Where to give birth: the options

Choosing your birth location

You can give birth at home, in a unit run by midwives (a midwifery unit or birth centre) or in hospital.

Your choices about where to have your baby depend on your needs, risks and, to some extent, on where you live.

You can usually consider any of these birth locations. But if your pregnancy is high risk or you have certain medical conditions, it's safest to give birth in hospital, where specialists are available. This is in case you need treatment during labour.

If your pregnancy is low risk and you give birth at home or in a unit run by midwives, you’re less likely to need assistance such as forceps or ventouse (sometimes called instrumental delivery).

Wherever you choose, the place should feel right for you. You can change your mind at any point in your pregnancy.

Find out what's in your area

Your midwife will discuss the options available in your area but if you're willing to travel, you're free to choose any maternity services.

As well as from your midwife, you can get information from:

children's centres
your GP surgery
local maternity units – find maternity services near you

You may also want to get advice from your friends and family.

Talk to your midwife about going to have a look around the local maternity services, and ask questions if you do not understand something or think you need to know more. Some hospitals also offer virtual tours on their websites.

Home birth

You can choose to give birth at home. This is usually only recommended if you have a straightforward pregnancy, and both you and the baby are well.

Giving birth is generally safe wherever you choose to have your baby.

But if you’re having your first baby, home birth slightly increases the risk of serious problems for the baby – including death or issues that might affect the baby's quality of life – from 5 in 1,000 for a hospital birth to 9 in 1,000 for a home birth.

If you've had a baby before, a planned home birth is as safe as having your baby in hospital or a midwife-led unit.

It's rare, but if something goes seriously wrong during your labour at home, it could be worse for you or your baby than if you were in hospital with access to specialised care.

If you give birth at home, you'll be supported by a midwife who will be with you while you're in labour. If you need any help or your labour is not progressing as well as it should, your midwife will make arrangements for you to go to hospital.

Advantages of home birth

The advantages of giving birth at home include:

being in familiar surroundings, where you may feel more relaxed and better able to cope
not having to interrupt your labour to go into hospital
not needing to leave your other children
not having to be separated from your partner after the birth
increased likelihood of being looked after by a midwife you have got to know during your pregnancy
if your pregnancy is low risk, a lower likelihood of having an intervention, such as forceps or ventouse (vacuum delivery), than giving birth in hospital

Considerations

There are some things you should think about if you're considering a home birth.

You may need to transfer to a hospital if there are complications.

Epidurals are not available at home, but you can use gas and air, a warm bath, a birth pool, TENS and any relaxation techniques you've learned. Find out about pain relief in labour.

Your doctor or midwife may recommend you give birth in hospital – for example, if you're expecting twins or if your baby is lying feet first (breech). Your midwife or doctor will explain why they think a hospital birth is safer for you and your baby.

If you choose to give birth at home or in a unit run by midwives, you should be given information by your midwife or GP about what would happen if you had to be transferred to hospital during labour and how long this would take.

Planning a home birth

Ask your midwife whether a home birth is suitable for you and your baby.

If you choose to have a home birth, your midwife will arrange for members of the midwifery team to help and support you. Here are some questions you might want to ask:

how long would it take if I needed to be transferred to hospital?
which hospital would I be transferred to?
would a midwife be with me all the time?
how do I get a birthing pool?

Midwifery units or birth centres

Midwifery units or birth centres are more comfortable and homely than a maternity unit in a hospital. They can be:

part of a hospital maternity unit, where pregnancy (obstetric), newborn (neonatal) and anaesthetic care is available
separate from a hospital, and without immediate obstetric, neonatal or anaesthetic care

Advantages of a midwifery unit or birth centre

The advantages of giving birth at a midwifery unit include:

being in surroundings where you may feel more relaxed and better able to cope with labour
being more likely to be looked after by a midwife you have got to know during your pregnancy
the unit potentially being much nearer your home
if your pregnancy is low risk, a lower likelihood of having an intervention such as forceps or ventouse (vacuum delivery) than giving birth in hospital

Considerations

There are some things to think about if you're considering giving birth in a midwifery unit or birth centre.

You may need to be transferred to a hospital if there are any complications.

In a unit that's completely separate from a hospital, you won't be able to have certain kinds of pain relief, such as an epidural. Ask your midwife whether the unit or centre is part of a hospital or completely separate.

Your doctor or midwife may feel it's safer for you to give birth in hospital.

Planning a birth in a midwifery unit or birth centre

Ask your midwife if there are any midwifery units or birth centres in your area. There may be others you can use if you're prepared to travel.

Hospital birth

Most births happen in an NHS hospital maternity unit. If you choose to give birth in hospital, you'll be looked after by midwives, but doctors will be available if you need their help.

You'll still have choices about the kind of care you want. Your midwives and doctors will provide information about what your hospital can offer.

Advantages of hospital birth

The advantages of giving birth in hospital include:

direct access to obstetricians if your labour becomes complicated
direct access to anaesthetists, who give epidurals
there will be specialists in newborn care (neonatologists) and a special care baby unit if there are any problems with your baby

Considerations

There are some things you should think about if you're considering a hospital birth:

you may go home directly from the labour ward or you may be moved to a postnatal ward
in hospital, you may be looked after by a different midwife from the one who looked after you during your pregnancy
you're more likely to have an epidural, episiotomy, or a forceps or ventouse delivery in hospital

Planning a hospital birth

Your midwife can help you decide which hospital feels right for you. If there's more than one hospital in your area, you can choose which one to go to. Find out more about the care provided in each so you can decide which will suit you best.

Birth questions to ask

Here are some questions you might want to ask if you're considering having your baby in a midwifery unit or birth centre, or in hospital:

Are tours of the maternity facilities available before the birth?
When can I discuss my birth plan?
Are TENS machines available for pain relief or do I need to hire one?
What equipment is available – for example mats, a birthing chair or bean bags?
Are there birthing pools?
Are partners, close relatives or friends welcome in the delivery room?
Are they ever asked to leave the room – if so, why?
Can I move around in labour and find my own position for the birth?
What is the policy on induction, pain relief and routine monitoring?
What types of pain relief are available, such as epidurals?
How soon can I go home after the birth?
What services are provided for premature or sick babies?
Who will help me if I breastfeed?
Who will help me if I choose to formula feed?
Will my baby be with me all the time or is there a separate nursery?
Are there any special rules about visiting?
How long would it take if I needed to be transferred to hospital from a birth centre?
Which hospital would I be transferred to?
Would a midwife be with me all the time?

Wherever you decide to give birth, you can change your mind at any stage of pregnancy. Talk to your midwife if there's anything you're not sure or want to know more about.

Find out more about your choice of place of birth on the Birthrights website

If you are thinking about unassisted birth

You can choose to have a home birth without a midwife with you (unassisted birth). This is sometimes called freebirth.

Talk to a midwife if you are worried about your care.

They can:

discuss with you the role of the midwife and help you make an informed choice
personalise your care and support so it’s right for you.

If you decide to have an unassisted birth, you can change your mind at any time during your pregnancy or labour. NHS midwives will always be available to support you.

A midwife can offer you support and advice during labour, and check on the health of you and your baby. They'll know if you or your baby need help, and can arrange for medical attention if needed.

If you have an unassisted birth, you’ll need to tell a GP or local maternity services about your baby’s birth as soon as they’ve been born. This is because by law every birth in the UK needs to be recorded (notified) within 36 hours. A GP or midwife will need to see you before they can notify the birth.

When the birth has been notified, your baby will get an NHS number for their NHS care.

Find out more about freebirth, unassisted childbirth and unassisted pregnancy on the AIMS website