Homebirth Advice Leaflet

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What is this information about?

This information is about what you need to know and prepare if you are planning to have your baby at home. It includes advice on:

• Who will attend your homebirth
• When and how to contact a midwife
• What you need to provide and prepare at home
• Pain relief options
• Monitoring during labour
• What to expect after birth
• When and why you might need to transfer to hospital.

Why have I been given this information?

You have received this information because you are considering or have planned to give birth at home. If your pregnancy has been healthy and low risk, homebirth can be a safe and positive experience. This leaflet aims to help you prepare and understand what to expect.

Who will attend my baby’s birth?

Normally, two midwives will attend your birth.

During the day, this is usually a midwife from the team.

At night, a midwife from the on-call team will attend. A student midwife may also be present, with your permission.

If your local team is unavailable, another midwife will be allocated to attend your birth.

How do I contact the midwife?

When should I phone?

Call the triage line:

• If your waters break
• When contractions are every 5 minutes or sooner if needed
• If you have any concerns at any time
• If labour starts during the day, call early to allow planning.

How can I help the midwife find my home?

• Use the what3words app to help locate your address
• Turn on outside lights if it’s dark
• Give parking instructions if access is difficult.

Who can be with me during the birth?

You can choose anyone to support you, a partner, relative, friend or doula.

Your children can also be present, but it’s helpful to have someone specifically to look after them, especially in case a transfer to hospital is needed.

What do I need to prepare at home?

For the birth environment:

• A good portable light or torch
• Handheld mirror
• Adequate heating in the room
• Clean water supply
• Plastic sheet/shower curtain for the bed or floor
• Old clean towels and sheets
• Incontinence pads or change mats
• Maternity sanitary pads
• Disposable or old underwear
• Overnight hospital bag for you and baby (in case of transfer)
• Refreshments for the midwives
• Reliable phone signal or landline.

For the baby:

• 2 soft towels
• Vest and babygrow
• Cardigan and hat
• Nappies and cotton wool
• Cot blankets and sheets.

What equipment will the midwives bring?

Your midwife will bring:

• Birth equipment
• Gas and air (Entonox)
• Resuscitation equipment
• Documentation.

What pain relief can I use at home?

• You may wish to hire an obstetric TENS machine (ask your midwife)
• You can also use a birthing pool (discuss emergency exit options with your midwife)
• Please wait for the midwife before getting into the pool.

How will the midwife monitor me during labour?

• Regular checks of your temperature, pulse, and blood pressure
• Monitoring of your baby’s heartbeat with a Sonicaid
  • Every 15 minutes in early labour
  • Every 5 minutes in second stage (pushing phase)
• Support with bladder care and comfort.

What if I need to transfer to hospital?

If a transfer is needed, this will be discussed with you. It will usually be by ambulance, and your midwife will come with you. Your partner will follow in a car. Reasons for transfer include:

• Concerns about the baby’s heartbeat
• Heavy bleeding
• Labour not progressing
• Raised blood pressure
• Significant meconium in the waters
• Complex tears that cannot be stitched at home
• Placenta not delivered
• Request for stronger pain relief
• Baby needs additional care after birth.

If you decline a recommended transfer, the midwife will notify the senior midwifery team and continue your care at home while ensuring safety as best as possible.

What happens after the birth?

Your midwives will stay with you for at least an hour after birth. They will:

• Check both you and your baby
• Support feeding
• Give Vitamin K (if you consent)
• Leave you with emergency contact numbers.

Your midwife will plan your postnatal care and arrange a follow-up visit.

What about the newborn checks?

A newborn check will be arranged within 24 hours of birth. If a home visit is not possible, you may be asked to attend the postnatal ward.

What if I need Anti-D?

If you are rhesus negative and require Anti-D, you will need to attend hospital for the injection, as it cannot be given at home.

What are the risks and benefits of a homebirth?

Benefits:

• Less likely to need a Caesarean or instrumental delivery
• Lower chance of heavy bleeding
• Babies are less likely to have birth injuries or need resuscitation.

Risks:

• If transfer is needed, there may be delays
• Around 1 in 3 first-time mothers transfer to hospital
• For second or later births, about 1 in 8 transfer

If induction is required, your care will be transferred to hospital.

Where can I find further information or advice if I need it after I have read this information?