Home births

A homebirth is particularly suitable for you if:

• You and your baby are healthy
• You are expecting one baby
• You are between 37 weeks and 41 weeks plus 6 days’ gestation
• Your baby is presenting head down
• This is your first pregnancy, or previous pregnancies and labours have been normal
• You spontaneously go into labour yourself without having your labour induced

The Birth Place Study (2011) found that low-risk women planning the birth of their baby at home were more likely to have a straightforward vaginal birth than women planning birth in an obstetric unit. For low-risk women planning the birth of their first baby at home, there was noted to be a slight increase in risk of babies being born with serious medical problems (9 per 1000 births (0.9%)) at home compared to an obstetric unit (5 per 1000 births (0.5%)). For low-risk women planning the birth of their second or subsequent baby at home, there was no difference documented in the risks of baby being born with serious medical problems at home compared to an obstetric unit.

If you have a straightforward pregnancy, and both you and the baby are well, you might choose to give birth at home. Your allocated midwife will be able to advise as to whether they think a home birth is suitable for you and your baby, as well as being able to answer any questions such as ‘how do I obtain a birthing pool’ for a home water birth and ‘who do I contact when I go into labour’. If you are outside of this criteria and would like to birth at home, then please discuss this with your midwife who will refer you to one of our senior midwives to discuss your birth preferences and make a plan with you.

The homebirth service is covered by our community midwives. Pain relief options include gas and air provided by the midwives.

In the event that there are any concerns about you or your baby’s wellbeing in labour or following the birth, or you request pethidine or an epidural, then a transfer to the labour ward at Salisbury hospital will be recommended during labour. This transfer will take place by an ambulance provided by South Western Ambulance Service or South Central Ambulance Service (depending on where you live). The transfer time will depend on how far away you are from Salisbury hospital, and this will be discussed with you by your midwife. The ambulance request will be categorised depending on the reason for transfer, and the midwife will discuss this with ambulance control. In the event that the midwife has any urgent concerns with the wellbeing of you or your baby then they will request a category 1 ambulance (see below). There may be times where an ambulance is delayed which is outside of the control of the maternity unit.

Statistics for response times (time to arrive at your property) for ambulances:

The most common reasons that a transfer is recommended to the labour ward from home would be:

• There are concerns with the observations of you and your baby in labour or after the birth
• You would like an epidural
• There is a delay in the progress of your labour
• The colour of your waters are blood stained or there is meconium in your waters (baby’s first poo)
• Your placenta is not delivering
• There are concerns about the presentation or position of your baby or your baby’s cord is presenting first
• You experience heavy bleeding following the birth
• That you have experienced a tear which requires a review by an obstetric doctor (such as a complicated tear involving muscle or other structures, or a third or fourth degree tear which involves your back passage)
• Maternal request for a transfer

The Birth Place Study (2011) research found that transfer to an obstetric unit for women who planned their birth at home occurred in 45% of first time mothers, and 10% of second time or subsequent mothers.