Hight risk home birth: what are your options
If you’ve been told you’re high risk, you’ve probably assumed a high risk home birth with a private midwife OR WITH THE NHS isn’t possible. A lot of women do. But that’s not always the case. According to the NICE intrapartum care guidelines, women have the right to choose any birth setting, including at home, and should be supported in that choice. I have to say in this recent climate is not as easy at it seems and if you wan tto fight for your choices, this is why I’m here for!
What does high risk actually mean?
High risk doesn’t mean something is wrong. It means there’s something in your pregnancy that needs a closer eye.
Women get labelled high risk for all sorts of reasons:
✦ A previous caesarean
✦ Being over 35
✦ A higher BMI
✦ Gestational diabetes
✦ A breech baby
✦ Twins
✦ IVF
✦ A previous hard or traumatic birth
That’s a really wide range. A healthy 36 year old with no other issues is in a very different situation to someone managing a serious medical condition. But both can end up with the same label.
Does high risk mean I have to go to hospital?
No. Not automatically. In the UK you have the right to choose where you give birth. That includes at home. Nobody can make you go to hospital.
What should happen when you get a high risk label is a proper conversation. One where someone sits down with you and explains what the risk actually is, how likely it is, and what can be done about it. Not just a referral and a closed door.
A lot of women don’t get that conversation. They get the label and that’s it. That’s where things go wrong.
What can a private midwife do?
A private midwife gives you time. Real time. To go through your history properly, look at your situation as a whole, and talk through what your options actually are.
That means:
✦ Looking at you as a person, not just a risk factor
✦ Going through the evidence for your specific situation
✦ Supporting you to make a decision that feels right for you
✦ Being with you all the way through so nothing gets missed
✦ Being honest when a home birth makes sense and honest when it doesn’t
Independent midwifery care isn’t just about what happens on the day. It’s about the whole experience, continuity of care, feeling supported, feeling prepared, having someone consistent in your corner from the start. That matters just as much as the birth itself.
What high risk situations can work at home?
Every situation is different. But as a rough guide, these are things that can often be supported well at home:
✦ VBAC (birth after caesarean)
✦ Gestational diabetes
✦ 3rd degree tear
✦ Being over 35
✦ Higher BMI with no other complications
✦ A previous traumatic birth
There are also situations where I’d have a straight conversation with you about whether home is the right call. I won’t dress it up if I have concerns.
It’s also worth being real about this: a pregnancy can start low risk and things can change. New complications can come up further down the line. No one can promise you the birth you’re hoping for. What I can promise is that you’ll have honest, consistent support whatever happens.
What about insurance?
As an independent midwife I’m fully insured and that means I take on cases carefully. Part of that is having proper conversations with my indemnity cover about complex situations. This isn’t a barrier, it’s part of making sure the care I give is safe and properly backed up. If your situation is complex I’ll be upfront with you about what that means.
What if my NHS midwife has said no?
You can disagree with that advice. You still have the right to birth at home.
But what I do is built on relationship and trust, and that has to go both ways. I choose the women I work with just as much as they choose me. Not every situation will be the right fit and that’s okay. When the relationship is right the care is better for everyone. If after talking I don’t think I can give you what your situation needs, I’ll tell you honestly and help you find someone who can. That’s not a rejection. It’s the same honesty I bring to everything else.
What I can say is that if we do work together, you’ll have someone who is genuinely invested in you. Not just on the day but through everything before and after it.
Want to find out if a home birth is right for you?
The best place to start is a conversation.
No one can guarantee the birth you want. But I can promise the support throughout.
with love, V
