Compare maternity options: labour ward, birth centre or home birth
What are the options?
- : In the maternity unit of a hospital, with medical facilities and doctors on hand if you need them.
- : A more homely environment led by midwives, where the focus is on birth without medical intervention. There are alongside midwifery-led units (on the same site as a hospital) or freestanding birth centres (in a separate location).
- : Two midwives come to your home to support you during labour and as you give birth.
Who will care for me?
- Labour ward: You’ll be looked after by midwives, and doctors will be there if you need them.
- Birth centre: Midwives will care for you.
- Home birth: Midwives will care for you.
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. Opioid drugs such as pethidine are sometimes available.
- Home birth: Your midwife can bring gas and air and you can buy or hire a Tens machine. If you decide you want stronger pain relief, you’ll need to transfer to a labour ward.
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.
- Home birth: You can hire or buy a birth pool to use at home.
What if I need medical help?
- Labour ward: Doctors and neonatal specialists are available, and you can have a caesarean if you need one.
- 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.
- Home birth: You'll be taken to hospital in an ambulance and your midwife will come with you.
How safe is it for babies of healthy, low risk women?
- Labour ward: As safe as planning birth in a birth centre.
- Birth centre: As safe as planning birth in a labour ward.
- Home birth: As safe as planning 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 to the baby.
What happens after the birth?
- Labour ward: You'll be discharged within a few hours after a straightforward birth. If you or your baby need more care, you'll both be moved to the hospital's postnatal ward.
- Birth centre: You'll be discharged within a few hours after a straightforward birth. If you or your baby need hospital care, you'll both be taken to a postnatal ward.
- Home birth: Your midwives will stay with you for a couple of hours after a straightforward birth. If you or your baby need hospital care, you'll both be taken to a postnatal ward.
Coronavirus and birthing options
Coronavirus may impact where and how you give birth.
Although you may have been hoping for a delivery at home or in a midwife-led centre, pregnant women with suspected or confirmed coronavirus are being advised to give birth in a hospital obstetric unit so that both mum and baby can be continually monitored.
This kind of monitoring can only take place in an obstetric unit where both doctors and midwives are present.
It is also reported that women with symptomatic COVID-19 have an increased risk of caesarean birth, making it even more important that they give birth in an obstetric unit where prompt access to emergency care is available.
If you have suspected or confirmed coronavirus infection, a birthing pool delivery in hospital isn't recommended as the virus can sometimes be found in faeces.
Not only that but it may also be difficult for healthcare staff to use adequate protection equipment during a water birth. If you are well it may be possible to have a water birth but you should check with your team.
If you have chosen a home birth or one in a midwife-led unit that isn’t co-located with an obstetric unit, it’s important to understand that these services rely on the availability of ambulance services for rapid transfer to hospital if needed and the right number of staff to keep you safe.
If these aren’t in place, it’s possible your local health trust or board might not be able to provide these services.
A Royal College of Obstetricians and Gynaecologists (RCOG) spokesperson said: 'Women’s birth plans should be followed as closely as possible. Please check with your local maternity as to the birthing options available.'
If you go into labour, call your maternity team for advice and let them know if you have suspected or confirmed coronavirus.
If you have mild symptoms you'll be encouraged to remain self-isolating at home and when the time has come to go to hospital you're advised to get there by private transport where possible.
When you arrive you should notify them of your attendance before entering the hospital and you'll be met by staff who will take you to a suitable room.
You will also be tested for coronavirus. This currently involves swabs being taken from your mouth and nose and you may also be asked to cough up sputum (a mixture of saliva and mucus).
Coronavirus and partner support
New guidance from the NHS says pregnant women in England should have access to support.
This means having one person with them throughout their pregnancy, during labour, birth and their immediate postnatal period, as long as their support partner is not showing any symptoms of coronavirus.
The support partner does not necessarily need to be co-parent or baby's father and the chosen person can accompany the mum-to-be to any scans or appointments.