Reconsidering a homebirth.

[Deemented]

I'm 21 weeks and decided pretty early on that i wanted a homebirth. I still want a homebirth, but a few things have come up which is causing me to reconsider my decision.

My firstborn twin son had a condition called posterior uretheral valves, which meant he was unable to live long after birth. It also means that if i were to have another boy, then there is a chance that either the same condition could reoccour or if not PUV's then he would be more likely to develop a kidney or renal problem.

I'm going to be having further scans during this pregnancy, just to check everything is ok, but as any problems could develop at anytime, i'm wondering if a homebirth is such a good idea... what if any problem doesn't present til birth, and the baby needs urgent intervention?

WWYD in my situation?

[holliejobber]

Im sure you'll get some good advice from your midwife. Even if there is a small risk i would give birth at hospital. Labour is such a small part of having a child that i wouldn't say it is worth any long term consequences.

[TheDMshouldbeRivened]

hospital. Even if there's a small risk its not worth it. Ask for the birthing room so its half way.

[LuluMaman]

I would be thinking twice about a homebirth in such circumstances if there is a chance of serious problems that won;t be known until birth, especially if urgent intervention could be a life saver.

perhaps wait and see what the further scans say.. if all is well, is there a greater chance that there won't be problems at birth?

on balance, being in a MLU in /attached to a CLU might well be safer for you, it is a decision you need to make with more information

also, you sound like you are doubting that homebirth is best for oyu and you won;t labour as well or as efficiently if you are stressed and anxious in your surroundings

you could compromise and spend as much of your labour at home before going in to deliver

[warthog]

hospital, without a doubt.

[racmac]

Deemented - sorry to hear about your first born son. I am very pro homebirth and had 2 homebirths against medical advice.

Im not sure how to put this tactfully and i dont want to offend you or anyone else but how did you find out about your first born having PUV? Was it through scans - is it something that you knew before hand.

IT might be easier if i explain why i wonder - when i did lots of reading about homebirths i read a story about a lady who had refused all scans and medical interventions etc - she gave birth to a child and it was apparent that he would not survive - Hospital would have made no difference - he would have died in hospital but would have been immediately taken for treatment and put on life support - but because she was at home her and her husband were able to hold him and comfort him and hold him until it was time for him to be taken to the Hosptial and she said that this gave her and dh the time to bond and mourn in peace without the Hospital involved.

Are they able to tell 100% through scans that your son has or has not got PUV

I suppose if there was a chance that your son could need treatment in Hospital after birth that would stop him from being in pain or stop him from sying then no doubt on Hospital birth - if the scans are 100% clear then consider homebirth - i dont know anyhting about the condition

[NewPenName]

wELL, congratulations on yr pregnancy. i'm v pro-home birth but wouldn't for this one if i were you. You probably would be down as higher risk so not suitable for HB anyway. Good luck, i'm sure you'll get v good advice.

[sabire]

Ask to discuss this with a senior midwife, and with your consultant. Whether you have a homebirth or not, it's not a good idea to stick a 'high risk' label on your pregnancy without properly informed input from people who understand your obstetric history.

Good luck!

[Deemented]

Thank you for all your replies.

racmac - we found out at 14 weeks that DS was likely to die after a routine scan at 12 weeks showed a possible umbilical cyst.

The PUV's can develop anytime during the pregnancy, but at the 20 week scan everything looked fine 'at the moment' where the sonographers words.

I really do want a homebirth, after an awful VBAC experience with dd, but i can't help but wonder if hospital really would be the best place.

[racmac]

That must have been really hard to come to terms with - i understand your fear of Hospital birth - i had a horrible time with DS1 and found my hb's far better experiences.

I dont believe that you will find a supportive midwife - i was lucky and although Consultant advice to me was no HB my mw was wonderful and supportive both times and actually listened to me.

If you had a scan at 39 weeks and everything looked ok - would they support you then?

I think id probably go to Hospital in your case but only you know all the circumstances and obviously know lots more about PUV's

[Deemented]

I've just spoken with my bereavement midwife today and she thinks having baby in hospital would be a wise idea, however she has made me an extra appointment with my consultant for next week to discuss it with him.

[belgo]

I'm also very pro home births, but even if all of your scans are normal, and everything goes well during your pregnancy(and I hope it will), I'm concerned that during your labour you might get very worried about your baby being born, and I know that if I was you, I would want the security of a hospital.

If you feel that you might need more support during labour, have you thought about hiring a doula?

[Deemented]

A doula would be a great idea, but unfortunately we don't have a lot of spare cash at the mo.

[Deemented]

Have appointment today with Consultant to iscuss my request for a HB.

Bit nervous.

[CarmenSanDiego]

It's very possible you could get a trainee doula for free or just a token amount. DONA require three births before they can certify so many trainees will work for free if you find a local trainer and ask them if they can recommend someone.

I'm pro-homebirth and wouldn't know what to tell you. I think you need to work out the risks of the condition reoccurring. After all we all run SOME risk of a condition happening which needs urgent medical care for the baby. It's a question of how high that risk actually is for you. If it's 1 in 200, I would probably go homebirth. If it's 50/50, hospital.

But... it depends on whether there's anything that could be done in hospital. Racmac is right. If the hospital can save your baby's life or stop the baby suffering if the condition occurs, then hospital is probably a good idea. If not, then it might be calmer for you all at home.

[CarmenSanDiego]

Good luck with the consultant appointment. Might be a good idea to review homebirth.org.uk and possibly print out any relevant info if you feel it might be a difficult meeting.

[Deemented]

Appointment today went much as expected - not very well.

Consultant would not entertain the idea of a homebirth whatsoever. He told me that should i go ahead and have one then it would be against his advice. He stated that the safest place for baby and i to be would be in hospital, vbac. He wasn't especially concerned about any renal problems occouring with baby at birth as i am having regular scans. He's more concerned about my c-section scar rupturing. Said that if i were at home and this were to happen then baby and i would most likely die.

I asked about giving birth in the birthing unit, but he again pulled his face. He said a water birth would not allow them to properly monitor baby. I said that plenty of women have vbac in water and are monitored by doppler, and he said that it's easier for the midwives to monitor with a probe on the head. I think that's the crux of it there - it's easier for the midwives...

I told him about my concerns about having to lie down continuously and he said that we could perhaps negotiate that i be allowed to walk round for maybe ten mins every hour. God, i can see this slipping out of my control as i type.

He wants me to see the head of midwifery and speak to the head of the labour ward wrt my birth choices. I just feel i'm being steamrolled and guilt tripped into doing what they want me to. I reminded him how hard i had to fight to get a vbac with DD and he just laughed. His parting shot was - 'I'll wear you down yet...'

I fear he might be right.

Go back in six weeks...

[Roomfor2]

Why on earth would you want to risk it with all the potential problems that you have listed, not to mention the risk of death that your consultant has told you about?

I had a hospital birth and it was absolutely fine. Plenty of help on hand if needed, equipment all there, no worries about there being a delay with help if there was a problem during or after. You are only there for a few hours, would it really make that much difference to you to insist on doing it at home and take all these huge risks?

I don't mean to sound harsh at all, apologies if it comes across that way, that's not the way it is meant, but the reason it is being taken out of your control is because other people (i.e. your medical team) know best in this situation, and you need to be in the safest place for this birth, not the one you perceive to be the nicest (or whatever word you choose to put there).

[LuluMaman]

I don;t like his attitude or tone at all

if the renal issues are not going to be a problme and he is treating you as a VBACer, then a home VBAC or VBAC in the birthing unit is not something he should be talking yuo out of

intermittent monitoring for VBAC has been discussed on here, if you search for it, and the research re intermimttent re constant monitoring

even with CFM, you acn sit on the bed, sit on a birth ball, lean on the bed, go on all fours on the bed.

the notion of spending your entire labour pretty much immobile is totally old fashioned and counter productive

i;d ask for a different consultant and see head of midwifery and explain you are being treated like an idiot

the risk of scar rupture is equivalent IRRC to that of cord prolapse

yes, it is a risk, but with one to one care at a homebirth you are more likely to have it picked up on quicker !!

[LuluMaman]

why is he saying your baby needs a foetal scalp monitor, which is invasive , before you are in labour?

he is setting you up for a labour that does not progress, taht goes to c.s IMO

get in touch with AIMS.

[Deemented]

Roomfor2 - I don't want to risk it, but i would like to have some conrol over how i give birth.

With my DD, now 16 months, i had to fight to have a vbac. Consultant (same one) refused point blank a water birth and kept pushing for a c-sec, which i really didn't want as there was no clinical need, other then the fact i'd had one previously.

When i went into labour with dd, the midwives insisted that they break my waters to put a probe on her head. They did this, and i spent the next eight hours flat on my back in bed. DD was back to back, and that coupled with the fact that i have bad back problems anyway, made the whole experience horrendous. I think this was the reason i ended up with a 3rd degree tear and over thirty stitches...

This time, i'd like to have some say over what happens, some control. I want to be able to get up and move around if i so wish. Ideally i want a HB because i know they wont let me in the pool at the birth centre, and with my back, i find the water really helpful, so that's another reason for wanting a hb - i can labour or birth in the pool if i so wish.

I've looked into the incidence of uterine rupture, and it's one in 200. If i was properly monitored at home, the midwife would be able to notice any problems sooner as it'd be continuous one to one care.

I'm not going to be stupid, and if i needed to go to hospital then i would... i just want to be able to have some say in how i birth my child.

[CarGirl]

Your experience sounds horrific, both losing your son & the vbac. The drs attitude is truly unaccetable IMHO.

I was always way overdue and was induced so couldn't have my requessted homebirths.

However for my last birth I refused continous monitoring, I let them monitor baby for 45 mins after each pessary (the period of time when the baby is most likely to get stressed apparantly) after that I was off that bed, without the monitoring stuff and on a birthing ball asap.

My birth notes were very short and concise. I think it's having the courage of convictions on the day to say "no"

Mine included:
no continuous monitoring
no automatic catheter if I have an epidural
no to having an ARM

I can't remember what else but there was a whole list of "Nos" I also said my partner was there to carry the bags and to witness the birth and not to be my birthing partner and therefore I would need a midwife to be my birthing partner.

They duly obliged and I had the most amazing & easy labour despite being induced.

HTH

[Deemented]

Thanks CarGirl - thats really helpful

[CarmenSanDiego]

Deemented, you need another consultant.

If the renal problems don't present any risk, then there is no reason not to VBAC at home and you are no different from any other VBACing woman.

Your consultant sounds horribly old fashioned and not up to date on research which shows the safety of VBAC. Indeed, you may well be safer at home where a midwife will watch you constantly and take notice of your physical appearance and signs than in a hospital room where you will mostly be left alone. If he quotes uterine rupture as a problem, there have been plenty of cases where this has been missed in hospital, while home birth midwives will be with you constantly and know how to spot the signs early on. Uterine rupture is less than 1 in 200 and less likely than any of the other complications of labour (e.g. cord prolapse, haemmorhage etc.) Balanced against the risks of a c-section, I would (and did) opt for a home VBAC.

Totally agree with Lulu that your consultant is setting you up for failure to progress, an impossible labour and a C-Section.

[CarmenSanDiego]

BTW, I had a waterbirth at home and the midwife had no problem monitoring underwater with a doppler. Very safe and happy birth.

[Henry73]

If you go on the Doula UK website you can get a doula for as little as £200, or if cash is really a issue there is a hardship fund that is means tested and you would only pay what you can afford?? I am a member of Doula UK so please PM me if you need more info?

Ema xx