If you are thinking about where your baby will be born, have you thought about a homebirth with a private midwife?
The NHS midwifery teams in Sussex (University Hospitals Sussex, Surrey and Sussex Healthcare, Maidstone & Tunbridge Wells and East Sussex Healthcare all aim to support homebirths, but all are facing significant staffing issues. They will aim to support anyone who meets their criteria for homebirth, but in some cases this excludes people on the basis of age, gestation at start of labour or other factors. Some of these criteria, but not all, are evidence based. I am happy to discuss these with you on a personal basis. Many people have a homebirth with a private midwife when the NHS have said they cannot support it. There are situations when I will advise birth in hospital, but I will always explain my reasons.
In most cases the NHS midwives work in teams and it would be one of the team who comes to you in labour, being joined by another midwife once birth is imminent. You do not get to choose who comes, and you may or may not have met them previously. If it is important to you to choose your midwife , and continuity is important, it is certainly worth considering homebirth with a private midwife. You can interview and choose the midwife who is right for you. We build a relationship over the weeks of pregnancy, as we visit you at home to provide antenatal care. We get to know you and your family (including your pets), so that on the big day we feel like a trusted friend. Some people find that a good compromise is to employ a doula who can provide continuity and can work alongside the allocated NHS midwife on the day. There are some amazing doulas in Sussex – I have recently had the pleasure of working with Laura, Sarah and Roma.
Sometimes staff shortages mean that the NHS simply do not have enough staff to be able to send midwives to you at home. Sometimes you will be told by “experts” on social media etc that if you are told this, you should insist on staying at home and that a midwife will be sent. Sadly this is incorrect and potentially risky advice. None of the units want to disappoint you. If they had midwives they could send they would so so. However, if they have got barely enough midwives to provide safe care in the hospital, they cannot send two out to a homebirth. This is the reality of the NHS in 2023. This is a political issue, so please try not to be angry with my NHS colleagues who are doing their best with poor resourcing.
If you are clear that homebirth is for you, or if you want the option when labour starts, you need to consider what your options are and make the plan which is best for you. You may decide that it is easiest simply to go to the hospital if midwives are not available. You can decide to stay at home and birth without a midwife (known as freebirthing). You may also want to think about booking a private midwife.
I get calls fairly frequently from people who are in labour and have been told that no NHS midwives are available. They phone me, asking if I can go, right now, to support them to birth their baby at home. Unfortunately, the answer has to be no. Firstly, I am probably on-call for clients who booked with me many weeks ago. They have to be my priority. Secondly, if I don’t know anything about you, I cannot be confident that I will be able to provide safe care, or indeed whether homebirth is a safe and appropriate option for you and your baby. It isn’t right for everyone and I always have extensive discussions with my clients in advance of deciding place of birth. Thirdly, it is a legal requirement for me to have professional insurance in place, before attending in labour, for each individual client that I provide birth care for.
Some of my colleagues are willing and able to offer very small packages of care for anyone who wants a homebirth with a private midwife. This may include meeting you a couple of times before labour, attending the birth and perhaps one or two visits afterwards, I am not comfortable doing this, because I believe that what makes the difference in terms of getting the best experience and outcomes for you and your baby, is that I really get to know my clients, discuss various possible issues and situations, and build a strong relationship with you. When labour starts, we have a shared plan and expectations, I know your home and your family, and I come to you to provide care throughout your labour and birth. I have a back-up midwife available, who in almost every case you will have met in advance, who will join us when birth is close. I then provide postnatal care for you and your baby, including the routine healthchecks. Occasionally, circumstances mean that I advise a client to transfer to hospital. In this case I accompany you. True continuity.
Most of my clients start their care with me as soon as they are pregnant (some even come to me pre-conception). This means that if you think you may want my services, you should contact me as early as possible. The initial consultation is free, to see if we are a good fit. I provide midwifery care across East Sussex and West Sussex, as well as the borders of Surrey and Kent.