Each year, several hundred thousand children are born in the UK alone, with just under 700,000 coming into the world in 2016 across England and Wales. Improvements to healthcare and access to quality prenatal and delivery assistance, combined with medical advancements in fertility help have kept the birthrate in the UK steady for several years. While having a child is not an uncommon occurrence, women and their family members have varied experiences when it comes to labour and delivery. Part of that experience comes down to where the child is born: at the NHS in a traditional hospital setting, through a childbirth centre, or in the comfort of one’s own home. Choosing where to deliver a child is intimately personal, and there are several factors that should be considered when doing so. Having some detail on the expectations of hospital births and alternatives to the NHS is helpful in making the most appropriate decision for each expectant mother.
The largest percentage of expectant mothers choose to deliver their child in the NHS. At a maternity unity within the hospital, a team of midwives and doctors are tasked with managing labour and delivery from start to finish. The hospital is often the safest place for a woman to give birth because there is ample access to care and expertise should delivery become complicated. Expectant mothers have the ability to request pain medication during labour, along with other anaesthetics that may help ease the discomfort they experience. Newborn specialists are also on hand to care for the newborn shortly after delivery, providing some level of peace of mind to the mother and her family members. Although there are clear benefits to delivering a newborn in a hospital setting, there are very real drawbacks of which expectant mothers should be aware.
A specialist from a solicitors group that handles medical negligence cases involving pregnancy and childbirth explains that informed consent is often an issue when babies are born in the NHS. Informed consent is a legal requirement that entails receiving permission to perform exams or procedures from a member of the medical community. Expectant mothers are in some cases not given an opportunity to consent to labour and delivery procedures that could harm them and ultimately, their newborn child. When informed consent is not given, women experience traumatic effects on an emotional and physical level, most of which cannot easily be remedied.
A recent survey of new mothers highlights the issues surrounding informed consent during the process of labour and delivery, citing that 13% of mothers felt as though they were not given a chance to consent to a procedure that impacted their labour and delivery. Childbirth centres, another option for expectant mothers to give birth, had a much lower percentage of 7% when recent mothers were asked the same question. It is important for women to have choices when giving birth to their child, and informed consent is a crucial part of the process.
Childbirth centres offer an alternative to the traditional NHS hospital setting for mothers who want a different experience when delivering their child. A childbirth centre, sometimes referred to as a midwifery unit, provides a more comfortable setting than a hospital maternity unit, with a smaller, more homey feel and the same midwife the expectant mother grew to know during her pregnancy. Some childbirth centres are adjacent to a larger hospital facility, while others are disconnected or part of a smaller community hospital. Statistics show that women who experience childbirth in a centre are more likely to have positive thoughts surrounding their labour and delivery, and the informed consent issue is less prevalent.
While childbirth centres are becoming more popular among expectant mothers, there are some drawbacks to utilising this resource for labour and delivery. The most notable is when complications arise, women may need to be rushed to the nearest hospital to ensure safe delivery of their child.
The final alternative to giving birth in the NHS is a home birth, where the mother delivers her child at home. A midwife is still present and a crucial part of the labour and delivery process, offering a sense of security that the birth will take place without major issues. Women giving birth at home do not have the option for an epidural for pain management or general anaesthetics, but the labour process can be an experience that is uninterrupted and involves the mother’s spouse or partner, other children, or loved ones. Pregnant women who are not high risk or do not foresee complications with delivery are the best candidates for a homebirth. Similar to childbirth centres, delivery of a child at home may require a visit to the hospital if labour or birth turns involves any complications.
Whether an expectant mother decides to delivery her child in a traditional hospital setting, a community childbirth centre, or in the comfort of her own home is a truly personal choice. However, making that decision requires an understanding of what is and is not available during labour and delivery, and the options the expectant mother has for managing her own childbirth process. The good news is that there are options to select from, offering pregnant women a choice in how they bring their newborn into the world.