Hospital or Home Birth?

Hey Gorgeous Mama!

Congratulations on your pregnancy and your upcoming birth!

If you are starting to make plans for your birth and you’re trying to decide whether a home birth or a hospital birth is for you…you’re not alone. It is an absolute MINE FIELD. Trying to make such an important decision about the birth of your baby can feel really over whelming…which is why I have laid out all the information you need to make an informed decision in this blog post.

It’s no secret that I am a big fan of home-birth having had one myself…but I appreciate that home-birth isn’t for every body…just like hospital birth isn’t for every body.

There is a bit of a misconception that as Hypnobirthing teachers, we’re trying to convince every body to have natural births at home and this REALLY isn’t the case. I am simply encouraging you to see both home and hospital birth as viable options. So often people write off the idea of a home birth before they’ve even really looked into it. And honestly…once you hear some of the facts and figures I’m about to share with you…you may be surprised! My role as a Hypnobirthing teacher is to provide you with facts, evidence and guide you into making decisions that are right for YOU.

So let’s get into this!

Should I give birth at home?

I wrote off a home-birth with my first baby before even really considering it. It just wasn’t something I even wanted to entertain…why? Because just like to many other people, I believed hospital to be the safer place to give birth. That was BEFORE I was truly educated on all things birth.

With my second baby, I did a whole lot more research and was pleasantly surprised to discover that actually, for the majority of pregnant women, giving birth at home is statistically the safer option.

This doesn’t really seem to make sense at first glance…but when you look into what physiological birth needs in order to unfold…it makes perfect sense.

As mammals, in order for our births to unfold as nature intended…we need to feel safe and unobserved and calm…which is literally the complete opposite of the sort of environment you’d find in a hospital. Interventions are much more likely when birthing in a hospital environment BECAUSE it’s simply not the sort of place that we’re biologically wired to give birth.

So what if something goes wrong at home?

This is the big question…this is the big reason why so many people decide to birth their baby in a hospital. The fear that IF something goes wrong at home…that the ambulance may not be quick enough or that the right care won’t be immediately available. This is perfectly valid. I completely understand why you might be feeling this way…

But I think it’s also good to understand a home birth and what happens at a home birth.

In the UK, if you birth with the NHS at home you are entitled to have 2 NHS midwives attend you in your home while you birth. Midwives are skilled, knowledgeable, qualified health care professionals who know and understand birth. They are also skilled at being able to spot if something is amiss and will start to take action long before something turns into an emergency. You are not left to simply fend for yourself!

It’s interesting to note that a review of data in 2018 covering 14 suitable studies from 1990 onwards demonstrated that there is no discernible difference in serious outcomes (ie death or life changing injury) between a hospital and a home birth. This means that in the unlikely event that an emergency were to occur, the likelihood of you and your baby surviving is the same whether that emergency occurs in a home birth setting or a hospital setting.

So what are the benefits of choosing to birth in a hospital?

Okay so the most obvious benefit to birthing in a hospital is immediate access to emergency medical care. If serious intervention is required and you’re already in a hospital then there’s no need to call an ambulance and transfer, you’re already there. You’re already in the place where the equipment and the medical staff are. That is really reassuring to some people and a major factor in their decision making.

The other major factor is that in a hospital, you have access to stronger pain relief. You can have gas and air and pethidine in a home environment, but if you wanted something stronger like an epidural, this is only available in hospital as it’s done by an anaesthetist.

Most labour wards come equipped with birth pools nowadays and this is freely available for you to use if it’s not already in use. If you were to want a water birth at home you would need to be responsible for hiring or buying a birth pool yourself. You’d be responsible for filling it and caring for it and this can be a bit of an obstacle for some couples. Knowing that the birth pool is already provided and dealt with by somebody else in a hospital can be reassuring.

“I started pushing at exactly 8am and at 8:04 her head was born. At 8:06 our daughter arrived in the world.

We had delayed cord clamping and my husband was able to cut the cord before a physiological 3rd stage. We had to stay in for 24 hours for observation due to the meconium but all was fine during that time and we were discharged.

Considering how scared I’d been to give birth without a pool, I needn’t have been. In some ways the dry land birth was even more positive than my previous water birth, this one was much quicker and I had no pain relief. I actually feel very privileged to have experienced both of my very different positive births.” - Rachel

What are the benefits of choosing to birth at home?

Physiological birth happens best when mum is undisturbed, feeling safe and comfortable and in dim lighting and preferably a familiar environment. This is REALLY easy to achieve at home because it’s already a familiar environment that you can control. You can control who is there, what it looks like and so much more. The fact that birth happens so much more easily at home means that you are 3 times less likely to need an instrumental intervention if you plan to birth at home.

Birthing at home also means no uncomfortable car journey to the hospital during labour. When you’re in labour, your instinct is to be moving freely. You’ll want to rock and sway and dance with your contractions. If you’re strapped into a car, you’re not able to do this and it can be extremely uncomfortable.

Birthing at home means that you are less likely to ask for pain relief than if you birth in a hospital. The fear and anxiety experienced when you enter a hospital environment can create tension in your body which makes your contractions more painful. Birthing at home means you’re more likely to be calm and relaxed which makes for a much more comfortable experience.

Birthing at home guarantees that you’ll have access to a birth pool if you want one, whereas if you’d like to use the birth pool in a hospital setting, there’s a chance that it may already be in use on the day you go into labour.

What are the negatives of choosing to birth in hospital?

When we look at the negatives of both hospital and home births….mostly we’re just looking at the positives of the other option.

Choosing to birth in a hospital means that you are more likely to require an intervention due to the fact that biologically we are not wired to birth in bright, loud, sterile environments surrounded by strangers.

Uncomfortable car ride to the hospital during labour with the added stress of carrying hospital bags and also trying to figure out how to put a new born baby in a car seat on the way home when you’re sore and exhausted.

Birthing in a hospital means that you are more likely to ask for pain relief due to the fact that this is an environment that you don’t feel comfortable in.

There’s more chance that you won’t have access to the facilities you want if you choose to birth in the hospital. The most obvious example of course being the birth pool but some labour wards come with other equipment as well such as birth balls and slings and en-suite bathrooms. There’s always a possibility that somebody else has nabbed these before you get there.

There’s one more added negative that I think is worth mentioning and that’s the fact that once you enter a hospital, you subconsciously take on the role of patient and are less likely to be confident in advocating for yourself and your choices because you’re out of your comfort zone. Birthing at home means that you’re “on your own turf” so to speak so you tend to feel much more at ease with speaking your mind, questioning things and holding your boundaries.

“I feel incredibly lucky that I was able to have the birth I wanted - a natural home birth. Every time I think back to my birth, I am filled with such overwhelming positivity. I truly believe Hypnobirthing was the main driver which enabled this as I was equipped with knowledge and was empowered to make decisions about my birth, ensuring I was happy whatever happened.” - Amy

What are the negatives of choosing to birth at home?

In the rare event that an emergency were to occur, you’d need to be transferred to hospital for treatment. Although I will point out that this is usually a quick and relatively stress-free process. And interestingly, the most common reason for transfer to hospital from home birth isn’t because there’s an emergency, it’s actually for additional pain relief.

Which brings me onto my next point, if you require stronger pain relief such as epidural, you can’t have that at home. MOST women who choose to birth at home find that they are able to cope perfectly well with just their breathing exercises and their relaxation that they learn on a hypnobirthing course with perhaps the gas and air that the midwives bring BUT if you do decide that you want something stronger then you’d need to transfer to hospital.

If you wanted to have a birth pool at home, you’d need to hire or buy one yourself. Some couples do find this to be a bit of a barrier, but in my opinion it is worth the investment.

So how do I decide whether to give birth in hospital or at home?

When making your decision about whether you wish to birth your baby in hospital or at home, it’s important that you make a decision based on what’s right for you and your individual circumstances. For most women, birthing at home is statistically the safer option, however you may have individual risk factors that means you’d be safer or FEEL safer birthing in a hospital.

I recommend that you do lots of further reading and get really familiar with what it means for both settings. The Positive Birth Book by Milli Hill is a great place to start.

Remember that ultimately it is your choice where you wish to birth your baby. Certainly your health care team can give you recommendations and advice as to what they think is best…but they aren’t in charge of your body. Only YOU can make decisions about where and how your give birth.

If you are on the fence and really can’t decide, my advice is to plan for a home birth. The reason being, if you change your mind at the last minute, it’s much easier to change your mind and switch to a hospital birth than it is to decide at the last minute you want a home birth. Yes, you absolutely CAN decide at the last minute that you want a home birth, but it’s a much smoother ride if you decide and plan for it early on.

Whatever you decide Mama, do what feels right xxx