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Publication - Advice and guidance

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

Published
3 June 2024
Directorate
Children and Families Directorate
Topic
Children and families, Health and social care
ISBN
9781836013150

This is a draft document, which we are currently seeking your views on.

View supporting documents Supporting documents

What does the evidence show about births in different settings?

You may wish to discuss what the evidence shows us about the risks and benefits of births in different settings with your midwife when discussing your birth choices.

Birth is generally very safe for women at low risk of complications and their babies. The diagrams below show outcomes for women and their babies when birth is planned in different settings. The diagrams refer to healthy women at low risk of complications.

Spontaneous Vaginal Birth

Spontaneous vaginal birth means that you go into labour by yourself (labour is ‘spontaneous’), and give birth without assistance from instruments (ventouse or ‘vacuum’ birth, or forceps), without Caesarean and without general, spinal or epidural anaesthetic before or after birth.

What are the chances I will have a spontaneous vaginal birth in each birth setting?

Table 1 shows the percentage of women who had a spontaneous vaginal birth or an intervention in each birth setting, for their first baby. In an obstetric unit, 54% had an intervention, 46% had a spontaneous vaginal birth. In an alongside midwifery unit, 38% had an intervention, 62% had a spontaneous vaginal birth. In a freestanding midwifery unit, 30% had an intervention, 70% had a spontaneous vaginal birth. For births planned at home 33% had an intervention, 67% had a spontaneous vaginal birth. Table 2 shows the percentage of women who had a spontaneous vaginal birth or an intervention in each birth setting, for their second, third or fourth baby. In an obstetric unit, 30% had an intervention, 70% had a spontaneous vaginal birth. In an alongside midwifery unit, 9% had an intervention, 91% had a spontaneous vaginal birth. In a freestanding midwifery unit, 5% had an intervention, 95% had a spontaneous vaginal birth. For births planned at home 4% had an intervention, 96% had a spontaneous vaginal birth.

Birth with Forceps

Birth with forceps and emergency Caesarean birth, ventouse or ‘vacuum’, and forceps, are sometimes needed to help deliver the baby.

Like Caesarean births, births with forceps are more common amongst women having their first baby, compared to women having their second or subsequent baby. In some cases, the use of instruments is not successful, and then a Caesarean birth is performed.

What kind of birth can I expect to have?

Table 1 shows the percentage of women who had a spontaneous vaginal birth, birth with forceps or ventouse/vacuum, or Caesarean birth in each birth setting, for their first baby. In an obstetric unit, 16% had a Caesarean birth, 23% had a birth with forceps or ventouse/vacuum, 61% had a spontaneous vaginal birth. In an alongside midwifery unit, 8% had a Caesarean birth, 16% had a birth with forceps or ventouse/vacuum, 76% had a spontaneous vaginal birth. In a freestanding midwifery unit, 7% had a Caesarean birth, 11% had a birth with forceps or ventouse/vacuum, 82% had a spontaneous vaginal birth. For births planned at home, 9% had a Caesarean birth, 13% had a birth with forceps or ventouse/vacuum, 78% had a spontaneous vaginal birth. Table 2 shows the percentage of women who had a spontaneous vaginal birth, birth with forceps or ventouse/vacuum, or Caesarean birth in each birth setting, for their second, third or fourth baby. In an obstetric unit, 5% had a Caesarean birth, 6% had a birth with forceps or ventouse/vacuum, 89% had a spontaneous vaginal birth. In an alongside midwifery unit, 1% had a Caesarean birth, 2% had a birth with forceps or ventouse/vacuum, 97% had a spontaneous vaginal birth. In a freestanding midwifery unit, 1% had a Caesarean birth, 1% had a birth with forceps or ventouse/vacuum, 98% had a spontaneous vaginal birth. For births planned at home, 1% had a Caesarean birth, 1% had a birth with forceps or ventouse/vacuum, 98% had a spontaneous vaginal birth.

Birth is generally very safe for women at low risk of complications and their babies. These diagrams show outcomes for babies when birth is planned in different settings.

Poor outcomes are rare, but can happen in any setting.

Table 1 showing the outcomes for babies when birth is planned in different settings. For a first baby, for births planned in obstetric units, alongside midwifery units and freestanding midwifery units, 5 per 1000 had a poor outcome, and 995 per 1000 babies were born healthy. For births planned at home, 9 per 1000 had a poor outcome and 991 per 1000 babies were born healthy. Table 2 showing the outcomes for babies when birth is planned in different settings. For a second, third or fourth baby, for births planned in obstetric units and freestanding midwifery units, 3 per 1000 had a poor outcome, and 997 per 1000 babies were born healthy. For births in an alongside midwifery unit and births planned at home, 2 per 1000 had a poor outcome and 998 per 1000 babies were born healthy.

These tables are taken from the King’s College “Birth Place Decisions” leaflet, with data from the Birthplace in England Research Programme

Contact

Email: thebeststart@gov.scot

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