In light of the spread of the COVID-19 coronavirus, many women are now considering home birth, even if it isn’t something that they would have thought of before. Here we outline the answers to the most frequently asked questions about home birth in Northern Ireland:
- Is it safe?
- Am I allowed/suitable?
- What are the pros and cons of home birth?
- What if I have to transfer into hospital?
- What happens if something goes wrong?
- How do I book a home birth?
- What about the mess?
- How can I find out more?
In a word, yes – for most women it is safe to birth at home with the support of a midwife.
The official NI guidance is available at rqia.org.uk/planningbirthathome
It contains full details about home birth in Northern Ireland, including the statement that it is SAFE for most women.
- Home birth is safe for most women
- Home birth is offered in all parts of Northern Ireland
- Midwives will bring essential equipment to your home
Research has shown the following with regards to Home birth.
|Giving birth for the first time||If you have had a baby before|
|79% chance of having a normal vaginal birth||98% chance of a normal vaginal birth|
|45% chance of transfer to obstetric unit||12% chance of transfer to obstetric unit|
There is a less than 1% chance of your baby having a serious medical problem at birth regardless of place of birth.
Women who birth at home tend to need fewer interventions than women who book a hospital birth. For healthy women having a straightforward pregnancy, less than 1% of babies have serious medical problems, regardless of the place of birth.
Again, the short answer is YES. It is up to you where you have your baby.
However the pathway is slightly different depending on whether there is an issue to do with your health, your baby’s health/development, or your history.
If you are well and your pregnancy is straightforward, you are automatically suitable for home birth and you simply need to inform your midwife of your plan to birth at home.
If you have one of the ‘complications’ or factors listed in the purple box below, you are also deemed automatically suitable for home birth. This often surprises women who assume that these factors will make it more difficult to birth at home.
Home birth is particularly suitable for women who are having a straightforward pregnancy, and have therefore not experienced any complications. This means that you are pregnant with one baby, that both you and the baby are healthy, and that you go into labour between 37- 42 weeks of pregnancy.
However, home birth may also be suitable for other women, such as those described in the box below (from the RQIA Planning Birth at Home Guideline).
|Home birth is suitable for you if you:|
If you have a complication other than those included in the purple box – for example if you have previously had a caesarean section – then it is recommended that an Individualised Care Plan is agreed as part of the preparations for your home birth.
The Individualised Care Plan will focus on issues specific to you and to this pregnancy, rather than on any general issues associated with pregnancy and childbirth.
All discussions about the ‘risk’ or ‘chance’ of complications with your birth will follow best practice.
This means that discussions will be
- Individualised and relevant to you and your pregnancy
- Evidence based and balanced (particularly when discussing uncommon events and complications)
If you still have any questions after you have talked with your midwife, or if you want more support for your choice of birthplace, you can get in touch with the Head of Midwifery/Consultant Midwife from your local Health and Social Care (HSC) Trust (contact details available on your local HSC Trust website).
Depending on your situation, you may need additional discussions and an Individualised Care Plan:
Your midwives and doctors will follow the pathway below when supporting you through your pregnancy. Apart from additional discussions, if needed, to create an individualised care plan, your antenatal care will follow the usual pattern
To chat to other women who have had home births or are planning to birth at home, consider joining the facebook group ‘Northern Ireland Home Birthers and Hopefuls’.
In the meantime, here’s a summary of the Pros and Cons as included in the official NI guideline:
Almost all women transfer into hospital during labour. Some women booked for home birth transfer to hospital during labour – commonly for additional pain relief or because labour is slow. Most home birth transfers are not emergencies – blue lights are rare! Transfer can be via your own car or by ambulance. Home birth transfers are usually calm, peaceful, and slow.
If this is your first baby, there is a reasonable chance that you will transfer at some stage during labour or after your baby is born. Women who have done this say that it was still worth booking the home birth as they enjoyed all of the benefits of having much of it at home with their own midwife.
The official NI guideline outlines some common reasons for transfer:
|During labour||After the birth|
Adapted from South Eastern Health and Social Care Trust ‘HOME BIRTH - When a transfer to hospital for ongoing care may be needed (2017)’ document.
It is important to note that your midwife is skilled in dealing with all of these situations at the time, and that you can transfer safely and calmly to hospital if you need extra monitoring or intervention by an obstetrician (childbirth doctor).
It is rare for things to go wrong at a home birth. If there is a problem or a concern about you or your baby, your midwife will manage this while also recommending you transfer into hospital if appropriate. It is also important to note that sometimes things ‘go wrong’ in hospital simply because the woman is in hospital. When a woman is comfortable and relaxed in her own home, with good caregivers and a feeling of security, birth generally goes very well.
Simply let your midwife know that you are considering having a home birth, or have decided to birth your baby at home. She will then make the necessary arrangements, including developing an individualised care plan with you if needed. She will also ensure that all of the equipment she will need is delivered to your home. This usually happens around 37 weeks.
Women who have had (or are planning) a home birth in Northern Ireland have suggested the following tips for you to consider:
- Hire or borrow a birthing pool – water birth is amazing!
- Think about your older children. You can arrange a babysitter, or they can be there for the birth.
- Do you want your pets to be there? If not, you’ll need to arrange for them to be looked after.
- Have the right food available – for you, your birth partner/s, (and for the midwives, if you want to).
- You don’t need a huge room, especially if you’re not hiring a pool.
- Nobody will inspect your house for cleanliness! All homes are suitable for home birth (unless your home is unsafe in some way).
- Make your birth room special by putting up fairy lights and printing out affirmations, if you want to.
- Cleaning up isn’t a big deal – there’s much less ‘mess’ than you would think. Buy a cheap plastic sheet or shower curtain and throw it out afterwards.