Am i too far from Hospital for a home birth? 20-30 mins.(18 Posts)
"The outcomes for ALL mothers (including first time mothers) were as good as those for obstetric units."
The outcomes for the babies of first time mothers however is not as good.
I live around 20 miles away from the nearest maternity unit. That part never entered my head with my HB for DC2 tbh. The midwives were very pro homebirth and were experienced with it. Everything went perfectly
By the time DC3 was due I planned on another HB. I was slightly more concerned about it though as the ambulance numbers in the area had dropped, they were having to take pts to the 20 mile away hospitals (3 in the area) as the local hospital had had its A&E downgraded. It meant it was much more likely that they would be out of the area if called by the MW. MW was still pro HB but it was something she had to make me aware of when she came round to do the booking at 36weeks. As it was I ended up getting induced at 42 weeks in hospital.
This time round I'm still contemplating a HB but there's talk of the ambulance station closing so that might influence things a bit.
Tiddly if it helps, I wasn't strapped in when I was taken in and I still had the gas and air. It was like the wildest, but most painful theme park ride going!
The median transfer distance for the free standing MLU's in the 2011 Place of Birth study was 17 miles. The outcomes for ALL mothers (including first time mothers) were as good as those for obstetric units.
The journey time does bother me, not sure how well I'd manage it in established labour - DS was back to back and repeating that strapped down in a moving vehicle would be my idea of hell!
I'm keen on HB in theory, but not actually opposed to hospital, so I'm still very much on the fence.
I think we'll probably do the same as last time - book a HB and then wait to see what happens. Once labour actually starts I may decide I'd rather go back to Hosp, but if we end up with a high-speed second birth like so many of our friends then at least the house will be prepared!
Thank you all for your input, I shall no doubt re-read this thread several times!
I think it's something you'll have to weigh up for yourself. I had a 3.5 hr labour with first DC and a very easy time (in hospital). We are roughly 40 mins from a hospital and I mentioned to my GP about the possibility of a home birth with DC2. The advice he gave me was that it was up to me and I was low risk, but that if anything did go wrong then the hospital distance was a concern (supposing a minimum of 15 mins to get an ambulance to me - then 40 min drive - it could be an hour before I reached hospital). He said that the chances of a disaster happening were probably 1 in a 100 - but that if I were that 1 in a 100 and the baby died because I suddenly needed an emergency caesarian, say, then it would be of no consolation to me. I decided not to go for home birth in the end. To me, the risk of anything going wrong with baby wasn't worth justifying my vague feeling that I'd quite like a home birth.
I suppose the decision ultimately depends on a lot more than the distance to hospital.
I have friends who stayed at home for labour then travelled to hospital but found it very painful. This could be the case no matter how long you've been in labour for.
You have to weigh up what's most important to you and how low risk you are. Also how much do you not want to go to hospital. The latter was a big consideration for me and as much as I would have transferred in if necessary, I'd have been VERY unhappy about it. I started the home birth with no real intention of going to hospital so the transfer time wasn't a huge consideration for me.
Maxbear - '...Some might see this as a good reason for delivering in hospital, but sometimes it is too easy to rush to theatre, once a section has been done, it can't be undone and there are certainly some caesarean sections that are not as necessary as some obstetricians will have you believe! hmm"
But then a 'normal birth' or alive/healthy baby is a retrospective diagnosis once everything has gone swimmingly!
3rd the idea that theatre can be ready & indeed baby out much quicker than 30 minutes in an emergency. The decision to delivery audit standard for a category 1 (emergency) section is less than 30 minutes.
I wouldn't want to attempt a homebirth that far away - but am aware that I am paranoid!
I work as a midwife and don't feel any more concerned going to a home birth a mile away than I do fifteen miles away. None of the out of hospital evidence specifies how far away you have to be or not. Just that for a low risk mum home birth is a safe option. Having said that I had my own last baby in January 2010 when there was lots of snow. I had decided that if he came when the roads were still not safe I was going to go in to the mlu within the hospital in case a fast emergency transfer became necessary (4 miles) Happily he was born at home the first day that I deemed it to be ok to go for a home birth, still snow on the ground but roads weren't too bad. I would not risk a home birth if there was a strike or problem with the ambulance service though. In my experience they are always there quickly but I think it is reasonable to elect to go to hospital in the event of a major incident or if there was a problem with ambulances.
I would agree with laluna that there is no way it takes 30 mins to prep theatre in an emergency within the hospital, in the event of a dire emergency if the theatre is clean and free the woman can be taken there and baby out within 10 mins in an absolute dire emergency such as severe bleeding, cord prolapse. Some might see this as a good reason for delivering in hospital, but sometimes it is too easy to rush to theatre, once a section has been done, it can't be undone and there are certainly some caesarean sections that are not as necessary as some obstetricians will have you believe!
5 in favour, 2 against!
Thank you all for replying - I know I'm jumping the gun even thinking about it, but DS's birth was uncomplicated (apart from being 4wks early) and I only needed G&A, so it seems logical to me to try for a HB next time.
I guess it's not my decision in the end, I can book a HB but the baby will have the biggest say in what happens!
Doesn't seem to worry them.
20 plus minutes from here depending on traffic and probably at least that for an ambulance to find my house.
DD is 11 our local ambulance service didn't get their not very good sat. Nav until she was in juniors.
I had planned a hb but we are not far from the hospital. As it was I seriously haemorrhaged and ended up in intensive care. In my case it was life or death and I'm so glad I wasn't at home. However its very unusual and you'd be likely to transfer in at the hint of a problem. I'd now worry that you are too far but presumably the mw and consultant would know best in your case.
I've no idea way hb proponents say it takes so long to prep a theatre. It didn't take that long either time with me (first c section, second forceps/haemorrhage.) does anyone know how long it does take in an emergency?
I did it, probably 20 min drive on a quiet day. Wasn't a problem for the mw, had a great hb. I was happy to go to hospital if the mw decided we needed to.
I live 30-40 minutes from the hospital. I had a blue-light transfer from my home birth.
Didn't speed them up much at the hospital - they didn't seem in much of a bloody rush when I got there, all very calm, dr had buggered off elsewhere for a bit All was fine btw.
The chance of things going catastrophically wrong very quickly are small. The MWs would suggest you transfer in at the merest hint of something not being right anyway.
Thirty mins plus the time it takes for the ambulance to be called and to arrive. We had a case last year where there was a significant delay due to problems with the ambulances and the outcome was dreadful.
PS - there is no way it takes 30 mins to prep an OT for an EM CS.
Depends if you think you could endure that journey in labour. I'd hate it. I attempted a home birth with ds and was blue lighted to hospital. The hospital is about 5 mins drive away, but it was snowy and the traffic was dire, so it took about 30 mins to get there. It was hell, it really was.
I think it's probably ok.
I hear it takes 30 minutes to prep a theatre for an emergency anyway.
It's worth bearing in mind that the midwife watches you vigilantly one on one care. As she doesn't have to watch other patients, any problems are likely to be picked up so sooner, thus avoiding the need for an emergency transfer.
I had a HB but admittedly was only 10 minutes away from hospital. It wasn't that much of a consideration to be honest as I was determined to do everything BUT go to hospital as I hated the prospect. Luckily baby behaved and I had lovely relaxed HB.
I was booked for a home birth with DS but ended up admitted to hospital as my waters broke at 36wks and labour didn't start for a few days. I was perfectly happy with my hospital experience, but would prefer to be at home next time if poss.
I'm not pg yet but am wondering whether to try for a home birth again next time - my community midwife was very enthusiastic about it last time, she said it would take 20 mins for a blue-light transfer, but in a normal car it takes us 30 mins to get to the hospital (fairly rural roads, no heavy city traffic).
I wanted to ask those of you who have had/attempted home births;
What's your honest opinion? Do you think that's a bit far away?
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