Choosing where to give birth

Why choosing where to give birth matters

6 min read

Find out how planning to have your baby at home, in a birth centre or in a labour ward can affect your birth experience.

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The type of birth you have and the care you receive will be shaped by the choices you make about where to give birth. Read on to find out more and watch our video of Cathy Warwick, former chief executive of the Royal College of Midwives, as she explains why you should think about where to give birth.

Where can I give birth?

You can plan to have your baby in one of the following birth environments:

  • a hospital maternity unit (also called a labour ward or obstetric unit)
  • a birth centre (also called a midwife-led unit)
  • at home.

Where you plan to give birth can affect many things, from the facilities available to how likely you are to know your midwife. Our Birth Choice tool helps you find the best options for you, based on what’s important to you when it comes to giving birth as well as personal information such as your age.

Research from the National Childbirth Trust (NCT) and the Women’s Institute published in 2017 found that women who were more aware of their options for where to give birth were more likely to get their choice realised. Women who had given birth before were more likely to know their options so, if this is your first baby, explore and understand your options to help increase the chances of having the birth you want.

Find the right place to give birth

Discover whether birth in a local labour ward, birth centre or at home would be best for you.

Find your best fit

How could my decision affect my labour?

1. Pain relief available during labour

Different methods of pain relief are available depending on the birth environment you choose, so find out more about your pain relief options in a labour ward, a birth centre and at home.

Using medical pain relief is more likely in some birth settings than others. The Birthplace study of almost 65,000 women found that women planning to give birth in a labour ward were substantially more likely to have an epidural than those planning to give birth at home or in a birth centre.

Of course many of the pain relieving drugs aren’t available for use at a home birth or in a birth centre.

That said, the study found that even when a low-risk woman was transferred into a labour ward from home or a birth centre, she was still less likely to have an epidural than a low-risk woman who had planned to give birth in the labour ward all along.

For example, only 21% of low-risk first-time mothers planning a home birth had an epidural compared with 38% of those who planned to give birth in a hospital labour ward.

Find out more about intervention rates in different birth settings.

2. Having a water birth or using water for pain relief

Water is more likely to be used by women who plan to give birth in a freestanding birth centre or at home than by women who plan to give birth in a maternity unit. Therefore, choosing to have your baby in an out-of-hospital setting gives you a better chance of using water in labour.

The image below outlines this finding from the Birthplace study, showing how many first-time mothers use water for pain relief in labour in different settings.

How many first time mothers use water in labour?

For women who have given birth before, the likelihood of using water in labour also differs depending on where they plan to give birth.

Find out more about using water in labour and having a water birth.

3. Who looks after you during your pregnancy and labour

If there are no complications during your pregnancy, you will usually be looked after by midwives and only seen by a doctor if there’s a problem. Find out more about the staff looking after you and how this can affect your birth experience.

Where you choose to give birth can affect the extent to which you can get to know your midwives before the birth, and whether you’ll already know the midwives who will be with you during labour and birth.

In the 2017 survey by the NCT and the Women’s Institute, the majority of women reported that knowing their midwife had a positive impact on their labour, with around two thirds saying it made them feel more relaxed, confident and safe. Similar research from the NCT in 2013found that women who gave birth in a freestanding birth centre or had a home birth were more likely to have already met the midwives caring for them than women who gave birth in a maternity unit.

Find out more about the benefits of knowing your midwife.

4. How far you have to travel in labour

If you choose to give birth in a hospital or a birth centre, you’re likely to have to travel there while you’re having contractions. Think about how far you’re prepared to travel, as this will affect your options, and read our tips on how to plan your journey to the hospital or birth centre.

If you plan on having a baby at home or in a birth centre, you may have to travel to a hospital if you need extra help during labour. The chances of this happening differ depending on whether or not this is your first baby, so read our article on transferring to hospital during labour to find out more.

women choosing where to have baby

5. Your chance of having medical interventions

Planning a home birth or giving birth in a birth centre reduces the likelihood of needing medical interventions, such as being induced or having an unplanned caesarean.

Find out about different types of intervention or how intervention rates differ between environments.

Intervention rates can vary widely between hospitals. Use our Birth Choice tool to compare the rates at your local units.

6. Whether you can access specialist medical care or facilities

You’re likely to be recommended to give birth in a maternity unit if you’re carrying twins, your baby is breech, you’ve had a caesarean for a previous birth or if you’re at increased risk of complications for any other reason.

If you have a disability or a medical condition that needs the support of a doctor, you might require specialist facilities that will only be available in certain units.

If you would still prefer not to have your baby in a hospital, find out more about negotiating your options if you are at increased risk of complications.

7. Support for breastfeeding

It’s normal to need a helping hand when breastfeeding for the first time. Unicef awards Baby Friendly accreditation to hospitals that are particularly supportive towards breastfeeding mothers. Use our search tool to find out if your chosen unit has been accredited.

8. Your postnatal care

How long you stay in the unit after the birth can vary from a couple of hours to a few days, depending on how you and your baby are, as well as on the policies of the hospital.

Our guide to postnatal care goes through what you can expect after giving birth at a labour ward, birth centre or at home.

Use our search function to look up the postnatal facilities at your local hospitals.

Honest birth stories from real mums

Watch our videos of nine mums talking about why they decided to give birth in a birth centre, on a labour ward or at home, and what their experiences were like.

More from Which?

  • Use our Birth Choice tool to help you find the right place for you to give birth.
  • Find out what to expect with different birth places – be that a labour ward, birth centre or at home.
  • Our pushchair reviews can help you find the best pushchair most suited for you and your baby’s needs.

References

These are the sources of information used in this article.

Plotkin, L, Support Overdue: Women’s experiences of maternity services National Federation of Women’s Institutes/NCT: London (2017)

Bourke, G, Support Overdue: Women’s experiences of maternity services, National Federation of Women’s Institutes/NCT: London (2013)

Birthplace in England Collaborative Group, Perinatal and maternal outcomes by planned place of birth for healthy women with low risk pregnancies: the Birthplace in England national prospective cohort study, BMJ 2011;343:d7400 (2011)

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