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How common is it to transfer during a home birth?

(29 Posts)
amitymama Fri 18-Jul-08 22:11:42

It seems everyone I know who has attempted a home birth has transferred. Granted, most of them were first-time mums so that might have had something to do with it (not knowing what to expect, midwives more pushy to transfer since they have an 'unproven pelvis', etc..) but it's really getting me down. It's made me feel that I should prepare to transfer and then be glad if I don't but I don't want to go into it thinking that way. On the other hand, I don't want to be really disappointed and feel silly if I do end up going into hospital.

If you had to transfer do you wish you had considered the possibility so you weren't so disappointed or do you believe that 'keeping the faith' is important?

Rhian82 Fri 18-Jul-08 22:16:01

I think 40% of first-time mothers transfer to hospital.

I'm thinking about a home birth (first child) and I'll definitely get a bag and whatever ready so I can transfer if necessary, then just go with it I think.

madmouse Fri 18-Jul-08 22:19:57

I did consider the possibility and it was part of my birth plan.

My dh and I saw it as starting labour at home and taking it from there, and i can recommend that attitude. So when I started to develop PE and my blood pressure went funny i was ok to go in and for al sorts of reasons I thank God on my bare knees that I did.

I also discovered that a hospital birth is not the end of the world and that good midwife support etc is available. I know I was lucky, but I was offered floor space on a matress, aromatherapy, heatpack etc before any stronger pain relief. I ended up with the works but stll feel positive about my labour.

mylovelymonster Fri 18-Jul-08 22:20:57

I attempted a first-time home-birth, and needed to go into hospital for an assisted delivery after about 24hrs. I was disappointed, however at the time it was absolutely the right thing and ultimately DD was safe and delivered very quickly and without undue stress to either of us (kiwi-ventouse) so ultimately not bothered.

When the time comes you will know what the right thing to do is, and the midwives are very good and supportive, but will suggest going in to hospital if/when they think it's absolutely necessary. Pack a hospital bag just in case, but you may never need it. Another woman I know had a perfectly lovely and event-free water birth at home a few days before - her first too - supported by the same MW I had.

ShowOfHands Fri 18-Jul-08 22:28:14

I transferred in after a 26hr labour (6 hours of pushing). I had a bag packed and ready just in case but honestly hadn't thought I'd need it. I ended up with 3 failed ventouse attempts, an extensive episiotomy, failed manual rotation attempt and eventual emergency cs. I tell myself in retrospect that without the transfer me and dd wouldn't be here. There was no other way for her to come out. I struggled very much indeed with feeling that I 'failed' in some way. I feel strongly that whatever your birth, wherever it takes place and however your child is born, the key thing to remember is that there are no guarantees. Plan for your ideal birth but accept whatever might happen and focus on the end result.

I'd have a homebirth next time btw. If 40% transfer then 60% stay at home! The odds are on your side.

Aefondkiss Fri 18-Jul-08 22:29:47

I had my ds at home, but my pfb was born in hospital, though, if I had felt more confident I probably could have had an hb first time around because it was a very straightforward and fairly quick first labour.

As pp have said it is good to be prepared to go where you need to be, when you are having your baby, I went into my hb very open to going to hospital, but as confident as I could be that I would have a hb.

Good luck, I hope you get your hb.

mylovelymonster Fri 18-Jul-08 22:34:25

ShowOfHands - OUCH!!smileThat was quite a lot of assistance.
If we have another one (fingers crossed) we'll try for a HB again. Second one's supposed to be easier......

amitymama Fri 18-Jul-08 23:08:26

I definitely plan to have a birth plan with details for what I want to happen in case of hospital transfer but am not as sure about having a bag packed. Part of me knows it would be sensible and only there as a precaution but another part of me thinks that if I pack that bag I am already subconsciously packing up my belief in myself and giving in to the 'hospital ride', so to speak. I know it's silly but I'm trying to come to grips with it.

This will be my second birth, btw.

Aefondkiss Fri 18-Jul-08 23:13:50

I didn't pack a bag when I had my ds at home, you don't need to pack a bag really! it is all inconsequential stuff imo.

Blu Fri 18-Jul-08 23:40:06

I absolutely refused to entertain the idea of ending up in hospital - which is how I came to be on the post-natal ward with nothing more useful than an outsize box of breast pads - no money, baby clothes, nappies. mothing...and DP went home t sleep and couldn't be woken for bloody hours so I was stranded!

tRansferring was OK though - I knew we needed help, and I was glad I had spent the longest part of labour in relaxed surroundings at home.

In fact during the succesful ventouse delivery, the registrar said 'if you'd been labouring in hospital, this would have been a CS hours ago!'.

Ate Sat 19-Jul-08 02:29:13

I had DD1 in hospital, DD's 2&3 at home. With my homebirths, I, like Blu, refused to entertain the idea of going to hospital. In my birthplans I did outline my wishes were it to happen but didn't have bags prepared, etc.

I had straightforward births but I felt that having very experienced birth partners (akin to trained doulas in their knowledgability and experience) and community midwifes really helped up the chances of straightforward births at home IYSWIM.

My DSister had a her first (direct OP) baby at home with an experienced birth partner and private midwife. A friend had her second at home, and another friend had her first at home. Each, including my two, without transfers.

Transfer was mentioned with my friend who had her first at home but with the right support, she managed to birth a direct OP baby wthin 18 hours, no assistance, no tearing, no need for intervention, etc. I was lucky enough to be birth partner at a couple of these births.

There is no doubt that some occurances during or after birth necessitate transfer to hospital! I've been lucky enough to be involved in births which haven't. I couldn't comment on the regularity of transfers but do believe that the right support can make the difference when a transfer isn't necessarily the only answer and that yes, faith can go a long way.

Ate Sat 19-Jul-08 02:42:00

Just thought to add (maybe this could be considered statistical in some sense!) none of the people mentioned above used conventional pain relief, all aimed for and succeeded in active births and internal examinations were kept to a minimum (denied completely in my births), with a commonly held belief that the spiral of intervention can start with those very early interferences with the bodys natural processes, endorphins, mechanisms, not to mention emotions. Instinct was sought, respected and relied upon. smile

naturelover Sat 19-Jul-08 09:11:02

I had my first at home with no pain relief and no intervention (only one internal exam) and it was a very positive experience. Had community midwives and a trainee doula with me and DH.

However... I had to transfer after the birth with a retained placenta - but managed to be home again within a few hours. Despite the transfer I was very happy with my experience and would definitely try for a homebirth next time. I did have a bag packed although I hadn't packed any clothes for myself (meant I came home in a blood-splattered nightie!)

One of the community midwives said a few days later that in hospital I would not have been "allowed" to push that long (over 3 hours) and that in hospital they'd have had me on a drip and used ventouse to get baby out. I'm so glad I was able to stay at home. It was very empowering when the midwives just sat back and let me get on with it, and our doula really gave me faith in my own body to birth naturally.

littleducks Sat 19-Jul-08 09:16:32

My second birth was an unplanned homebirth, after the actual birth there were some problems with dh, the paramedics finding the things i wanted (black knickers for example) until i told them to just fetch me my hospital bag, i then could dress myself and baby easily, so perhaps have everything on your hosp list in a bag or box (that might feel different) just to make things simpler regardless of whether or not you transfer.

EssieW Sat 19-Jul-08 09:19:35

I transferred after 40 hours because DS not coming out and a very long 2nd stage. Eventually persuaded out with forceps. Like others, glad I was at home for as long as I was and gave my body the best chance to birth without intervention.

Would definitely try a home birth again - but transfer in earlier if similar problem. I packed a bag - useful to have (even if for the midwives at home to have everything at hand). Also DH was so stressed and panicked, he wouldn't have been able to pack a bag at that point anyway

Guadalupe Sat 19-Jul-08 09:20:47

I had to transfer due to meconium in the waters but I know several first time mums that had successful home births. In fact, I can't immediately think of anyone who went to hospital when they had planned a home birth except for me!

kazbeth Sat 19-Jul-08 11:10:02

I had a first baby home birth but didn't transfer. I did pack a hospital bag though just in case and it was handy to have everything in one place so my husband could find it.

I'm sure I've read somewhere (maybe the homebirth.org website) which has stats that show that even if you transfer you're still less likely to have interventions. From reading the home birth threads on here it seems that even people who've had to transfer are glad they did it (the home birth that is).

Hannah81 Sat 19-Jul-08 17:09:47

I had my second at home (planned) and i did pack a few essentials in a bag "just in case" - i thought of it this way: they would only send me to hospital if i needed to be there and if you do end up being transferred, then its only because they are putting the safety of you and your baby first. Its better they transfer you to hospital if there is even a small risk, than take this risk at home and something go wrong.

So if I were you, plan for your homebirth, but if you are transferred, then don't beat yourself up over it, and if all goes well, you can be discharged after 6hrs anyway.
good luck, hope all goes to plan for you.
xx

amitymama Sat 19-Jul-08 19:05:56

Thanks everyone, you've really made me feel tons better. I had planned to have everything I need for the birth divided into two boxes (labour and postnatal) so I suppose if I had to transfer I could just tell DH to throw the postnatal stuff into a bag and that'd be most of the stuff I need. That way it's all together but I don't have that mental block that I'd already packed my bag ready for transfer.

Celery Sat 19-Jul-08 19:20:42

It's much more common to transfer with first babies than subsequent babies. It's 40% for first babies, I wonder if anyone knows what the stats are for subsequent babies? First births are often longer and more complicated, but not always. You don't say, amitymama, is this your first birth?

Had I planned a HB with my first, I am certain I would have transferred, due to circumstances. I went on to have two perfectly normal, much faster, homebirths.

maxbear Sat 19-Jul-08 19:56:28

Generally about 30 - 40% of first time mums need transfer, usually for a slow labour or a long second stage, so usually not an emergency. Second and subsequent timers who have had normal deliveries before are much less likely to need transfer, about 10 %.

madmouse Sat 19-Jul-08 22:44:41

Amitymama, you also take out travel insurance in case you fall ill abroad and mortgage protection in case you lose your job. That is life.

eekamoose Sat 19-Jul-08 23:06:06

I have just had a think about the mums I know who wanted homebirths for first baby.

There are seven. All in London.

Five of them were transferred in to hospital. Two had c-sections.

Of the two who had their babies at home, both went on to have their second babies at home.

Of the five who went in to hospital: three had second babies, none of them at home.

All ended up with living healthy babies.

So that is 4 home births and 12 hospital births. And 16 healthy babies. (I think???)

HTH.

amitymama Sun 20-Jul-08 09:03:53

Celery, no it's my second birth.

maxbear, thanks for those stats, that makes sense. I thought I had read 10% somewhere but I didn't realise that was for non-first-time mums and so that's why I thought all of my friends transferring seemed high. But like I said, all but one of them were first-timers so it makes more sense now.

IndigoMoon Sun 20-Jul-08 09:13:42

i think the higher transfer rate on first time births is the length of time that a woman can labour for, tiredness and generally not coping with the pain.

i had my second at home and hospital was never ever mentioned. my pulse did start racing for a short time and they did discuss keeping an eye on it but once i had some tea and toast i was fine.

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