From MIDWIFERY MATTERS, Issue No.104, Spring 2005
If you are considering or would like a home birth but do not know how to get
the midwifery care you need from the NHS:
Contact your local midwife. Every area is different but one of the following
should be able to help you find a community midwife:
" Telephone your local hospital and ask for the community midwifery manager.
" Telephone local hospital and ask for the Head of Midwifery.
" Your GP's surgery may have a midwife attached who can provide all your
care.
If you are being told you cannot have a home birth, for whatever reason:
1. Contact the Head of Midwifery and inform her that you are planning a home
birth and that you expect her to provide a midwife to attend you in labour at
home. Refer her, if necessary, to the NMC circular on home birth (www.nmc-uk.org/aArticle.aspx?ArticleID=1970)
2. Should the contact be less than positive, write a letter confirming your
plans and post to the Head of Midwifery as well as copying the letter to Caroline
Simpson, Department of Health (address below). Suggested letter available from
AIMS (see below).
3. When you go into labour and would like a midwife present, call and inform
them.
4. There is also the option of an independent midwife which involves the payment
of a professional fee - probably in the region of £2000 - £3000.
If later in your pregnancy you are told that midwifery staffing is difficult
or there aren't enough midwives trained in home birth so you may be required
to come to hospital for the birth of your baby:
You should consider repeating your intentions.
The staffing and training problems of the National Health Service are not your
problem.
Reasons that may be given to you to attempt to refuse your choice include:
" This is your first baby
Your response 'There is no evidence to support the view that planned home birth
will compromise me or my baby'.
" You are 'overdue'
Your response 'Normal human gestation ranges from 37 to 42 weeks (it varies
from woman to woman and there do appear to be familial tendencies). Planned
home birth when I seem to be over my due date with no other risk factors will
not affect the outcome of my pregnancy.'
" Your baby is too big or too small
Your response 'It is well documented that there are no accurate measurements,
either with ultrasound or by palpation, that can truly predict the size of the
baby'.
There can be reasons to reconsider your choice including the following
" You may develop true pre-eclampsia, confirmed by abnormal blood screening;
this is very uncommon in subsequent pregnancies unless you have changed your
partner.
" Diabetes (either pre-existing or gestational) in most instances would
indicate that a hospital birth may be wise, though there are several cases of
women who have chosen to birth at home with diabetes and the outcomes have been
good.
" Obstetric cholestasis, which can be a dangerous liver condition diagnosed
by blood screening tests, may require early induction of labour in hospital.
If you do not feel confident in the midwife you have been allocated
" Contact the Head of Midwifery at the local hospital and request a change
of midwife; you may choose to give your reasons but you do not have to.
" Keep notes, including the time and date, of whom you speak to with a
brief outline of what they say
" Should you need further support or wish to discuss your situation further,
the following organisations may be able to help you:
Association of Radical Midwives
www.midwifery.org.uk
Helpline: 01865 248159
Association for Improvement in the Maternity Services
www.aims.org.uk
Helpline: 0870 7651433
www.homebirth.org.uk includes very practical information and help as well as research summaries
Letters should be copied to:
Caroline Simpson
The Department of Health
Richmond House
79 Whitehall
London SW1A 2NL
caroline.simpson@dh.gsi.gov.uk
Updated LW April 3, 2006