sometimes different. By working together with
parents and health professionals we can try to
improve and achieve positive outcomes for
families.
Helpful tips for parents when thinking
about place of birth:
There Are No Guarantees
We are very fortunate in the UK that most
births have a positive outcome. Midwives and
obstetricians working in partnership with
parents help to create an understanding of
risks associated with childbirth so that parents
can be well informed of the choices open to
them. Sometimes, health professionals and
parents misunderstand the importance of this
information despite the encouragement for
parents to be actively engaged in planning
their care. It is a natural instinct to believe that
everything will go as planned, but the fact
remains that for some parents, the outcome
may not be in keeping with this expectation
and in a minority of circumstances, the
outcome can be heartbreaking.
The majority of pregnancies end happily, yet
the simple truth is that when it comes to
childbirth there are no absolute guarantees of
the likely outcome. Modern maternity care and
working in partnership with parents means that
we can minimise the risks associated with
childbirth. Many parents plan the way in which
they wish to be cared for during pregnancy,
labour and birth and however much they want
to believe that events will occur exactly as
planned, for some parents, the outcome is
It is important to discuss your options for place
of birth with your midwife at the time of the first
booking appointment and throughout the
pregnancy. This will ensure that you have all
the information you need and that your
decision has been well thought through.
You do not need to make a decision
immediately about where or how you wish to
give birth, as your final decision may be
dependent on other factors. You can decide at
any stage of your pregnancy where and how
you wish to have your baby.
If you are considering a home birth, discuss
the pros and cons with your partner/family,
midwife, your local NCT counselors and other
parent support groups in your area.
Read relevant information; for example the
MIDIRS Informed Choice leaflets which deals
with aspects of choice in pregnancy and
labour. You may also wish to read the RCM’s
Home Birth publications or visit the Campaign
for Normal Birth website.
Think about key questions that are relevant to
your own situation in terms of your health and
local circumstances before deciding on where
and how to give birth. For example, are you fit
and healthy and have a straightforward
pregnancy with no existing medical conditions?
Have you visited the local maternity unit or
Birthing Unit? You may be able to visit in
person or access a virtual tour which will give
you information on the local maternity services
and infrastructure e.g. the nearest unit might
be full and what to do in such cases. Some
units publish a variety of statistics, so just ask.
Consider what support is available during
labour from your partner, family, friends or
others.
Have you asked about maternity unit closures?
How often does this happen and what
arrangements would be in place for transfer if
your local unit was closed when you go into
labour?
Consider the distance to the local obstetric unit
if you are having a home birth or in a Birthing
Unit. Have you discussed with your midwife the
arrangements for a transfer to hospital if this
becomes necessary during labour or even
after birth? Try to get an unbiased perspective
on transfer, the implications and what it might
mean for you.
Some other key points to consider:
Do you wish to use a birthing pool? If at home
– have you got information on where to hire
birthing pools?
Do remember to discuss with your midwife
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when you can get into the pool and why she
may want you not to use the pool or leave the
pool at certain times during labour.
Do remember to discuss why you may not be
able to give birth in the pool and what this
means to you. You may have set your heart on
giving birth in the pool but circumstances may
dictate whether you are able to do this.
Try to get to know the midwives in the team. It
is not easy to determine who may be present
when you go into labour but try to
communicate your wishes and decisions to
your named midwife and in your birth plan.
Jake’s story
made our decision based on the information
we were given.
Would we have opted for the Birthing Unit if we
had received all the available information?
We were absolutely heartbroken that Jake was
stillborn. This is why we continue to work
tirelessly to ensure that changes will be made
in the way these matters are dealt with, so that
other parents can be made aware of the issues
they must consider when they make their
decisions about the place of birth.
Please go to www.jakescharity.org for Jake’s
story
References and useful links
MIDIRS (2008) MIDIRS Informed choice leaflets. MIDIRS,
London. MIDIRS publish a comprehensive list of 25
informed choice leaflets. The topics relate to pregnancy,
childbirth and the postnatal period and support best
practice in woman-centred care.
RCM (2003) Home Birth Handbook, Volume 1: Promoting
Home Birth. RCM: London
RCM (2003) Home Birth Handbook, Volume 2: Practising
Home Birth. RCM: London
http://www.rcm.org.uk
http://www.birthlinkuk.org
http://www.rcmnormalbirth.org.uk
http://www.jakescharity.org
Joss’s story
About the National Maternity Support Foundation
We had planned a natural water birth at a
standalone Birthing Unit but during the labour,
we required a transfer to an obstetric unit.
We did not really consider this scenario
because we were only a few minutes away
from hospital if a transfer was necessary.
We did not know that there were
circumstances when maternity units could be
closed to admissions.
We understand that no one can accurately
predict the workload on a given day – labour is
unpredictable and babies come at all hours of
the day.
We feel we did not have all the information
needed to make an informed decision, so we
I have always believed that I wanted to have
my babies in a non clinical environment if
possible, and that hospitals are there if we
need them. It is a personal choice, and of
course I can only speak for myself! Having now
had experience of care at home, in hospital
and in a birthing centre, I feel we have been
well supported in all our choices and
experiences.
We had half a home birth for our first baby,
followed by a transfer to hospital due to an
ante partum haemorrhage. However, we
managed to have a natural delivery and overall
a very positive birth experience.
Please go to www.rcmnormalbirth.org.uk for
Joss’s story
The NMSF is a registered charity set up by Jake's parents
Andrew & Rachel Canter following the tragic stillbirth
of Jake Canter. The NMSF's founding principles are to
take a 'proactive educative approach' to maternity care
occupying the 'sensible middle ground' of public opinion.
For more information on the NMSF please go to
www.jakescharity.org
About the Royal College of Midwives (RCM)
The RCM is the only professional organisation and trade
union run by midwives for midwives. It is the voice of
midwifery, providing excellence in professional leadership,
education, practice, influence and representation for and
on behalf of midwives.
This leaflet has been produced jointly by the National
Maternity Support Foundation and the Royal College
of Midwives
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