Draft: Birthplace Decisions, Information for pregnant women and partners on planning where to give birth

Why would I be advised to choose a particular birth setting?

If you are generally healthy and have a low chance of complications, you will be advised that any birth setting (at home, in a community midwifery unit or alongside midwifery unit, or in an obstetric unit) is suitable. Midwives provide your individualised care in these settings and will help support you through your labour and birth.

In this guide, ‘having a low chance of complications’ includes:

• Other than the common discomforts of pregnancy, you are generally healthy and well.
• You have no significant medical conditions (such as diabetes or high blood pressure) affecting you or your baby.
• If you have given birth before, there were no complications (such as heavy bleeding after birth).
• You are pregnant with one baby only (not twins or triplets).
• Your baby has grown healthily during pregnancy and is in a ‘head down’ position.
• You are between 37–42 weeks (term), and you have not developed new problems just before your labour begins, such as bleeding, your waters breaking more than 24 hours before labour begins, or developed infections that could be passed to your baby.

Low chance of complication does not mean there is no chance of complication.

You may have medical or other conditions which mean that you are advised to give birth in an obstetric unit where you have access to care from midwives, obstetricians and the wider team. More intensive monitoring facilities are available if you or your baby require these. You will still receive care from a midwife throughout and will be supported to have the birth that is right for you. Some of the conditions that mean birth in an obstetric unit will be recommended for you are listed in Appendix 1 on page 13. The list is not exhaustive, and your midwife or obstetrician can discuss this further with you.

If you have been advised to give birth in an obstetric unit it is important that you understand why this has been recommended.

If you have been advised to give birth in an obstetric unit, but would like to consider birth in a midwifery unit or at home, then discuss this with your primary midwife as early as possible. Your primary midwife will work with you to support your informed choices about place of birth, discussing your plans and preferences early on can help your midwife support you to develop a personalised/individual care plan. Page 16 includes some additional resources and contacts for you.

In order for you to reach the right decision, you need to be able to weigh up the potential benefits, harms and limitations of the available options.

Thinking ‘BRAN’ before your appointment will help you prepare and be able to actively engage in the conversation and make informed decisions.

When deciding where to give birth to your baby ask your midwife or obstetrician:

1. What are the Benefits?

2. What are the Risks?

3. What are the Alternatives?

4. What if I do Nothing?

To find out more see It’s Okay to Ask! – Publication | NHS inform