Homebirth and Freebirth. How They Compare and How They Differ

If you are pregnant and reading the news right now, you may feel anxious. Homebirth can feel unsafe because of media headlines. Freebirth can feel terrifying because of extreme stories shared online. It is hard to make a confident choice when everything around you sounds dramatic and confusing.

So let us slow everything down. Let us look at what homebirth and freebirth actually involve. Let us explore the similarities and the differences with calm evidence and clear explanations so you can make decisions from knowledge and not fear.

Both Homebirth and Freebirth Are Legal in the UK

You have the legal right to choose where and how you give birth. This comes under Article Eight, which protects your right to respect for private and family life. The courts have confirmed that this includes your choice of place of birth and your choice of birth companions.

This means both homebirth and freebirth are lawful. You cannot be forced to give birth in a hospital. You cannot be forced to have medical staff present if you do not want them. Your body and your birth are yours.

If you are interested in finding out more about your legal rights surrounding birth, you can click here to take you to the Birth Rights fact sheet.

They also have a factsheet on freebirth.

Both Homebirth and Freebirth Allow You to Give Birth at Home

Most births begin at home, even if the plan is a hospital. A planned homebirth means you stay at home until your baby arrives, with midwives coming to you. A freebirth also takes place at home, and the place itself is the same. The main difference is who is present with you.

Home is where many people feel safest, and labour works best when your body feels safe. Evidence shows that undisturbed environments support oxytocin and reduce adrenaline, which helps labour progress well.

Unfortunately, with a planned homebirth, if you are using NHS midwives, a homebirth is not a guarantee. Not all Trusts have a functional homebirth team, and even if they do, it isn't guaranteed that midwives will be available when you call.

One way to get around this is to hire an independent midwife, which guarantees attendance at your home birth.

Both Allow You to Choose Who Is With You

At home, you choose your birth team. You can invite as many or as few people as you want. You are not limited by hospital rules. You can include your partner and your doula and your older children and anyone else you trust.

Freebirth gives the same freedom. You can also choose no one except your partner if that feels right for you. Doulas can attend both homebirths and freebirths.

Choice over who is present matters because your birth hormones respond to your environment. Trust and comfort support safer physiological birth.

With an NHS homebirth, it is unlikely that the midwives who attend will be the same ones you have seen in pregnancy, you may have never met them before. As with any type of birth within the NHS if you are uncomfortable with the people who are supporting you, you can request a different staff member, but as we discussed above, NHS homebirth teams and stretched and this may require a transfer to hospital.

As above, the way around this for homebirth is to hire a independent midwife, who you will get to know throughout your pregnancy and will guarentee attendance at your birth.

Both Allow You to Transfer to a Hospital if You Choose To

You always have the option to transfer to the hospital. You can do this at any point if you decide you want medical support. Nothing about planning a homebirth or a freebirth removes this option.

Transfer is simply part of the pathway. Research from the Birthplace Study shows that planned homebirth is safe for healthy women with low-risk pregnancies and that transfers are usually for slow labour (which isnt always a cause for concenr) or requests for pain relief and not emergencies.

Freebirth also allows transfer. You can call for an ambulance or travel by car. The choice remains yours.

At both the decision to transfer remains in your control. In a homebirth the midwife will give their clinical reccomendation based on their experience and their assessments to help you make your decision. In a freebirth, you will need to depend on your instinct and knowledge.

The 'risk' of a homebirth is that the midwives reccomendations introduce fear and doubt, they must follow guidelines by law which are not always evidence based or supportive of physiological birth. You could regret the transfer, it could start a cascade of interventions, or it could be exactly the right choice for you, this is why its important to make a fully informed choice.

With a freebirth, you are dependent on your own instinct and knowledge , the risk here is that you miss a sign that something is wrong, and do not transfer soon enough. The benefits though is that without the 'noise' of other people you may be able to be fully intune with your body and your baby.

Both Give You Control Over Tests and Appointments in Pregnancy

Choosing a homebirth does not mean saying yes to every appointment offered. Every test and scan is optional. You have the right to decline anything that does not feel right for you.

Choosing a freebirth does not mean declining everything. You can accept any tests or scans that feel helpful. Some people decline most care and this is sometimes called wild pregnancy but you do not have to follow that model to freebirth.

Care in pregnancy should always be informed and voluntary.

If you are interested in Informed consent you can read my blog here.

Many people dont decide on a freebirth until later on in their pregnancy, so have already had the majority of appointments and scans, for others its a decision they make at the start, some dont even take a pregnancy test!

Some women choose to have a scan to check where the placenta is and identify any issues with the baby which may lead them to change their plans. Others decide to rely on their instincts and signs from their body.

With a homebirth is it still important to make informed decisions when it comes to tests, some of the results may not change YOUR decisions but may introduce pressure or additional admin / visits which can be stressful.

Neither Guarantees Survival of Mum or Baby

Birth carries rare risks no matter where you are. Most births unfold with no issues but there are situations that can become dangerous in any setting.

There are events that happen only when medical staff intervene such as coached pushing or breaking waters which can increase the chance of harm. There are events that can happen at home without medical staff such as a fast heavy bleed.

It is important to understand that no setting offers a guarantee but both settings can be safe when you make informed choices that reflect your body your history and your circumstances.

One Gives Immediate Access to Medical Care

Homebirth midwives bring clinical skills and emergency medication and equipment. They can manage a shoulder dystocia with evidence based techniques. They can manage postpartum haemorrhage with medication. They can support newborn resuscitation.

They can make a rapid decision to transfer and they know what to look for.

A freebirth will not include listening to babies heartbeat, blood pressure checks or vaginal examinations. For some this is a big positive, for others they want the option of some clinical care knowing they can choose what they accept.

In a freebirth you are responsible for recognising when to call for help. You may face a delay while an ambulance arrives which can matter in very rare situations. This is one of the main differences and it is something to consider when planning.

Another thing that could be something to consider for both a homebirth or a freebirth is how far away you are from a hospital incase a transfer is required.

Not all homebirth or freebirth emergencies can be dealt with at home, and some emergencies are time sensitive.

One Has a Higher Chance of a Coercion Free Undisturbed Birth

Some people feel safer without medical professionals present because even the gentlest midwife is still an intervention in the hormonal environment.

Research shows that undisturbed physiological birth tends to be the safest for healthy women with low risk pregnancies because oxytocin works best when there is privacy and calm.

Freebirth gives a higher chance of complete privacy. It does not guarantee this because you may still choose to transfer. But beginning in your own space with only chosen people reduces the chance of unwanted interventions and coercion.

Homebirth can also be undisturbed when you have supportive midwives who understand physiological birth but not all midwives work in this way and some people feel anxious about this.

So How Do You Choose

Both homebirth and freebirth offer autonomy and privacy and control. Both give you space to birth on your terms. Both allow you to avoid the hospital system which can feel overwhelming or unsafe for many women who have experienced coercion or trauma before.

The difference is mainly around clinical support and how fast help can arrive if it is needed.

Your decision will come from your own risk comfort zone your history and your instincts.

When you understand the facts you can make a choice that feels grounded and steady rather than fearful.

If you want to talk through your options in a calm evidence based way and want support to plan a birth that feels safe and informed you can work with me as your virtual doula.

We can explore your rights your preferences your fears and your hopes and create a plan that feels like yours.

You deserve a birth that feels clear and calm and confident whether that is homebirth or freebirth.

Who am I?

I am Charlotte, a Virtual Doula, providing bespoke evidence-based pregnancy support to families who want an empowering birth.

With 10 years + of clinical research experience, a biomedical science degree, and two hospital births under my belt, I use my knowledge to provide pregnancy support to help you make informed decisions about your pregnancy, birth, and postpartum.

I provide pregnancy support for all types of births, including hospital births, helping you to navigate NHS guidelines and have an empowering, positive birth.

Find out more here!