Choosing where to give birth

Your rights during pregnancy and birth

11 min read

Understand your legal rights to receive the maternity care and choose the birth that you want.

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All pregnant women in the UK have the right to make their own choices about their care during pregnancy and birth, and to have their choices and their dignity respected by health professionals.

In practice, this means you can choose:

You also have the right to:

Choosing where to give birth

You can choose where to give birth.

As far as possible, all NHS trusts should offer you the choice of giving birth in a hospital where care is overseen by doctors, in a birth centre (which can be part of the hospital or on a separate site) where care is led by midwives, or having a home birth.

However, this will depend on what’s available locally (for example, not all trusts have birth centres) and your options can also be limited if you or your baby are at a higher risk of complications during labour and birth.

If you’ve been told by your midwife or another healthcare professional during your pregnancy that you can give birth at home or in a birth centre, you can legitimately expect to be able to give birth there.

For more information, our Birth Choice tool allows you to compare options when deciding where to give birth, based on your preferences, personal circumstances

I’ve been told I can’t give birth in a birth centre. What are my rights?

You might not be offered the choice of a birth centre if there isn’t one in your local area, or if you don’t meet the clinical criteria because you’re at increased risk of complications during labour and birth.

For example, most birth centres only accept women who are having straightforward pregnancies, are within certain age and weight limits, and who haven’t had previous birth complications. You can check the eligibility criteria for your chosen birth centre on our unit information pages.

For more information, see our guide on negotiating your care if you are at increased risk of complications.

I’ve been told I can’t have a home birth. What are my rights?

Unlike a birth centre, you can’t be denied the right to give birth at home. You are responsible for making your own decisions about where you give birth and can legally have a home birth, even if you’re considered to be at higher risk of complications.

If you’re finding it difficult to arrange a home birth, contact the hospital where you’re receiving maternity care and ask for the contact details of the supervisor of midwives. Talk to them about your situation and discuss the differences in safety, transfer rates and intervention rates compared to giving birth in the labour ward, so you can weigh up the risks and benefits personally. If you still want a home birth, let the supervisor of midwives know.

If they still can’t arrange a home birth for you, you can seek support from a variety of organisations. Find out who to get in touch with if you can’t get support for a home birth.

Can I plan to give birth unassisted?

You can legally choose to give birth with no medical or midwifery assistance at all, in what’s known as a ‘free birth’. Your partner, family members or a doula can be there to support you during the birth, but no-one is allowed to act as a midwife unless they’re a registered healthcare professional.

A midwife or doctor can refer a woman to social services if they deem that by going ahead with an unassisted birth there would be a significant risk to the baby after the birth. However, simply choosing to give birth unassisted is not on its own enough reason for a social services referral.

Can I ask to have a caesarean?

Yes. If you’re pregnant and want to have a planned caesarean for no medical reason, you can tell your midwife or doctor, who will outline the risks and benefits of both a caesarean and a vaginal birth to support you in making an informed choice.

NICE guidelines state that trusts should give women without medical reasons elective caesareans if they still want one after being offered support to prepare for a vaginal birth. However, despite this guideline, some trusts still refuse to grant elective caesareans without medical reason. If this is the case in your area, you may need to arrange to have your caesarean birth at a hospital further away.

If you’ve been planning a vaginal birth, you may decide during labour that you would like to have a caesarean instead. At this point, you’re not entitled to a caesarean unless the doctor decides there’s a medical need.

Find out more about requesting a caesarean.

I’m booked into one hospital but would now prefer to go somewhere else. Can I change my mind?

It shouldn’t usually be a problem to change where you’re booked to give birth. You will need to check that the hospital or birth centre you plan to change to is prepared to accept your booking. First, check that you meet their admittance criteria and live within the catchment area.

To change your booking you can go via your GP and get them to refer you, or contact the new unit to ask for an appointment.

In this video, Cathy Warwick from the Royal College of Midwives explains that you can usually change your mind about where to give birth.

I think I’d like a home birth, but what happens if I change my mind?

If you change your mind about having a home birth during pregnancy, your midwife can change your booking. It’s even possible to change your mind when you’re in labour – you can decide at any time that you would prefer to be in the hospital, and can transfer there.

Be aware that, in some cases, transferring to give birth in hospital may mean you’re looked after by different midwives.

In some areas of the country, a final decision about where to have your baby is not made until you’re actually in labour, and the midwives stay with you wherever you choose to give birth.

Find out more about having a home birth.

Your rights during labour

When you’re in labour, you have the right to accept or decline any treatment or procedure that’s offered to you by a health professional. It’s against the law for any medical treatment to be given to you unless you have given your informed consent.

What is informed consent in birth?

Your consent must be sought before every procedure and examination, however minor. For example, you need to give consent to be monitored during labour, have a cannula inserted in your hand or have vaginal examinations. Your consent is also required for bigger procedures like an assisted birth or caesarean section.

Consent must be sought every time a procedure is proposed. For example, if you’re given several internal examinations during labour your consent must be given before each examination.

For the consent you give to count legally, you must genuinely agree to receive treatment.

  • You must be well-informed about the proposed procedure in advance, and
  • you can’t be pressured or bullied into receiving the treatment.

While consent doesn’t need to be recorded in writing, it’s usual practice to sign a consent form for surgical procedures.

However, there are a few exceptions to the consent rule and these include:

  • when someone is considered not to have the capacity to make their own decisions
  • in an emergency situation when a person cannot consent because of their physical condition.

Can I refuse to be induced?

Your consent is required for any medical procedure, and you’re within your rights to decline an intervention such as having your labour induced.

It’s important that you’re given all the information you need to weigh up the risks and benefits of accepting or declining an induction, as well as the alternatives to being induced, before you make your decision.

If you decline to be induced, your decision should be supported.

Find out more about being induced.

I don’t want an episiotomy (cut). Can I refuse one?

You should be asked before a midwife gives you an episiotomy. You can refuse to have one, but you need to be aware that this may be an emergency procedure to enable your baby to be born quickly. Sometimes a midwife will give an episiotomy if she thinks it will avoid a serious tear that may cause longer-term problems.

If possible, discuss your concerns about having an episiotomy with your midwife before you go into labour, so you can understand the circumstances in which you may need one.

What are my rights to pain relief?

If you have requested pain relief, it should be provided unless there are good reasons for refusing to provide it, such as a clinical contraindication (ie a medical reason for not providing the treatment).

Not all methods of pain relief are available at every maternity unit, which can limit your options when you give birth. Use our Birth Choice tool to find out which pain relief methods are available at birth centres, labour wards or during a home birth in your area.

Can I choose which midwife I have in labour?

It’s unlikely that you’ll be able to choose the midwife you have in labour. If you know a midwife who’s working when you’re in labour, you may be able to request that they look after you, but there’s no obligation for this to happen.

If you don’t like the midwife who is looking after you in labour, you can request a different one – get your birth partner to speak to the midwife in charge of the labour ward.

Can I choose my birth partner(s)?

A birth partner is someone you choose to have with you during your labour, in addition to any health professionals. Those caring for you should respect your choice of birth partner.

In exceptional circumstances, a hospital may have the right to refuse your choice of birth partner, for example, if the person has previously been violent towards health professionals.

Hospitals also sometimes have a policy on how many birth partners are permitted in the room with you at one time. You can check the criteria for your chosen hospital or birth centre on our unit information pages.

Your rights during pregnancy

You have the right to maternity care throughout your pregnancy and birth, but you can also decline any tests or appointments you don’t want.

Do I have a right to maternity care?

All women in the UK have the right to receive antenatal and postnatal care and care during birth.

If you’re considered to be living lawfully in the UK – ie, if you have a UK passport or permanent residence – you have the right to receive free NHS maternity care.

There are also other circumstances in which you’re entitled to free NHS care, for example if:

  • you have claimed asylum
  • you have been granted refugee status
  • you have been the victim of trafficking or modern slavery.

If you’re not considered to live in the UK lawfully, you still have the right to receive maternity care, but you may be charged the cost of the care you receive.

It’s important to note, however, that all maternity care is classed as ‘immediately necessary treatment’ and must not be refused or delayed for any reason. So even if you’re not able to pay, you must still be offered maternity care when you need it.

See Maternity Action for more information about your rights to maternity care.

Can I choose my midwife?

Some maternity services try to provide continuity of care by creating small teams of midwives who are responsible for all your care, from antenatal appointments through to labour, birth and postnatal care.

You’re more likely to get continuity of care if you live in the catchment area of the hospital you’re booked in to. You can look up your local units in our search to see if you’re in their catchment areas.

Find out more about the benefits of knowing your midwife.

Can I decline scans and screening tests?

All maternity care is optional, and you have the right to decline any appointments, tests or ultrasound scans offered to you.

If you feel that you don’t want to undergo testing, or you don’t understand the benefits of certain appointments or screening tests, tell your midwife or doctor how you feel. They can explain the purpose of the proposed testing to help inform your decision.

If you decide you don’t want to have scans or screening tests, your choice should be respected by health professionals.

Find out more about NHS antenatal care.

After you’ve given birth

If you feel that you didn’t receive the care you needed when you gave birth, there are steps you can take to get a clearer idea of what happened. You also have the right to make a complaint about the care you received.

Accessing your records

If you receive NHS maternity care in the UK you will receive a set of maternity records, often called your handheld notes, at your booking appointment. You will keep these with you throughout pregnancy and birth.

After the birth, the hospital keeps your records. However, at any time, you can ask your GP, midwife, doctor or health visitor whether they can obtain your and your baby’s records for you. Access requests must be processed within 40 days. The NHS is committed to providing healthcare records within 21 days.

Access can be refused if it’s believed it will be detrimental to your health, either mental or physical, or if the information could disclose information relating to a third party (non-healthcare professional). It’s unlikely that either of these grounds would apply to maternity records.

Making a complaint

If you’re not happy with the care you received during birth, you can make a complaint.

See our guide to the steps you need to take and an example letter for raising a complaint with the NHS trust responsible for your care.

If you have concerns about your maternity care before you give birth – such as being able to give birth where you want or your entitlement to say no to recommended procedures – speak to your healthcare professional or their manager as soon as possible.

You can also speak to a supervisor of midwives who can help and advise you further.

Visit the Birthrights website to find out more about your legal rights.

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