Home birth

[Sheepoverthemoon]

Has asking for a hb been a challenge with the midwife and drs? I'm really keen to have a home water birth (and thought I did my research well) and was really positive for asking, but my friends have been trying to put me off and say that it's a battle to get a hb for your first baby and it's very risky for the first one...
Any advice would be great

[JokersGiggle]

They will be reluctant to let you as its your first but if everything about your pregnancy is textbook prefect you stand a chance of getting what you want. But be prepared for a hospital birth, they won't take any risks.
You stand a good chance with your second as they can use your first labour as a guide, but still only if pregnancy is perfect.
If you have a home birth and you need to be taken to hospital for any reason they will take you to any maternity ward with space, could be one you haven't visited etc and you lack any sort of control.
Maybe accept a hospital birth but book the water pool and be in control of what you want each step of the way rather than just let things happen/going along with people? You can stay at home for a long time with the labour then in but make it known you want to go home asap.

[CityDweller]

Have to disagree with Jokers. I had absolutely no problem booking a home birth for my first baby with my hospital. The community mw team were completely supportive, even as I went increasingly overdue, and I successfully and safely delivered my baby at home.

Of course, you have to be prepared to go into hospital should the mws advise you to during labour (and the chance of transfer for a first baby is higher). Similarly, if anything crops up during your pregnancy that makes you high risk, then they'll want you to give birth in hospital. But if a hb is what you want, then that is your right - first baby or tenth baby.

[CatsCantFlyFast]

I agree, my midwives have mentioned a home birth at every appointment, and this is my first.
I would recommend reading factual websites and talking to your midwife for info...base your decision on this rather than the hundreds of scare stories that will get thrown at you whenever you mention in

[CityDweller]

Oh yes, another tip is to be judicial about who you share your plans with. I didn't really talk about my hb plans other than with very close family and friends. I just didn't want to deal with all those (usually wrong) scare stories and other people's fears and prejudices.

[misog2000]

I'm another planning a home birth with my first, both hospital and community midwives have been very supportive and positive about it.

[JokersGiggle]

I think it depends where you are. Where I am it seems no one is supported in going for a hb, but it would seem in other places you are. I really wanted one but was made to feel selfish and like I was putting my baby at risk so gave into pressure for a hosp birth lines like "could you live with yourself of things went wrong?" kept coming up.... Felt awful. Maybe we should move area before ttc for a better chance of hb! Hospital wasn't fun....

[Fairypants]

My mw suggested it with dc1 but I didn't really know how I'd feel in labour so opted for hospital- I could have had a HB as I didn't want/need anything that I couldn't have had at home and had a 6 hour discharge. Hospital wasn't bad though- just not necessary for me.
Dc2 was born at home and mw's never questioned that. Currently expecting dc3 (and now 36 and more than 10 years since last dc so slightly higher risk) and they have all been v positive.
They suggested I go to a local HB group (its worth looking on the net whether there is one local to you) and one community mw goes to the meeting there every month.
I am booked to my nearest hospital so will transfer there if there are any complications which I am happy with and I will visit it later on so I know what to expect if I need to go there.
The mw at the HB group said it is a woman's right to have a HB and that mw's have a duty to care for women wherever they are but I would always listen to their recommendation.

[Fairypants]

Oh and the increased risk of transfer is mostly down to maternal request ie. wanting more pain relief rather than being an emergency per se.

[atthestrokeoftwelve]

I had wanted a home birth too, my community midwives were not supportive so I had a hospital birth.

And I am very glad I did. Enough said.

[Raxacoricofallapatorius]

I had no problems getting my midwives to agree to a home birth with dc1. Or dc2. I transferred for an emcs with both however.

[EyelinerQueen]

I don't think it's true that you'll be discouraged.

For healthy pregnancies home birth is every bit as safe as hospital.

No-one tried to discourage me when I told them (note: didn't ask for) I'd be having a HB with my first.

I'm planning another for DC2 in July.

Remember, you don't need anyone's permission. Do what is right for you and your baby.

[atthestrokeoftwelve]

you don't needs anyone's permission- but you do need support. My midwife came to chat with me about home births, told me all the team were quite inexperienced in home births in my area, how important the crash pack was, talked about the procedure if resusitation was needed and paramedics came. It was clear she did not want me to have a home birth.
While I knew I had the right to a home birth what woman would want that with an unsupportive midwife?

[JaneinReading]

My mother had me in hospital and the rest at home. Even then it was known that first births are often the hardest and longest. I had my last at home.

however you have a right to have a home birth if you want one so go by what you feel is best. My home birth was certainly the nicest one. I was dissuaded by the head of midwifery when I asked for one for the first and I gave in but only on the basis I could lave the hospital within 6 hours of birth which I did with all first 3 children (so no nights in hospital which is a reasonable compromise - home the same day)

[EyelinerQueen]

Fair enough stroke it's a shame you live in an area that can't offer mums full and uncompromised support.

The HB rate here is quite high and my midwives were amazing.

Another factor to consider OP is your proximity to hospital. I am 10 minutes away. If I'd been further than that I might have had more reservations.

[atthestrokeoftwelve]

Eyeliner I gave birth in hospital in the end, and I am mightily glad I did. My son would not be alive if he had been born at home.

[emsyj]

"Eyeliner I gave birth in hospital in the end, and I am mightily glad I did. My son would not be alive if he had been born at home."

How do you know what would have happened if you had been at home, though? I had a crash section with my first baby, having been dissuaded from the idea of a home birth by lots of scare stories. Lots of people said afterwards, 'Ooooh, I bet you're glad you did the sensible thing and went to hospital', 'I bet you're glad you weren't at home' etc etc. But actually, if I had been at home the whole thing would have played out very differently. As it was, I stayed at home until I felt I had to go to hospital. I arrived at 9cm dilated and shortly afterwards was fully, at which point I was whisked off to theatre as DD1 was in serious distress.

But if I had been at home, a midwife would have come out to me earlier in labour. I would have been checked and DD1's heart rate monitored. I also would imagine I wouldn't be left crawling on my hands and knees in a corridor for 15 minutes . So that being the case, I may well have been transferred much sooner and been able to have an emcs under a spinal or epidural - and been awake to see my first child come into the world. And prevent the maternity ward staff giving my baby a bottle of formula whilst I was still unconscious despite DH telling them not to. It would not have been the same birth at all.

So it may be that your case is different and that your particular birth in hospital saved your baby - but it would be better IMO if you specified why that is, because otherwise your post just reads like scaremongering. How rare is it that the situation you experienced happens? What would have been the course of events if you had opted for a home birth? I think it is important to set all this out.

[CatsCantFlyFast]

It takes ~30+ mins even in a hospital to prepare for a crash section. This time is similar or lower for people transferring in for a homebirth

[CatsCantFlyFast]

*from a homebirth

[PenguinsEatSpinach]

You can read up on homebirth safety in a big recent study - link here. Broadly, homebirth is safe. It is just as safe for second and subsequent births. It is slightly greater risk for first births, but not to a level that would make it a 'risky' decision.

Do just be aware that you stand a fairly high chance of transferring in. But mostly for slow progress or more pain relief, rather than an emergency.

[EyelinerQueen]

emsyj I'm sorry you had such a shit experience

I didn't want to start a bunfight but you have said what I was thinking.

All too often you hear about babies who would have died if they'd been at home. But sometimes the very reason for the emergencies is being in a hospital, not being allowed to labour at your body's own pace and then the inevitable medical interventions that follow.

My Mother was very unsupportive of my HB. Even now, despite the fact that I had an uncomplicated and good birth, she blethers on about all my cousins and their babies who "would have died" if they had been as silly as me and had a HB.

These are women who were rushed through their labours and who were then deemed as failing to progress and then had interventions which in all likelihood caused the foetal distress that then necessitated an emergency section.

I can't help but think that these births would have played out completely differently if they hadn't been in hospital.

Obviously there are situations where there is genuine risk to the baby and mother and hospital is the best thing to do is to transfer to hospital but it's certainly not that common.

[emsyj]

On a more positive note though, EyelinerQueen, I had DD2 at home and it was a very healing experience. Lots of people thought that was utterly bonkers after my birth first time around - you can imagine, I'm sure, the faces of those who had said "Ooooh I bet you were glad you went to hospital" after DD1!

[Jcb77]

Notwithoutmymerkin.... Nope. Sorry. Quickest I've seen is 10 minutes decision to delivery time. And quite a few not very much longer than that. Some 'crash' sections are more 'crashing' than others. And if out NOW is what you need, it can be done in less than 30 minutes. You'd be bloody hard pressed to transfer in by ambulance, to theatre and delivered, within 30 minutes from making the phone call. It's not just about how long the ambulance journey takes. Fortunately, most situations are not nearly so time dependant. But they can be, and they can happen without warning in perfectly fit young women with perfectly normal pregnancies.

[Roseandmabelshouse]

Erm no, crash sections can happen in minutes
If they need to.

[emsyj]

FWIW I think the time lapse between the decision to perform an emcs to the time of delivery for me was 15 minutes.

Jcb77 can you give some more information about the type and frequency of the situation you describe where a normal and healthy pregnancy results, without warning, in a time-critical emergency? I'm assuming from your post that you are a midwife or doctor and will have some useful information to add here.

[PenguinsEatSpinach]

That is true JCB, although it's interesting that stand alone MLUs don't appear to have any statistical increased risk, despite also needing ambulance transfer in many situations.

I only have one experience of a super urgent crash section amongst my group of friends. It had become that urgent because my friend had been left labouring alone for hours and by the time anyone noticed, she was being prepped for a general running along the corridor. I wonder to what extent the ability to 'rescue' a situation in a CLU/alongside MLU is actually compensating for less that attentive care letting things get to that point in the first place (obviously not totally, things like cord prolapse...). So whether hospital birth would be safer if it was managed as cautiously, resourced as fully, etc as homebirth.