care, free from the rigidity of hospital protocols. In general, the midwives will stand in the background until needed. Some mothers say they often forget they are even there!

You have exactly the same medical equipment at home as you would in a birth centre, but you are also in the place you know and feel most relaxed in and that feels completely comfortable for you.

A recent study has found that giving birth at home in low risk pregnancies, had no significant difference in the adverse outcomes for mothers and babies.


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