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 options about where to have your baby will depend on your needs, risks and, to some extent, on where you live.
If you’re healthy and have no complications (“low risk”) you could consider any of these birth locations. For women with some medical conditions, it’s safest to give birth in hospital, where specialists are available. This is in case you need treatment during labour.
Women who give birth at home or in a unit run by midwives are 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 – find a children’s centre near you
- your GP surgery
- local maternity units – find maternity services near you
- the NCT – which can put you in touch with other mothers
- maternity services liaison committees – ask at your local hospital’s maternity unit
- the Birthplace study – published in November 2011, this compared the safety of births planned in different settings
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 don’t understand something or think you need to know more.
If you have a straightforward pregnancy, and both you and the baby are well, you might choose to give birth at home. In England and Wales, just over 1 in 50 pregnant women give birth at home.
Giving birth is generally safe wherever you choose to have your baby.
But for women having their 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.
For women having their second or subsequent baby, 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, if you have any
- 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
- lower likelihood of having an intervention, such as forceps or ventouse, than women giving birth in hospital
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. The Birthplace study found that 45 out of 100 women having their first baby were transferred to hospital, compared with only 12 out of 100 women having their second or subsequent baby.
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 it is, 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 obtain 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, making it easier for people to visit
- lower likelihood of having an intervention such as forceps or ventouse than women giving birth in hospital
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. The Birthplace study found that approximately 4 in 10 women having their first baby in a midwifery unit or birth centre were transferred to hospital, compared with approximately 1 in 10 women having their second or subsequent baby.
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.
Most women give birth 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 and general anaesthetics
- there will be specialists in newborn care (neonatologists) and a special care baby unit if there are any problems with your baby
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
- women giving birth in hospital are more likely to have an epidural, episiotomy, or a forceps or ventouse delivery
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 fathers, 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?
- Are epidurals available?
- How soon can I go home after the birth?
- What services are provided for premature or sick babies?
- Who will help me to breastfeed my baby?
- Who will help me if I choose to formula feed?
- Are babies with their mothers 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.
Which? Birth Choice can help you think about the right birth place for you.
Healthtalk.org has women’s experiences of thinking about where and how to give birth.
Your choice – where to have your baby
Two NHS guides – one for people having their first baby and one for people who have had a baby before – are available to explain what birth choices you have and the research that may help you make a decision:
Media last reviewed: 27 Feb 2017
Media review due: 20 Mar 2020