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Giving Birth at Home: The Essential Guide

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/ by Gudrun Getz M.A. / November 20, 2019

If you’d told me 20 years ago that I’d be giving birth at home I would have laughed in your face.

It might surprise you to learn that I never used to want to have children at all, let alone give birth to them naturally at home. I was terrified of the pain of childbirth thanks to movies and TV shows. Women screaming and yelling in agony while masked male doctors ran around panicking like it was a deadly medical emergency. Urgh, no thanks!  

The story of how I went from anti-birth to writing about the benefits of giving birth at home is another post for another day. But my journey led to me having the most wonderful, positive home birth and I want to share with you what a fantastic experience it can be.

In this post I’ll give you a rundown of everything you need to know if you’re considering giving birth at home too.

Table of Contents

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Why have a home birth?

Here in the UK, your three main options for where to give birth are:

Hospital labour ward

Midwife unit

Home

At first I thought I’d probably end up choosing the midwife unit housed within one of my locals hospitals. It seemed like a good compromise between a high-intensity labour ward and what felt at the time like the scarier option of home.

But after my first midwife appointment I ruled out going anywhere near the hospital if I could possibly help it. The midwife declared my pregnancy “high risk” due to me being over 35 and having mild asthma. She ticked the “labour ward” box option on my form, even though I told her I wanted a midwife unit. I decided if this was how they treated my birth choices at the very first appointment I wasn’t going anywhere near a hospital on the big day! 

The more I researched what it would be like giving birth at home, the more I set my heart on it. Here are some of the reasons I chose to birth at home:

  • I knew I would feel safer and less anxious in my own home rather than a hospital. I’d had several negative hospital experiences over the years and I associate hospitals with trauma and stress. 
  • I wouldn’t need to transfer from home to hospital in the middle of labour. If you’ve seen Look Who’s Talking you’ll understand why I loved the idea of staying at home!
  • I would be more in control of my birth choices. Being told by the midwife that I would “have to” give birth on the labour ward told me everything I needed to know about how I would get treated during labour. Many women who have labour ward births have their choices overridden and ignored. I didn’t want that happening to me. I wanted to be in control and empowered in my birth experience. 
  • Less chance of unnecessary interventions such as forceps or ventouse. In hospital, it’s easy to get pressured into procedures that aren’t necessarily in your best interests. Not being pressured into having unnecessary interventions was very important to me. 
  • Not being separated from my husband after the birth. Mothers and their birth partners often get separated after a hospital birth and either can’t stay overnight or have to sleep separately. After giving birth at home birth you can just curl up in bed together. This ended up being one of my most blissful moments.

Other reasons for why you might want to consider giving birth at home include:

If you have older children you don’t have to leave them.

It can be very distressing for children when their mother leaves the family home to give birth. This is especially true if they have negative ideas about hospitals.

If this is their first sibling it might make it even harder for them to connect with the baby if their mum has been “taken away”. Giving birth at home means that they can be aware of what’s going on and childbirth can be normalised for them. 

Some mothers even get the older children involved in the birth process. Depending on their age they can help to fill the birthing pool or even cut the umbilical cord. Even if you don’t want your older children to be there for the moment of birth, giving birth at home means you don’t have to leave them altogether.  

Continuity of care with a midwife you know

With a hospital birth, it’s pot luck as to which midwife will be on duty and looking after you through birth. If you have a home birth you are more likely to be assigned one or more midwives who will stick with you through the whole process and be there at the birth. Having continuity of care is shown to result in fewer interventions, more natural births and less risk of loss of life for the baby. It’s a wonderful comfort to know you’ll be taken care of by someone you’ve built up a trusting relationship.


Is giving birth at home safe?

So many people immediately ask if home birth safe when they hear about it. We’ve gone so quickly from the majority of births taking place at home (in the first half of the 20th century) to people assuming it’s unsafe to birth unless it’s in a hospital. Let me be clear though:

YES 👏  GIVING 👏   BIRTH 👏  AT 👏  HOME 👏  IS 👏  SAFE

In the case of women who have given birth before, it’s just as safe as giving birth in a hospital.

For first time births, it’s statistically safer to choose a midwife unit but giving birth at home is still a safe option for an uncomplicated, low risk pregnancy. A UK study in 2011 found that, out of 1,000 planned home births, only 4.3 resulted in serious complications. The odds of serious complications occurring did double in the case of a first-time pregnancy, but the odds were still very low (9.3 out of 1,000 births).

This study also revealed that the chances of having an emergency caesarian section were dramatically lower among women who planned a home birth. There are many circumstances under which having a hospital birth poses a greater risk due to greater likelihood of intervention. Someone recently told me I was “brave” for having home births. I told her I thought women going into hospital were the brave ones as they’re more likely to end up in surgery!

One reason people think a home birth is dangerous is due to having less medical equipment on standby. In the case of a low-risk pregnancy, you’re unlikely to need the specialist equipment of a maternity ward.

If it starts to look as though you or the baby need medical attention not available at home, the midwife will spot the signs early enough to initiate a hospital transfer in plenty of time. In reality though, most home to hospital transfers are at the request of the mother and not the result of an emergency.

In terms of risks to the baby, an international study concluded there is no greater risk of infant death whether the birth was planned for home or hospital. 

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    What if home birth goes wrong?

    Only a very small number of home birth end in serious complications. Midwives are highly trained medical professionals who will know exactly what they’re doing. With your consent, they’ll be monitoring your baby’s heartbeat throughout the labour. Midwives have a range of equipment on hand to deal with home birth emergencies. They can deal with haemorrhages, umbilical cord complications and even resuscitation in a worst case scenario. If there are any signs that something isn’t right, they’ll call an ambulance and get you transferred to hospital.

    There’s no need to worry that you won’t get the medical help you need in the highly unlikely case of an emergency. Women in labour are right at the top of the priority list for UK ambulances and the local emergency team is often told about local home births in advance. Even if you live in the middle of nowhere, you’ll have paramedics with you in a flash if you need them.


    Your circumstances: “can I have a home birth if…?”

    Can I have a home birth with my first baby?

    Yes, you always have the legal right to choose a home birth including with your first baby. There are slightly higher risks associated with giving birth at home with your first child but these risks are relatively low. In a 2011 study, 9.3 out of 1,000 planned home births by first time mothers resulted in serious complications. This was as opposed to 5.3 in labour wards and 4.5 in freestanding midwifery units. 


    Can I have a home birth if I am high risk?

    You are legally entitled to give birth at home whatever your physical health circumstances. Some people believe home birth is illegal in a high risk pregnancy but this isn’t true. Medical staff have no authority to dictate where you can or can’t give birth. The only rare exceptions are when a woman has severe mental health issues and is unable to make decisions for herself.

    If your pregnancy has been labelled “high risk” it’s important to learn more about exactly why. As I mentioned, my pregnancy was deemed “high risk” because I had a history of asthma. However, my asthma had been mild for some time and it was over 5 years since my last attack. I believe the midwife told me I was high risk and put me down for a hospital birth to make life easier for her team. This is just my suspicion, but it’s not uncommon for medical staff to say a pregnancy is high risk in an attempt to discourage home births. Your birthing rights should be at the forefront of any care provider’s mind and you must therefore get to the bottom of why you have been declared high risk.

    If you’ve been told you have a high risk pregnancy and are still hoping for a home birth, don’t be afraid to be pushy and try to get the supportive conversations you need to have with your care provider. The organisation AIMS (Association for the Improvement of Maternity Services) can offer you advice on your rights and help you to find the information you need to make informed decisions. 

    There are, of course, many circumstances under which the safest place for a woman to give birth is in the hospital. It’s important that you speak with your care provider under these circumstances. 

    recent study from the Netherlands looked at why there has been an increase in women with declared high risk pregnancies ignoring medical advice giving birth at home, often without medical support. It showed that the reasons for doing this included women not trusting medical staff and experiencing conflict over their birth plan. Many of these births had negative outcomes for both mother and baby. Please do try and find a middle ground and a peaceful solution with your care providers if they are urging you for a hospital birth.


    Can I have a home birth with twins (or more)?

    In the UK a home birth with twins is rare. Pregnancies with multiple babies are considered high risk and are usually planned as a hospital birth under the care of a obstetrician.

    However, you are always entitled to give birth at home if you wish and a home birth with twins is possible. They are usually attended by independent, private midwives specialising in multiple births.

    The risks with twin births include premature birth and the need for resuscitation. There are many strong arguments in favour of following medical advice and choosing a hospital birth. There’s an excellent page on the arguments for and against twin home birth here with additional resources and home birth videos.  


    What pain relief is available at a home birth?

    Giving birth at home means much more limited access to medical pain relief. This is a positive thing if you would like to access the many benefits of a natural, drug-free birth. The pain relief options you have available at a home birth are:

    • Enthonox (AKA Gas & Air)
    • Pethidine or Diamorphine
    • TENs Machine
    • Birthing Pool
    • Self-Help Methods e.g. Hypnobirthing

    Enthonox aka gas and air

    giving birth at home naturally photo

    This is s a mix of oxygen and nitrous oxide gas. It has no actual anaesthetic effect but it takes the edge off the pain.

    Enthonox has no harmful side effects for either you or baby. However, it’s a greenhouse gas that accounts for 2% of the NHS’s carbon footprint, so it’s not eco-friendly.

    Pethidine or diamorphine

    A morphine-like injection into the buttock or thigh that takes about 20 minutes to take effect and lasts for between 2-4 hours. This method isn’t suitable close to the end of birth as it can interfere with the baby’s breathing. It also can’t be used with a birthing pool.

    Pethidine can make you feel sick and drowsy and many women dislike the sensation. It also crosses the placenta and affects your baby making them drowsy and harder to breastfeed in the crucial first days. 

    TENs machine

    This is a small machine with sticky pads that attach to your back, sending a mild electrical current to the nervous system. It works by stimulating your body’s own natural pain relief mechanisms. You can hire or buy a TENs machine or sometimes your midwife may bring one with them. They’re generally most helpful in the early stages of labour and can’t be used in a birthing pool.

    Birthing pool

    giving birth at home naturally photo natural home birth tens machine birthing pool

    You can easily hire birthing pools, from companies who will provide everything you need. They come and take it away and deal with all the cleaning it for you.

    You can also buy water birth supplies online. In some cases your midwife may be able to provide one so speak to her before investing in anything.

    A water birth isn’t an eco-friendly option due to the high water usage. But given the epic pain of childbirth perhaps you can live with a bit of eco-guilt…! 

    Self-help methods

    Meditation, deep breathing, hypnobirthing and affirmations are just some of the tools you can use to help you cope with the pain from within.

    I attempted to use some mind over matter during labour with a very basic free hypnobirthing app. However I really wish I had invested in a proper hypnobirthing course. When it came to the big day, I found I didn’t have enough hypnobirthing practice or breathing techniques to help me.

    There are lots of hypnobirthing teachers out there and you may like to find a face-to-face practitioner in your area. But if you’re looking for an economical but high-quality product that you can download and start using now then I highly recommend KG Hypnobirthing.

    The course is a full in-depth antenatal programme available online where you can enjoy learning at home where you feel comfortable. You can obviously learn at your own pace at any stage of your pregnancy and have the resources at

    KG Hypnobirthing offer:

    • A full in-depth antenatal programme available online with 12 hours of video content
    • All the supporting documents, audio downloads and materials you need
    • An accompanying Facebook support group so you can build a network of fellow hypnobirthers around you
    • Online learning at home where you’re comfortable and not at the mercy of someone else’s timetable
    • A special COVID-19 module to give you extra support through the pandemic

    The course costs just £45 making it easily the best value online hypnobirthing course around.

    If you’re still on the fence, check out my introduction to hypnobirthing or my guide to hypnobirthing breathing techniques (with free PDF download).


    What do you need for a home birth?

    You don’t need all that much for a home birth and your midwife will let you know what is essential. However the key items I found essential were:

    • Key documents e.g. maternity notes and emergency numbers
    • Old towels, including an extra large one
    • Plastic sheeting
    • Blankets
    • A bucket
    • A way to keep cool
    • A hot water bottle and foil
    • Water bottle with straw

    I stashed everything in a large silicone bucket so that my birth team knew exactly where to find things when they needed them. There were some other nice-to-have items as well so I’ll go through everything I had available.

    Key documents

    These include. your natural birth plan, maternity notes and important phone numbers. Don’t just rely on having these numbers in your phone as someone else may need them in an emergency.

    An extra large towel

    If you’re planning a water birth you’ll need a nice, big clean towel for you and the baby to snuggle up in and get some skin-to-skin time. 

    Old towels

    I know this is a bit of a Hollywood home birth cliché (“GET ME HOT WATER AND TOWELS RIGHT NOW!!”) but seriously, get as many as you can lay your hands on. They’ll be especially useful in the case of a water birth but midwives seem to get through piles of them even with a dry birth.

    For a good ecological option try posting in your local Facebook group and asking for people’s old towels. Most folks are more than happy for you to take them off their hands! 

    Plastic sheeting

    Not a very eco-friendly essential but very important to protect furniture, carpets etc from water (if you’re having a water birth) and the various bodily fluids you’ll be producing!

    To minimise the environmental impact you could again ask in your local Facebook groups to see if anyone has any old shower curtains or plastic table covers to give away. Or invest in a big tarpaulin if you think you’ll be able to use it after the birth. The downside is someone will need to clean it but I’ll leave that problem with you 😜

    Blankets to wrap baby in

    I bought traditional cellular receiving blankets. Joules have some gorgeous ones made from organic, responsibly sourced cotton. I also love Aden + Anais silky soft bamboo dream blankets if you’d like something truly special to envelop your little one after their long-awaited arrival into the world.

    A bucket

    I spent a lot of my time with my head in one of these during my birth and I recommend you have one on standby!

    A way to keep cool

    I had a USB rechargeable hand fan that provided a lot of relief from the nausea of labour. I also made sure there were flannels available. Labour is hot work and, depending on the season, you might find yourself in the middle of a heat wave like I did so make sure you’ve got options for keeping cool.

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      A hot water bottle and foil

      Fortunately these items weren’t necessary in the end but they were requested by my midwife in case there was a medical need to quickly raise the baby’s body temperature. A hot water bottle is also useful for pain relief in the early stages of labour. 

      Container, cool bag and ice blocks for placenta storage

      This is only necessary if you plan on keeping your placenta for consumption, burial or artistic purposes. I’ll write a post on placenta practices at a later point, but if you already know you’ll be keeping yours, you’ll need a 1.5-2.5L container and a large enough cool bag to store it, along with at least 8 ice blocks to keep it cold until your placenta practitioner comes to collect it. 

      Water bottle with straw

      I had another water bottle already but someone recommended one with a straw for labour and I am SO glad I got one. It just means you can sip water from any position and don’t have to shift position to have a glug. It made a huge difference and I still use it on a daily basis as it makes it easy to drink a load of water. Mine is plastic and was purchased in my pre-Amazon-boycotting days so I don’t want to recommend the one I got, but I found these stainless steel ones on Etsy that are much more durable.

      Bin bags

      Birth is never completely zero waste so you’ll need a load of bin bags for the midwives. Make sure they’re with your birthing kit so they don’t have to fumble around looking for them in the back of the kitchen cupboards!

      Snacks and drinks for your birth team

      Depending on how long you’re going at it you may even want to go the extra mile and shove on a slow cooker stew in the early stages so you and your crew can get some much-needed sustenance later on. 

      TENs machine

      Excellent for helping relieve pain in the early stages. I bought mine from a local sell or swap Facebook group for £10.

      Birthing ball

      giving birth at home naturally photo

      These are super useful for finding comfort and aiding various birthing positions – you can pick one up from Etsy.

      Also, check out the Spinning Babies® website for excellent free resources on optimal birthing positions using the birthing ball, plus tips on preparation for labour. 

      Massage oil

      Having your birthing partner, doula or midwife give you a massage between contractions is a wonderful way to get some much-needed TLC during labour. Personally I love sweet almond oil and Tisserand have a beautiful ethically harvested and 100% vegan one. It will be perfect for use in baby massage too.

      Essential oils

      Again Neal’s Yard is the place to go for ethical essential oils to add to your massage oil or diffuser. They have everything from calming lavender to invigorating citrus blends. Just make sure you know how to use essential oils safely during pregnancy – obviously during birth you’re FINALLY near the end of your pregnancy but better safe than sorry! 

      Diffuser

      Investing in a good diffuser will really help see you through not only your home birth but the rollercoaster ride of baby sleep over the months ahead. I got my diffuser with labour in mind but I still use to fill the bedroom with lavender scent for Ursula’s bedtime routine and with eucalyptus when she has a stuffed up nose. 

      Music player

      Having some relaxing music and birth affirmations really helped me towards the end of labour but you may also want an energetic soundtrack for motivation! Whatever your choice of tunes, some kind of music playing device (with plenty of charge if it’s wireless) is definitely a home birth must-have. I’ve got a Bluetooth speaker from John Lewis to link with my phone and I love the convenience of being wireless.

      Hospital bag

      Hospital transfers aren’t always emergency ones, often women decide on the day that they would rather be where the drugs are! Obviously if you’re planning a home birth the hope is that you won’t end up transferring but I do recommend having a bag ready just in case, even if it’s just the bare essentials. The last thing you need is to have to think about packing while you’re in the middle of labour and, for me, I’m the sort of person who wants to pack my own bag rather than have someone else do it for me on the fly. 

      Maternity pads

      Post-birth bleeding is very much a case of skipping nearly a year’s worth of periods and then having them all come at once! I highly recommend Pussy Pads customised cloth sanitary pads as the greenest postpartum option. You can pick your own fabric, length and absorbency to suit your needs. Bear in mind that she’s just one woman making cloth pads and you need to order a couple of weeks in advance. They’re well worth the wait though and I continued to use her cloth pads every month until I was ready to return to my Organicup.

      Having said that, in the first few days after birth I couldn’t face the laundry and faff of reusable towels so I initially used Natracare maternity pads, which were brilliant. Nothing is 100% biodegradable in landfill so these do have an environmental impact, but they’re pretty ethical as far as disposable pads go and are very reasonably priced for an organic product. 

      Maternity pants

      Speaking of endless periods you’ll be needing some big, baggy comfy knickers for immediately after birth and the next couple of weeks.

      Reusable bed pads

      One of the most wasteful items usually listed on a home birth kit is disposable bed pads. As useful as they are for protecting your bed sheets and sofa from the inevitable leakage in the first few days postpartum, I personally couldn’t bear all that waste.

      giving birth at home naturally photo

      Instead I opted for buying two second hand cot mattress protectors, one to wash and one to use. I also found these eco-friendly puddle pads on Etsy – although more of an investment, bear in mind they’ll come in handy further down the line for potty training. In the meantime, they’re the perfect size for popping under your bottom while you sit back, take it easy and snuggle your lovely little newborn.


      Final FAQs

      Can a midwife refuse to attend a home birth?

      A midwife is under a professional obligation to support women in their right to choose where to give birth. You cannot be forced to give birth in a hospital and every NHS Trust in the UK is expected to have provisions in place to ensure home births are attended. 

      It is not uncommon, however, for medical staff to attempt to coerce expectant mothers into having a hospital birth they don’t want simply because home births are less convenient for them. I have seen countless stories in home birth groups on Facebook of women being told they “aren’t allowed” to have a home birth for a variety of implausible reasons. If you are told you can’t have a home birth despite having a generally low risk pregnancy, always ask for a second and even third opinion. If you need support in order to have the home birth you are entitled to, visit the Birthrights and AIMS (Association of Improvement to Maternity Services) websites to find out how they can help you. 

      Do you have to go to the hospital after a home birth?

      No, not if everything has gone smoothly – that’s one of the awesome things about a home birth, you get to just curl up in your own bed to snuggle your newborn straight away.

      There are certain circumstances under which your midwife may advise a transfer such as issues delivering the placenta, heavy blood loss or tearing that needs extra attention but most midwives will be reluctant to move you unnecessarily. 

      At my home birth, once I was clean and dry, nursing and cuddled up in bed with Ursula, my husband, birth team and I all clinked a glass of champagne saved from the wedding and then enjoyed some local wood fired pizza. I tell you, that was the best pizza I’d ever had!


      giving birth at home naturally photo

      Giving birth at home was the most phenomenal experience of my life and I was as surprised as anyone to discover that the process of giving birth naturally can be a positive one. I have no doubt that if I had given birth in a hospital rather than at home, my birthing experience would have been far less positive.

      If the idea of giving birth is something that fills you with fear and anxiety, I highly recommend considering a water birth at home where you can feel comfortable in your own familiar surroundings, birthing your new bundle of joy naturally and with the love and warmth of your own home to welcome them to the world.

      I now have a guide to making sure you have an empowered birth during the current COVID-19 lockdown, whether you give birth at home or in a hospital. Check it out HERE.

      However your baby arrives in the world, I wish you a positive and empowered birth story.

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