Home Birth Vs Hospital?
A blog focusing on experiences and advice regarding home births and hospital births.
If you are currently pregnant when reading this, then, congratulations! I hope your pregnancy is going well and you are looking forward to your imminent arrival. If you have pondered for a slight second about a home birth then your state of mind will be … home birth?... hospital? …. home birth?..... OR… hospital?! over and over in your head. I too, have experienced this and I hope this blog helps somewhat in your decision making.
I gave birth to my first in a hospital and gave birth to my second son at home. So I have experienced both types of birth and I can share some of those experiences with you. It is important to remember that I unfortunately didn’t have the best experience at hospital but I know that lots of pregnant ladies do have a positive experience when giving birth in a hospital location. This blog also includes a client's point of view and a midwife's take on it too!
When I arrived at hospital, I was in a lot of pain and contractions were only two minutes apart. Once I had taken the car journey, (which was quite painful during the contractions as my body wasn't allowing me to sit down at the time), then got out the car, walked across the car park with my husband who was carrying our bags and a bag for baby, it felt like we were both worn out before it had really started. I hadn't considered the travel to the hospital, only that it was a short 15 minutes drive so I would definitely advise considering all the lumps and bumps in the road, how far the hospital is, how many bags you are planning on taking and the distance from the car park to the hospital too. Everything seemed slower and harder during labour so the simpler you can make the journey, the better. Also consider that if you have a lovely car that you wouldn't want to spoil, some waterproof protector bed mats come in useful incase your waters leak.
When I arrived, I was asked to take a seat in the waiting room, something I hadn't considered either. I had thought in my head as I was in this much in pain that I would be seen straight away. Luckily for me, as I was standing with my hands against the wall breathing through the contractions unable to move, I think the midwives could see I was in quite a lot of pain so they examined me. I am not sure if this was just luck or whether they make their choices based on who comes through the door. After being examined I was 8 cm dilated so I was taken to a room so I could have the baby.
I was then wheeled (backwards I might add!) in a wheelchair which felt like I was on a rollercoaster; bashing into doors, mean whilst having contractions. Luckily, I had attended a lot of hypnobirthing sessions whilst pregnant which equipped me with important breathing and relaxation techniques so that I didn’t start to panic. Apparently, babies heart rate kept increasing every time I had a contraction so I needed to be put on a monitor. I was asked to lie down on the bed and this is when all my hope and ease started to fly out the window. I had attended hypnobirthing sessions leading up to the birth because I wanted to know ways in which I could stay calm and relaxed, which in turn, helps your body relax and release oxytocin which helps to birth your baby. I especially learnt during my sessions that lying on your back is not such a great idea. Little fun fact for you here….and look this up just to know that I am right, in “ye olde times” … well, around the 1600’s; we used to always give birth standing up! Until King Louis XIV wanted to watch his baby being born so he insisted that his partner give birth lying down. (Information from my midwife’s insta page; (@midwife.morgan) follow her for more information and interesting facts! Flash forward to the 21st century and hey presto!.. you still have women who lie down, closing down the pelvis which can result in increasing the pain.
Through the contractions I got asked by the midwife if I felt any pressure to push... I didn't really know as everything felt like pressure but the midwife then instructed to me that at the next contraction to breathe and then chin to chest and push really hard. I thought to myself; “Ahhh no, I didn’t want to do this!” But I was being swept away by the professional telling me what to do AND during all of this, I was unaware until after the birth that my nicely typed up birth plan complete with plastic wallet, had not even been looked at! Which stated I wanted to be upright, allowing baby to birthed as naturally as possible without any forced chin-to-chest pushing. As I was conscious that baby seemed a bit stressed every time I had a contraction, I just followed advice because I was worried about baby. But, I was lying on my back, legs in stirrups, forced pushing.. no candles, no darkness in the room. So, all in all, so far, the birth was not as I wanted it. Looking back, I can accept that birth can go many ways and it is great to remain open minded to the possibility that the birth may not go the way you want or think it might go, but, it is always advisable for you to have options. During this time of being on my back, I wasn't offered any other alternative and I felt very still whilst the monitor was on me. It wasn't until after the birth that I found out that you are allowed to stand if you have a monitor attached to you, so this may be one of the questions you could ask your midwife prior to the birth.
I then pushed for two hours and the birth resulted in forcep delivery. I then had to deliver the placenta which didn’t want to part with me even after two injections. However, even after gently pulling on the cord, the placenta didn’t want to budge, then the midwife continued to pull increasingly hard on the cord ( which was attached to my body!) which was so painful that I had to have gas and air just to get through it. I wish at the time I had the voice to say stop. I found out later on that pulling so hard on the cord is extremely dangerous and painful and it should only be encouraged out, not pulled. Looking back now, if I were to give birth in hospital again, I would still have a birth plan and I would ask my birth partner/s to speak on my behalf so if there is anything I wanted, they could communicate this for me. You can also provide information relating to the 'after birth' which relates to the placenta on your birth plan but I would definitely recommend making sure that the partner knows what you want.
Once I had my baby I spent the rest of the night in hospital as I gave birth around 1am. There were often times I would be disturbed throughout the night, even though I had only just got the baby back to sleep, (and I had only had 10 minutes sleep myself) whereby a midwife would come flying through the door talking really loudly causing baby to wake up. I could understand that I may need to be interrupted through the night and was expecting that this would happen and I wouldn't expect any hospital staff to be whispering to each other through their night shifts but it would of been more respectful when entering the room to talk at a more appropriate level. It led me to feel quite anxious every time the door opened.
During the time in hospital, I often got knocks on the door and various people sticking their head in, but no one really introducing themselves which led me on a few occasions to ask the cleaner for more formula or a passing visitor if they had seen my midwife. It all seemed confusing. I honestly hadn't thought about the amount of people I would come into contact with whilst I was there and I have heard good things about other parents having good experiences with hospital staff but I didn't seem to form any sort of bond with any of the midwives, a lot of other parents remember names of midwives and such, which I didn't.
Just before I Informed the hospital that I wanted to go home ( as I was given no information about when I could leave) I realised that baby wasn't feeding on formula as well as I had hoped. So I tried feeding him again but he didn’t seem to take much. When a midwife knocked on to my door I asked why he might not be feeding very well. Without asking me, the midwife took the baby away from me and started feeding him herself. I hope not all midwives would do this, as they do tend to encourage parents to feed their baby themselves. Considering and hoping that this experience is not very likely to happen again, I would say that it would be worth considering how you are planning to feed baby and how you might receive support in hospital. Will it be supportive? Can you get that sort of support at home? Do you need to take your own formula in? What if you were to run out? All these questions can be put to your midwife. It definitely didn't make me feel confident and I would of preferred the midwife to support me in feeding my baby myself rather than taking him from me or at least, to ask permission first.
Once I had made the decision that I wanted to home, I hadn't thought to ask any one to check me over. A midwife (who had only just appeared) read my notes and gave me some advice and then told me I could be discharged. I was never checked over physically and I hadn't thought to ask once she said I should be well enough. I had also really struggled to walk whilst in hospital and I had only taken a few steps to the bathroom with support and that was all I could manage. At the time, I thought this was normal but afterwards I was sent to physio as my knees had badly weakened and with the episiotomy pain and pain from the umbilical cord being pulled I was in a lot of pain. I only really realised this the second time I gave birth, where my recovery, was much quicker. I would ask advice if you are staying in at hospital on mobility; Is it safe to just rest? Is it advisable to go for short walks? and don't feel you have to leave if you haven't got the answers that you need. Again, it wasn't until my midwife visited me at home that she was surprised to hear my stitches weren't checked before leaving hospital but she was able to do this for me at home.
Now fast forward two years and I had decided that I would have a home birth. A complete different and positive experience. Even though I was in just as much pain for the most part, I felt more empowered and comforted by being at home. There is something about being in your own home; a bit like when you are due back from a holiday and look forward to sleeping in your own bed, it naturally gives you comfort. It was helpful to know how to prepare for the birth such as having handy towels that I didn't mind "staining" and such things like a shower curtain ( great to catch the mess!) and I had them all in a handy pile so we knew where they were, should I need them. I know one of the things you are already thinking; " Is it messy?" To be honest, I was unaware of 'the mess' but both my birthing partners said that the midwives cleaned everywhere. Actually, come to think of it, once I had given birth and had a walk around the house, there was very little to tell I had even given birth at all. However, this is something that can be discussed with your midwife. You may want to think of things such as; which room would I use to labour in, do I want a water birth, would I mind if my carpet/sheets/favourite rug was stained?
This birth was very different, I felt in control and aware of everything that was happening around me. The midwife allowed me to labour with my birthing partners which consisted of my husband and Mum, often she would check me and baby and then retreat to a safe distance away where she can watch my progression from afar but overall, it was me and my birthing partners together getting me through the pain and it felt very supportive. The midwife only came over during certain times to complete the checks she needed to do, she was able to advise how the birth was progressing and keep checking if I needed anything but she also provided me and my family with personal space which felt more comforting.
I had music playing that my husband knew I would like and we had access ( by "we" I mean my birthing partners as I couldn't manage much to eat or drink) to tea, coffee and snacks ( It was a 9 hour birth) and any thing the birthing partners needed during that time. At hospital, a birthing partner can be a little limited to refreshments and has to take visits to the hospital shop or cafe. When I had my hospital birth my husband ended up eating off the snacks we had brought with us and had to pop out for any sort of substantial food. As a side note, it is also helpful that your birth partner can get sleep on the first night after having the baby as usually the birth partner has to have a night on a uncomfortable chair next to the bed. Giving birth at home means no uncomfy chair for the birth partner too!
If you are a household with not much privacy; overlooked by other houses or very thin walls, I would prep your neighbours to the fact that you are giving birth at home (if you know them well enough!). I am sure my next door neighbours heard me, but hey! she was polite in saying that she didn't! My birthing partners made sure that my curtains/blinds were closed and that I had privacy at all times.
I didn't opt for a inflatable water tub to be brought as I wasn't sure if I wanted it or not so I chose to use my bath instead. It was so much more relaxing as I could choose to go in and out of my own bath and spare bedroom on the bed. However, this time, I could lie on my side, knowing that it was better for me and baby and I didn't have to ask permission from anyone if I wanted to change position.
This labour was longer than my first, but it felt more supportive that I was able to do what I could myself without any rules or intervention at certain times which perhaps the hospital would have to follow. You also have access to gas and air and the midwife even arranged for more to be delivered for me. I know the most common question parents ask me is regarding how safe I felt as the hospital have all the drugs, all the necessary equipment etc. I didn't feel nervous at all, even at times when the midwife struggled to find the heartbeat as he was a wriggler, I stayed calm and awaited advice. There is always a chance that you would have to be bundled into an ambulance and taken to hospital to finish the birth however, I think this is rare and your midwife can always advise what would happen if you required urgent support.
Overall, I much preferred this birth. I felt in control of the situation and I felt safe and I think a lot of that thought process was provoked by the fact that I was very relaxed being in my own home, even though I was in pain at the time. One of the most enjoyable things about having a home birth, I felt, was at the end where baby had been born and I was able to have a bath and rest in my own bed and sleep when I needed to, without being interrupted by others (apart from the baby) and subsequently, I felt that my recovery was quicker. I was still able to receive the care I required and I was checked thoroughly by the midwives and provided with care after the birth. The baby was able to be checked over too including their weight and height etc. The only check we weren't able to complete at home was the hearing check but it just meant a quick visit to hospital a few weeks later when everything had settled down.
A client's review
I am a Mum but I am a photographer too so it was important to me to ask one of my clients about her home birth experience. She was able to share the below about her experience:
"I had a home birth with my second baby. I hadn’t felt quite confident enough to do it for my first. My midwife reminded me that I was in control of where I birthed my baby. This made me feel at ease knowing I could change my mind at any time.
I had the same midwife throughout pregnancy with both my boys. We created a strong bond and I felt confident that she had to be there during the birth of my second son.
Having my baby in my own surroundings made me feel comfortable and at ease.
My midwife helped me find the strength and courage to go for a home birth. I felt totally empowered and had major respect for myself after giving birth at home. It was the best experience of my life"
A midwife's review
Here is my actual midwife (Morgan)'s statement regarding home birth. Morgan was my midwife throughout my second pregnancy and she delivered my baby safely at home.
Birth is a time to feel secure and safe. When a woman births at home she is in her own nest
and is surrounded by colours, textures, lighting and sounds she loves. Her own bed, where
she finds solace in rest and sleep, is available for birthing. She is in the place she will soon
share with her baby. What better place is there to relax in the total way she needs to in
order to give way to the birth process? Plus, we are seeing these better outcomes through
evidence such as the Birth Place Study (2011). This study identified that for ‘low-risk’
multiparous (women that have birthed before) women, home was as safe as hospital, with
added benefits such as significantly and substantially reduced rates of intrapartum
caesarean birth, instrumental birth or episiotomy. However, it also identified that for
nulliparous (women that have not birthed before) women there was a slight increase in
adverse neonatal outcomes. However, this has not been found in a meta-analysis of 500,000
planned homebirths (Dahlen, 2019; Hutton, et al., 2019; Reitsma, et al., 2020).
So why do we only have 2.1% of births in England and Wales happening at home?
Sadly we rarely hear, see or read about the straightforward, physiological, ‘boring’ births
since birth moved away from a community supported event at home. Instead we see the
portrayals of labour and birth in books, films, newspapers, tv dramas and soap operas,
which are over dramatised. We even hear these stories from friends, family and strangers
causing fear and pain to be embedded into our deep unconscious minds. These feelings are
then increasingly likely to appear during labour and when we experience fear; our body’s
response is to release adrenaline and to tense our muscles in preparation for a ‘fight or
flight’ reaction. This primitive, mammalian response to fear is helping to protect us from the
unknown. However, the problem with this is that when our muscles tense when we are
trying to use them, we can cause pain. So, due to the uterus being made up of layers of
muscle and the labour process contracting and relaxing those muscles to open the cervix, if
you have physical tension in your body those muscles cannot work as well and cause you
feelings of pain. The pain then generates more fear and the body becomes increasingly
tense, causing even more pain. This is called the Fear, Tension, Pain cycle. Tools such as
hypnobirthing can break this cycle through knowledge, relaxation techniques and
empowerment. Hypnobirthing informs women and their partners about the processes of
birth and introduces them to those ‘boring’ births, to show they do exist and that they can
experience them too with the best birth support and knowledge. Once most of my clients
understand this, it’s then when it clicks that birthing at home would enable them to feel
relaxed and safe, keeping aware the adrenaline that would cause pain and prevent
progression in labour, increasing the need for interventions.
My passion for midwifery gets stronger with each birth I attend that a woman feels
empowered and involved in the decision making process, whether that be at home,
hospital or caesarean section. A quote that stays with me throughout my midwifery
" I do not care what kind of birth you have... a homebirth, scheduled caesarean, epidural hospital birth, or if you birth alone in the woods next to the baby deer. I care that you had options, that you were supported in your choices, and that you were respected." January Harshe
BA (Hons) Midwifery
MSc Advanced Midwifery Practice Student
Home Birth Midwife
Birthplace in England Collaborative Group: Brocklehurst P, Hardy P, Hollowell J et al. 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;23(343):d7400.
Dahlen, H., 2019. Is it Time to Ask Whether Facility Based Birth is Safe for Low Risk Women and Their
Babies?. The Lancet, Volume 14, pp. 9-10.
Hutton, E. et al., 2019. Perinatal or neonatal mortality among women who intend at the onset of
labour to give birth at home compared to women of low obstetrical risk who intend to give birth in
hospital: A systematic review and meta-analyses. The Lancet, Volume 14, pp. 59-70.
Reitsma, A. et al., 2020. Maternal outcomes and birth interventions among women who begin
labour intending to give birth at home compared to women of low obstetrical risk who intend to give
birth in hospital: A systematic review and meta-analyses. The Lancet, Volume 21, pp. 1-10.