Homebirth with UCLH : University College London Hospitals NHS Foundation Trust

UCLH offers homebirth to any service user that lives within our catchment area. It is important to confirm with the midwifery team that you live within the UCLH catchment area early in your pregnancy, so that you have plenty of time to transfer to your local hospital who can facilitate a homebirth.

You can discuss place of birth, including homebirth at any of your midwife appointments. At your 36-week midwife appointment, your midwife will go through your birth preferences and arrange the homebirth assessment if you have opted to birth at home. If you have any additional risk factors in your pregnancy, homebirth may not be recommended to you. However, we will do our best to support you and your midwife will refer you for a discussion with a senior midwife to discuss your birth options and create an individualised care plan with you.

Evidence suggests that women/birthing people who plan a homebirth are less likely to experience caesarean section, assisted birth (forceps or ventouse), induction of labour with artificial hormones, epidural analgesia, episiotomy, perineal tears involving the anal sphincter and infection.

More comfortable, relaxing and private than the hospital setting
Boosts labour hormones (oxytocin and endorphins)
No need to interrupt your labour to travel to hospital
After birth you can enjoy time with your family in your own home, in your own bed.

“My birth at home supported by UCLH couldn’t have been better. It was my first baby and I really believe being in my home environment enabled me to labour in a way that left me feeling in control but still safe with the midwives around me. I wish everybody could have the birth I experienced.”

“The most beautiful thing about it was that our 2 year old at the time had slept through the whole thing and woke up to just us and her new baby sister. Couldn't think of a better way to introduce a sibling, in their own surroundings, no hospital or strangers coming in and out, It was perfect. Hence why on our third pregnancy we had absolutely no doubt that homebirth was the only option for us!”

All planned homebirths are attended by two experienced midwives. The midwives will bring the necessary equipment to monitor you and your baby’s well-being. At a homebirth we offer the same level of monitoring during labour as the birth centre. This includes regular observations such as blood pressure, pulse and temperature. We also offer intermittent auscultation, with a hand-held doppler which is recognised as a safe method of monitoring for people with no risk factors. The midwives will also bring resuscitation equipment and emergency drugs. Our team work closely with the London Ambulance Service.

The Birthplace national cohort study was designed to answer questions about the risks and benefits of giving birth in different settings, focusing in particular on birth outcomes in healthy women with straightforward pregnancies who are at 'low risk' of complications. The key findings include that for women/birthing people having a second or subsequent baby without complication, homebirth is a safe option for place of birth. There was no significant difference in adverse outcomes in comparison to birthing in the hospital. Birthing in a midwifery setting significantly reduced the chance of having an unplanned caesarean section, assisted birth (using forceps or ventouse) and episiotomy.

If it is your first baby, you have a higher chance of transferring to hospital during labour or immediately after birth (around 45% compared to 10% for second/subsequent pregnancies). There is also an increased risk of adverse outcomes of baby for first births. This risk is 9.3 per 1000 births for a planned homebirth compared to 5.3 per 1000 births for births planned in a hospital.

In an emergency, the ambulance crew should arrive within 8 minutes. In some situations, you and your baby may need to be transferred in separate
ambulances for safety.

Reasons we would recommend transfer to hospital:

Reduced fetal movements in labour
Fetal heart rate concerns
Abnormal maternal observations, such as raised pulse or temperature
Green/brown leaking fluid (meconium stained liquor)
If your labour is lasting a long time and the midwives suspect a delay
If your waters have been broken for over 24 hours and your labour is not yet established
If you would like further pain relief
Abnormal postnatal bleeding (postpartum haemorrhage)
More complicated perineal suturing
If your baby required any resuscitation post birth
A recommendation for closer observations in the postnatal period for you or your baby
Enhanced breastfeeding support
If you no longer wish to continue your labour at home and would prefer to be in hospital.

Techniques to manage your labour:

Breathing exercises/hypnobirthing
Music
Massage by birth partners
Aromatherapy
Mobilization
Rebozo
Hydrotherapy (rented pool/or shower/bath
TENS machine
Comb Technique
Paracetamol
Entonox (gas and air)

Free options for renting a birthing pool to use at home: camdenhomebirth@outlook.com

If you have other children, it is important to consider with your birthing partners if you would like them to be present at home during your labour.

If you would like your children present at home, we recommend having an additional adult to care for them whilst you are in labour and who can stay at home with your children if you need to be transferred to the hospital.

If you own pets, you need to think about how they will react to your labour and birth and how they will react to the midwives being present in your home. Please consider having them in a separate room. Also, it may be more appropriate to have a family member or friend care for them /be on standby to care for your pet if you are transferred to the hospital.

Please also note, some midwives may have allergies/phobias and may require your pet not to be present in the room.

After baby is born and you have birthed your placenta, the midwives will normally stay for 2 hours post birth. During this time, you may require some stitches, they will support you with skin-to-skin contact and feeding your baby. The midwives will arrange for a home visit the day after you give birth.

All babies are recommended to have a “Newborn Physical Examination” within 72 hours post birth. This is performed by a midwife who has done an additional training course. This may be able to be done at home or we may give you an appointment in the hospital. You can read about this examination on the NHS website. It is also recommended that your baby has a hearing screen, you will receive a letter in the post with an outpatient appointment for this.