Pregnancy and birth

Braxton Hicks | Bringing on labour | First stage of labour | Second stage of labour | Third stage of labour | Pain relief | Breathing in labour | Birth partners | Water births | Caesareans | Recovery after a c-section

Where to give birth

You've got three alternatives about where to give birth – home, hospital (some hospitals have midwifery units attached to the main obstetric unit) or a birth centre. Well, more, if things don't go to plan and you count the back of a taxi or an ambulance. 

Home birth | Hospital birth | Birth centre

You can get the information to help you decide where to have your baby from your midwife, GP, other mums (including Mumsnetters, obviously) and organisations such as BirthChoiceUK.

Having your baby at home

If you want a home birth, you don't need your GP's 'permission'; you can book one direct with the midwifery team providing community care. If your request is refused, you may need to talk to the supervisor of midwives at your local hospital.

Home births are not recommended if:

    •    You're expecting more than one baby
    •    Your one baby is lying in a breech position
    •    You've got complications such as placenta praevia or pre-eclampsia
    •    You've got a health condition such as epilepsy
    •    You're less than 38 weeks pregnant when you go into labour (some areas say 37 weeks)

Having had a caesarean previously doesn't rule out a home birth, contrary to popular opinion, but you'll need to agree to go to hospital at the first sign of any problems.

A home birth takes a bit of preparation, but not much gear or equipment, and its intimate familiarity appeals to some women: "No strangers were able to walk in when I was facing the door with my legs in the air. The food was considerably better and on demand and, despite my partner's fears, no mess went beyond the pads and sheets we had prepared." Bubbly

NHS guidelines say two midwives must be present for a home delivery. You can also hire an independent midwife who will look after you throughout your pregnancy.

There are a couple of important things to consider before you discover how economical with the truth your female friends and relatives were about how painful labour is:

Pain relief: you can't have an epidural with a home birth, but you can have gas and air, and pethidine, so you're ruling out one form of pain relief before you go into labour.

Complications: if you do have to be transferred to hospital it can be a pretty painful journey. As one Mumsnetter puts it: "It's easy to say, 'oh the hospital is only six miles away', but it's no fun being in the advanced stages of labour in an ambulance. It was no fun for my poor husband either, who was following and waiting for the blue lights to go on." Gem13

Things to make sure you've got ready (or at least got in) beforehand include:

• Plastic sheets to protect your bed and floor coverings
• Clean towels and blankets to wrap baby in
• Good lighting so your midwife can see what's going on
• An overnight bag for hospital, which contains your pregnancy notes (and birth plan if you have one in case you end up being transferred to hospital.

And, of course, if you want the lowdown on exactly what you do and don't need for a home birth, find out on Talk.

"I had half a home birth. I started labour at home with a water pool and very supportive midwives. Just as I was about to start pushing, the midwives discovered my daughter was breech so I went to hospital, quickly and with little fuss." Emmagee

If you've got other children, you'll need to work out what they'll be up to while Mummy's not available for playing Duplo or doing bedtime stories

"I had many sleepless nights worrying about my son and where he would go at various stages of the day. People told me it would all fall into place and sure enough, my son slept through the whole thing only two rooms away." Hughsie

And it's probably a good idea to ensure your partner is as committed to the idea of a home birth as you are, and focusing on what's happening:

"Luckily, I was concentrating on other things when my first son was being born, otherwise I might have noticed my husband nipping into the sitting room every few minutes as his football team were playing on TV - and I thought he was boiling water and getting fresh towels!" Oxocube

There are pros to home births:

"I gave birth on the edge of the sofa with a beanbag behind me, which was very comfortable. The midwife was wildly excited as I ‘breathed the head out’. After the birth I snuggled down on the sofa while my daughter had a feed and the midwives tidied up and made tea. My son slept through the whole thing and wandered in the next morning to find a baby in the bed." Hopeful

And cons, some potentially serious:

"My son was born with a severe infection and had to be whisked to an ITU within minutes, where he spent the next two or three days fighting for his life. Giving birth isn't just about 'you' and which whale music you want to listen to, but also about your baby and the unforeseen things that can happen, which is why I'd have any subsequent babies in a hospital." Emmabee

"One of the joys of having my babies was bringing them home. It was just so exciting. If I'd had them at home, I would have been all too aware of housework and the needs of my elder son and would have found it hard to maintain the 'cocoon of just baby and me' that I had at hospital." Lil

Having your baby in hospital

If you've decided you need the option of things like epidurals and set visiting times, then your first point of contact is your midwife or GP, who'll probably assign you to a consultant unit at a local hospital. The choice you have over this will obviously depend on where you live

But before you get too hung up on which hospital, think about the sort of birth you'd like in an ideal world (it won't be ideal, of course, but hopefully this increases your chances of it being pretty good):

• Do you want a water birth?
• Are you anxious to avoid a caesarean?
• Do you want the birth to be led by midwives or a consultant obstetrician?
• Is it important you get to know the midwife who'll be helping you deliver beforehand?
• Is there an anaesthetist available 24/7 to do epidurals?
• Can you have more than one birth partner present?

When you're choosing which hospital it's important (probably vital) to take account of other mums' experiences, but as Mumsnetter Pie warns: "Don't listen too hard to hospital horror stories. Every hospital or practice will have screwed up somewhere down the line, but I don't think that has to reflect on the overall standard."

If you're hoping for an intimate atmosphere, with more personal care, then a birth centre might be your best option or a midwife-led unit:

"NHS midwife-led units cater for low-risk, 'natural' births. The one I attended had a birthing pool, low sensory room, showers and baths, gas and air, and pethidine (or equivalent) on hand for pain relief. Epidurals are not available but the unit was on the floor below the maternity unit so I could have been transferred if necessary. The small team of midwives were brilliant at helping me manage without an epidural." Nicki

Again, what's available on the NHS will depend on where you live and your personal preference:

"I'm not certain it matters that much whether you know your midwife when you deliver - I'd much rather have continuity of care during the pregnancy, and an open-minded midwifery team during the birth." Boyandgirl

"My advice would be to ask around. Find out what kinds of experiences people have had at each. Weigh those personal experiences in with the statistics." Expatka

Statistics on things such as c-section and induction rates are available online, but as Boyandgirl points out: "It's important to view such things in context. The hospital I gave birth in has relatively high rates for certain interventions, but that's because complicated pregnancies/ births are referred there nationally, so only a minority of births are uncomplicated."

And another mum, Meid, adds: "I had a choice of two hospitals and asked which one the midwife team would prefer to send me to. It was the right question as they did have a preference. I found out from my postnatal group that those who'd been to the other hospital had all had their babies delivered by midwives they didn't know, whereas of those who had been to the preferred hospital, some had known the midwife."

Go and look around the hospital(s) you're keen on. But if you decide to switch, you may have to be prepared for a battle

"Where I am, you have to fight to switch out of the main hospital into one in a neighbouring area. Yes, it's supposedly your 'right' to do so but that doesn't make it easy! You can, of course, simply turn up at the hospital of your choice in labour if you have any problems switching." Soupdragon

Having your baby in a birth centre

If your pregnancy is low risk, or you really want a non-interventional, midwife-led delivery, then find out if there's a birth centre in your are

Epidurals and caesareans aren't an option in birth centres, so if there are complications during labour you might have to be transferred to hospital

"My partner went to a birthing centre. Unfortunately, after about 21 hours the labour wasn't progressing and she was in a lot of pain. We decided my partner needed to go to hospital for an epidural. As soon as we made the decision they were great. They called an ambulance and within 30 minutes we were on the way to hospital. A midwife went with us to hand over, and we got messages throughout the rest of the labour that they were phoning to see how my partner was doing." Dot

"I had my son in a birthing centre. It was fantastic - very clean and new - and the care I got was great. I had my first two children in the labour ward, and the birthing centre was just a million miles better." TalkingTree

Where you end up giving birth will depend on lots of factors, such as where you live, your personality and preferences, whether it's your first child, whether there are any known complications and so on.

But like most things to do with pregnancy there are known unknowns but also unknown unknowns. So, even if you've gone all out to have your baby in one particular place, it can still change at the last minute owing to things such as your baby stubbornly refusing to get in the right position for his or her outward journey, or someone else getting to the birthing pool before you. 

As this mum points it: "Both my deliveries were so different (planned c-section for breech and successful VBAC ) but in some ways, the fact that I didn't have a lot of control over everything was good for me, as it started off how the looking after children bit of my life was going to be ie unpredictable. It's good we have choices, but sometimes those choices aren't available at the time." DarrellSHiver

Braxton Hicks | Bringing on labour | First stage of labour | Second stage of labour | Third stage of labour | Pain relief | Breathing in labour | Birth partners | Water births | Caesareans | Recovery after a c-section