Summary

  • Homebirth means you plan to give birth at home under the care of a midwife. 
  • Homebirth can be an option if you are healthy, have a low-risk pregnancy and are able to access a maternity hospital quickly and easily.
  • In Victoria, homebirth is available through selected public hospital homebirth programs or with a private midwife. 
  • To practise in Victoria, midwives must be registered with the Nursing and Midwifery Board of Australia. You can check this by using the search function on the Australian Health Practitioner Regulation Agency website.
  • It is important that you fully understand your options and make an informed decision about your care during pregnancy and birth by speaking with your doctor or midwife. 
  • You can change your mind about having a homebirth at any time and decide to give birth at a hospital instead.

What is homebirth?

Homebirth means you plan to give birth at home under the care of a midwife, with as little intervention as possible. (Note that in this document where the term ‘midwife’ is used it refers to a midwife registered with the Nursing and Midwifery Board of Australia.) 

Homebirth can be an option if you are healthy, have a low-risk pregnancy and are able to access a maternity hospital quickly and easily.

Some reasons why you may consider a homebirth include:

  • You want to be cared for by a midwife of your choice.
  • You can give birth in familiar surroundings where you may feel more relaxed.
  • You want greater control over your birth experience in your home environment.
  • You don’t want to leave your other children.

You can change your mind about giving birth at home at any time and decide to have your baby at a hospital instead. During your pregnancy your midwife may also advise that a homebirth is no longer the safest option for you or your baby and that your pregnancy care and birth of your baby should be managed in a hospital.

Homebirth – things to consider

If you are thinking about having a homebirth, consider the following questions.

HomebirthPic1250x250  HomebirthPic2250x250  HomebirthPic3250x250 

My home and family

  • Will I feel safe at home?
  • Who will look after my other children if I need to travel to hospital?
  • How do I get to hospital if I need to?
  • Can an ambulance easily get to my home if I need one?
  • Is my midwife close by and easy to access?
  • What are the costs of a homebirth?  

My baby and me

  • Am I healthy and is my pregnancy low-risk?
  • Am I happy to give birth without access to an epidural?
  • Were my other births uncomplicated?
  • Did my previous babies need unexpected extra care at or after birth?

My care team

  • How can I find out if my midwife practises safely and has the right skills?
  • Is my midwife part of a team?
  • What can I do if I feel worried about my care?
  • Can my midwife continue to care for me if I need to go to hospital?
 

Here are some more questions you might want to ask your midwife if you are thinking about having a homebirth.

Is homebirth an option for me?

Each pregnancy and birth is different and you need to seek advice from your doctor or midwife about whether homebirth is an option for you. Homebirth may be an option if you:

  • are healthy and experiencing a low-risk pregnancy 
  • have a safe and suitable home environment 
  • can get to a maternity hospital easily if you need to (public homebirth programs usually require that you live within a 30 minute drive of the hospital).

Low-risk pregnancies are usually where you:

As a pregnancy progresses, changes can happen to your situation that may affect your decision about having a homebirth. This can include when:

Other factors that may affect your suitability for a homebirth include if:

  • this will be the first time you give birth
  • you are more than 42 years of age
  • you are younger than 17 years of age
  • your pregnancy has been supported by assisted reproductive technology, such as IVF
  • you are not able to attend your antenatal care appointments
  • you have not had any pregnancy screening tests including pathology and ultrasounds.

Note: This information is provided by way of example and is not a comprehensive guide as to whether a homebirth may be suitable or not. It is essential that your doctor, specialist or midwife assesses your suitability and any risk factors for a homebirth to determine whether homebirth is an option for you.

Making an informed decision about homebirth

It is important that you have all the information you need to make an informed decision about whether to plan for a homebirth. 

Ask your healthcare providers about the care they provide, their skills and experience. This is important to help you fully understand your options and make an informed decision about your care. Take a friend or family member with you to help you make sure that you have heard and understood all the information and advice provided. 

Here are some questions to ask your midwife if you are thinking about having a homebirth.

Is homebirth safe?

A lack of high quality Australian evidence means that our understanding about the safety of homebirth mostly comes from research in other countries, including the United Kingdom’s Birthplace study

In healthy women with low risk pregnancies, the Birthplace study found that:

  • for women having their first baby, a planned homebirth increased the risk of serious problems for the baby from 5 in 1,000 for a hospital birth to 9 in 1,000 for a homebirth
  • for women having their second or subsequent baby, a planned homebirth appeared as safe as having a baby in hospital.

Australian professional bodies have also published their positions on the issue of homebirths: 

Ask your doctor or midwife for further information to help you make an informed decision about homebirth.

Guidelines for midwives

The Safety and quality guidelines for privately practising midwives outline the safety requirements that all privately practising midwives must follow. You can read these if you want to know more about how midwives make sure the service they offer is safe. 

For example, did you know the following?

  • Two skilled and registered health professionals must be present at the birth of your baby.
  • Your midwife needs to be skilled and competent in basic adult life support and newborn resuscitation. 
  • Your midwife needs to seek your written informed consent.

Talk to your privately practising midwife to find out how they put the guidelines into practice. Be sure to include a discussion about insurance, as the professional indemnity insurance for privately practising midwives does not cover labour and birth.

The National midwifery guidelines for consultation and referral help midwives to provide quality midwifery care. These guidelines (in particular Chapters 6–9) could be helpful to you if you are thinking about having a homebirth, and you want to have a more informed discussion with your midwife about:

  • the suitability of different maternity care options
  • how they are using the guidelines to provide your care.

What are my other pregnancy and birth care options?

Before choosing a homebirth, speak with your doctor or midwife about the range of pregnancy and birth care options available to you. These are known as ‘models of care’.

Many public hospitals offer models of care where you are cared for by a small, multidisciplinary team of clinicians, usually led by midwives, known as ‘caseload’, ‘midwifery group practice’ and ‘team midwifery’. 

Collaborative midwifery models provide another model of care. For example, Northern Health has partnered with a private midwifery practice to enable women to give birth in the hospital as the private patient of a privately practising midwife. 

These models of maternity care:

  • allow you to receive ongoing care from a midwife or team of midwives
  • can support your choice to have a birth with as little intervention as possible
  • provide access to medical backup if it is needed.

Homebirth in Victoria

Each year about 310 women give birth at home in Victoria through public hospitals and private midwives. About 50 women planning a homebirth each year transfer to hospital during labour. 

Homebirth through a public hospital

In Victoria, both Casey and Sunshine hospitals offer the option to give birth at home under the care of public hospital midwives: 

  • About 80 women each year give birth through public homebirth programs. 
  • Each hospital has its own criteria for women accepted into its homebirth program. The criteria reflect what is safest for the local community and the staff involved, and the experience they have of providing safe homebirths. 
  • If you are eligible for Medicare, a public homebirth is free of charge. 
  • All care is provided by staff (midwives and obstetricians) employed by the hospital, though obstetricians do not attend homebirths. Staff are supported by a comprehensive system of clinical services, supervision and review that is governed by the hospital.
  • The maternity staff work to an agreed procedure for maternity care and are covered by the hospital’s insurance.

Use these links to find out more about homebirths though public hospitals in Victoria:

Homebirth with a private midwife

Homebirth services are also provided by privately practising midwives in Victoria: 

  • About 230 homebirths per year are supported by private midwifes.
  • Employing a privately practising midwife can cost up to $6,000 before rebates. Be sure that you clearly understand your midwife’s fees, what they cover and whether you are eligible for a private health fund rebate.
  • You can claim a Medicare rebate for the costs of care given during pregnancy and after the birth of your baby if: 
    • you employ a midwife who can provide Medicare rebateable services
    • you are Medicare eligible. 
  • You will be required to pay the full cost of an ambulance if you do not have ambulance cover.

Private midwives’ professional indemnity insurance does not cover labour and birth at home.

Private homebirth services – finding a midwife

You can find a private midwife by:

  • using the Midwives Australia website
  • using the Midwifery and Maternity Provider Organisation Australia website
  • asking a friend, relative or work colleague for a recommendation.

Things to remember when choosing your private midwife

When choosing a private midwife:

Where to get help

References

More information

Pregnancy and birth services topics

The following content is displayed as Tabs. Once you have activated a link navigate to the end of the list to view its associated content. The activated link is defined as Active Tab

Content Partner

This page has been produced in consultation with and approved by: Department of Health and Human Services

Last updated: May 2018

Content on this website is provided for information purposes only. Information about a therapy, service, product or treatment does not in any way endorse or support such therapy, service, product or treatment and is not intended to replace advice from your doctor or other registered health professional. The information and materials contained on this website are not intended to constitute a comprehensive guide concerning all aspects of the therapy, product or treatment described on the website. All users are urged to always seek advice from a registered health care professional for diagnosis and answers to their medical questions and to ascertain whether the particular therapy, service, product or treatment described on the website is suitable in their circumstances. The State of Victoria and the Department of Health & Human Services shall not bear any liability for reliance by any user on the materials contained on this website.