who's contemplating a home birth - want to discuss it?

[elliott]

Hi there
Noticed that quite a few of us who are now pregnant are planning or thinking about home birth - katherine, motherinferior, princesspeahead, www etc. I'm just 17 weeks now and very undecided about what to do, so would welcome hearing other's thoughts and views. What has motivated your choice? What are your greatest worries/fears/hopes? What is the deal in your area re midwife care - do you feel confident in your midwives? Lots of other thoughts but that should do for now...

[princesspeahead]

ohhh, thank you for starting this thread! loud applause for elliott

choice motivated by:

1. wanting to keep away from hospitals - after both prev births ended up in and out of hospital because of post partum haemmorage (after dd) and a congenital problem of baby (after ds). completely irrational but hope that if I don't even give birth there then I can give them a miss completely.
   
2. have moved from teeny tiny london house where I would have felt like I was giving birth in the neighbours living room, to a bigger place in the middle of the country which feels much more like our permanent home and somewhere I'd be able to labour in privacy.
   
3. the feeling that having given birth 2ce I'm more confident and relaxed about the concept of birth and my ability to know what is going on
   
4. the thought of falling into my nice comfy bed afterwards rather than a horrible noisy NHS ward in a rubber bed where they can't even give you a single pillow!
   
   Midwife care in my area good in theory, terrible in practice so have hired a wonderful independent midwife who is doing all my antenatal care and who I like very much. Very nice to know exactly who is going to be there with me. Extremely expensive though...
   
   Main fears - that I'm kidding myself that I can manage the pain with only a birthing pool and gas and air, when I had an epidural with the other two! Or that I will also need to be induced again (as I was with the other two) and so will end up in hospital anyway.
   
   that's about it for now... looking forward to hearing from others

[motherinferior]

If you'd told me 10 months ago that I was contemplating home birth I'd have been amazed. But when I really started thinking about my last birth I realised how much I wanted to keep out of hospital. Like PPH, I'm sure that part of this is just hoping to dodge the inevitable horror of birth - like her, I've hired a water pool (which we MUST try out)...

Last time I had a 'light' epidural that didn't work very well. It was in relatively early - 5 cm I think, possibly less - after I'd been in a lot of pain for a long time. I laboured on for ages, with my excellent midwives (more on that later) next door with a woman who was delivering, so when the docs came in and misread my monitors they nearly caesarianed me without any consultation - it was only when they mentioned it to my m/wives (nobody told ME) that they were told, in no uncertain terms, to go back and check that they weren't picking up my heartbeat instead of the babe's. In any case, labour stalled, stopped, had to be restarted - all very painful. In the end I had an emergency ventouse because the cord was round the baby and, with a first birth, it was bound to take a long time and she was in distress (my own midwives felt this, so I agreed).

However, I found the hospital experience then, and afterwards, very casual/brutal and unpleasant. So this time I would really, really like to stay at home. IMO, the reason to go to hospital is for an epidural - and don't get me wrong, I really appreciated it last time; however, if I can manage without one, I'd rather stay home.

I do find it very difficult to contemplate, and part of me wonders if I'm just kidding myself given that I had an epidural 'so early' last time (ie after about 12 hours in escalating pain). Ironically, last time I was with an excellent midwifery practice which gave pretty well independent levels of care, on the NHS. This time I'm with a bog-standard community team, but most of them seem very nice. Oh, that's the other thing - I really don't want just to go to hospital and, most likely, get whoever's on duty - who could be utterly fab but equally could be knackered, and is I think much less likely to challenge the docs' decisions (I may well be wrong on this). I really don't want an unnecessary caesarian.

Interestingly, when I did visit the labour ward last week, I felt quite panicked by it. Last time I felt rather that by the time I got there I wanted to give over control and be looked after. This time relinquishing control feels more as if I'd be relinquishing things I valued as well.

My main problem is dp's misgivings - he's worried. And it doesn't help that his dear mother - usually a star - keeps going on about my age and how it isn't a good idea at 40. (ACtually she hasn't gone on about it, but even raising it drove be bananas, and upset me quite a lot.) I haven't even mentioned it to my mum - although in fact she had my sister at home, annoyingly effortlessly, 37 years ago. All the friends I've talked to about it have been incredibly supportive. And I have to say, consulting other women on mumsnet has been what swung it with hiring a pool (oh yes, my local hospital doesn't have a pool plumbed in at the moment, either).

I'm trying to keep an open mind, but I would like to do it at home. I am very, very worried about the pain. Actually I think that's realistic - every single literary and oral culture says childbirth is painful. But like I say, if I can manage without an epidural - or rather get to the point where the idea of leaving the house to get one is just worse than staying - I would really like to...

[Wills]

Meeeeee. I've just agreed that I will have a home birth with my midwife but I'm still torn over whether or not to hire a water bath. My reasons are that I was induced last time I think unnecessarily. Looking back I was told well your blood pressure is rising we could induce you. Not knowing anything about being induced I jumped at the chance. I felt that from that point on I lost control and that things got really frightening and that this only made matters worse. Instead of talking to me I felt like a lump of meat on a production line with decisions being made about me instead of with me (and this despite my dh and dm being there and also seriously fighting my corner). I could go one about the actual birth but that's not what you're after. I do feel that at home with a midwife I will be more in control. I'm someone that fills in the gaps in terms of information. It is far better to tell me what is happening that to let me guess. Also being at home you can change your mind. My midwife has told me that as long as baby is not actually on its way i.e. third stage etc then I can go into hospital at any point. She's fine with this. So by opting to have a homebirth for me I get the best of both worlds. Calm, more relaxed, hopefully someone who will communicate with me (because they're not having to help 5 other women labour at the same time) and if the pain gets too much or something looks not quite right then I can go in anyway. The way I see it I don't loose.

As for my fears - yes you wonder if by having the baby at home you are putting yourself and it at unnecessary risk. To counter that I think the way I was treated whilst in hospital only made things far worse and so that's not necessarily true. When dd's heartbeat started to stop, no-one could find either a midwife free or a consultant to come and check and that's whilst being in a hospital. It was 20 mins before anyone came - about the same time it would take for me to get to hospital - so again no difference - I hope!.

Hmm - my thoughts about a waterbirth are that its bloody expensive to hire! I've looked at splashdown and a pool is basically going to cost us 250.00. If I could look into the future and see that I would have the home water birth that I desire then I wouldn't hesitate but at the moment it feels a little like a lottery. My blood pressure is just starting rise and this could mean that a homebirth is ruled out for me in which case its a lot of money to waste!

Well that's my current thinking HTH

[Oakmaiden]

I'm booked with an independant midwife for a home birth too!

Reasons - well, I was planning one first time around, because it just seems to me that birth isa normal physiological event, and that in the absence of any problems then home is where I should be. Didn't work out first time round though - got "taken in" because ds had passed meconium (although actually this is normal for a post dates baby, so it really wasn't a good reason to go in). Anyway, far more important this time around, because in the meantime I trained as a midwife in the local hospital, and the thought of ending up with some of the midwives I worjked with just makes me feel ill with anxiety! Some of them are lovely - but some were just complete cows and I don't know what I would do! Hence the independant midwife (who actually practises with my old year tutor from college!) (Incidentally I didn't complete my training - my ds was diagnosed with ADHD and ASperger's, and it was just too hard for him to be in nursery school so much).

Hopes and fears - I hope that it will all go well, and I will have a fairly short labour, using nothing butthe birthing pool for pain relief. Fears - that it will hurt, and I won't be able to cope with it! That there will be something wrong (I haven't had a scan or any tests - and don't intend to - so there could be anything). Funnily enough I have no real anxieties abuot things going wrong during the birth - probably because I know how unlikely they are to go wrong without warning, or without medical people interfering with the noe=rmal physiological process!

[motherinferior]

Wills - it is pricey but less pricey - about £200 for the 'inflatable' which is supposed to be for women who had shortish first labours but they said would be fine for me (but I'm only 5ft tall). I know exactly what you mean by a lottery, but decided that if I really did want to seek out non-epidural means of pain relief (I am such a wuss with pain, you wouldn't believe) it JUST might swing it. OTOH how far along are you? Because I got mine only a couple of weeks ago, and I'm now 37 weeks. So in reality I don't think you have to decide quite yet.

[princesspeahead]

aren't there a lot of us!
motherinferior - I wouldn't worry about your age, my mw says that age is completely irrelevant in her opinion. and second births are indubitably easier than first - may not be any shorter overally, but the pushing bit (which I found the most exhausting part of my first labour) is unrecognisably easier with the second which I why I think so many mothers feel so much better so quicker after second births.
wills - I think you have the right attitude - my midwife said that at some point she will say to me "this is your last chance to go to hospital if you would like to" and before that I can always transfer if I decide I can't manage at home. so good to keep an open mind. birthing pool is expensive, but from what I have heard from friends who have used them they can make the difference between the pain being manageable and not. so I've bitten the bullet! but if it is unaffordable I'm sure you can get quite a lot of the benefits from a deep bath.
oakmaiden - funny, I also don't have any fears about huge medical disasters or anythign being wrong with the baby, my fears are all about being able to handle pain! wonder why that is...

[elliott]

glad I started this thread! I'll add a few of my own thoughts...which interestingly are quite different from those I've heard so far.
I've just posted my first birth story on the 'positive' birth thread, so won't go into detail - it was fairly quick, very painful in the final hour or so of first stage, and managed with gas and air. So I don't have (many) pain relief worries - I know it will be painful, but know I can cope. I'm not so keen on the idea of water - partly because I feel a bit worried about delivery under water, partly because having a bath really slowed me down last time (though that could be a good thing!) and partly because kneeling was my preferred position last time and not sure if this is possible in a pool (wobbly sides??)
Main reasons to have a home birth are really that the things I didn't like about last time were all to do with hospital - awful ride in the back of the car in advanced labour; delivery by complete strangers; the feeling that I was some kind of freak because I was having a normal delivery; feeling that I was 'expected' to lie down on the bed; hideous postnatal stay etc. But I know that hospital will be ok, so wonder if I am just being self indulgent to aim for a 'better' birth?
I also worry about mistiming the trip to hospital - obviously I'm quite worried about leaving it too late, given the speed things happened last time, but also worried that I will over compensate and turn up right at the beginning!

My main fear is about the baby - that it will come out flat and need resuscitating without experts on hand. But I know this is not a very big risk - especially if things progress quickly again. I also know a couple of people who tore badly during home births and needed transfer to get stitched up - not an ideal end to the experience! I'm also worried that the community midwives really don't have a whole lot of delivery experience.

On the plus side, the main motivating factor is just that I think it would be great not to have to be away from home at all. I also think the midwives will have a much clearer idea of the kind of approach you want at home. I like the idea that I can decide at any stage to go to hospital - its only about 20 mins away - so if things are going slowly I can always change my mind.

Ok getting a bit long now so will stop.

[motherinferior]

I'm actually not worried about my age myself, I just don't like being wound up about it. OTOH DP is worried about it, keeps pointing out that 'things do get less supple as you get older'...silly prat.

I'll just have to see. Quite honestly, I've reached that point of pregnancy where you start wondering about elective caesarians just to get the damn thing out - and I did catch myself thinking the other day 'why did I ever have objections to surrogacy?'

Nap time now. Little bugger kept moving about all last night. As did I.

[motherinferior]

Elliott - our posts crossed - what's self indulgent about wanting a decent experience?

And do you know for sure how much experience your community midwives have? I have to admit I've not asked mine in detail, but since they've actually allotted me the m/wives with waterbirth experience - even though I'm not sure I'll end up delivering in water - I've decided to trust them.

[musica]

We're going for a home birth - largely because of the after birth experience - much nicer to be at home, not have dh kicked out. Also we live almost next door to the hospital, so if there were a problem, it would take only 1 or 2 minutes to get there. Everyone was really positive about it - midwives and doctor thought was great idea!

[princesspeahead]

elliott, that's why I've forgone my community midwives. I was told I could get any one of 25 of them (I'd only meet one beforehand!) and they collectively did 30 births a year. the one I have met had done one home birth in 17 months or so - not good enough. hence the independent midwife who does 20 - 30 births a year herself!

[elliott]

motherinferior, the thing is, there wasn't anything really bad about my experience last time (in the delivery room anyway, and I'd be able to avoid the postnatal stay this time) - I just think a home birth has the potential to be really special, IF it all goes well.
PPH (now there's a rather unfortunate abbreviation for your nickname!!) - my immediate area has about 6-8 midwives, I've met most of them already and there is one in particular who would be great (unfortunately she's not attached to my practice). The night rota is shared with another similar sized team, so that is where the problem might come in. I think as a team they do a couple of deliveries a month. And of course they have their refreshers in hospital. BUT you do get two midwives for the delivery, which I think is important especially if babe does need attention afterwards - does your midwife have any assistance at the delivery? I can see the attraction of an independent midwife but I'd be very surprised if any exist in this area (no demand really, certainly not 20-30 births per year) not to mention the cost.

[Oakmaiden]

Elliot - all midwives are trained in resuscitation of both mother and baby. There are very few unforeseeable emergencies that can't be coped with at home - and most of these would be pretty dicey in a hospital too. Off the top of my head I can't actually think of anything that could happen "suddenly" at home and not be dealt with.

You will probably find that your comm midwives sometimes do shifts on the labour wards etc too - and bear in mind that in most trusts you need to have a certain number of years experience in all aspects of midwifery before you will be considered for the post of community midwife. They will have lots of experience (which of course doesn't necessarily mean they will trust a woman's body to do it's job properly sigh).

[princesspeahead]

elliott, - I know, that's why I prefer to be called HRH to PPH
my independent midwife isn't exactly in my area (40 mins away) and if she didn't exist I don't think there is anyone else I could use. She is in partnership with another midwife (who lives about 10 mins closer), so there is cover if for some reason she is elsewhere, but she does the actual birth herself, there aren't two of them per birth.
your team sounds great, I'd be happy with that. If I had a smaller team of say 8-10, and could meet a few of them to get happy with them, I'd stay with the community team. But since the only one I met had so little experience of home birth (and hadn't had any refresher time in hospital for 3 years), and said "home births are fine as long as the mothers listen to me and do what I say" in NOT a good way, I decided to go the independent route!

[Wills]

Agree with Oakmaiden in terms of emergencies. My midwife took me through all contingencies etc and she put me at ease. I also agree that the reason I would suddenly change my mind might be more to do with wanting an epidural! Although I have told my midwife that at even the slightess hint of trouble I want to go in.

I just feel that I would maintain some control and that by doing that I wont get so wound up and basically frightened. Surely keeping me calm will lead to a better birth for baby - well that's my theory. I think dd was extremely stressed when she finally came out - a little like me!

Motherinferior - I'm 31 weeks so need to start considering fairly soon. I can see myself electing to do it and finding out they're all out

[Gem13]

I'm toying with this like last time.

The thing is, last time I ended up in hospital (transferred from a birthing unit) and had a horrid birth experience (until DS was born when everything became wonderful ) and so I was pleased to leave all associations behind. I haven't gone back to the book I took in with me, the t-shirt I wore couldn't be saved so went in the bin and DH (star!) didn't play the CDs I'd taken so they are not 'blemished' by the ordeal. Even so, getting in the bath was a weird one (started off in water) and having a drink with a straw made me feel shaky for ages!

Afterwards, it was lovely to come home to my safe, secure house.

This time, there is DS to think of too. I don't want to leave him to go to hospital but then I don't know what would happen to him either if I was at home. I think he'd be really disturbed waking up to find someone else here or going off to play and coming home to find a baby!

It's a long way off for me though (I'm 6 weeks), so plenty of time to ponder.

[WideWebWitch]

Oh Elliott, thanks so much for starting this thread, I really want to talk about it too. I had a successful home birth last time, with my first, 5.5 years ago in London. I liked being at home, with my own bath and bed and having some privacy and degree of control (in as much as you can control labour). My mum, dh and 2 midwives were there for the birth, which was 8 hours - well, actually a bit longer but midwives agreed to only record start of labour when they arrived rather than when contractions had started because they didn't want to put me under time pressure since the consultant's view was you had to go to hospital after 12 hours labour. I had no stitches (7lb 1oz), only mild tears which healed naturally. So it was a good experience and friends tell me I raved about it afterwards (blimey, did I?). I only had gas and air and do remember that it hurt like hell and was over very shortly after I thought I was about to die. I think I want a home birth again - the idea of hospital scares me, a lot. Mainly because:

• I hate the thought that dp may be sent home afterwards - I loved the 3 of us (ex dh though) cuddling up together in our bed after ds was born, a new family
  I completley agree Oakmaiden, for me, if I'm not having an epidural why bother with hospital? (and I don't think* I want one, although immediately after ds was born I said "if I ever do that again I want more drugs" )
  
• The look of the labour ward helped scare me into home birth last time - I just remember lots of metal contraptions
  
• I've heard a lot of horror stories about hospital - midwives ignoring people etc etc and very few about home birth. I suppose, as one of my books points out, the dynamic is very different if you're inviting people into your home
  
• I have ds to think about and would rather he slept through it/was at school/was there (eek!) rather than sent off or looked after while I go away for hours and hours.
  
  But I am scared that I now live in the country and am an hour from a hospital (15 minutes max last time). So if anything did go wrong it would be hard and a long journey to transfer. OTOH as Oakmaiden says, there isn't too much that can go wrong without warning. I'd like a pool too this time (although prob won't - we can't afford it) and a doula, which I'm looking into (may do a bartering deal with one, can't afford that either). I really like the idea of having someone who is there to support me emotionally without being as involved as my partner. I'm really hoping it'll be even quicker this time but I was in blissful ignorance before last time and this time, since I know what to expect, I'm much, much more scared than I thought I'd be. I'm also scared that maybe I'll die, although I know this is irrational and unliklely. And everyone, statistically planned home birth is as safe as hosptial birth, absolutely. I have just been reading up on it. There isn't any mess either and age shouldn't make any difference. Motherinferior, I was wound up by people commenting on my age (36) as a reason for going into hospital too. So nice to have somewhere to discuss this. Sorry to have gone on so long but thanks for this thread elliott.

[elliott]

www, love that bit about it being over 'shortly after I thought I was about to die' - completely sums up my experience too!
Have to say I think my age (37) is completely irrelevant.
I suppose I should come clean here and admit that the reason I'm a bit hung up on the risks of a home birth is because I have a medical background, and now spend most of my time working with perinatal statistics. So I am probably unhealthily aware of all the things that might go wrong (but almost certainly won't).I also know something of the research on safety of home birth and I don't think it can ever now answer the key question about whether home or hospital is safest (too much selection bias) - though of course it can tell us that serious complications are very unlikely in planned home births. I suppose what I really think is that there are some small risks that you take with a home birth, but on the other hand I also have sympathy with the view that hospital births can create risks - particularly since I went through it, and can clearly see how my very straightforward delivery could have been completely sabotaged if I'd been put on my back and strapped to a monitor.
And of course I have a lot of medical friends (including neonatologists) who would be happy to tell me of all the deliveries they've attended where things went pear-shaped quickly and unexpectedly. So perhaps I won't talk about it with them

[WideWebWitch]

Elliott, every time someones starts to tell me their birth horror story I want to tell them to stop but can't quite do it, it's like a car crash, y'know? Can't say it helps though, as you know! Please don't say that about the stats, was reassuring myself with those

[elliott]

www - I thought that was quite reassuring, myself!! Sorry I'm just someone who likes to stare the worst case in the face and then decide, ok if I can cope with that, it should be fine!
Also regarding the horror stories, the thing is these people only ever see the problems, and only come in right at the end, so they don't REALLY know how sudden or unexpected it was. And I think with a history of one good birth behind us, and being healthy and prepared etc etc, I really think there is vanishingly small chance of a problem arising unexpectedly.

[Wills]

Elliot - I'm like you and look at the bad cases first, workout how to prepare from them and then hope with fingers well and truely crossed that they wont happen. The thing is www that if things do go wrong being in hospital isn't necessarily a solution in itself. As I said below they couldn't find anyone to help out. There were no panic buttons to hit etc so.... Anyway my current thoughts are definitely that my experience in hospital actually created the issues and that by being at home I have a better chance of avoiding them. gosh but I'm doing well here at persauding myself! :0

[Wills]

Blast meant

[motherinferior]

This is a really useful thread. Thanks, elliott!

I'm going to admit something - every time I read about 'holding your baby in your arms' after birth I think back to when dd was born. I didn't want to hold her; I didn't want to touch her; I was so exhausted and traumatised, after the rush to theatre, the vast array of medical personal, the arc-light shining up my crotch as she was ventoused out, and the comment from the sadistic (female) doc of 'we'll try this before a caesarian'.

Given the circumstances, this was pretty well unavoidable. Similar circumstances may arise this time. And fairly soon afterwards - probably minutes - I did want to see her and touch her and in no way do I think that beginning affects how I feel about her now. But another sort of birth would be nice.

[Katherine]

Wow brill thread. REally need this after this weekend (see thread about SIL). I had a horrible hospital birth with DS although it would have been fine if they'd left me in the MW run unit instead of shoving me in an ambulance on the cat and fiddle road so I only just made it to hospital, tore really badly, left me in a pool of blood for ages (DH had to clean up in the end while I staggered into the shower, so painful) then took 2 hours to stitch me up before calling a Dr, leaving my baby to get really cold and terrible care on the ward afterwards too. Never ever want to go back there.

So had DD at home and it was trully magical. Not really very painful at all. Very relaxed, peaceful, comfortable, clean and an hour later we were all tucked up in bed. DS wandered in next morning and said "oh look a baby". Moments to cherish rather than want to forget.

So my reasons this time are:

1. Don't want to repeat the horrible medical trauma of hospital.
   
2. Both labours were quick - DD 1hr20mins so not sure I'd make it to hospital even if I wanted to.
   
3. Don't want to go traipsing round the countryside when in labour
   
4. Want to go to my own bed afterwards.
   
5. Felt that some of the special moments were stolen in hospital - came back from the loo to find a MW had taken DS for his first bath - should have been my job. With DD waited till next day then we got in our own bath together. Lovely.
   
6. Feel that birth should be a personal family expereince, not surrounded by strangers in a strange place.
   
7. Feel that things are less likley to go wrong at home. It just feels more secure.
   
   Its a rural area with a cottage hospital and a great team of community MWs. I've met most of them now so am unlikley to get a stranger and they are all pretty competent and friendly. I am confident that they have dealt with most things in their unit and they all do quite a lot of homebirths too.
   
   My biggest fear is that the labour will be too different to last time (in a negative way) and this will really confuse me and that DH won't make it home in time -possibly that the MW won't make it in time either but that seems less important than DH missing it!
   
   I'm really looking forward to my homebirth. I hope that my children will be around to share it and that it will be a really special time for all of us. I'm not really frightened about things going wrong,. I just hope everything goes according to plan