Printed at: 02:28:09 / 17-11-2019

Home birth at MKUH

This information leaflet has been produced to provide information about the Milton Keynes University Home Birth Team.

Who can have a home birth?

If risk factors have been identified either at the start of your pregnancy or are ongoing, then it is highly likely that you will be recommend by your Midwife and/or Obstetrician to give birth in hospital. Evidence supports that this is the safest place.

We know that the labour ward is not the ideal environment for all women and therefore there are alternative options for women who are at low risk of complications.  NICE guidance for Antenatal care, states that ‘Healthy women who are at low risk of complications should have an opportunity to choose where to give birth’ and this includes home birth.

The general criteria for home birth excludes women who:

  • Have existing medical conditions that may affect them or the baby.
  • Have had a previous caesarean section/s or significant complications during a previous pregnancy, labour or birth.
  • Are expecting more than one baby, or whose baby is not head down after 36 weeks
  • Start labouring under 37 weeks gestation.

This list is not exhaustive – please speak to your Midwife as they can advise if you are at low risk of complications.

 What are the benefits of having a baby at home?

Home is arguably the place where most of us feel safest, and labour hormones work more effectively when we are relaxed, calm and feel secure. Evidence suggests that women experience a shorter labour at home compared to birthing in a hospital.

At home you have access to your own facilities i.e. bathroom, birthing pool, bed, food, drink, music etc. and therefore you can create an environment that suits your needs. Many partners also report feeling more involved in the birth as they are comfortable in their own home.

You are guaranteed one-to-one care throughout labour by an experienced Midwife and we routinely call a second Midwife for the birth (if not before).

Evidence has shown that for women with straightforward pregnancies who have their second or subsequent baby at home, the risk of a poor outcome for the baby is the same as for babies who are born in hospital.

What are the risks of having a baby at home?

For women who chose to have their first baby at home, the evidence shows  there is an increased chance, around 45%, of transferring into hospital either during labour or shortly after giving birth. This falls to around 10% when women are having subsequent births at home. The risk of having a poor outcome when having your first baby at home is around 1%, compared to around 0.5% for a planned birth in hospital.

Birth is generally very safe, however occasionally things don’t go according to plan. The Midwives at home therefore monitor women and babies well-being closely from the moment they enter your house, until the moment they leave.

If any concerns are identified, the midwife will discuss these with you and recommend transferring into the nearest maternity hospital via ambulance for increased monitoring.

Emergency situations in the home are rare; nevertheless the Midwives attending your birth will carry a comprehensive range of equipment including equipment that would be required in an emergency.  All Midwives are highly trained to manage an emergency in childbirth and attend retraining on a yearly basis as a minimum requirement.

Will I change Midwives if I decide to have a home birth?

If you are considering a Home Birth, the next step is to discuss this with your current community Midwife.  If your pregnancy is straightforward, then your community Midwife will offer you the chance to transfer care to the Home Birth Team. This is to provide continuity of care and the opportunity for you to build a relationship with your named Home Birth Midwife. If however you prefer to remain with your existing Midwife then this will be facilitated.

 Where will I have my visits from the Midwife?

Your antenatal visits from the Homebirth Midwife will be at home and occasionally at a clinic based in a Family Centre, your 36 week appointment is always at your home. This is an ideal opportunity to discuss your birth preferences and any practical issues surrounding the home birth.

The majority of your postnatal visits are likely to be at home, however we work alongside the traditional community Midwives and so you may be asked to come to clinic for particular appointments. Many families find coming to clinic beneficial as they are allocated a specific time slot as opposed to waiting in for the Midwife.

Will I need to go to hospital after giving birth at home?

The experienced Midwives can provide immediate postnatal care and undertake all routine checks. This includes stitches (if required), initial baby check/weight and Vitamin K. If there are any concerns after the birth, the Midwife will recommend that you and/or baby are transferred to hospital. The midwife attending the birth would transfer with you via ambulance and we would of course endeavour to minimise any separation of mother and baby.

An appointment will be made within 72 hours of birth for the newborn and infant physical examination. This is undertaken at the hospital by a paediatrician and is recommended for all babies. You shall also receive an appointment for your baby’s hearing check via the post.

 What equipment do I need to supply?

 The Midwives attending your home birth will have all the necessary equipment required for the birth of your baby. However we do recommend you supply some extras:

  • Towels – a large bag of towels in the room you are delivering.
  • Plastic covering for your bed/sofa/floor – we recommend large sheets or shower curtains.
  • Torch and mirror are useful for any birth, so that we can keep lighting to your preference.
  • Isotonic drinks and light snacks.
  • A packed overnight bag in case of transfer to hospital with supplies for mum and baby.
  • Absorbent sheets (puppy training pads) are ideal.

If planning a water birth we would recommend all of the above with the addition of:

  • Pool and liner
  • Plastic sieve
  • Additional towels
  • A suitable mirror for use in the pool

Will I know the Midwives who attend my birth?

 The Home Birth Team will attend the majority of home births in Milton Keynes and therefore you are likely to have met the first Midwife who comes to your house. In addition to undertaking your antenatal care, we run monthly ‘Meet the Midwife’ events.

The wider community team will continue to attend home births to support the Home Birth Team and therefore you may not have met this Midwife. All community Midwives at Milton Keynes University Hospital will have a minimum of one year postgraduate experience.

Is a home birth messy?

 It is recommend that you provide sheeting to protect carpets, sofas etc (low-cost shower curtains are normally very effective). The Midwives carry large incontinence pads that can soak up bodily fluids and then take away the placenta and other materials before they leave. Your house should therefore look the same before and after your home birth.

What pain relief can I have at home?

 When Midwives are on call for home births, they carry Entonox – more commonly known as gas and air. We do not carry any other pharmacological pain relief. There are other options to consider that many women find useful:

  • Hydrotherapy i.e. pool, bath, shower etc
  • Hypnobirthing
  • Aromatherapy – please speak with your Midwife for suitability prior to use
  • Music
  • Moving around/birthing ball
  • Massage
  • TENS – Transcutaneous electrical nerve stimulation

If I decide to have a home birth, can I then change my mind?

 You can change your mind at any point, even whilst in labour, and your wishes will be respected. All you would need to do is inform your current Midwife who would then arrange for your care to be transferred back to the Midwife at your GP surgery.

 Meet the Midwife events:

 We run monthly Meet the Midwife events for women and their partners to attend. This is an opportunity to meet face-to-face with the Home Birth Team, ask any questions and see the equipment we use.

Please ask your Midwife for the next date, or contact the community midwives office.

You can also visit the Home Birth Team’s Facebook page where all events can be found.

Useful websites/sources:

www.npeu.ox.ac.uk/birthplace

www.homebirth.org.uk/

Birth Place Decision Support

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