Which birthplace is safest depends on each mum and each pregnancy?
Homebirth and birth centres are safe:
- for healthy mums having healthy babies,
- for those who have regular checks from a midwife during labour and birth including baby’s heart rate, mum’s blood pressure
- when an obstetric unit can be reached quickly for births started at home where the checks suggest more support is needed.
On average one in seven women who have had a baby before will need to transfer to a hospital for more support if they are having a homebirth or are giving birth in a birth centre, which is in or alongside the hospital.
This compares to less than one in 10 women who will need to transfer from a freestanding birth centre to hospital for support.
When having a first baby, up to half of the women will need to transfer during labour or just after the birth if they start at home, and around one third who start in a birth centre. Freestanding birth centres have slightly fewer transfers than alongside birth centres for first-time mums (36% compared to 40%).
Healthy mums with healthy babies can safely be supported at both home and birth centres. More than 99% of babies will arrive safe and well. For mums who have had a baby before, both settings are equally safe. For first time mums, some will prefer to choose a birth centre (freestanding or alongside), where 99.5% of babies do well, rather than home where 99.1% of babies do well.
Obstetric units are the safest place for:
- Women with health conditions where labour could cause problems
- Babies who are more vulnerable when the normal process of labour may be less safe, such as premature babies, or when a health condition is found during a scan.
- Obstetric units are the only place for:
- Caesarean section
- Using an epidural in labour
Obstetric units are not advised for:
- Healthy women with healthy babies who wish to avoid interventions, where possible. The evidence shows that you are more likely to have an epidural, an episiotomy (cut to vaginal opening), an assisted delivery, or heavy bleeding if you birth in an obstetric unit.
Obstetric units are designed to help healthcare professionals provide close monitoring during labour and birth. This is essential for mothers and babies with conditions where there may be complications giving birth. Close monitoring can, however, interfere with the labour and birth process. This is why there is no ‘one size fits all’ approach to choosing your birth setting.