Home birth at MKUH
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Home Birth at Milton Keynes
This leaflet has been produced to provide information about the Milton Keynes University Hospital Home Birth Service.
The latest available data shows that the home birth rate for England and Wales rose slightly in 2021 to 2.4% following a 5-year decline.
The homebirth service is provided by our team of Community Midwives who share an on-call service throughout the day and night.
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 service users overall experience shorter labours at home compared to birthing in a hospital.
Evidence shows that labouring at home reduces the requirements for stronger pain relief, reduces the chances of assisted birth such as forceps or ventouse and increases the chances of spontaneous vaginal birth.
At home you have access to your own facilities i.e. bathroom, birthing pool (which is guaranteed), bed, food, drink and music 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. In addition, if you wish to have other birthing partners this will be supported and can be discussed with your Midwife.
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).
Homebirth with risk factors
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 having a home birth.
We wish to support all service users where possible, however if there are risk factors present throughout the pregnancy then it is likely that you will be recommended by your Midwife and/or Obstetrician to give birth in hospital. Evidence supports that this is the safest place if you have specific risk factors such as below:
- Have existing medical conditions that may affect you 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
- Baby is not head down after 36 weeks.
- Start labouring under 37 week’s gestation.
This list is not exhaustive – please speak to your midwife as they can advise if you are at low risk of complications.
If you wish to speak to the Consultant Midwives regarding a home birth but are aware you have risk factors then they would be happy to arrange an appointment for you, your Midwife can arrange on your behalf, or you can email them yourself: [email protected]
What are the risks of having a baby at home?
For service users who choose to have their first baby at home, the evidence shows that there is an increased chance (compared to subsequent labours) of transferring into hospital either before, during or after labouring at home. Percentages for these are 45% approximately for first baby, falling to approximately 10% for subsequent babies following a vaginal birth.
The risk of baby having an adverse outcome when having your first birth at home is around 1%, compared to around 0.5% for a planned birth in hospital. For those with straightforward pregnancies who have their second or subsequent baby at home, there is no increased risk of adverse outcomes for mum or baby.
Birth is generally very safe, however occasionally things don’t go according to plan. The Midwives at home therefore monitor the wellbeing of you and baby 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 you 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 required in an emergency.
All midwives are highly trained to manage an emergency in childbirth and attend retraining on an annual basis as a minimum requirement.
What do I need to do if I want a home birth?
If you wish to discuss a home birth, then speak to your Community Midwife who will be able to answer any further questions you have. We will then complete your appointments as usual. A home birth assessment appointment will be arranged with you between 34-36 weeks when we will visit your home and discuss the individual aspects of your birth.
When you go into labour and call Maternity Triage, inform them you are booked for a home birth, and they will arrange the on-call Midwife to contact you.
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 stiches (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 endeavour to minimise any separation of mother and baby.
We will arrange the baby to have their Newborn Examination Screening within 72 hours, this may be possible at home with an appropriately trained Midwife or we will provide you with an appointment at the hospital with the Paediatric team.
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 birthing
- Plastic covering for your bed/sofa/floor – we recommend large sheets or waterproof 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?
Community Midwives share the on-call duties for home births and therefore it may be a Midwife you have met in your pregnancy, but this cannot be guaranteed.
Is a home birth messy?
It is recommended 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 experience.
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.
If you would like to have Pethidine available at home, then please discuss with your Midwife and they will arrange this to be prescribed for you to collect by 37 weeks. Please refer to the Pethidine at home leaflet for more information, located on the Hospital Website.
There are other options to consider that many women find useful:
- Hydrotherapy i.e. pool, bath, shower etc.
- Hypnobirthing
- 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.
Useful Contact Numbers:
Community Office: 01908 996484
Maternity Triage: 01908 996483
Useful Websites/ sources: