Can I choose where I want to give birth?
Yes. Within the NHS there are four main places that you may choose to have your baby:
- Hospital birth (Labour Ward/delivery suite)
- Theatre
- Birth centre
- Home.
Hospital birth
In a hospital birth you will be on a Labour Ward, also called a delivery suite. This is a mixed midwifery and obstetric unit, meaning that both midwives and doctors – including consultants, registrars and junior doctors – work there. Labour wards are designed to provide care to a wide range of women who may have differing risk factors, medical conditions or pregnancy-based conditions.
Because of this, the rooms have more medical equipment than other delivery areas including maternal observation monitoring, baby electronic monitoring and resuscitation equipment for baby.
Most labour ward rooms will have a delivery bed in the room. However will also have active birthing equipment such as birthing balls, stools, bean bags and soft mats – simply ask the midwives on the unit for what they can provide. Some labour wards may also have birthing pools to enable water births.
There may be a recommendation for you to have your baby continuously ‘monitored’ in labour. But you do not have to be on the bed for this – as long as your baby’s heart beat can be heard you can be in whatever position is comfortable for you.
Some labour wards may have wireless monitoring, also known as ‘telemetry’. This allows for more freedom of movement, and can even be used in birth pools. Ask your midwife if your local labour ward has wireless monitoring available.
The labour ward will have all options of pain relief available including ‘gas-and-air’, pethidine/diamorphine injection and an epidural.
Most hospitals will have photos or virtual tours of their labour rooms on their websites. So you can become familiar with what the rooms look like.
Operating Theatre
If you have a caesarean section, whether it is a booked/elective or emergency, this will take place in ‘theatre’ – also known as an operating room.
Different hospitals will have different size theatres and a different number of staff accordingly. However, there will be at least 2 surgeons, one anaesthetist, and a midwife. There may also be a scrub nurse, operating department practitioners and ‘circulators’ ‘(who help with the logistics and equipment in the theatre).
Depending on the reason for the caesarean, there may also be paediatricians (children and baby’s doctors) present or in an adjoining room to assess baby when they are born.
Most hospitals allow a birthing partner in the theatre with you. And if the caesarean is not time critical, you may have the opportunity make the environment more comfortable, for example playing your own music.
Many birth preferences can still be applied to a theatre setting (providing mum and baby are well) including delayed cord clamping, feeding and skin-to-skin contact with either yourself or your birth partner.
Birth centre
A birth centre is usually run by only midwives, although some may also have doctors too. They can be stand-alone (meaning it is in a separate location from the labour ward) or joined with/near the labour ward.
A birth centre’s focus is to facilitate ‘low risk’ births and provide a more homely and relaxed environment than other options. Most birth centres will have birth pools; and active birthing equipment such as birth balls, stools, ropes, bean bags, and mats – all to encourage free movement and upright positions in labour. For some resources explaining different positions see here.
Most birth centres have many pain relief options including birthing pools, helping with breathing techniques, massage, aromatherapy, gas-and-air and pethidine. You can also bring equipment from home such as a TENS machine, lighting and music to help you relax. If you would like an epidural or a ‘remifentanil infusion’, this would require a transfer to a labour ward.
Home birth
Home births are safe and can have many benefits, including reducing stress and studies show being in a familiar environment; with less interventions can reduce the risk of operative deliveries and complications.
At a home birth, two birth attendants (midwives, student midwives or midwifery support workers or health care assistants) will join you in your home environment during your labour and delivery. They will bring equipment with them they need including delivery gloves, cord clamps, suturing materials and baby resuscitation equipment. You will be asked to provide towels/blankets for your baby.
Many companies also hire out or sell home birthing pools that can be inflated, filled and drained from home.
You can use pain relief types including breathing techniques, massage, warm water, aromatherapy and a TENS at home. The midwives will also bring gas-and-air and pethidine if you wish. If you want further pain relief it may require a transfer to the labour ward.
So can I choose where I want to give birth?
Yes. Where you give birth is your choice.
Your midwife or doctor may recommend a place of birth to you. For example, if you have any risk factors in your pregnancy, it may be recommended for you to birth on a labour ward – rather than a birth centre or at home.
Or, in some cases, an elective caesarean in a hospital operating theatre may be recommended.
Where you give birth should always be an informed choice that you make for yourself. If you think a birth centre or home birth would be your place of choice, speak to your midwife about your thoughts.
They may arrange an appointment with an obstetric consultant (doctor), consultant midwife or birth centre midwife, to talk through the risks and benefits with you – so that you can make an informed decision.
