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Setting up a home birth service in East London: lessons learned and reflections on the first year

02 September 2019
Volume 27 · Issue 9


A dedicated home birth team was established in a deprived inner London borough offering continuity of carer to women choosing home birth. Establishing a new service brought unique challenges, and the team was required to adapt quickly, introducing new ways of managing workload and adapting policies to suit the needs of the population and service. Reflecting on some of the challenges faced in the first year of operation is useful to allow the team to learn and grow, and to help others to establish similar services in their area.

Women in the UK can choose to give birth in any of four locations: obstetric unit, alongside midwifery led unit, freestanding midwifery-led unit or their own home. Evidence shows how giving birth at home results in good outcomes for mothers and babies, is cost-effective and can enable improved continuity of carer, resulting in higher maternal satisfaction (Birthplace in England Collaborative Group et al, 2011). However, data from 2016 shows that only 2.1% of babies were born at home (Office for National Statistics (ONS), 2017).

A dedicated home birth team was set up in one area of London to increase the local home birth rate, and this article sits alongside a report on the outcomes achieved during the first year of operation (Foley et al, 2019). It seeks to document the lessons learned during this launch phase, which may be useful for others in a similar situation. It also provides some reflection on the achievements of the service, changes made along the way and future plans.

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