Choosing where to give birth

Within the UK parents-to-be can choose between three different environments to give birth in:

• Labour ward (Obstetric Unit or Delivery Suite)
• Birth Centre (Birth Unit or Midwife-led Unit)
• Home

To understand and compare which choice is for you, there is some information about differences between the three:

Labour Ward

The labour ward is the maternity unit of a larger hospital and has medical facilities such as

• Obstetricians (doctors for maternity)
• Epidurals for pain relief
• Assisted birth by ventouse, forceps or Caesarean Birth
• Neonatal Unit
• Paediatricians (doctors for babies & children)
• Midwives will mainly look after the mother in labour and if complications arise, doctors are available to provide additional care.

  Women with an increased risk of complications are likely to be recommended to give birth on a labour ward.

Reasons for giving birth on a labour ward

• Medical conditions which mean that birth may be more complicated
• Known conditions which make it more likely that your baby needs special care
• You are sure you will want an epidural for pain relief
• There is no midwife-led unit nearby and you do not wish to have a homebirth

Take note of

• Planning to give birth in a labour ward increases the likelihood of having medical interventions compared to a homebirth or a birth at a birth centre
• There may be limited availability of birth pools for pain relief or waterbirths

Birth Centre

The birth centre is a smaller place to give birth in with an emphasis on natural childbirth.
There are two types of birth centres:

• Alongside a labour ward within a hospital
• Free-standing – the birth centre is situated away from the main hospital within a small community hospital or a stand-alone building

Midwives will look after you and provide a friendly homely atmosphere with an emphasis on natural childbirth. Mothers with a straight forward pregnancy and low risk of complications during birth are usually offered the care at a birth centre. There are no medical facilities, so mothers with a risk of complications will be recommended to give birth in a labour ward.

Planning a birth at a birth centre means that women are less likely to need medical interventions. The only pain relief that is not available is the epidural. All other methods of pain relief are offered in a birth centre.

Reasons for choosing to give birth at a birth centre

• You would like to give yourself the best chance to have a natural birth
• You would like to be able to use a birthing pool for pain relief or waterbirth
• You would like to give birth in a homely environment
• You feel you could have a natural birth
• You prefer to avoid having medical interventions
• You would like to have a better chance of being cared for by a midwife you already know

Take note of

• In case of complications or wish to have an epidural, you will need to be transferred to the nearest labour ward. This means a ride in the ambulance if you are at a free-standing birth centre or you will have to be transferred within the hospital at an alongside birth centre.
• Some birth centres also offer care after birth such as breastfeeding support, others don’t. Check what’s available at your local birth centres
• You are unlikely to be offered to give birth at a birth centre if you or your baby show complications during pregnancy such as breech or transverse position, twin-pregnancy etc.

Homebirth

If you decide to have a homebirth, midwives will come to your house and look after you during labour and after the baby is born. If complications arise or you decide that you would like an epidural you would have to be transferred to a labour ward; usually by ambulance.

Reasons for choosing a homebirth

• You would like your baby to be born in a familiar and private environment
• You would prefer not to have any medical interventions
• You have confidence in your body’s ability to give birth
• You would like the have the chance to have met your midwives before birth

Take note of

• If the hospital or birth centre are very busy, they may not be able to send a midwife to your home
• You will need to transfer to hospital if you wish to have an epidural or if any complications arose during labour or after birth
• You may hear lots of people disapprove or say ‘that’s brave’
• If carrying twins or if you had a previous Caesarean birth, a homebirth may be less safe. However you still have the right to a home birth.
• For first-time mothers a homebirth is very slightly less safe for your baby than giving birth in a labour ward.

To find out more about your local choices  for childbirth including statistics and more, Which? & BirthChoiceUK have teamed up to help you choose the right place for you. Simply visit their website, enter your postcode and off you go!