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Planned homebirth but no midwife on call today

(18 Posts)
Tintini Sat 01-Oct-11 17:24:00

I'm aiming to have a homebirth but my waters started leaking first thing this morning and when I phoned the midwives they said no-one was on call today and so I would have to go to hospital when I'm in established labour. There will be someone to do homebirths tomorrow morning apparently, but I guess by that point it will have been 24 hours since my waters broke, so I think they will want to me to go in. Feel a bit down about it as I feel in a bit of a catch-22 situation, unless I time it really really well! Haven't had any contractions yet - just a bit of very mild cramping. I know I can't control it but I'm not sure whether I want things to speed up or not now!

Has anyone been in a similar position? Can I stand my ground on the homebirth if it all happens today, or put them off getting me to come in tomorrow to speed things up if still not much has happened tomorrow?

Thank you for any advice!

addictediam Sat 01-Oct-11 17:32:02

no advice, but shocked no mw is on call today, what if therre were an emergency!

can you phone and ask someone else?

dancingbeads Sat 01-Oct-11 17:35:33

I'm sure someone more knowledgeable will be along soon but I'm pretty sure they have a duty to provide you with a midwife. Having said that when I had my last homebirth, it took about an hour for them to find a midwife - she nearly didn't make it in time. So give them plenty of time to find someone if you decide to stay put.

VivaLeBeaver Sat 01-Oct-11 17:39:09

Mmmm, our local hospital is doing this at the moment as there is such a staffing crisis. There have been a lot of community midwives who have left and not replaced yet, though they are interviewing but it takes time.

I'm sure some people will say stand your ground and insist someone has to attend and you could maybe try it. But to be honest I don't think it will always work. If there isn't a community midwife on call then they can't ring someone at home and tell them they have to go into work. The labour ward midwives won't go partly because they're staffing labour ward but also because they may well not feel confident to facilitate a home birth. Plus they won't be insured to drive to your house. They won't be in the pool car insurance and personal insurance doesn't cover you for work purposes.

squiggleywiggler Sat 01-Oct-11 17:55:46

To offer another perspective I have been with clients in this situation (midwives all attending other homebirths) and a labour ward midwife (who was comfortable with homebirths) did attend.

We simply repeated that we would be staying at home and expected a midwife to attend as the home birth had been pre-planned.

Though I know the situation might be different from trust to trust in terms of availability I have found that in the situations I've been in like this standing our ground has worked.

Obviously if you don't mind going to hospital then making a big fuss may not be the right thing for you, but if a homebirth is important to you then you do have the right to insist.

I'm copying and pasting the advice from the site at the bottom of this post as it gives a useful way of handling this situation.

It might also be worth phoning back now and asking to speak to the supervisor of midwives on duty. You can explain that you expect a midwife to attend and, as they do in fact have some advance warning that someone is likely to be needed tonight, expect a midwife to attend.

It's also worth saying, that some women do opt to forgo admission.induction after 24 hrs if they aren't in established labour. Again I've been with a couple of women who felt they wanted to do this and both went on to have a normal birth at home. Not saying this is what you should do, just letting you know that nothing is compulsory!

If you can get your partner to deal with this so you can concentrate on relaxing and letting your body do its thing then all the better.

What if you phone when you are in labour, and are told no midwives are available?

Many homebirth advocates feel that it is still important to stand your ground in this situation. If the labour ward is really this busy, is it a safe place for you to labour? You do not need to feel guilty about making the labour ward manager's job harder; while she may have a tough job, you are having a baby. She has ward crises every week and, by next week, will have forgotten that you ever existed. You, on the other hand, will remember this baby's birth for the rest of your life.

To the best of my knowledge, and from discussions on the Homebirth UK email group, in every case where a mother has insisted that she is staying at home and that she expects a midwife to be sent, a midwife has indeed been sent out. It is important to make clear that you will not accept a paramedic, nor will you accept transfer to hospital in an ambulance if one is sent out.

Here is some advice from Shawn Walker of the Norwich Home Birth group:

Over the past three years, we have seen this a lot among our group in Norwich / Norfolk. Here's what we recommend if it may happen to you:

Have someone with you who is not your partner or mother or other close, emotionally involved person. This person should have ideally had a successful homebirth herself and at a minimum be entirely supportive of your plans to do so, comfortable advocating for you in a situation where you are being told that there will be no midwife sent, and able to be calm in such a situation.
Prepare your supporter by practicing the 'broken record' technique with her. No matter what they say, your supporter should keep replying that you are going to give birth at home and are expecting a midwife to be sent. When they say they definitely won't send one, she should keep playing the record -- 'Clare is going to give birth at home and we look forward to seeing a midwife.' Needless to say, you should not be involved in this exchange -- you have enough to do! And we recommend that someone other than your partner be the spokesperson, so that your partner can concentrate on you. At no time should your advocate say, 'Okay' or 'I understand' or try to reason with the person on the phone. Just keep playing the record.
Don't think of it as preparing yourself for a fight; think of it as preparing not to fight by being clear about your position and having support to keep strong in that position.
My doula colleague and I have been successful with this technique many times, even when they are absolutely insisting they will not send someone. The only time it wasn't successful was when a close family member did the advocating -- and that person was very concerned about there not being a midwife. None of the couples who chose not to have another supporter with them chose to stay at home when told they had to come to hospital. When you think about it, that's a lot of pressure for a dad-to-be to be under in such a situation.

Norwich Birth Group -- "

Tintini Sat 01-Oct-11 18:22:04

Thanks all for the advice. I will try to stand my ground if things happen tonight. To be honest, it's all going so slowly that I can't imagine being in labour for a while yet - perhaps I'll be lucky and need one tomorrow morning when there will be one! At the end of the day, I guess if there's no midwife, there's no midwife.

dikkertjedap Sat 01-Oct-11 22:48:09

In the end it is most important that you and your baby are allright. I would go in if it looks that waters will be broken for 24 hours due to higher risk of infection plus maybe there are other reasons why labour is not progressing. Good luck.

architien Wed 05-Oct-11 17:50:18

I hope your baby and you are ok. It's a disgrace that they said you had no MW to attend you.

BoffinMum Wed 05-Oct-11 17:55:40

1. They are obliged to attend you in labour. It is part of their ethical code.
2. They have access to independent midwives in many cases and can ask one of them to attend at the hospital's expense.
3. You can go well over 24 hours after waters breaking without problems - don't feel you have to go in before going into labour just because of some local policy and artificial deadline. I went 40 hours, for example. I think I looked the stats up at the time and the vast majority of women go into labour within 2 days anyway.

Tintini Wed 05-Oct-11 20:08:04

Hello all and thanks so much for your support on saturday. I gave birth to a wonderful baby boy at home on Sunday! He's my first and the labour was incredible - I actually enjoyed most of it and I'm sure that had a lot do with being at home. In the end I was very lucky because at the point where we needed the midwife she was back on call and could attend.

BoffinMum Wed 05-Oct-11 20:27:47

Yay! Congratulations!

fit2drop Wed 05-Oct-11 20:35:52

awww lovely news, Congratulations and a warm and loving welcome to your lovely little boy.

architien Thu 06-Oct-11 09:15:21

:D wonderful!

Now at every available opportunity let folk know that women can give birth at home if they feel it's better! If folk don't know it's safe and appropriate they don't ask for it and don't then this service gets taken away!

themightyskim Thu 06-Oct-11 09:55:32

Thats a lovely end to your story congratulations on your son smile

squiggleywiggler Thu 06-Oct-11 13:22:38

Huge congratulations!

Withwoman Mon 10-Oct-11 15:08:08

'National Institute for Clinical Excellence
Inherited Clinical Guideline D
Induction of Labour
Issue Date: June 2001
Induction of labour in the presence of prelabour rupture of the membranes (PROM)
Prelabour rupture of the membranes (PROM) occurs in 6-19% of term pregnancies.
The risks of PROM at term relate to maternal/neonatal infection and prolapsed cord. Epidemiological data on time interval from PROM to spontaneous labour suggests that most (86%) women go into spontaneous labour within 24hrs of rupturing their membranes. The rate of spontaneous labour after this is about 5% per day.
As the time between the rupture of the membranes and the onset of labour increases, so do the risks of maternal and fetal infection. Induction of labour reduces these risks.
Women with prelabour rupture of the membranes (PROM) at term (>37 weeks) should be offered a choice of immediate induction of labour or expectant management.
Expectant management of women with prelabour rupture of the membranes at term should not exceed 96 hours following membrane rupture.'

It is quite acceptable to accept expectant management for 96 hours.

bumpybecky Mon 10-Oct-11 15:09:51

I was about to say 'stand your ground they will come out' but too late! huge congratulations on your baby smilesmilesmile

EggyAllenPoe Wed 12-Oct-11 20:00:15


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