Ever wonder why so many women are scared off by the thought of a home birth?

[foxytocin]

These questions [[
store.aqa.org.uk/qual/gcse/qp-ms/AQA-3561-H-W-QP-JUN09.PDF from AQA]] give an insight into our mindset.

3 (a) Suggest four advantages of having a hospital birth.
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3 (b) Name three types of pain relief usually available in a hospital.

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(3 marks



Where was the mention of home births here - or the disadvantages of hospital births.

[chocolatestar]

I origionally wanted a home birth but the midwife scared me out of it. She said if something went wrong they legally had to look after me and leave the baby. She freaked me out so I went for hospital again even though last time I felt fine at home but got scared at hospital.

[WelcometoProfessorJungleGore]

Apparently the risk of stillbirth and neonatal death is increased fourfold with a homebirth.

That would be enough to scare me off.

The most dangerous time in a baby's life is during birth and straight after. Time is crucial, minutes even in a critical situation. I would prefer to be on site where the medical professionals can attend straight away.

Even in a hospital things take time and minutes can be wasted. I think the baby has to be the priority when planning the birth.

FWIW I think the idea of homebirth is lovely.

[WelcometoProfessorJungleGore]

Chocolatestar - at what your midwife said.

[2kids1dog]

No I haven't. And I would do everything possible to scare a woman out of home birth because if DC1 were born at home, that's where he would have died. No prior clue that this would happen either.

We have modern medicine at our disposal - we'd be foolish not to avail ourselves of it at such a precious time as childbirth.

Not forcing medicine upon anyone, but if you had a choice between holding your DC in your arms at home, but dead, and holding them alive, in a hospital, I know what I would choose.

You are lucky if you have had the fortune to take the risk of home birth and come away with a positive experience.

[Bumperlicious]

'Apparently the risk of stillbirth and neonatal death is increased fourfold with a homebirth'

Where do you have that info from? I've just had a home birth & did a lot of research & never came across that view.

It was the midwife who convinced us to go through with it in the end, not that she was trying to persuade us, but her info & reassurance made us feel it was the right thing to do.

[piscesmoon]

It just didn't appeal in my case-it wasn't a case of being scared off.

[Panzee]

I would have had to tidy up. :o

[piscesmoon]

Agree Panzee! Much more relaxing to go to hospital and concentrate on the birth and baby.

[Bunbaker]

All the home births I have ever heard of have been very positive experiences. That said, it is because all the mums have had low risk pregnancies and were deemed to have a low risk labour.

We always hear horror stories about hospital births because all the complicated and high risk ones are in hospital anyway.

In my case I had a high risk pregnancy and it was thought that the labour might be difficult, so I never even considered a home birth. In the end I had an easy pregnancy and a straightforward 6 hour labour with only TENS for pain relief.

The hospital was great and the staff were fabulous and very supportive when DD showed no sign of wanting to latch on. I had no intention of bottle feeding her and they wouldn't let us home until we had successfully established breastfeeding.

[oxocube]

It makes me really sad to hear these horror stories . I had two of my three children at home because it felt right for me. It was a choice I made based on my personality, proximity to a hospital should either my baby or me need to be transferred and also based on my own medical history/low risk pregnancy.

I still fail to see why this is such a contentious issue - we are blessed to have choices about many things in our lives. Home birth or hospital birth - one is not better or more worthy or more 'brave' or sensible than the other! Its simply a matter of preference

[frakkinstein]

Now there are 2 midwives at a HB apparently 1 for the baby and 1 for the mother.

That paper is ridiculous. I hope 2010 was more balanced but I doubt it.

[cory]

I'm with Panzee on this. Having to worry about a presentable house at such a vulnerable time was not my idea of a relaxing experience. But perfectly happy for other women to make their own decisions.

[DuelingFanjo]

"And I would do everything possible to scare a woman out of home birth because if DC1 were born at home, that's where he would have died"

why would anyone want to scare someone out of making an informed choice?

I am having a hospital birth but my mum had 2 home births and is really supportive of them.

I know someone who had a great home-birth and only had a hospital birth with her second because the weather meant a midwife couldn't get to her.

I think scaring people out of doing things is awful. People should be given all the facts (goos and bad) so thay can make an informed decision.

[kikibo]

Home birth is not dangerous. Ever wondered how it is that nearly half of all babies in the Netherlands is born at home?

Right, most of them die?

Monitoring is crucial of course. And some of the stuff on Mumsnet about the UK freaks me out to be honest. I mean, no woman should decide to have a home birth before being thoroughly screaned for possible complications (which they do do in the Netherlands without a doubt, though they do do a lot more home births in situations that would be deemed difficult i other countries). And yes, it is true that one can have unforeseen complications, but then it is the midwife's role to ensure that everything is sorted. Which is definitely not impossible, but the task of midwife in a hospital is less demanding than the one for an independant one... And that's probably where the problem lies: midwife's training is not suited probably for non-hospital births and so... look for one with load of experience.

[hildathebuilder]

I agree that scaring people is awful. But my DS would have died had I not given birth in hospital. So might I have done. I know these events are rare, I knew that before I had DS but they do happen, and no amount of statistics, or information ever prepares you for the risks of giving birth. Although I had had problems during my pregnancy I was low risk. I then had a placental abruption causing a huge haemorrage. I had considered homebirht and am all in favour of choice. But homebirth can be very dangerous.

[upahill]

I dismissed the idea of a home birth and I am glad I did tbh.

There were some unexpected complications. The birth started off OK but things happened.

I had pre booked a private room which was great especially when I became ill afterwards. Nobody would have been at home to look after me and the baby if I had been at home.

The hospital was a good expierence for me on both occasions

[Marjee]

I chose to have a hospital birth because I didn't know how I'd cope and I wanted the option of an epidural if I felt I needed one. In the event ds got distressed and was born by ventouse so I thought I'd made the right decision in going to hospital.

In hindsight I truly believe that if I'd had a homebirth I would have been much calmer and more in control. I was very distressed and frightened when I got to hospital and I was made to lay on my back which I believe is the worst possible way to give birth. I think that at a homebirth a mw would be more likely to encourage moving around and getting into a good position to give birth and I could maybe have avoided the episiotomy and ventouse delivery.

On paper it looks like ds was saved by the intervention but I think that it was unnecessary and was actually caused by being in hospital. If I had another baby I would definitely consider a homebirth.

[Tangle]

re. risk of stillbirth or neonatal death much higher at homebirth

There was a study published earlier this year that reported these results. It was retrospective and considered data from many western countries. There's data on it on NHS Choices.

Before condemning home births on the basis of the headline statistics bear in mind that there were a few key factors that the study did not control for. One of these was the qualifications and skill of the HCP attending the birth. Once this was taken into consideration there was no statistical difference in outcomes between home and hospital births in terms of neonatal mortality. It should also be remembered that the numbers of babies that died were very small in any instance (although I do understand that's no consolation when you are the one out of a very large number).

To my mind, this review highlighted the fact that safety in birth, and particularly in homebirth, is highly dependent on the competence of the attending HCP. In the UK we are fortunate to have access to well trained MWs such that planned HB is an option that is statistically as safe as hospital birth for many women - especially those with low risk pregnancies.

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IIRC there was another study out recently that looked specifically at the outcomes of IMs, who tend to specialize in HB. They found that outcomes were significantly poorer - but again, when other factors were considered and like with like groups were compared the risk was the same. In addition to handling mainly HBs, IMs caseloads often include women with more complex pregnancies that the NHS will not support in their informed choice. Again, it doesn't find that HB is dangerous or that using an IM puts you and your baby at risk - although that is how the headline was portrayed.

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What both studies showed me was that more research needed to be done on the detail - probably as a prospective study rather than as a retropsective analysis. With particular regard to the IM study, more work needs to be done on why high risk women are choosing a HB with an IM in preference to a hospital birth and what can be done in hospital to make that a more acceptable choice to them.

[PURPLESWAN]

My blood pressure was through the roof and my son was "distressed" if he hadnt have popped out when he did I would have needed an emergency ceserean - if we had been at home (30 minutes from the hospital at best) its possible one if not both of us would have died.

Plus I didnt want to mess up my house

If its something you really believe in then fine but you really do need to make an EDUCATED decision and not make it on some airy fairy basis. You also need to take responsibility for this decision and not reserve the right to sue if things dont go to plan as a result of overrulling advice to use a hospital.

[notnowbernard]

I have had 3 positive, straightforward hospital births

All in the pool with no interventions or drugs other than gas and air

Home after 6hrs

I wasn't averse at all to the idea of a homebirth with DC1. But DP really wasn't keen, and because I was equally open to the idea of a hospital birth I went with that (wanted DP to be chilled about it too)

With DC2 and 3 what really put me off a homebirth was the noise... we are in a flat, neighbours from all angles. I would have felt inhibited (like I couldn't make the racket I wanted, basically) and that could have had a detrimental effect on the process of labour

[comtessa]

It's also not just about birth but afterwards too. My friend had a straightforward birth in hospital, but then her placenta ruptured (or similar - can't remember exact words she used) and she needed immediate blood transfusions.
I love the idea of a homebirth, but in practise, I just would not do it.

[omaoma]

Panzee - you are wrong! The midwives tidy and clean EVERYTHING away - i think it's like a personal point of pride thing for home-birth midwives, that you go have a shower and when you get back the place is immaculate. Honestly, mine was not a tidy birth and the place was clean as a whistle afterwards.

Personally I felt the same thing about hospital birth - i thought, if i am going to have to clean blood off the toilet before i go, i'd rather it was my own blood and not some other poor woman's :(
heard very bad things about hygiene on labour wards

[Tangle]

Regarding individual cases where disaster was averted by being in hospital, I'm always wary of commenting as without knowing all the details its very hard to comment.

What I do know is that within my circle of friends there have been a number of hospital births that have been portrayed as "I/baby would have died at home". And in all of those cases digging into the story revealed that either the birth had become an emergency through lack of care in hospital, or things had stalled an dragged on until intervention was necessary. The former is comparable to an unattended HB and the later would only be a problem at home if the mother refused to transfer in - but in neither situation would a planned HB have guaranteed a worse outcome, and arguably with the formed it may have improved things as there would have been one to one care during the labour.

There are undoubtedly lives that have been saved by being in a hospital environment. But equally I believe there are babies that die or are injured because they are in hospital.

There is no single right answer and women need to be supported to make an informed choice such that they do what's right for them, not what they're frightened into. I'd like to think that the exam question at the top of the thread just happened, this year, to discuss hospital birth and the benefits of HB are covered in the syllabus. But I suspect that I'd be very naive if I believed that :(

[TheOldestCat]

I was scared by the thought of a homebirth.

Then I had DC1 in hospital. Grim, grim, grim.

So we opted for a homebirth for DC2, having weighed up all the risks. It was fantastic.

Of course, I was fortunate to have a straightforward labour with no complications. I hope, had the two midwives I had with me for the entire birth noticed something going wrong I would have been transferred to hospital in time. But I'll never know.

It's very difficult to make an informed choice and there are risks to both.

PS there was no mess at all, not even on our ill-advised cream carpets.