Home birth after 42 weeks

[ginagenie]

Hi
I'm currently 41+4 and still very much want to try for a home birth if I go over 42 weeks.
The midwives don't even want to let me go past 42 weeks as its hospital policy to induce by then so have booked for me to come in at 42 weeks but if baby is ok I would much rather wait and monitor.
No complications in pregnancy and I'm low risk. I keep reading that it's my decision and no one can force me to be induced or refuse me a home birth but I'm feeling a lot of pressure and not very assertive or confrontational at moment.
Just wondered if anyone had any tips or experiences they could share on home birth after 42 weeks where midwives were reluctant?
At the moment my best idea for a plan is when in labour just to say I'm not happy to come into hospital and hope they don't argue too much.
I'd obviously go in if there was good reason but a blanket 42 week rule doesn't feel v logical or fair to me. Thanks

[mudandmayhem01]

There are very good reasons for being induced at 42 weeks, the risk of stillbirth increases considerably. Also there is a higher chance of an overdue baby needed special care immediately after a birth. I am sure some who has had a baby more recently than me can post some current guidelines.

[QuilliamCakespeare]

Is there anything on the AIMS website? They usually have very sensible articles/advice. It's your body and your baby so your opinion matters.

[scaredofthecity]

For me it is not something I would risk. The guidelines are there for a very good reason. I was induced and had my DS at 42+2. He was fine but the midwives were very twitchy. They have seen it when it all goes wrong and no matter how 'natural' the whole process is, the reality is that some women just aren't able to labour without assistance.

[ginagenie]

Thanks I have looked at AIMs it mainly says you need to be forceful.
Induction has plenty of risks as well and I can't have any spinal assistance for birth or c section so if induction puts baby into distress or doesn't progress I'm heading for a general anaesthetic which is riskier for me and for the baby so I'd like to avoid.
I've read gestation can naturally be longer especially if you have variable cycles (mine are 27-36 days) as long as he's kicking, there's a strong heartbeat and enough fluid I don't feel there's a reason to induce for the sake of what could be a few days extra.
Midwife says my cervix is progressing and baby is really low so I'm still hopeful things can happen on their own.

[ginagenie]

It's not even that they seem worried it's more they keep saying well this is what's written down in policy so we have to follow that.

[ginagenie]

Thanks good to hear someone who stood up to hospital and it worked.
I will have scan Monday if I refuse induction, I'm happy to have the increased monitoring, don't want to put baby at risk. From what I have read if monitoring, 37 weeks and 43 weeks carry about the same stillbirth risk and no one gets that upset about babies being born at 37 weeks.
No one knows if this baby really is 41+4 it's just a best guess so they make a best guess at risks whereas induction has very definite risks.

[FrankAndBeans]

The blanket rule is for the safety of babies. You are right when you say you don't know if you have a 41+3 baby in there, you could be even closer to 42 weeks. Do whatever get your baby out safely.

[mudandmayhem01]

I think you should look into daily scans as an option. The refusing induction and the homebirth are separate issues. I would investigate the increased need of resuscitation/ special care of babies that are post 42 weeks ( a small but significant one) There is no way of working out to the day exactly how far overdue you are, and that is why midwifes are cautious. Do your research, compare AIM and NICE Guidelines and make an informed choice you feel happy with. The increases in risk are small but are obviously catastrophic if you are in that tiny percentage. There are also risks to c- sections and inductions too.

[Brown76]

I've been in your position. I'd suggest:

Read the AIMS booklet on induction by Sara Wickham (can download from Amazon and read on computer or phone).

Also understand the risks to your baby of going well over-term.

Asking to see a supervisor of midwives and see a copy of the hospital protocol on induction/home birth/post dates labour. Then have a proper meeting/discussion about your particular circumstances.

I found talking to a senior midwife who was a specialist in "normal birth" very helpful, she didn't sugar coat the risks but also was clear that delaying induction wasn't 'forbidden' and that I had a choice but had to understand all aspects of that.

Do try and relax as much as possible, as the pressure around this issue can be tremendous. I wish you well in making your choices.

[Princesspinkgirl]

You can refuse but please pay close attention to your baby these guidelines are there for your unbornbaby sake many woman have chosen to go on and wait till baby came

[silverfishlondon]

I planned a homebirth with first baby but went overdue and was induced at 12 days over. I was gonna ask for 14 days over but it depended when appointments were avaliable so bear that in mind!
On the day going in i was crying on the bus there, so unsure if i was doing the right thing- should i be going natural at all costs and reject this medical cascade or should i agree? They got a consultant to come speak to me (again) and she had had a homebirth herself which made me feel she knew where i was coming from. She said that some babys will be stillborn if get later and tho its a small risk it does increase. They simply do not have the info to predict which ones- even with daily scans- so advise induction.
I went with it and felt much better as soon as decision was made. Had pessary and allowed home, then labourd in birth centre pool once established. I felt i had a pretty 'natural' normal labour but unfortunitly dispite a LOT of pushing the position of her head ment i couldnt get her down and had csection. But actually- induction bit was ok for me. And i didnt have a pool at home and LOVED the birth centre one!

[mudandmayhem01]

Silver, I like your birth story. Lots of positives about the pool and the birth centre,, good non patronising support from your consultant. So many women say things like I failed if birth ends in a C- section. No birth that ends in a healthy baby and mum is a failure. My second was a an attempted homebirth, had to transfer to hospital for second stage, lots of people said oh how disappointing for you, but overall it was a really positive experience, lovely pool at home and the NHS at its best when needed at the end.

[silverfishlondon]

Thanks mudandmayhem! I felt at least i tried! Im currently overdue and waiting for a hospital VBAC, so trying to keep the same mindset, if it doesnt work out as i want at least i gave it a go.
Should say to OP: i had local midwife team on call just for me for homebirth, as apparently i was the only one that month. If they are not expecting you to have homebirth wont necessarily be avaliable. Also if they consider it higher risk then they dont have to agree to support your choice by attending. Yes you can insist on staying at home but you might get paramedics arriving not midwife- sure thats not what you want.

[LittleBee23]

My hospital didn't induce til 40+14 so I was happy to wait til then but I think I would have found it a difficult choice to make post 42 weeks. I didn't want induced and feel that induction isn't always the best course of action but equally it's a scary choice to make with other stats pointing toward it being riskier.

I was lucky in that I had spontaneous labours before the cut off. Fingers crossed baby comes before you need to make the choice x

[DeepanKrispanEven]

I can't have any spinal assistance for birth or c section so if induction puts baby into distress or doesn't progress I'm heading for a general anaesthetic which is riskier for me and for the baby so I'd like to avoid.

I don't think that's correct, is it? I had an induction for DC1 and subsequently had an epidural.

[DeepanKrispanEven]

No one knows if this baby really is 41+4 it's just a best guess

Well, yes. So it could be 42+4, or more.

[sycamore54321]

You are NOT low risk if you go over 42 weeks. Your baby is at significantly increased risk of death. Make any decision you want - you are an adult after all - but do not kid yourself that the very real risks to your baby do not exist when making your decision.

[LittleBee23]

Being induced also means it is no longer 'low risk'.
I don't think there's any reason to be so harsh.
It's not an easy decision to make.

[Pluto30]

The risks outweigh the "ideal birth plan", IMO.

[Oly5]

I think it's selfish to put a baby at risk like this. Really, how would you feel if your baby was stillborn?
The best laid birth plans go to the wall because, quite frankly, giving birth is a risky business.
I was SO pleased to be in hospital when things went very wrong for us. Your chance of being transferred to hospital is high anyway, especially if you're a first time mum.
Good luck with your decision but I'd always put the baby - and the expertise of the medical profession - first

[ICJump]

I just wanted to say a had a wonderful induced birth at 42+1. I laboured under a shower, then a pool. I felt joyous and triumphant.
I wanted to share that story because at the 41++ I felt like I had no good options, wait it out felt scary but so did induction.
I just wanted to reassure you there can be good choices what ever you do

[LittleBee23]

I don't think it's purely about 'an ideal birth plan'.
I didn't want induced because I wasn't comfortable with the risks involved. I did a lot of research at the time and found it a very hard decision to make. I was very fortunate that I didn't have to make the decision.

I think it's completely unfair to assume that someone doesn't want an induction purely due to being 'selfish' and wanting the 'perfect birth'.

It's not as clear cut as that.

For the record I also had a lot of the same comments made about having a homebirth - how I was being selfish wanting a home birth and putting baby at risk and how I just wanted to do it for the experience etc. Ironically I mostly chose a homebirth because dd1 was a 2.5 active labour and I knew the chances of me having an unplanned homebirth was dd2 was very high so I weighed up the risks and chose that.

It's not black and white and every mother has different fears about different risks.

[sycamore54321]

Humans are generally rubbish at risk assessment. As illustrated on this thread. Risks of induction v risks of post-dates failing placenta? No contest if you look at the evidence.

Someone above called my comments harsh. I refuse to be part of the Internet community that cheerleads women into ignoring medical advice and puts them and their babies at huge risk. Lots of people can come on and say they refused induction and delivered babies at eleven months just fine and while that may be true, because it is not all-or-nothing, it doesn't mean anything about the safety profile of what you are doing.

Monitoring can only show once something has started to go wrong - why would you want that? OP please discuss your plan with a doctor. Do not gloss over the risks. Understand them and then by all means, decide v

[MyschoolMyrules]

Listen OP. Carefully. Most posters have written that the risks of stillbirth increase. Listen to them, as this is correct. Do not put your baby's life at risk.

I was 40 + 13 days when placenta stopped working efficiently and I pushed the date of the induction to the limit. When I was rushed into hospital the surgeon simply said 'we have MINUTES' to get this baby out. Trust me, please trust me you do not want to be in a similar situation.