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Home or Away

Where you choose to have your baby is a big decision – it’s important to choose a setting where you will feel comfortable and in control. We help you decide…

ALL About Hospital Births

It is generally recommended that first-time mums and those who could face high-risk pregnancies – like older women or those with medical conditions such as diabetes or high blood pressure – should opt for a hospital birth. Also, those mums who experienced difficulties first time around should think about giving birth in a hospital environment.

Check it out
Hospitals vary considerably when it comes to policies and procedures to do with labour and delivery – let alone the facilities on offer. For example, not all hospitals have pools for water births, or the ability to administer mobile epidurals. So, before you choose a hospital, arrange a tour of the labour ward and delivery suite. Investing time now will mean you are less stressed out later.

How to prepare

Think about writing a detailed birth plan and work it through with your midwife well before your due date to make sure it’s realistic. Talk to your partner. As long as he knows how you feel and what you want, he can explain everything to the medical team if you are unable to do so on your big day. If the prospect of changing midwives halfway through labour worries you, then ask your midwife about the NHS Domino scheme whereby a community midwife goes with you to the hospital and delivers your baby. If this scheme isn’t available in your area, your GP practice has a duty to provide the best possible alternative. Do anything you can to feel relaxed – take your favourite music in wit you or your own pillow. Don’t be shy.

The pros of a hospital birth

Medical expertise and essential equipment are immediately available. More pain relief options.

The cons of a hospital birth

You may feel as if you have less control over what is going on than you’d like. Some women can become stressed if the midwives intervene too much. If you have a long labour, or if you arrive at the hospital near the end of a shift change, it is possible that two or more different midwives may be looking after you. Not always ideal.

All About Home Births

If, overall, you’ve had a problem-free pregnancy and no obstetric complications, then giving birth at home could be a good choice for you.

Even if you are in good health, you may encounter opposition from health professionals – and family and friends – so don’t be bullied over your decision.

Are there risks?
Studies show that giving birth at home is no more risky than in hospital. Your midwife will monitor you closely throughout and if she feels that your risk factor has changed enough, she will recommend a hospital delivery. And, don’t forget, if at any time during your pregnancy – or during labour itself – you want to switch to hospital, you can!

Home birth The advantages

You may well feel more relaxed and in control. The birth may be easier – and even quicker. There’s more room to freely move around and try different positions until you’re more comfortable. You’re less likely to need pain relief or medical intervention if you’re having a home birth. You’ll have more continuity of care with your midwife.

Home birth The disadvantages

Should things become complicated you may need to be transferred to a your local hospital. Your options for pain relief will be limited. There will be no one on hand should you want an epidural.

Top Tips for home birth

Book equipment well in advance. It can be hard to get hold of a birthing pool, for example. There will be home birth support groups in your area. Contact the National Childbirth Trust (www.nct.org.uk) for advice and details of your nearest home birth classes. Find a midwife who specialises in home births well in advance – it costs from £2,000 to £2,500 for antenatal, birth and postnatal care, so find one you like. Contact the Independent Midwives Association (www. independentmidwives.org.uk) Pack a hospital bag and, if you have children, arrange childcare just in case you need to go to hospital.

What is it?

Induction
This is the starting of labour by artificial means. These can include inserting a pessary into your vagina, breaking your waters, and putting a drip into your arm. Some women prefer to avoid induction unless it’s absolutely necessary.

Electronic foetal monitoring (EFM)
This records your baby’s heartbeat and measures your contractions. Many hospitals use external EFM – when two small electrodes are strapped to your abdomen – routinely for 20 minutes when you are admitted to the labour ward. Once your waters have broken, the medical staff may suggest internal EFM – when a small electrode is attached to your unborn baby’s scalp. Some women who want a low-tech labour prefer to avoid being monitored.

What is it? Episiotomy
Sometimes a cut in the perineum (the area between the vagina and anus) is made to help deliver the baby’s head if the cervix has not dilated enough or fully.
However, some women would rather risk a small tear naturally than be cut, if at all possible. You will usually be stitched up soon after the birth and you may feel a little sore.

Vitamin K
After birth, vitamin K is given orally or by injection, to prevent a rare but life-threatening bleeding disorder. Vitamin K is generally given routinely to newborn babies in UK hospitals.

ALL ABOUT Active birth units

Attached to maternity hospitals, active birth units are run by midwives and supportive obstetricians. They offer a different approach that might suit what you are looking for. Try to attend the special preparation classes – you’ll be taught breathing and relaxation techniques for pain relief.

On the move
This choice offers a half-way house between a home and hospital delivery. You are encouraged to walk around, relax in a bath and give birth in a position that feels comfortable to you – with little or no pain relief or medical intervention.

Of course, in the event of you needing emergency treatment, such as a Caesarean, you would be transferred to hospital where medical experts and help will be on hand.

During your pregnancy, you’ll have all the usual antenatal checks with your midwife, but you will also be able to attend preparation classes at the unit.

Active birth units
The pros

Your birth will be natural and you’ll have full medical backup on hand if you need it. Being active can help you cope with pain better and often results in a quicker and easier birth.

Active birth units
The cons

They are hard to find. A private unit can be very costly if that is your only option locally. While some active birth units are able to carry out epidurals, many can’t, so if you do want extra pain relief, you may need to be transferred to hospital.

All about water births

Giving birth in water tends to create a very special and unique atmosphere – it’s a very different experience from having your baby in a hospital or a home that’s for sure.

The basic theory behind a water birth is that your baby has been in the amniotic sac for nine months and birthing into a similar environment – water – is both gentler for the baby and much less stressful for the mother.

Making a splash The advantages of having a water birth

Immersion in warm water is an excellent form of pain relief. Some women feel the relief as soon as they lower themselves into the pool.

For others, it takes 10 to 15 minutes to feel the benefits.

Being immersed in water is an intensely private experience. Many women feel secure and in control. Water gives support and makes it easier to try different positions – as well as providing extra buoyancy. The warm water is a natural aid to relaxation, releasing tension and anxieties, and leaving you free to go with the flow of the contractions. Water birth is often accompanied by dimmed lights and aromatherapy oils, which can also aid relaxation. With less anxiety, the body produces less of the stress hormones, adrenaline and noradrenaline. This in turn allows more endorphins to be produced, which are the body’s own pain killers, promoting wellbeing. Studies have shown that the mother’s blood pressure can drop between 10 and 15 minutes after entering the water. You can still use entonox, (a pain relief option involving gas and oxygen), while you are in the pool, and some women turn to this during the intense contractions at the end of the first stage of labour. The atmosphere of a water birth is less rushed, allowing you to relax. The second stage of labour can take longer, which may be due to less pressure on you to push.

Mel Says…

‘All three of my births were very different. The first was an emergency C-section. My second involved an epidural which slowed down my labour so much that I had to have an episiotomy (a cut down below) and assisted delivery. And with my third, I had a natural birth and it was amazing! Evie was born within an hour of reaching hospital with no complications. I was told I’d be able to go home that afternoon and was over the moon. However later on, I haemorrhaged, due to some of the placenta being left in my womb. I thought I was going to die as blood just gushed from me. Having the clot removed just after being stitched was excruciating, but even with that scary experience, I would still recommend a natural delivery if possible.’

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