If it's your first baby and you're toying with the idea of a home birth, Christine Hill advises you to think long and hard

The pluses of having your baby at home are obvious – familiar surroundings, home comforts and a midwife you have met before and feel comfortable with. If this is your second pregnancy and your previous delivery was completely straightforward, things are much more predictable as regards labour and a home birth is well worth considering.

If this is your first baby, I have to add some notes of warning:

Nearly 90% of women have a baby without any help at all from doctors, but when you're having your first, there's no way of knowing if you're going to fall into this group.

By opting for a home birth, you're counting on a totally straightforward delivery. This is the unpredictable bit. A normal, uncomplicated birth is nothing to do with your personal health, level of fitness or how conscientiously you practised your breathing at the antenatal classes. You can’t arrange to have one, however hard you try.

Apart from the shape of a woman’s pelvis, the main factor that influences the length and type of labour a woman has is the position and size of her baby. In order to have a trouble-free birth, a baby needs to be lying with his head down and to one side.

During labour, the uterus contracts in order to dilate the cervix and also to rotate the baby’s head, so he can be born with the back of his head first. This is the smallest diameter of his head and will pass through the pelvis easily.

With one in ten first-time births, the baby descends into the pelvis with the back of his head against his mother’s spine (it’s called Occipito Posterior or OP) which means that the baby has to rotate before he can be born.

This can be a problem for some women, as labour tends to be longer, and occasionally the baby has difficulty rotating properly. If your baby is in this position, you are very likely to need an epidural as labour can be long and you may get back pain.

I know I'll be labelled a doom merchant but I must also tell you that a small percentage of babies need medical help (forceps or a Caesarean Section) in this situation.

Of course, if your labour doesn’t go as quickly as it should, and you need an epidural because you're exhausted, can't cope with more pain or your midwife isn't happy about your baby, you can be transferred to hospital. But no woman in labour likes to be moved, let alone transferred by ambulance to a hospital which may be several miles away.

You'll have gathered by now that I think it's better to have a first baby in hospital but if you hate the idea, then talk to your GP or a midwife at your antenatal clinic.

Many hospitals have what is called a ‘domino’ system. This is a good alternative to a home birth for first time mothers. Your midwife delivers you in hospital, (so all available medical care is on site should you need it) but you return home after four hours or so, with the same midwife who looked after you in labour. It seems a pretty good compromise to me.