What are the options?
The type of birth you have and the care you receive will be shaped by the choices you make about where to give birth. This can affect many things, from the facilities available to how likely you are to be cared for by a known midwife. Options usually include:
- Labour ward in the maternity unit of a hospital, with medical facilities and doctors on hand if you need them.
- Birth centre which may be at an 'alongside' midwifery-led unit (on the same site as a hospital) or 'freestanding' birth centre (in a separate location). This is usually a more homely environment led by midwives, where the focus is on birth without medical intervention.
- Home birth where two midwives come to your home to support you during labour and as you give birth.
Use our Where to give birth tool and answer a few simple questions to find out which birth setting best suits your personal preferences.
Coronavirus update: To find out how this affects you, read our advice on Coronavirus and birthing options.
What is a labour ward like?
Located within a hospital, the labour ward has medical facilities and doctors on hand if you need them. It's sometimes called a delivery suite or an obstetric unit.
You'll have your own room during labour with medical equipment such as CTG (cardiotocography, to monitor your contractions and your baby's heart) and a bed that can often be adjusted for height so you can give birth in different positions.
Many labour rooms have birthing equipment such as birth balls, pools or mats, while other hospitals offer 'home-from-home' rooms for women at low risk of complications.
Pros of a labour ward
- Wide range of pain relief options available This includes epidurals and gas and air (entonox) - and without the need to be transferred to a different setting.`
- No need to travel during labour If there are complications you are already there.
- Ideal for those with a medical condition that may complicate the birth For example, pre-eclampsia or a breech baby.
- Doctors and medical equipment are nearby This may give you added reassurance if you are anxious about the birth.
Cons of a labour ward
- Birth pools aren't always available Most labour wards don't have one in every room so you may not be able to use one.
- Medical interventions are more likely For example, you are more likely to have a Caesarean if you're on a labour ward.
- You may have to stay on the postnatal ward These can be busy and less private than a birth centre, plus your partner may be asked to leave the hospital overnight.
What is a birth centre like?
Birth centres - which are also called midwife-led units - have an environment that is more homely than a labour ward setting, and the focus is on birth without medical intervention.
There are two types of birth centre: an 'alongside' or 'co-located' birth centre at a hospital which also has a labour ward, and a 'freestanding' birth centre, which is in a separate location to the main hospital, often in a small community hospital or in a purpose-built building. In Scotland they are called community maternity units.
Birth pools are often provided so you can use water to help cope with pain in labour, as are beanbags, pillows and mats.
Pros of a birth centre
- You're more likely to use a birth pool than in a labour ward.
- Natural pain relief might be offered The midwives in birth centres often have more experience of natural pain relief methods such as hypnobirthing and aromatherapy to support you through the birth.
- Birth centre births are slightly safer for your baby than having a home birth, if this is your first baby, according to statistics.
- Partners may be accommodated overnight Many birth centres have double beds and allow your partner to stay overnight after your baby is born.
Cons of a birth centre
- They aren't set up for complicated births Complications or the need for an epidural will mean transferring to a hospital ward.
- A birth pool isn't guaranteed Some birth centres don't have birth pools in every room so you may not be guaranteed one.
- You may not meet the birth centre admission criteria For example, if you baby is breech or you are expecting multiples.
- There might not be a birth centre near you.
What is a home birth like?
Having a home birth can be a good option if you want to give birth naturally in familiar settings.
A midwife will come to your home to support you in the early stages of labour and by the time you're in the later stages of labour and for the birth of your baby there will be two midwives with you.
They will bring gas and air with them as pain relief for when you go into labour, plus you can hire or buy a TENS machine or, if you want to use water in labour or have a water birth, a birth pool to set up at home.
You also have the option of paying for a private midwife (such as an independent midwife) to attend your home birth.
To arrange a home birth, contact the midwives at your local NHS maternity unit or midwives working in health centres near where you live.
You can change your mind about where you have your baby, even if you're quite far into your pregnancy, so if you're already booked into a birth centre or labour ward and feel you'd rather give birth at home, speak to your midwife.
Pros of a home birth
- Giving birth in a familiar and private environment may help you to feel relaxed and more able to cope with the pain of labour.
- Your midwife or midwives will only be looking after you and won't have responsibility for anyone else at that moment except you.
- Option to have more birthing partners with you You might also want other family members to be part of the birth experience, including older children.
- Being able to use a birth pool for pain relief or water birth Although these may be possible in a birth centre or even in a labour ward, there's no guarantee they'll be available when you need them.
- As safe as a hospital birth for some women Statistically, if you're having an uncomplicated pregnancy with a second or subsequent baby, a home birth is as safe for your baby as a hospital birth.
Cons of a home birth
- Pain relief options are limited and if you need more than a birth pool, gas and air or a TENS machine, these won't be available to you in a home setting.
- A home birth isn't the safest option for first-time births according to statistics, compared to a labour ward or birth centre. Nearly half of all first-time mothers planning a home birth are transferred, compared to around one in 10 women who have had a baby before. However, many community midwives are still supportive of women having their first baby at home.
- Not all areas have home birth teams and means that arranging one may be trickier than planning a hospital birth.
- Home births require preparation such as getting refreshments ready for you, your partner and the midwives, protecting floors and furniture with sheets and towels, setting up your own birth pool and considering whether upstairs floors are strong enough for it, and possibly letting neighbours know about your home birth in advance.
Get prepared with our home birth checklist.
Who will care for me?
- Labour ward: You’ll be looked after by midwives, and doctors (including obstetricians and anaesthetists) if you need them. You're unlikely to know your midwives, although some maternity units offer the opportunity to get to know your midwives either through 'team midwifery', or 'caseloading', where a single midwife (or a pair of midwives) has full responsibility through your pregnancy, birth and postnatally.
- Birth centre: Midwives will care for you. In areas where you can choose the birth centre early on in your pregnancy, you're more likely to be looked after by a small midwifery team who you'll get to know before you go into labour. However, in other hospitals you can only book the birth centre later on in the pregnancy and up until then you'll receive the same antenatal care as women booked to give birth on the labour ward.
- Home birth: Midwives will care for you. Once you've booked to have a home birth with the NHS, you're likely to have your antenatal appointments with a small team of community midwives throughout your pregnancy. In early labour, you'll have one midwife with you and this will increase to two once you're in the later stages of labour and for the birth.
Find out more about your antenatal care.
What pain relief is available?
- Labour ward: All medical pain relief options, including epidurals, are available as well as gas and air. Talk to your midwife about using self-help methods including hypnobirthing or massage.
- Birth centre: You can use gas and air as well as natural pain-relief methods such as hypnobirthing and aromatherapy. Opioid drugs such as pethidine are sometimes available.
- Home birth: Your midwife will bring gas and air and you can buy or hire a Tens machine or birth pool. If you decide you want stronger pain relief, such as an epidural, you’ll need to transfer to a labour ward.
Find out more about your pain relief options.
Can I have a water birth?
- Labour ward: Birth pools might be available – ask your midwife about your hospital’s facilities.
- Birth centre: Birth pools are usually available – ask your midwife how many rooms have a birth pool so that you can manage your expectations.
- Home birth: You can hire or buy a birth pool to use at home. Check if your upstairs floor is strong enough for a birth pool once it's filled with water.
If you're really keen on having a water birth, you may want to take into account the fact that women who give birth in a freestanding birth centre or at home are more likely to have a water birth than women who plan to deliver in a labour ward.
Find out more about planning a water birth or using a birth pool in labour.
What if I need medical help?
- Labour ward: Doctors and neonatal specialists are available, and you can have a Caesarean if you need one. In certain situations, such as if you have pre-eclampsia, a breech baby or you're expecting twins or multiples, you may be advised to give birth on a labour ward.
- Birth centre: From a freestanding birth centre you’ll be taken to hospital in an ambulance. If you're in an alongside birth centre, you'll be moved within the hospital. Statistically, you're less likely to end up having medical interventions such as an unplanned Caesarean if you give birth in a birth centre.
- Home birth: If your midwife is concerned for the health of you or your baby, you'll be taken to the nearest hospital in an ambulance and your midwife will come with you. As is the case for deliveries in a birth centre, you are less likely to have medical interventions such as an assisted birth or an induction if you have a home birth.
Find out more about safety and interventions during labour.
How safe is it for babies of healthy, low-risk women?
- Labour ward: As safe as planning to give birth in a birth centre.
- Birth centre: As safe as planning to give birth in a labour ward.
- Home birth: As safe as planning to give birth in a labour ward or a birth centre for those who have given birth before. For first-time mums, there’s a small increase in risk of complications to the baby.
If you're unsure about what your options are, speak to your midwife.
Find out more about private maternity care.
What happens after the birth?
- Labour ward: You'll stay in the delivery room or a separate recovery room for a couple of hours after a vaginal birth or Caesarean, to make sure you and your baby are both doing well and feeding gets off to a good start. You'll be discharged within a few hours after a straightforward birth or transferred to a postnatal ward if you've had a more complicated birth, for example a Caesarean or assisted delivery.
- Birth centre: You can usually stay with your new baby and birth partner in the same room where you delivered for the first few hours after birth to rest, have check-ups and make sure your baby has had their first feed. You'll be discharged within a few hours after a straightforward birth or taken to a postnatal ward if you or your baby need hospital care.
- Home birth: Your midwives will stay with you for a couple of hours after a straightforward birth to make sure you and your new baby have everything you need and feeding gets off to a good start, as well as helping to clean up any mess. If you or your baby need hospital care, you'll both be taken to a postnatal ward by ambulance.
Find out more about your postnatal care.