Hoping for water birth in a birth centre near you? Kingston, St. George's, Chelsea & Westminster, St Thomas’ and St. Helier all have them - what do you need to know?

How can I maximise my chances of a water birth in a birth centre near me?

Most parents I speak to in pregnancy are worried about a pool being available when they get to the birth centre, but I always explain that really they need to focus their energies on getting onto the birth centre in the first place! Most hospitals don't discuss birth choices with you until 36 weeks, but it's good to be preparing and working out your options earlier on in pregnancy so you can advocate for what you want at this appointment. You can sometimes watch virtual tours of the local SW London birth centres online, or even better go and visit on an in person tour (offered routinely at St George's and St Helier), or ask to be shown round.

If your pregnancy is "low risk", then giving birth on the birth centre would be supported by your hospital, however, it is really not unusual for "risk factors" to be identified in your pregnancy. In my experience many of these are brought up near, or at, the end of pregnancy, not giving you a long time to consider them. It would be impossible to go through all scenarios now, which is where the support of a good doula can come in so you don't feel like you always need to be one step ahead! But there are many sources of quality information out there for you to research yourself. I would really recommend the work of Dr. Rachel Reed, Sara Wickham, AIMS, and the podcast The Great Birth Rebellion.

In terms of having a water birth specifically - we can see from the statistics above less than 50% of women using a birth centre give birth to their baby in the water (they may still use the pool for pain relief). In some cases this will be due to maternal preference, or that there wasn't time to fill the pool. Or you may be told that you can use the birth centre but not a birth pool, again you would need to look into the evidence for this recommendation in pregnancy.

There are some reasons why you may be asked to get out of a pool during labour and this NHS document has a helpful list:

• To use the toilet
• For additional pain relief
• If there is any evidence of meconium staining
• If there is difficulty in hearing your baby's heart rate or any irregularity in the baby's heart rate
• For internal vaginal examinations
• If your blood pressure, pulse or temperature become abnormal
• If your labour does not progress as expected
• In order to deliver the placenta

These are all topics that you would need to research and decide what you think about them (remember in birth, all care and recommendations are offers, not orders!). You would need to do this in advance of your labour for the best chance of making an informed decision at the time.

I've been told that I am not allowed to have a water birth on the birth centre - what can I do then?

Each birth centre in SW London has their own policies on women who meet their criteria to use the them. If you meet the criteria, then you would not usually meet any barriers to going to the birth centre in labour. Although it still may not be proactively offered: so make sure you know what is available so your birth partner can ask for what you want at the time. You may ask or be asked to transfer to labour ward during your labour, and the points listed above about reasons to get out of the pool are also the kind of things you would want to know about when making a decision on this.

If you don't meet the criteria, then you may be told that you are not allowed to birth on a birth centre, however, the reality is much more nuanced than this. This article from BirthRights gives an amazing explanation, but the simple answer is that we have a right to choose the place where we give birth. The only reason you can be refused access to a birth centre is if there is a good evidenced based reason that you or your baby cannot be provided safe care there.

One major reason for being discouraged from using a birth centre is a recommendation for continuous fetal monitoring (CTG) in labour, but actually there is very little evidence that this improves outcomes for babies, and only in very specific circumstances: I recommend reading some of the amazing work from Dr Kirsten Small on this topic. Therefore if you are comfortable with declining the offer of continuous monitoring in labour, this alone would not be a evidence based reason to deny you access to a birth centre.

If you want to birth on a birth centre near you when you don't meet the criteria then ask to speak to a consultant midwife to make an "out of guidance" birth plan to use the birth centre. This must be done before you go into labour to ensure a smooth and well supported journey for you and your baby when you arrive at the hospital.

Ok... so what are the birth centres near me like in South West London?

It's finally time to have a chat about the ins and outs of our local birth centres! So here are some of my observations after supporting women as a doula at all our local birth centres:

Location of birth centre relative to labour ward

The first thing to say is that Kingston, St. George's, Chelsea & Westminster, St Thomas’ and St. Helier all have alongside birth centres, which means they are in the same hospital building as the labour ward. This gives you easy access to obstetric care should you need or want this in your labour. At Kingston, St. Helier and St Thomas's the birth centres are literally adjacent to labour ward, in Chelsea and Westminster they are the same floor but across the corridor, and at St. George's they are two floors apart. I wouldn't say any of those factors has a major impact if you decided to transfer in labour.

Staffing levels

Almost all our local South West London hospitals are able to reliably staff their birth centres, which is not always the case across the UK and so we are lucky to have this provision. It is unlikely that if you arrive (and are eligible to access their facilities - see above!) that there would not be space for you. It is always sensible to ring in early labour though, so you know what availability is like and in some cases can make a decision about your timing of going in. The slight exception to this is St. George's - the latest statistics available from Jan 2025 say the birth centre was open 82% of the time. This is an improvement on recent years, and I know the staff are very motivated to raise the profile and availability of the birth centre. They also confirmed that they can sometimes open the birth centre for a woman who comes in labour and wants to use it - so this is always worth asking (again, I would ask on the phone in early labour to give them time to prepare).

Chelsea & Westminster, St. Helier and Kingston all have dedicated teams of midwives that have chosen to work on the birth centre and are therefore motivated to support women to have low intervention births there. The others may allocate depending on staff they have available at the time.

Triage

When you arrive at hospital in labour, you will first be assessed by a midwife to see whether they recommend you stay at the hospital or go back home and labour a bit longer. Now this is a whole topic in itself, but when I am supporting families who want to access a birth centre as a birth doula, I much prefer it if we are able to be "triaged" on the birth centre itself, rather than go to general triage and then be allocated to the birth centre. This is because the facilities are usually nicer (a single room rather than a bed on a bay), and the midwives will be more used to choices on your birth plan that you may have made to support physiological birth - for example no routine vaginal examinations or keeping the lighting low and external disturbances at a minimum. They will also not offer a routine CTG monitoring which means you have to be restricted to the bed and unable to move around freely. As above, an admission CTG is not evidence based to improve outcomes.

This element is a little hard to plan because maternity units sometimes offer a different route to triage depending on their capacity at the time, but clients booked with Chelsea and Westminster can ring the birth centre direct at any time and be triaged with the team there, and also at St. Helier. The other hospitals I've had different experiences depending on the day we've been - but it is always worth asking on the phone to be directed straight to the birth centre and your reasons for preferring to do this.

Birth pool availability

As above, although this is a common fear of parents, it isn't usually a problem to access a birth pool once you are on the birth centre. Sometimes if you go in a little earlier but decide to stay in, you may be encouraged to remain a smaller room without a pool - but as long as you are managing well this tends to be completely fine. I always recommend clients wait until the last moment to access the "next" coping strategy, and so in many ways getting in the pool for the pushing stage is ideal. But it's not set in stone at all.

Kingston, St. George's, Chelsea & Westminster, St Thomas’ and St. Helier all have birth pools available. The only really notable difference is St Thomas' don't have them in the main birthing rooms, but in a separate room (a small internal room with no windows) within the birth centre. So you move rooms to use the birth pool. I actually genuinely can't decide what I think about this, in a sense it's unsettling and in another mammals love to give birth in small, cosy, private spaces!

Postnatal care

A lovely benefit of giving birth on a birth centre is that they will do their best to keep you there postnatally, which means you will get your own room. There is generally a much higher staff ratio of midwives to families, and so more support with breastfeeding and postnatal care. This is never guaranteed, as it does depend on who they are supporting in labour at the time. There isn't really any difference between any of our South West London birth centres on this, as all have postnatal rooms and would try to accommodate you if they can. But you can always ask what is possible!

Birthing out of guidance

As mentioned above, sometimes you will need an out of guidance plan to access a birth centre. These are possible to arrange at any birth centre, but it will involve talking to the right person to support you. As a doula I have lots of experience in supporting clients to do this, and if you would like some information about helpful contacts or ways to go about this at the hospital you end up choosing - then just let me know. Interestingly the local birth centres have different criteria on automatic eligibility (for example, some "accept" women with gestational diabetes on metformin, and others don't). I can also help you navigate this and let you know what some of the local policies are. Feel free to contact me here or fill in the form at the bottom of the page.

I hope there is plenty of information here to help you understand better how to maximise your chances of a birth on a birth centre near you in South West London! Of course, homebirth is also an option...

Do contact me on the form below or check out my birth doula services here.