Place of Birth
So you’ve had your pregnancy confirmed, congratulations! It’s time to book to see your midwife for your first antenatal appointment, where you will make plans for a healthy positive pregnancy. Your first appointment can be quite a long one, with a full medical history taken and discussions surrounding the choices you will make regarding your pregnancy, and the care you wish to receive. The following pages offer lots of information around this and we encourage you to refer back to it often. One of the first decisions you may be encouraged to make is where you wish to have your baby.
Obstetric Units (Labour Ward)
These are based in hospitals that provide 24 hour services including medical, obstetric, neonatal and anaesthetic care. Although care is provided by a team of people, obstetricians (doctors who specialise in birth) lead care if you are at high risk of complications during labour and birth. Midwives also provide care to all women in an obstetric unit, and lead your care if you have a straightforward pregnancy and birth. Women with increased risk of complications are likely to be encouraged to deliver here. Full ranges of pain relief may be available, including birthing pools through to epidurals.
Alongside Midwifery Units
These are based within hospitals, but are separate from obstetric units. Midwives take responsibility for your care during labour, and support you to have a normal birth. They often have a more homely and relaxed feel. If you or your baby need specialist medical care or you decide to have an epidural for pain relief, you will need to be transferred to an obstetric unit on the same site. Transfer will normally be by bed or wheelchair.
Freestanding Midwifery Units
These birth centres are on a separate site from the nearest main hospital. Midwives take responsibility for your care during labour, and support you to have a normal birth. If you or your baby need specialist medical care or you decide to have an epidural or drugs for pain relief, you will need to be transferred to an obstetric unit, which may be several miles away. Transfer is normally by car or ambulance. These centres are generally recommended to women with low risk of complications.
Midwives are trained to help you give birth at home safely, and will also advise you if transferring into an obstetric unit would be best. Options for pain relief are limited, although many women find that the comfort of their own home help them cope with labour better. Transfer is normally by car or ambulance. Women with higher risks of complications may be encouraged not to have a homebirth.
Choosing the right place of birth for you should be an informed decision, and your midwife can discuss these options with you. A large recent study, known as the Birthplace study, published significant information about the outcomes for women birthing in different places. The study showed that for many women, homebirth or birth centres can be as safe as a hospital birth, and in many cases helped to facilitate a normal birth. It is also important to consider the environment that would suit you and your partner the best.
The following two sites are excellent tools in helping to understand the evidence around place of birth, and the most appropriate place for you. Your midwife will talk through all options available to you, and you may feel you need time to decide as the pregnancy progresses.