Options of where to birth

We offer support for home births if you live in the area our maternity services cover. 

Please speak to your community midwife to check if you live in the area we cover.

Homebirth might be a good choice for you if:

• You're experiencing an uncomplicated pregnancy
• Have no known medical conditions that may complicate your birth
• You're carrying only one baby
• Your baby is head down (cephalic presentation)
• You go into labour naturally between 37 weeks and 42 weeks (spontaneous onset of labour)
• You are having your 1st to 6th baby without previous complication
• You have a body mass index (BMI) between 18.5 and 40 at your booking appointment with good mobility

If during your pregnancy additional risks have been identified and you are at higher risk of complications developing during your birth you will be advised to give birth in hospital where specialised care is available.

However, if you still wish to birth at home that is your choice, please let us know so a plan of care can be made with you.

You will have an opportunity to discuss this with a senior obstetrician or consultant midwife to ensure you have all the information required to make an informed decision about your birth.

Benefits of a homebirth

The birth place study showed that, for those with a low risk pregnancy having their second or subsequent baby, a home birth is as safe as birthing in an obstetric unit and can offer additional benefits.

Read more details about this at: The Birthplace cohort study: key findings

• You're more likely to feel relaxed in your home, which can help the progress of your labour
• Some research has found those giving birth at home tend to use less pain relief. This suggests birth at home can be more manageable
• You can choose who is there during the birth and afterwards. You will not be separated from your family
• You do not have to worry about when to go to hospital or how to get there
• Research shows those who choose to have a home birth are less likely to need an epidural or instrumental birth

Risks of a homebirth

• You may need to be transferred to hospital. For your first baby you have a nearly 1 in 2 chance (45%) of being transferred to a hospital, for second or subsequent babies this is around 12% or just over 1 in 10 people.
  Common reasons for transfer to hospital are for stronger pain relief or slow progress in labour. 
  
  
• In the rare situation of an emergency, you may need to be transferred to hospital. The time taken to transfer to a hospital can lead to a delay in accessing specialist medical care.
  All our community midwives do carry emergency equipment to homebirths and are trained in maternity emergencies.
  
  
• For a first baby there is a small increase in risk of the baby being born seriously ill at home, this is 9 out of 1,000 babies, compared to 5 out of 1,000 in a birth centre or delivery suite.
  For second or subsequent babies there is no difference in risks to the baby between home or hospital.
  
  
• If you have any complications, you may be advised to have your baby in hospital. This means you and your baby can be monitored more closely and have instant medical help if there is an emergency.
  We might recommend that you give birth in a hospital if your pregnancy is high risk, for example twins or your baby is bottom down (breech) or if you have complications such as high blood pressure or a low lying placenta.

Alternatives to a homebirth

We have two alternative places of birth.

• Meadow Birth Centre - see the tab below.
  
  
• Delivery Suite - see the tab below.

If you plan to give birth at home you can still change your mind at any point during your pregnancy including during your labour, you can transfer to hospital at any point.

Pain relief options at home

During a home birth, you can have: 

• TENS, a method of pain relief involving electrical nerve stimulation. You can hire or buy a TENS machine for personal use.
• Hydrotherapy(water birth), this can relax you and make your contractions seem less painful. Pools can be bought, hired or sometimes lent from the trust or local charities- speak to your community midwife. 
• Paracetamol.
• Gas and air (entonox).

If you would like stronger pain relief for example an epidural you will need to transfer into hospital.

For further information about pain relief please visit our 'Pain relief options for labour and birth' webpage.

How to arrange a home birth?

The decision of where you want to give birth can be made at any stage of your pregnancy, however if you are considering a home birth it is useful to let your midwife know as soon as possible.

This is to ensure we have enough time to plan your birth, discuss in detail suitability, benefits and considerations you need to be aware of along with the practical aspects of giving birth at home.

What preparations or changes do I need to make to my home?

If you decide to plan a homebirth, your midwife will visit you at home at about 36 weeks of pregnancy to talk through your plans for your birth and give you all the information you need ahead of your birth.

You don’t need to make changes to your home it may be useful to get a few things ready:

• A waterproof groundsheet or cheap shower curtain to cover your carpet or bed 
• A selection of old towels
• Old t-shirts, knickers and maternity sanitary towels
• A selection of baby clothes, including a hat and some nappies 
• A crib or Moses basket, ready for your baby
• A packed hospital bag for you and baby in case you need to be transferred into hospital
• If you would like to use a birthing pool you will need to arrange this yourself

Make sure you have whatever you need to help you feel comfortable in labour and to keep your energy levels up. For example,  

• Some sports drinks 
• High-energy snacks, e.g. cereal bars

Who will be with me in labour?

Once you are in established labour a midwife will be with you at home, providing support and monitoring you and baby.

There may be a student working alongside them, please let your midwife know when birth planning if you would prefer not to have student present.

When the birth of your baby is near, your midwife will call a second midwife. This is usually in the 2nd stage of labour when you are starting to push. This means two qualified staff members will be present during the birth.

There may be some staff changes if your labour goes between the day and the night.

When I go into labour, who should I contact and when?

When labour starts, contact Maternity Triage on 01905 733060. The triage staff will ask some questions about what’s been happening so far.

If your labour seems to be progressing and you need care from a midwife, triage will contact a community midwife to come and see you at home. Between 8.30 am and 5pm this will probably be a midwife from your local team.

Outside these times there is an on-call system and the community midwife on call will come to your home. This midwife may be from a different community team but triage will arrange this.  

If you are under the care of a continuity team, you will have the number of your team to contact if you go into labour. However, if no one answers the phone or you have any concerns about yourself and baby call triage on 01905 733060. 

Do not send a message or leave a voicemail for your continuity midwife as they might not pick up the message for some time.

What happens after I've had the baby?

Your midwife will remain with you for around two hours after the birth of your baby. During this time the midwife will repair any perineal tears (if required), check that you are well, and that you have been able to have a wash/shower and emptied your bladder.

After skin-to-skin contact and a feed, your baby will be checked and weighed by the midwife, and Vitamin K given if you have given consent for this.

If you or your baby need any additional observations post birth, or a perineal tear is complex you may need to be transferred to Delivery Suite at Worcestershire Royal Hospital.

Where possible you and your baby will travel together, and your birth partner will follow separately.

Before leaving, your midwife will provide you with contact phone numbers in case of emergencies and for help and advice. They will tell your own community team that you have given birth and arrange for your normal community team to visit you.

Your baby will have their oxygen levels check prior to the midwife leaving you after the birth.

Your baby will also have a neonatal examination by a specially trained midwife, within 72 hours of the birth. This may be performed at your home, local children’s centre or on the postnatal ward at the hospital.

Read more about neonatal physical examinations on this page.

Your baby’s newborn hearing test will be arranged as an outpatient appointment at hospital.

Our Meadow Birth Centre is a midwife-led birth centre located at Worcestershire Royal Hospital.

The Meadow Birth Centre is run by experienced midwives. It offers a comfortable environment where birth is treated as a ‘normal’ process (without intervention), rather than a medical one. 

The four-room centre (each with an en-suite) is near to the delivery suite, but not a part of it.

It looks and feels homely – not like a hospital – helping you to feel comfortable and relaxed.

Video tour of the Meadow Birth Centre

Find a video below of a guided tour through the Meadow Birth Centre, taking in each of the birthing rooms as well as the family room and other facilities the centre has.

What is a birth centre?

A birth centre is a midwife-led unit with a home from home atmosphere and is designed to support those aiming for physiological labour and birth.

Why choose a birth centre?

According to the 2011 birth place cohort study, women who receive midwifery-led care in labour are:

• Less likely to have a medical intervention such as caesarean section, ventouse or forceps birth.
• Less likely to have an episiotomy.
• Less likely to need pain-relieving drugs in labour.
• More likely to have a straightforward birth.
• No more likely to have complications with their baby.

Read more details about these findings at: www.npeu.ox.ac.uk/birthplace

Who will care for me in the birth centre?

During labour you will have one-to-one care from a skilled midwife.

As a teaching hospital, we educate and train the midwives, doctors and paramedics of the future. You may be asked if you are happy to have a student participate in your care. Students work alongside a midwife and under their supervision.

You may also see one of our maternity support workers. They will support the midwives and help to care for you and your baby after the birth.

Who can be with me in the birth centre?

Visitors are not restricted in the Meadow Birth Centre, but we ask that the midwife caring for you can easily access you to provide care. It is best to choose people who will support and encourage you during labour.

What choices for pain relief are there in the birth centre?

• Breathing and relaxation
• Birthing pools
• Aromatherapy and massage - midwives can provide massage with a carrier oil for relaxation, please bring an oil you would like to use
• TENs machines are available for use in the birth centre
• Entonox (Gas and Air) is available in all the rooms
• Pethidine injection

What happens after birth?

When you and our baby are well, you will be able to go home. Early discharge enables you and your family to get to know each other in the comfort of your own home.

You will be supported by your Continuity or Community Midwifery team who will make their first visit to you the day after you are discharged home.

If you or your baby require extra care and support following birth you may be transferred to the postnatal ward.

Why might I be transferred from the birth centre?

National data shows us that 40% of first-time mothers and 13% of women having a second or subsequent baby will transfer to the Delivery Suite.

Sources:

• Birthplace in England research study, 2011: https://www.npeu.ox.ac.uk/birthplace
• NICE guidance Intrapartum Care: https://www.nice.org.uk/guidance/ng235/chapter/Recommendations#planning-place-of-birth

What happens if the birth centre is full when I am coming in?

As families tend to go home after a short period of time in the Meadow Birth Centre, it is unlikely that we would be unable to accommodate someone in labour coming in and can move people to a different room if necessary.

In the very unlikely situation of having all birth rooms occupied, you would be offered the use of the pool room on the Delivery Suite.

My pregnancy has some complications, can I still use the birth centre?

Our primary aim is to ensure that you receive the appropriate level of care to keep you and your baby safe.

Certain factors such as having a raised Body Mass Index (BMI), raised blood pressure, diabetes or a previous Caesarean birth may increase the chance of complications in labour/birth.

Any complications in a previous pregnancy or birth will also need to be considered. You will have had an initial assessment at your booking appointment, which will be reviewed and discussed with you throughout your pregnancy.

It is important that you discuss your birth options and preferences with your midwife or consultant as you could still be able to use the Meadow Birth Centre following an assessment and careful individualised birth planning.

On the Delivery Suite at Worcestershire Royal Hospital care in labour and birth is provided by a multi-disciplinary team of midwives, doctors and support workers. You will be looked after by a midwife who will provide one-to-one care while you are in labour.

Obstetricians, anaesthetists and paediatricians are also available 24/7 on the Delivery Suite, and will be called by your midwife if they are needed.

We have 10 private birthing rooms, including one with a pool, they each have their own en-suite shower room and toilet. In addition to this we have two maternity theatres, a recovery area for after theatre and three side rooms.

In each room there is:

• A specialised bed which can be moved into various positions to help labour and birth
• Birthing aids such a birthing balls that you can use to stay active during your labour
• A comfy chair for your birthing partner

There is also some equipment that we might use to help care for you or your baby, including:

• A machine called a cardiotocograph (CTG) used to monitor your baby’s heartbeat while you are in labour
• An electronic blood pressure machine 
• A drip stand and pumps
• A resuscitaire - a large standing device used if your baby requires some additional support with their breathing when they are born:
  
  

  A photo of a Resuscitaire in place on the Delivery Suite.

Videos and photos of our Delivery Suite

A video of our Delivery Suite is available below along with some pictures of our delivery rooms:

Birth partners

One birthing partner is welcome to attend with you for assessment of labour in triage. If you are admitted to delivery suite, a second birthing partner can join you and stay for all your labour care on delivery suite.

During the induction of labour process, you are able to have one birthing partner present on the antenatal ward. Once you are in established labour and have been moved to your own delivery room two birthing partners may be present at this time.

Who you might meet on the Delivery Suite

Care in labour and birth is provided by a multi-disciplinary team of midwives, doctors and support workers. We will work in partnership with you to provide individualised plans of care.

Midwife		You will be cared for by a midwife during your labour and birth on delivery suite. One midwife will be allocated to one family in labour. A second midwife will be present at the birth of your baby.
Maternity Care Assistant		Maternity care assistants will be available on delivery suite supporting the midwives with your care.
Student Midwife		As Worcester is a teaching hospital often a student midwife will be working alongside your midwife to provide your care. Please let your midwife know if you would prefer not to have a student present.
Obstetrician		An obstetrician is present on the delivery suite 24 hours a day.  They work alongside the midwives to ensure the care is personalised to you and your labour. There is usually a ward round at 8/8.30am and 8/8.30pm where the obstetric consultant, registrar, anaesthetist and Midwife in charge on shift will visit all the labour rooms and introduce themselves to you and your birth partner and review your medical history. If you or your midwives have any concerns during your labour and birth an obstetrician can come and see you at any point.
Anaesthetist		An anaesthetist is present on the delivery suite 24 hours a day. You will meet the anaesthetist if you would like an epidural for pain relief. They also may be involved in your care in the unlikely event that you become very unwell during your pregnancy or birth
Theatre team		We have a dedicated theatre team within maternity 24 hours a day. They will be present in theatre for planned or emergency caesarean sections. The team includes Scrub Nurse – This is the nurse who passes equipment to the obstetrician during your baby’s birth. HCA (Health Care Assistant)/ Runner- This person helps set up the theatre space, helps the scrub nurse to get everything ready and  bring anything extra that the team may need while you are in theatre ODP (Operating Department Practitioner)/Anaesthetic Nurse – They assist the Anaesthetist All the staff in theatre will say hello to you as you come into theatre and introduce themselves by role and name.
Hearing Screener		Hearing Screeners offer the newborn hearing test for your baby before you're discharged. Sometimes you may have the option to go home from delivery suite if your labour and birth has been uncomplicated. Hearing screeners can come to delivery suite to perform the hearing screening before you go. If they are not available an outpatient appointment will be made for you near to where you live.
Cleaner		Cleaners will be present on delivery suite to ensure the area is clean. They won’t enter your birthing room while you are in labour.
Ward Clerk		The Ward clerk is located at the front desk at the entrance of delivery suite. They will be able to let your birth partners in and out of delivery suite.

If you have your baby on delivery suite you will remain there for a few hours after the birth then you will be transferred to the postnatal ward for ongoing care.