The mere mention of a home birth may divide your friends and relatives, but what really matters is whether it’s the best choice for you and your baby. The term ‘home birth’ refers to a planned birth that occurs at home and is attended by at least one experienced midwife who has collaborative medical backup in case a transfer to the hospital should be necessary.

A planned home birth can increase the likelihood of experiencing a birth that is both satisfying and safe. This is important, as positive birth experiences (characterised by feeling safe, supported, respected, and heard) lead to better postpartum mental well-being. In this article, we’ll look at how labour is served by birthing in your own space and what the benefits are for you and your baby.

How does home birth work?

You can choose to have a home birth at any point in your pregnancy, though it is best to mention it to your midwife as early as you can. Some hospitals in the UK actively encourage women who are having uncomplicated pregnancies to consider them, especially if they’ve previously given birth without any issues for mum or baby. If your pregnancy is considered high-risk (meaning more likely to involve complications for you or the baby) by your healthcare team, you will likely be advised against a home birth.

Though nobody can force you to give birth away from home if you really don’t want to, there is good evidence that a hospital birth is safer if you have certain underlying medical conditions, are pregnant with twins or other multiples, or are otherwise deemed high-risk. It’s important to appreciate that, for a complicated pregnancy where medical assistance at birth is anticipated, your midwives might not have the equipment, drugs, or skills needed to deal with an emergency.

Once you’ve decided home birth is what’s for you, don’t worry about buying a new place to live or moving somewhere more "home birth-friendly." As long as you can make your home warm and have running water, it can be made suitable for the big event. The specifics of your care will vary from case to case, but generally your midwife will be someone who works or has worked for a hospital’s home birth team, whether you’ve chosen private or public care.

At your first antenatal check, it may feel like she’s asking for a lot of personal information but all is material to ensure the best possible care for you and your baby. Your midwife will talk to you about how the home birth team works, your place of birth, and the care you will receive during your pregnancy. Your midwife will see you almost every month of your pregnancy. If you’re already in your mid-third trimester, you’re probably chatting to her about your birth plan and home birth practicalities. She’ll tell you about any essentials you may need to have ready, such as sheets and the right clothing, but midwives bring all the equipment for monitoring, relieving pain, and supporting you and the baby with them to your home when they arrive for the big event.

Your midwife (or midwives) will stay with you for at least one hour after the birth (and clean up, though home birth is not usually as messy as people expect!). If you wish to breastfeed, she will help you put the baby in the breast as soon as possible. Before the midwife leaves, she will ensure that you have telephone numbers that you can call if you have any worries or concerns at any time.

She will make a postnatal care plan with you, advise you when to expect your next visit, and arrange an appointment for your baby’s routine newborn check and hearing check, which need to be undertaken in a hospital clinic or ward environment. If you have a Rhesus-negative blood group, it will be necessary to attend the hospital to have your postnatal anti-D injection administered. This injection needs to be given to you within 72 hours of birth.

What are the benefits of home birth?

A familiar environment

When your labour is getting started, it’s largely hormonally driven. Oxytocin is the “love hormone” you need to build to help the uterus contract at this early stage. The adrenaline release prompted by an unfamiliar hospital or birth centre environment filled with bright lights, clinical smells, and strangers keeps oxytocin from flowing freely. This is far less likely to happen at home. It’s not impossible that a disruptive situation will happen during your home birth—an uninvited guest or an unexpected disagreement with your midwife, for example—but you will feel far more able to manage your circumstances when the environment is your own.

More control over your birth experience

Home birth is an ideal choice if you’re concerned about unnecessary interventions or the over-medicalisation of your birth, as these are far less likely to happen if you give birth outside a hospital. In fact, evidence shows that healthy women with an uncomplicated pregnancy who plan to give birth at home are more likely to have a straightforward birth with fewer interventions – even if they subsequently transfer to hospital. Examples of interventions include the use of forceps, ventouse, episiotomy and emergency caesarean.

A greater role for the birth partner

Birth partners can sometimes feel excluded from the labour and delivery process. Giving birth at home makes your partner a star player.

Reduced cost

Home births cost the NHS less than births in other settings and, particularly if you would have a private hospital birth otherwise, are also more economical for you.

A greater sense of empowerment

Studies have shown that women who give birth at home feel more in control of their labour and feel their labour was a positive, empowering experience. They also begin motherhood with increased self-esteem and have an overwhelming preference for planning home birth again in the future.

Is home birth safe?

According to the most recent and up-to-date research evidence, yes.

However, even if you are having a low-risk, uncomplicated pregnancy, home birth may not be the right choice if it’s your first pregnancy. The 2012 Birthplace cohort study, which collected data that included nearly 17,000 planned 'low risk' home births in England, found that having your first baby at home could slightly increase the risk to the baby that doing it at a midwife or obstetrics unit. You are more likely to have a ‘normal birth’ (meaning one without any medical interventions), but there is a fairly high probability (45%) of being transferred to the hospital during labour or immediately after birth, and there appears to be a slightly increased risk of an adverse outcome for the baby (9.3 adverse perinatal outcomes per 1000 planned home births compared with 5.3 per 1000 births for births planned in obstetric units).

However, for women having a second or subsequent baby, the study found that planned home birth outcomes for the baby are broadly similar to those in an obstetric unit. This was also found to be the most cost-effective choice and carries all the same benefits of home birth we’ve already mentioned.

OK, I’m having my second baby, but I don’t live near a hospital. What if something goes wrong?

Midwives bring everything necessary to monitor you and your baby’s well-being, as well as resuscitation equipment, pain relief, and emergency drugs. This equipment is the same as that available in the birth centre attached to a hospital.

Your hospital will likely work closely with your local ambulance service to ensure a safe and speedy transfer, if one is necessary. It’s worth noting that most transfers from home in the UK are not emergencies; the most common reason is a labour’s failure to progress. A midwife will travel with you in the ambulance. If you’ve spoken to your midwife and obstetrician about this or any other concern and are still worried as your labour approaches, you have the right to change your mind and book in with a birth centre or maternity unit. As with any venue change, the sooner you let your midwife know about this the better.

How do I know if giving birth at home is right for me?

Unii has all the information you need to make an informed choice.