How do I choose between a hospital or home birth?

[AbsolutelyIDo]

I'm so torn. I like the idea of doing it at home, but am worried about anything going wrong and wishing I'd been in hospital. How did you make a decision?

[laurenwiltxx]

I chose birth centre because its more of the home experience

[soundsystem]

I had a home birth and the thing that swayed me was that I knew if I changed my mind and felt I wanted to be in hospital for any reason I could just go in. Whereas if I went to hospital and decided I'd rather be at home it would be a bit more difficult!

I'm 10 mins in a cab from the hospital, though, which made it an easy decision. If I was further away I might have thought differently!

Is it your first? I'm planning another home birth for my second and it's an easier decision as I have some sense of what labour will be like!

[WindTheFrog]

You'll have your midwife with you at home and if she feels there are any risks she should advise you to go to hospital, ring the ambulance and go with you. Have you spoken to your midwife about it?

[geekaMaxima]

You could go by the stats from the 2011 birthplace study.

If you're low risk and it's your first baby, the overall safest place (for both baby and mother health) is a standalone midwife led birth centre, followed by a midwife led unit attached to a hospital, followed by a consultant unit, followed by home birth. There's not much risk difference between the first three, but the rate of interventions (and maternal complications and recovery time) increases with each one. Home births for first-time mothers have a higher risk for the baby, which is probably less important if you're 5 mins from a hospital than if you're over an hour away.

If you're low risk and it's your second or subsequent baby, the overall safest place is home, followed by standalone midwife led birth centre, followed by a midwife led unit attached to a hospital, followed by a consultant unit. There's not much difference between the first two, as home births are very safe for mothers that are low-risk the second time round (i.e., they've already had a straightforward birth).

After that, it's personal preference. If you're the kind of person who is reassured by doctors and NICU being close by, then you might feel safest and have an easier birth in a hospital consultant unit. But if you're the kind of person who finds hospital environments stressful, then you might feel safest and have an easier birth in a standalone birth centre (or at home).

Talk to your midwife, know the relative risks, visit the options to get an idea of where suits you best, and pick somewhere that makes you feel safe and comfortable

[Fourormore]

www.homebirth.org.uk/ eased a lot of my worries.
I'm a few weeks away from my third home birth now. I had my first in hospital and the care afterwards was so awful (no food for nearly 24 hours afterwards, ignored, belittled) that I couldn't face that again so I had a home birth with my second and third.

You can always transfer in if you decide you want to be in hospital. It's very, very rare for something to go wrong without warning. With a home birth you'd be transferred in at the first sign of a problem.

I also watched The Business of Being Born on YouTube. It's American but very interesting.

[geekaMaxima]

One other thing to consider about home birth is whether the midwives in your area are used to doing them. Your midwife should be able to tell you if everyone who might called out for your home birth regularly attends home births.

Where I live, home births are relatively common (by UK standards) so all the community midwives are experienced in how to care for home births and water births, and have good judgement of when it's necessary to transfer, etc. It's experience like this that makes home births safe.

In other areas, home births are more rare so the attending midwives might be less experienced in home births and water births, and the judgement of when to transfer may be more variable. Some women in these areas hire an experienced independent midwife for a home birth rather than rely on the NHS midwives.

[AbsolutelyIDo]

Thanks so much for the brilliant advice. I really appreciate it. This is my second, DD was born in hospital after a strong of interventions I really didn't want (and still think could have been avoided). I felt very vulnerable in hospital afterwards and was laughed at by a midwife for trying to breastfeed with my 'tiny nipples'. Basically, it was a bit shit and I'd love to be at home this time. (As a disclaimer I'm still very grateful that I gave birth to a healthy child and that I was home quite quickly afterwards in fairly good shape myself). I'm only 10 mins from the hospital and I really think I would be calmer in my own environment and more able to deal with the pain. That's a really good point about how experienced the midwifes here are with home births though, I'll check that out.

[wigelspigels]

I had my 2nd at home 5.5wks ago. I knew from the start I wanted a Homebirth. 1st was born at an amazing midwife centre. My transfer time from home is slightly less than from the midwife centre. My midwives were amazing. My husband loved the experience too.

[wigelspigels]

Meant to add what a disgusting midwife making fun of your breastfeeding

Nipple size as such makes no difference as far as I know

[StrumpersPlunkett]

We had both boys at home
For us we worked on the premise that if there was the slightest hint things were not on track we would transfer. Or if it was more painful than I could handle.
No guilt or pressure either way.

I think it was partly as we were so open about it that it all happened as it did.
Good luck 😊

[PepperMallow]

I had DC 2 & 3 at home and DC1 in hospital having tried for a home birth. If I'd had the amazing support from my DC 2&3 (not twins) home birth teams with DC1, I'm very confident I would have been supported differently and had the homebirth I'd hoped for. I was v v close to the hospital for DCs 1 & 2.

I felt comfortable, confident and in control when home birthing. Whilst my hospital birth was better than I'd anticipated, being at home allowed me the confidence to be myself and take control of my labours and enjoy the relaxed nature of being in my own home once my DC was born. Although my DM did have to distract DC1 with loud toys at the latter stages of labour with DC2!!!!

Do you have a local homebirth team? I'd suggest meeting them if you can. My experience showed what a completely different experience it was and how relaxed it made my pregnancy, not just the labours (if being relaxed in labour us even a thing!).