Where to Deliver Your Baby

There are many decisions to be made during your pregnancy. Some are exciting but largely insignificant, such as what colour to paint the nursery. Others are just as exciting but more important, such as choosing the name he or she will carry for the rest of their lives or deciding whether or not to find out the sex of the baby before the birth (although this may have some bearing on the nursery colour scheme!). One of the most important decisions, however, is choosing where to have your baby.

What are the choices?

There are a number of options for where to have your baby. These include a maternity unit in a hospital, a midwife led maternity unit or even at home. While it is important to choose whatever makes you comfortable, each option has its pros and cons and you will most likely want and need to involve your partner and consult with your doctor and/or midwife about what is best for you. Maternity units and hospitals usually run regular tours where you will be able to visit the ward, see a delivery room and familiarise yourself with what is going to happen and where. It is well worth taking this opportunity if and when it arises.

If many women go into labour at the same time, your choice of maternity unit may be full. Ask your midwife what is likely to happen in this scenario and if you can, get a tour of the alternative facility too. If you are well prepared and organised for the birth nothing should phase you or throw you off your plan!

Hospital

If you have a long standing medical condition or have had complications during your pregnancy then it is very likely that you will be advised to have your baby in a maternity ward at a hospital where they are better equipped to deal with any problems that may arise. If you are likely to need a Caesarean section and/or if your birth plan includes an epidural for pain relief you will of course need to be in hospital for your delivery. There are a number of specialists within a hospital that can be consulted in the event of problems. You are likely to receive treatment from both obstetricians (specialists in labours in which there are problems) and midwives (specialists in natural childbirth).

Home

If you have had a healthy pregnancy you may be categorised as having a 'low risk' labour. This means that you are unlikely to experience any complications during labour and should be able to expect a straight forward vaginal delivery. If you are in this category you may be considering a home birth. It is, however, vital that you discuss this with your midwife. A home birth has many advantages, for example, you will feel more comfortable and in control; you can have your family around you for support and will be able to settle in at home with your new baby immediately. Your choice of pain relief, however, will be limited - you will not be able to have an epidural for instance. If you do find yourself in difficulty or your midwife feels that you or the baby are at risk at any point you will be transferred to the nearest hospital. Statistics show, however, that you are more likely to have a natural delivery without intervention at home than you are in a hospital. You will also have a greater probability of continuity of care. This means that you are likely to see the same midwife or small team of midwives during your pregnancy. This can be quite important for a home birth as it is likely you will feel more comfortable and confident with someone who is familiar to you.

Midwife run maternity unit

Some communities have midwife run units where many babies are delivered safely and in a comfortable 'home from home' environment. These units are useful in rural areas where the nearest hospital is some distance away. Midwife run maternity units are also available in other areas where they are sometimes located near the hospital in case of complications. To give birth here you will need to be considered 'low risk'. That means you are unlikely to require intervention or emergency treatment during your labour. These units are great for women who do not want to be in a hospital environment but also do not feel comfortable or confident enough for a home birth. Unlike a hospital, these units are usually not equipped for Caesarean operations or epidurals and have a natural birth policy or a 'birth without interference' ethos. This makes them a good choice for women who want to experience natural childbirth in a safe environment. As with a home birth, continuity of care is a benefit as it is likely that you will be with a small team of midwives who will see you through pregnancy and labour.

What should I expect during labour?

Everyone has a different experience during labour. There is no getting away from the fact that labour is a painful experience, but knowing what to expect and having a birth plan will help. We usually associate pain with an accident or injury or when something in our body is infected or not working properly. In labour, however, you need to know that the pain is a sign that things are going right, not wrong. Be honest with yourself about your pain tolerance, there is no shame in needing pain relief; millions of women in labour opt for it every day, if you want it and/or need it, ask for it. Until we experience it firsthand none of us really know how we will react to the experience of labour and birth and if this is your first time, your best bet is to find out as much as you can and then ask as many questions as you need to.