Where and how you have your baby will affect your birth experience. Here we talk about your birth options – like choosing where to give birth.
It’s a good idea to think about your birth choices well in advance, including where you want to give birth. Maternity services should give you choices and support you in where you want to birth (NICE, 2017). But your options for where and how you give birth will also depend on your needs, any risk factors you have and what’s available where you live (NHS, 2018).
Giving birth in the UK is usually very safe for you and your baby, wherever you decide to have your baby (NICE, 2017).
Where can I give birth?
A pregnant woman or person can choose to give birth anywhere – if they do not need an anaesthetic or surgery then all planned places of birth are open to them. While your options for where you decide to give birth will depend on your needs, you could have:
- a home birth
- your baby in a midwife-led unit or birth centre – a unit run by midwives
- a hospital birth
Birth at home
You might choose to give birth at home (NHS, 2018). If the pregnancy is low risk and it’s not your first time giving birth, you have a lower chance of having interventions at home and it’s as safe as giving birth in a hospital (NICE, 2017). Home birth can have many benefits, including freedom to move and not having to travel to hospital.
You should bear in mind that your chances with a planned home birth of transferring to an obstetric unit during labour or afterwards are higher for first births (45%) than subsequent births (12%) (NPEU, 2017).
Birth at a midwife-led unit or birth centre
You can choose to give birth at a midwife-led unit or birth centre. Midwife-led units can either be alongside a hospital maternity unit or can be freestanding from the hospital. Both types of midwife-led unit tend to be more comfortable and homely.
In separate birth centres, you won’t have immediate obstetric, neonatal or anaesthetic care (NHS, 2018). If the pregnancy is low risk and whether you’ve given birth before or not, having your baby in a midwife-led unit can be a good option. That’s because there is a lower chance of intervention at a midwife-led unit and it’s as safe as giving birth in a hospital (NICE, 2017).
Another consideration might be your chances of being transferred to an obstetric unit during labour or after birth. Transfers for first-time mothers were 36% for planned freestanding unit births and 40% for planned alongside unit births. Mothers who had given birth before had a 9% chance of transfer from a freestanding unit and 13% from an alongside unit (NPEU, 2017).
Birth at hospital
If you have certain medical conditions, it might be recommended to have your baby in hospital. This is because hospitals have specialists who can help you if you need any treatment when you’re in labour (NHS, 2018).
Unless you've been advised to go to hospital early, it's beneficial to stay at home until labour is established. If you go to hospital in early labour, it's more likely that you and your baby will have additional medical procedures and a longer hospital stay (Miller et al, 2020).
How do I choose where to give birth?
It’s important that you and your partner research possible choices for birth near to where you live and discuss your birth options so you can make an informed decision. You can weigh up the advantages and disadvantages of giving birth at each location. If you’re willing to travel, you can choose any maternity services (NHS, 2018).
Research has shown that women who plan to give birth at home or in a birth centre have a higher likelihood of a straightforward vaginal birth (Scarf et al, 2018; Homer et al, 2019).
This may be due to having more midwives to care for them and a greater likelihood of giving birth in an upright position (Dencker et al, 2017). Women are also likely to have fewer vaginal examinations, and other medical interventions including breaking the waters, episiotomy and a managed third stage of labour (Dencker et al, 2017).
You could ask your midwife for information and they can discuss the options available to you in your area. It’s also good to get information from other sources such as antenatal courses.
Where you decide to give birth will depend on your wishes and any needs for clinical support you may have. Wherever you choose - hospital, midwife-led unit or home - the place should feel right for you.
The tool below from Which? will help you find out what your choices are by combining your preferences with research evidence. You can discuss the results with your midwife to decide where to have your baby.
How do I find a place to give birth that feels right for me?
If you are considering a birth centre or hospital birth, you may be able to arrange a visit ahead of your expected due date (Which?, 2018a) or view a virtual tour. That way you can familiarise yourself with the location and facilities, and get a feel for it. The place where you choose to give birth should feel like a good fit for you (NHS, 2018).
Other things to consider include the type of facilities available. For example, you might be considering a water birth in a birthing pool for pain relief (Which?, 2018b). You can plan to have a birthing pool at home and they might be available at some birth suites and hospitals. But if you did want a pool, you might have to ask in advance about the type and number of birthing pools they have.
Where can I find more birth choices information?
- Children’s centres
- Your GP surgery
- NHS postcode search which lists maternity services in your area (England only)
- Local maternity units
- Maternity services liaison committees – you need to ask your local hospital’s maternity unit
- The Birthplace Study
- Your family or friends
What factors should I consider?
It’s important to make an informed decision about where you would like to give birth based on your preferences, any risk factors for you and the facilities available. Most women give birth at the place they had planned (58%), with a third changing their mind because of their changing needs. Only a minority did not get their choice because it was not available (one in 20) (NFWI and NCT, 2017, p73).
Some women transfer from home or freestanding midwife-led unit to labour ward after labour has started. Some transfers are made before the baby is born and some after the baby has been born. Transfers are more likely for women having their first baby (NICE, 2014).
A woman might be transferred because she has decided that she wants to move for a particular reason, such as wanting different pain relief. Other transfers may be suggested by the midwife in case a problem emerges with mother or baby, while a minority of transfers are due to an actual problem with mother or baby (NICE, 2014).
When discussing where to give birth, you might like to consider the following:
- What pain relief options will be available to me during labour? Check out your options in our articles about pain relief for home births, midwife-led units and hospitals.
- Will there be an option for having a water birth or using water for pain relief?
- Who will look after me during pregnancy and labour? Find out more in our articles about who looks after you at home, in a midwife-led unit and in hospitals.
- How far would I have to travel when I’m in labour?
- What are my chances of having medical interventions?
- Is it possible for me to access specialist medical care or facilities if I need them? You can ask your midwife and take a look at our articles about what happens if you have complications at home, in a midwife-led unit or at hospital.
- Will I have access to breastfeeding support at the facility?
- Will I receive adequate services for postnatal care?
(Which? Birth Choice, 2018)
Having done your research and talked about your birth options with your partner, you will feel more confident in your birth choices.
If you or your birth partner need to or want to change your mind about where you give birth, you can do this at any point in your pregnancy. You may find later on in your pregnancy, or even as your labour progresses, that your birth options or your choices change (NHS, 2018).
This page was last reviewed in March 2021.
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We also offer antenatal courses which are a great way to find out more about pregnancy, labour and life with a new baby.
Homer C, Cheah S, Rossiter C, Dahlen H, Ellwood D, Foureur M, Forster D, McLachan H, Oats J, Sibbritt D, Thornton C, Scarf V. (2019) Maternal and perinatal outcomes by planned place of birth in Australia 2000 – 2012: a linked population data study. BMJ. Available from: https://bmjopen.bmj.com/content/bmjopen/9/10/e029192.full.pdf [Accessed 29th March 2021].
Hutton E, Reitsma A, Simioni J, Brunton G, Kuafman K. (2019) Perinatal or neonatal mortality among women who intend at the onset of labour to give birth at home compared to women of low obstetrical risk who intend to give birth in hospital: A systematic review and meta-analyses. The Lancet. Available from https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(19)30119-1/fulltext [Accessed 29th March 2021].
Miller Y, Armanesco A, McCosker L, Thompson R. (2020) Variations in outcomes for women admitted to hospital in early versus active labour: an observational study. BMC Pregnancy and Childbirth. Available from https://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/s12884-020-03149-7 [Accessed 29th March 2021].
NFWI; NCT. (2013) Support overdue: women’s experiences of maternity services. Available from: https://www.nct.org.uk/sites/default/files/related_documents/Support%20Overdue%20Report.pdf [Accessed 29 March 2021]
NHS. (2018) Where to give birth: the options. Available at: https://www.nhs.uk/conditions/pregnancy-and-baby/where-can-i-give-birth/ [Accessed 29 March 2021]
NICE. (2014) Choosing place of birth : Resource for midwives. Available from: https://www.google.co.uk/url?sa=t&rct=j&q=&esrc=s&source=web&cd=&ved=2ahUKEwiA6qCDotXvAhWEoXEKHXM9BEwQFjAAegQIAhAD&url=https%3A%2F%2Fwww.nice.org.uk%2Fguidance%2Fcg190%2Fresources%2Fchoosing-place-of-birth-resource-for-midwives-msword-248730877&usg=AOvVaw2Zn9QlGQTjr5tGOSWyBryy [Accessed 29th March 2021].
NICE. (2017) Intrapartum care for healthy women and babies. Available from: https://www.nice.org.uk/guidance/cg190/chapter/Recommendations#place-of-birth [Accessed 29 March 2021]
NPEU. (2017) Birthplace in England Research Programme. Available from: https://www.npeu.ox.ac.uk/birthplace [Accessed 29 March 2021]
Scarf V, Rossiter C, Vedam S, Dahlen H, Ellwood D, Forster D, Foureur M, McLachan H, Oats F, Sibbritt D, Thornton C, Homer C. (2018) Maternal and perinatal outcomes by planned place of birth among women with low-risk pregnancies in high-income countries: A systematic review and meta-analysis. Midwifery. Available from https://www.sciencedirect.com/science/article/pii/S0266613818300974. [Accessed 29th March 2021].
Which? (2018a) Birth Choice. Visiting your local maternity unit – checklist. Available from: https://www.which.co.uk/birth-choice/choosing-where-to-give-birth/visiting-your-local-maternity-unit-checklist [Accessed 29 March 2021]
Which? (2018b) Birth Choice. Why choosing where to give birth matters. Available from: https://www.which.co.uk/birth-choice/choosing-where-to-give-birth/why-choosing-where-to-give-birth-matters [Accessed 29 March 2021]