Where Is The Best Place To Give Birth? My Experience of UK Birth Choices

Republishing my first birth story yesterday made me think about the different birth choices I made with my 3 children. I have given birth in a labour ward, in a Midwife Led Unit and at home, but which is best? If you are lucky enough to be low risk how do you choose which setting is best for you to give birth to your baby?

Every mother has a story to tell about how they had their baby. Everyone’s experiences differ because of their preferences, beliefs and the situation, but working out the best birthing location for you can help shape the birth. Here is my advice based on my experiences on how to choose the best place to give birth.

A pink birthing room of a midwife led unit in Harlow Hospital
How do you choose between giving birth in hospital, a birth centre or at home?

Your Birth Choices: The Differences Between Giving Birth In Hospital, A Midwife Led Unit and A Home Birth

Giving Birth In A Hospital Labour Unit

With my first I didn’t realise I had much choice about where and how to give birth, despite what they said in the NCT classes. From the moment I turned up at the hospital to be assessed the path felt like it was set. Whether it was the hospital, individual midwives, the speed of my labour or because I was having my first baby I wasn’t really given a lot of choices. 

Giving birth in a hospital is great if you feel reassured by the medical support on hand. Where possible I would recommend that you have a birth partner who understands what is important for you so they can help advocate your wishes when you might be feeling vulnerable and not able to. From drug preferences to birthing position you might not get to follow along your birth plan, but if your partner knows the really important things for you they can ensure you aren’t just swept along with what is easiest for the midwives (yes unfortunately this does happen).

This sounds like I am being negative about hospital births and my thoughts on it are complicated because my experience wasn’t amazing, but lots of people have great hospital births. Giving birth in hospital means that although you are looked after by midwives you have doctors and specialists on hand very quickly if you need them, I think the downside of that is it feels like they are likely to use interventions faster instead of letting nature take it’s course. High risk pregnancies are nearly always asked to give birth in hospital so maybe the midwives are expecting complications with all their pregnant ladies making them less patient and less open to listening to your wishes.

Giving Birth In A Midwife Led Unit or Birth Centre

I gave birth to my second child in a midwife led unit attached to a hospital, although I would have happily have gone to a stand alone unit if there was one nearby. The benefit of it being on a hospital site means that if there are complications you can be moved to the main labour unit very quickly, which provides the best of both worlds and reassurance for anyone nervous about giving birth. Around 4 in 10 women having their first baby are transferred to hospital, compared to about 1 in 10 for subsequent births (reference), but whether the unit is attached to a hospital or not there are processes in place to enable you to be transferred very quickly if it becomes necessary so I wouldn’t worry about if that will cause any problems.

Between my first and second children my views on what sort of birth I wanted and how prepared I was to be pushed around changed considerably and that probably came across in my attitude, however I felt that the midwives were much more prepared to listen to what I wanted, to answer my questions and to give me choices. I don’t know if it was the different location or the different hospital trust, but I felt treated as an adult this time rather than a child.

The atmosphere in the midwife led units is much more relaxed than in a hospital, the rooms can be less clinical and you are often given more space to focus on your birth and to bond with your baby after birth. 

Giving Birth At Home

I wouldn’t have had the confidence to give birth at home with my first child, but it is an experience I strongly recommend. For women having their second or subsequent baby a planned home birth is as safe as having your baby in hospital or a midwife led unit, for first babies there is an increased risk. I have written before about why I wanted a home birth and thanks in part to a good amount of luck this was my best experience by far. I think it might have been my most painful birth (although I didn’t use pain relied) and it was possibly my most cringeful birth (you’ll have to read my home birth story to find out why), but it was still the one I felt most in control in.

I think there are 2 key reasons why I strongly recommend home births: you get to control the environment in a whole different way to anywhere else because it is your home, and also you get more attention from the midwives. Depending on the time of day a midwife might visit to check on you and then come back closer to the time you are expected to give birth or they might stay with you the whole time, calling in a second midwife when you are near to giving birth. In my previous births I barely saw the midwives while I was in labour so this was a big difference.  If this feels too intrusive for you, don’t worry, they are good at blending into the background if you want space.

Where Can You Have A Water Birth?

I would love to know the stats on the number of people who want a water birth versus the number that actually get them. I know so many people who didn’t have them because the timing was wrong, they were too busy or some other complication, however the great thing is that if you want a water birth they are available in most hospitals now as well as Midwife Led Units and at home (if you hire one) so this doesn’t need to be a deciding factor on how to give birth.

Getting Help if you are Scared Of Giving Birth

My biggest and most important piece of advice to anyone about to have a baby is: trust your body. There are a lot of trained professionals who are there to takeover if the situation starts to go wrong so the important thing for you is to try and listen to your body and let it take the lead. The more interventions and pain relief you take the harder it can be to listen to your body, I’m not saying don’t take drugs, I’m not saying refuse all interventions. Take what you need to. Do what is necessary. If you have a long birth or midwives advise there is a significant risk to you or the baby you will need to review the options, but most births don’t need interventions.

When you are scared you inhibit the progression of labour, but of course it’s not as easy as saying “stop being scared” whether it’s your first birth and you aren’t sure what to expect or you have had a bad experience with a previous birth when you are going into labour is hardly the time to try and tackle any fear.

I really recommend starting hypnobirthing early in pregnancy so you have time to practice, but take it with a pinch of salt. Hypnobirthing can have you believing you will feel no pain and that you have total control over everything that happens. I would argue that pain is manageable and that you can’t control everything that happens, but you can control your response to what happens.

If you have had a bad experience then I would recommend some form of counselling to help you process what happened previously and to spend time talking it through with midwives to feel confident about how this birth will be different.

If you are currently pregnant you might find it useful to read what I planned to pack (and not pack) in my hospital bag with my second pregnancy and the newborn baby essentials I think you really need.

A pregnant woman and Birth choices: hospital, birthing centre or home birth.
Birth Choices, pin for later

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