Care in labour at home

Supporting you and your baby at home

Once you feel you are in labour or need additional support, please call the Pregnancy Assessment Unit at the hospital you have been booked in with – either University Hospital of North Durham or Darlington Memorial Hospital.

After your initial assessment they may keep in touch with you by telephone if you are in the early stages of labour (latent labour) until you need a midwife with you.

Two midwives will care for you in labour, once labour is established.

You may be asked if a student midwife can attend your birth with your midwife. We like to encourage student midwives to attend home births to gain valuable experience.

During your labour the midwives will support you in your birth plan and preferences and monitor the wellbeing of you and your baby. You will be supported in your choice of positions during labour.

Reasons for transfer to hospital

A midwife will recommend transfer of you and/or your baby to hospital if:

There are any concerns about your baby’s wellbeing during labour. This may be if there are concerns about your baby’s heartbeat or if your baby has passed meconium in your waters.
There is any abnormal bleeding from the vagina.
There are concerns about your health during labour. For example, raised blood pressure, pulse or temperature.
Your labour is progressing slowly, and it is considered likely some assistance is necessary.
Your baby is in a position that could make the birth more difficult.
You wish to transfer for any reason, such as for other pain relief.
Following an obstetric emergency (possible scenarios will be discussed with your midwife).
After the birth if there are any concerns with your baby’s breathing or temperature.
After the birth if you have a tear to your vagina or perineum that is considered too difficult to repair in the home or if it requires repair by a doctor.

You will have an opportunity to discuss this list further with your midwife at your home birth appointment at around 34 weeks.

If you are transferred to hospital, it will be by ambulance. The midwife will accompany you in the ambulance but may hand over your care to another midwife on arrival at maternity.

Your birth partner is likely to have to travel in your own car, not with you in the ambulance.

If your baby needs to transfer to hospital following the birth, where possible you or your partner may go with your baby in the ambulance.

Your midwife will talk to you about the locally available services and possible transfer times to your nearest obstetric unit.

Other concerns

If during your pregnancy additional risks have been identified and you are at higher risk of complications developing during your birth, you will be advised to give birth in an obstetric unit where specialised care is available. Your midwife will discuss these factors with you.

If you still wish to birth at home an appropriate plan of care will be discussed with you and this will be put in place with any necessary arrangements made in time for your birth.

It is also recommended that the planning of your birth be discussed with a senior obstetrician; to ensure you have all the information required to make an informed decision about your birth.