Where should I give birth? In hospital or at home?
Following on from my popular article on Where to give birth if you live in Solihull or Birmingham, this article looks at the types of place you can give birth if you live in the UK.
Midwife-Led Unit
A Midwife-Led Unit (MLU) is exactly what it says on the tin. The people looking after you in labour will be midwives rather than obstetricians. The main advantage of giving birth in a midwife-led unit rather than on a labour ward is that they tend to be kitted out in such a way that will encourage the flow of oxytocin which in turn will help your labour progress. They are more likely to have birth pools in every room and several people I know have described the Bluebell Centre at Warwick Hospital as being like a spa! It’s the closest you will get to having a homebirth without actually being at home, and if you don’t fancy a homebirth, it may be a good option for you.
It’s important to note that there are two types of Midwife-Led Units. They can either be attached to a labour ward (like Warwick, Heartlands, Good Hope and Birmingham Women’s) or free standing (like Solihull). The main difference is that if you need to be transferred to a labour ward for any reason, then you would need to go by ambulance if you are not already at a hospital with a labour ward. Whilst this understandable sounds daunting, it is very unlikely to happen and it would be done in plenty of time if required.
One of the biggest differences between an MLU and a Labour/Delivery Ward will be the types of pain relief on offer. Things like gas and air will be available on an MLU but if you are hoping to have an epidural, you would need to give birth on a labour ward. It’s best to check with your midwife or local unit what types of pain relief will be on offer. If you are at a hospital that has a labour ward attached, and you decide you want an epidural, you may be able to transfer from the MLU in order to get one. However, if you are at a free-standing MLU, transferring is less likely to be an option for you.
Homebirth
There is a reason more people are starting to opt for homebirths and there are several advantages of doing so. Before we even get into the idea of giving birth in a familiar environment, there is the obvious fact that you don’t need to get to the hospital. All the worries about when to go in are no longer required. You (or most likely, your partner) will need to call a midwife at some point, but you don’t need to travel anywhere. Not only does it just seem advantageous not to have to travel in labour, but a lot of women actually find their labour slows down en route to hospital so you will avoid that as well.
If you’ve always fancied a water birth, you can hire or buy birth pools so you are guaranteed to be able to use one (provided your partner starts filling it up soon enough, it can take a while). Alternatively, you can also use your bath or shower which can be great pain relievers during labour. That said, you should also be able to use these at a hospital but at home you can guarantee they’re clean and no one else will be using it when you want to.
Two things that often concern women about having a homebirth are 1) pain relief and 2) cleaning up. To address cleaning up first, the midwives will do that and you won’t even know anything’s happened. They’ll also make you tea and toast after the birth. As for pain relief, it’s a good idea to check what will be available but most things (such as gas and air and pethidine) usually are. It will mainly be an epidural that won’t be.
The other thing that often concerns people is going to hospital. And while this is an understandable concern, your midwives will be on top of the situation and if you do need a transfer in most cases they will know and call an ambulance well ahead of time. Between November 2021 and October 2022, there were 18 homebirths in the University Hospitals Birmingham Trust. Of these, five were transferred to hospital but only after the baby had been delivered.
Aside from not having to travel to hospital, there is a big advantage to giving birth at home. And that is because the oxytocin required to keep those contractions going, thrives in familiar environments. At home, you will naturally be more relaxed than in an unfamiliar hospital environment and you can set up the place exactly how you want it. This should mean that your labour is more likely to progress smoothly, free from outside interruptions which can vary from the lunches being brought round to birth partners playing shooting games for everyone to hear (this happened to me).
Another upside to homebirths is that you are less likely to have to think about childcare when you already have children. If you go into labour at night, your child can sleep soundly upstairs and all being well, you will already be at home when the birth is over. This may not work for everyone, but it certainly can be an advantage for some.
Whilst the idea of having a homebirth can be daunting and you may feel like your house just isn’t ready for that (hands up if you’re having renovations done while pregnant), it can be a wonderful experience to have your child at home. It may have more pros than you realise and there is a reason it is gaining in popularity.
Labour/Delivery Ward
The final option for where to have your baby is the labour or delivery ward. These are often much more medical environments, although some hospitals like Warwick are giving them a makeover to be more like their MLUs.
Usually, you would only give birth on a labour ward if your pregnancy is considered “high risk” and they want to monitor you. You would also come to a labour ward for induction and if you are already certain that you want an epidural you would need to go to the labour ward.
Some people find the idea of giving birth in hospital comforting, so if this is you then you might want to consider the labour ward.
When it comes to giving birth it is important to investigate all your options. For more information on what is available in Solihull and Birmingham, check out my article on Where to give birth in Solihull and Birmingham which looks at the facilities in a number of local hospitals.
