Find out how safe a home birth is likely to be for you based on whether this is your first baby or not and if you’re at higher risk of complications.
How safe a home birth will be for you depends on your personal history and circumstances. For example, if you’ve given birth before and are at low risk of complications, planning to give birth at home is as safe for your baby as planning to give birth in a labour ward or a birth centre.
But there are a variety of reasons why a home birth might not be recommended for you, such as if you’ve had a previous caesarean or suffer from any medical conditions that put you at higher risk of complications, so it’s a good idea to discuss any concerns you might have with your midwife.
Home birth for a first baby
If you’re having your first baby, a home birth is slightly less safe for your baby than giving birth in a labour ward, even if you’ve been told you’re at low risk of complications. In a labour ward, five in 1,000 births to first-time mothers result in serious complications for the baby (and the number is similar for a birth centre), but at home that figure is nine in 1,000.
Because of the slightly increased risk of serious problems for the baby, your midwife is likely to recommend that you give birth in a birth centre if there is one nearby, or perhaps a labour ward. It’s worth knowing that if you’re at low risk of complications, having a home birth means that you’re less likely to have a caesarean section and other medical interventions compared with giving birth on a labour ward, regardless of whether you’ve had a baby before or not.
Many community midwives are supportive of women having their first baby at home, so consider what will be best for you.
If you’re considering planning a home birth, remember to plan for the possibility of being moved to a hospital during labour if something does go wrong and consider how long that journey might take. Read our practical guide to planning a home birth to help you decide if it’s right for you.
Home birth for a second or subsequent baby
If you had a straightforward pregnancy and birth with your first baby (or babies) and haven’t been told you’re at increased risk of complications in this pregnancy, then home birth is as safe for the baby as if you give birth on the labour ward.
Since it carries no additional risks for the baby and also means that you’re less likely to need interventions (like an episiotomy or caesarean), a home birth could be a good option for you. If giving birth at home is something you’d like to consider, look up your local maternity unit or birth centre for details on how to book one in your area, or speak to your midwife.
Home birth after a caesarean section
If you have a vaginal birth after caesarean (VBAC), you have a slightly higher risk of complications than women who had their first baby vaginally. Specifically, there is a 0.5% risk of ‘uterine rupture’ which is where your previous caesarean scar tears open during labour. It’s a very serious condition for you and your baby and means you would need to have to have a caesarean immediately.
For this reason, you will be advised to give birth in a labour ward where your baby can be monitored and you can have quick access to surgery and blood transfusions if necessary. If you feel strongly that you want to plan to give birth at home, discuss your situation your midwife or doctor and read our advice on how to negotiate your care.
Home birth with risk factors
There are many different reasons why you may have been told that you’re at an increased risk of complications during labour and birth. Carrying twins or having been diagnosed with severe pre-eclampsia in a previous pregnancy are a couple of examples of factors that can make labour and birth more dangerous for you or your baby.
There are few studies into how safe home births are for women who have increased risk of complications, and your midwife will probably recommend that you plan to give birth in the labour ward as there will be medical staff and equipment at hand if you or the baby should need it.
However, because the conditions and circumstances can vary so much between different women, it’s worth discussing your options with your midwife, GP or obstetrician if you feel that a home birth might be right for you.
More from Which?
- Use our Birth Choice tool to find the best place for you to give birth – be that labour ward, birth centre or home birth.
- Find out what happens if something goes wrong during your home birth, and how likely you are to have to transfer to hospital.
- Read our advice on why choosing where to give birth matters.
These are the sources of information used in this article:
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)
Gupta JK, Smith GCS, Chodankar RR, Birth after previous caesarean birth. Green-top Guideline No. 45, Royal College of Obstetricians and Gynaecologists (2015)
National Collaborating Centre for Women’s and Children’s Health, Caesarean section. NICE Clinical Guideline 132, National Institute for Health and Clinical Excellence (2011)
National Collaborating Centre for Women’s and Children’s Health, Intrapartum care: care of healthy women and their babies during childbirth. NICE Clinical Guideline 190,London: National Institute for Health and Clinical Excellence (2014)