Where to give birth: your choice

In the UK, birthing individuals have the fundamental right to choose where to give birth. This includes the option to birth at home, in a birth centre or in a hospital.

You have the right under Article 8 of the Human Rights Act to a private and family life which includes the right to choose where you give birth and who is present!

Let’s have a look at a few options in Dorset and Hampshire from the Bournemouth, Christchurch and Poole (BCP) area.

Depending on where you live in the BCP area you have the following options to choose from if you wish to give birth in a consultant-led unit (labour ward).

  • St Mary’s Maternity Unit at University Hospital Dorset (Poole)
  • Maternity Unit at Dorset County Hospital (Dorchester)
  • Maternity Unit at Salisbury District Hospital
  • Princes Anne Hospital at University Hospital Southampton

Generally speaking, consultant-led units are advised for those who have pre-existing medical conditions and their pregnancy classed as high-risk. However, even if you are classed high-risk you still have a choice. More often than not that would mean a home birth either supported by community midwives or private midwives. Birth centres often have stricter guidelines and can refuse care if individuals don’t meet their criteria. If you are classed as having a low-risk pregnancy you can still choose to give birth in a consultant-led unit.

A birth centre is a maternity unit that is run by midwives and generally speaking accepts those people who are classed as low-risk which can often include no post-date pregnancies. It can be part of a hospital or a completely separate unit.

St Mary’s Maternity Unit at University Hospital Dorset (Poole):

  • Haven Suite – located within the maternity hospital
  • Bournemouth Birthing Centre (closed but will re-open after hospital reconstruction)

Maternity Unit at Dorset County Hospital (Dorchester)

  • The Cove – located within the maternity unit

Maternity Unit at Salisbury District Hospital

  • Beatrice Birth Centre – located on the same grounds

University Hospital Southampton

  • New Forest Birth Centre (temporarily closed for births) – stand-alone unit
  • Broadlands Birth Centre – located within the maternity hospital

Recently we have seen several closures of stand-alone birth centres mostly due to staff shortages, similar to dedicated home-birth teams. Despite the shortage of midwives and the crises maternity care provision has been going through for about a decade now, no one can force you to give birth away from home if that’s your preference.

You have the freedom to select the hospital or birth center for your birth. Your GP can refer you or you can self-refer. Even if it’s outside your area, you have the option to choose. If denied due to residency, you can request an exception through the Clinical Commissioning Group in England.

Home birth is not guaranteed by law but NHS Trusts are expected to run a dedicated home birth service, let it be through a home birth team or community midwives. Since it is your right to choose where to give birth you cannot be made to go to the hospital if you do not wish to. To care for you during labour and birth at your home is their duty and maternity services should adhere to it. Generally speaking, a trust should be prepared for scenarios like staff shortages, which may involve arranging for an independent midwife to assist with a home birth.

 

One more important thought on duty of care

The Nursing and Midwifery Council’s (NMC) Code states that midwives must put individuals’ interests first and make their safety their main concern. This is their professional duty. They should attend you at home if you ask for this, even if they don’t agree with your decision.

If you are in labour and the hospital tells you there is no midwife to attend to you at home, by law you cannot be made to attend hospital if you do not want to. You can always ask to speak to the Head of Midwifery and request to provide a midwife.

I am aware this is easier said than done, especially during one of the most vulnerable times of our lives, labour and birth. It can be challenging, to say the least, but if you feel that birthing at home is the right choice for you, be assured that the law is by your side.

 

Navigating choices and from whom to ask for help

Healthcare professionals may state that you must give birth in a hospital, nevertheless, it is your decision. You can ask for a detailed explanation as to why they recommend a hospital birth for you, ask for research findings, comparative studies and so on.

You can also seek a second opinion, speak with other consultants and/or choose another trust.

I strongly advise you to seek advice from an independent birth professional, someone who is not affiliated in any way with the maternity services to avoid bias. Independent midwives, Doulas or antenatal educators are great sources of information and some, like myself provide advocacy for their clients.

You can also contact other organisations for information such as Birthrights UK or AIMS (Association for Improvements in the Maternity Service).

You can attend antenatal classes, read books and blog articles, listen to podcasts to broaden your understanding.

A few words on ‘high-risk’ pregnancies

There are distinctions within the term “high-risk.” Factors like advanced age or preeclampsia will likely classify someone as high-risk, yet they vary significantly from each other!

High risk means that a woman and her baby face a higher-than-normal chance of experiencing problems during pregnancy and/or birth.

What is normal is comparative.

The expression: high-risk sounds very threatening but it is more like a cauldron where everything gets thrown in.

From the perspective of law, only YOU have the right to decide where to give birth. No one can overturn the decision you have made. Please, take the following very seriously: healthcare professionals MUST NOT put pressure on you, nor threaten you if they don’t agree with your choice.

 

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