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I am going to write in your notes that you are advised AGAINST a homebirth!

(47 Posts)
ShellyBobbs Thu 13-Nov-14 14:53:27

This is your fifth baby and you are a high risk of PPH.

Talk about shocked, this is what I was told yesterday after my 20 week scan. This is also despite 4 very healthy pregnancies and deliveries - the last one being a homebirth. This doctor seemed set in concrete with her opinions and there was no room to maneuver. Now I'm not stupid, I understand that there is some risk but she didn't want to discuss how it could be managed if it did happen at home, just 'I do not advise it'.

As a matter of interest the last doctor I saw at my 12 week scan was all for it and thought homebirths were a great thing. I'm under a specialist due to hypothyroidism which has no bearing on a homebirth.

Just venting really, seems like my area must have hit their homebirth figures for March 2015!

Booboostoo Thu 13-Nov-14 15:31:18

Why do you mind so much? She can't force you to have a hospital birth but she does have a professional opinion and needs to have it recorded that you have made a different choice in case anything goes wrong and her advice is questioned. I could understand if your complaint was an unwillingness to discuss options or give you information about risks but writing her advice in your notes shouldn't really bother you.

BlinkingHeck Thu 13-Nov-14 15:41:44

My midwife said all pregnancies are different, and just because you had healthy pregnancies and straight forward births before it doesn't mean this one will be. It is important that you know that. And if she advises against it then that's her professional opinion it's up to you whether you take her advice or not. But at least you have been told the risks. She is doing her job.

Efferlunt Thu 13-Nov-14 15:47:06

Not to scare you but a PPH is pretty grim I lost three ltrs and was told that if it had been a homebirth I would have died

It was only my second pregnancy though. It is difficult to predict. I've no idea what the risk factors for later pregnancies are.

ShellyBobbs Thu 13-Nov-14 15:53:44

I understand she was telling me the risks, she wouldn't tell me what they COULD do for me at home if it did become a problem, no mention of an injection after delivery for instance. It is a risk, however purposly not giving me the option of a homebirth is just wrong in this particular case as it is an option and plenty of women have done it. it was just very black and white with her, it wasn't a discussion it was a lecture - her attitude shocked me not the information.

ShellyBobbs Thu 13-Nov-14 16:02:10

I'm not very good at expressing myself on posts.

Firstly a fifth pregnancy is not a good enough reason alone to advise against a homebirth and when weighing up risks they do go off past pregnancies and births as well as your health etc.

I bet you were petrified by your pph, I've been reading about them.

Homebirths, such an emotive subject.

vichill Thu 13-Nov-14 16:02:21

Each to their own but I'd want black and white information in this instance. It is her job to assess risk not to rile you. I don't think emergency blood transfusions can be performed by midwives.

LaVolcan Thu 13-Nov-14 16:07:31

Did she say why she thought you were at risk of a PPH?

loudarts Thu 13-Nov-14 16:17:40

When I was pregnant with dc5 I was told I couldn't have a home birth as my uterus would be getting worn out hmm

ShellyBobbs Thu 13-Nov-14 16:21:41

Lavolcan, because it's my 5th, that's the only reason.

The transfusion risk was the same with my fourth, slightly raised but not nearly enough to not have a homebirth.

Was the first doctor wrong then in having a discussion about all the risks, checking I understood everything and giving me the OK? Nobody has commented on the conflicting opinions.

I'll add some links later to medical research about this subject just to show I'm not some raving tree hugger grin

I haven't made my mind up either way yet either.

minifingers Thu 13-Nov-14 16:21:55

Has anyone had their doctor write - 'has been advised of the risks of a hospital birth' on their notes?

Why not?

Why are the risks of homebirth discussed and documented, but not those of a hospital birth?

Specifically, did she point out that opting for a hospital birth increases the likelihood of a PPH?

ShellyBobbs Thu 13-Nov-14 16:22:45

loudarts, where did you have your baby?

minifingers Thu 13-Nov-14 16:24:10

"When I was pregnant with dc5 I was told I couldn't have a home birth"

I really, really wish women would start writing these comments down, getting the health professional who'd uttered them to put a signature to them, then making a formal complaint about poor communication.

ShellyBobbs Thu 13-Nov-14 16:26:27

minifingers, she would not even discuss a homebirth at all, despite my many questions. Research shows a hospital birth is much more risky due to intervention.

She then gave me a letter to give my doctor saying ,your patient has been booked for a hospital delivery'. shock

Do you have a community midwife who knows you and your history, and who is experienced with home births, whose advice you could ask, Shelly?

Most hospital doctors will have little or no firsthand experience of home birth, and they tend to see the births that are less straightforward, which can give them a skewed view of birth - if the majority of the births you see are complicated or difficult deliveries, you will tend to assume that that is the actual percentage of complicated deliveries in the general population. I think sometimes this can give them a somewhat pessimistic view of childbirth, and that can, IMO, make them less keen on home births.

A community midwife who is experienced at home births will be able to tell you what happens if there is a PPH after a home birth - how dangerous it is, what they could do (if anything) to treat it at home, and when someone with a PPH would need to transfer as an emergency to hospital.

IMO, you need more information than the doctor has given you - you need to know why she is saying you are at a higher risk of PPH! and how high your risk of a PPH is.

Then, with that information, you can talk to a community midwife, and explain why you are at higher risk and how much higher that risk is, and then you can ask her whether she would be willing and happy to deliver you at home, and ask her to explain her rationale behind her answer, whatever it is.

Then, based on that information, you can decide if it is a risk you wish to take.

If you decide against a home birth, have you considered a Domino?

I had two home births - both times my obstetricians were unhappy about the concept of me having a home birth, because it was a somewhat older mother, and I was overweight. But my community midwives, who were very experienced with home births, and very keen on promoting them, thought that I would be fine to deliver at home, and we went ahead - and I had two lovely home births, with d2 and ds3.

I felt that my midwives were being entirely honest and straight with me, and I trusted them, and their skills, knowledge and instincts 100%. If, at any point, they had said they thought I needed to go into hospital - even if it had been that they were getting a bad vibe that they couldn't quantify - I would have trusted them, and gone in.

ShellyBobbs Thu 13-Nov-14 16:28:35

and no, absolutely no saying hospital was any riskier.

loudarts Thu 13-Nov-14 16:32:17

I had her in hospital. The midwife refused to consider me for a homebirth and I didn't have the energy to argue with her. Was literally at the hospital 20 minutes before she was born and went home an hour later.

ShellyBobbs Thu 13-Nov-14 16:34:08

SDTG, she couldn't tell me how increased the risk is, it was a catch 22 conversation. 'How increased is the risk to be advising me against it', any increase and we advise against, it's your 5th!

I was trying to do exactly as you say but no luck.

I too trust the midwives so much more, I am seeing the doctor again 2 days before the midwife so will probably get another one. I'm going in armed with written questions this time.

5madthings Thu 13-Nov-14 16:35:46

Actually there is recent evidence to show that even if you are multiparous then there isn't an increased risk of pph providing you haven't had it before and it's a low risk preg etc. I will see if I can find the link.

I had them say this to me when I had my fifth.,. They can write it in your notes but they can't stop you having a homebirth.

ShellyBobbs Thu 13-Nov-14 16:36:25

loudarts, this is why I had my 4th at home, I labour very quickly and personally feel I would be more at risk of having a lay-by baby. I was advised by midwives to have a homebirth for thos reason last time. That was only 2 years ago!

ShellyBobbs Thu 13-Nov-14 16:40:02

5madthings, if you could find it that would be brilliant, thanks.

I'm glad why you all understand my frustrations, I would have this baby in hospital in a heartbeat if there was a real risk, but so far I can't find a legitimate reason.

5madthings Thu 13-Nov-14 16:44:10

LittleBairn Thu 13-Nov-14 16:44:51

It's a bully tactic intended to scare you into complying with them. Ignore.

5madthings Thu 13-Nov-14 16:46:14

This isn't the article I originally found but it is about your situation. Basically in some countries ie with poor access to health care etc yes it makes you higher risk bit actually in the uk the latest evidence is that parity alone does not increase your risk of pph.

The other link wad one I got from a thread on mnet, will look again later need to cook dinner!

ShellyBobbs Thu 13-Nov-14 16:48:15

5madthings, thanks so much.

little, it's scared my hubby. I went through this with him last time as he was bricking it incase anything went wrong, he then turned into an advocate grin

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