High risk home birth

[Grumpy19]

Hi. This is a bit long. Sorry.
I am expecting DC4.

DC1 was born by EMCS after a badly handled induction. DS was back to back, got stuck, nobody realised until a change of shift and new consultant realised he was in serious trouble. It was terrible.

DC2 was born at a difference hospital by VBAC. I had a 3rd degree year upwards but it was a far, far better experience.

DC3 was born in yet another hospital. Another successful VBAC but I was induced as my blood pressure had crept up.

Now expecting DC4 and the only real hospital option available is where DC1 wass born. I made it very clear to my consultant that I was upset at the idea of giving birth there again and she referred me to 'talking about birth' appointments with a midwife from the hospital.

So, I had a phone call today from the midwife who has suggested I have a homebirth instead. I said I didn't think I was able to due to being high risk but she said I didn't 'have to do what the trust suggested'

I am high risk due to VBAC, underactive thyroid and Low papp-a.

So, my question is, has anyone here had a homebirth when they were high risk? I feel in turmoil at the moment. On one hand, the idea of being at home, having my DH with me throughout (not being kicked out due to Covid) and not at that terrible hospital is a huge pull. On the other, I'm frightened if something goes wrong me and baby could be in serious trouble.

Any advice or experiences would be very welcome x

[HarrietM87]

Sorry I can’t be more helpful, but I also have an underactive thyroid (hashimotos) and have had 2 low risk pregnancies. I’m having a home birth this time. I don’t think it has any impact whatsoever on delivery, so at least you can cross that off the list.

If you’ve had 2 vbacs then you know you can give birth vaginally. With low papp A, my understanding was that it could affect the baby’s growth, but not sure how it makes the birth more risky? Worth discussing all this with your midwife before deciding I think.

[thetangleteaser]

I would say that although on paper you sound high risk, actually if you separate the issues then you actually aren’t as such.

You’ve had 2 successful VBACs without any issues with your scar and had a subsequent delivery since your third degree tear so no reason to think this baby would not be born vaginally.

The low pappA can cause blood pressure issues and increases your risk slightly of having a small for gestational age baby but these things will be monitored. If growth scans demonstrate good growth and your blood pressure behaves then no reason you can’t have a home birth. Same with your thyroid, if you have proper monitoring during the pregnancy then no reason it should affect your birth.

As long as when you reach 37 weeks none of the above factors have impacted the pregnancy or any new issues crop up then I think you’d be appropriate for a home birth if that’s what you want😌

[TenThousandSpoons0]

Even though you’ve had two VBaCs, there is still an increased risk of rupture. I am surprised she suggested this to you.
More importantly - if you are feeling afraid of the idea then a homebirth is not for you. You need to be absolutely happy and embrace your decision - but you also need to be absolutely happy with the idea of transferring to hospital if things don’t go to plan. I don’t think you are either of those things just now which means you need lots more talking.
It sounds like it’s been a long time since your problems at that particular hospital - perhaps things have changed, staff have changed etc? They would be extra cautious with you I think due to the problems you had before. I’d encourage you to keep talking/thinking it through, or explore birthing at a different hospital.
Agree the thyroid and Papp- a don’t add birth risk as long as your pregnancy goes well to that point (eg normal growth, normal blood pressures etc)
Good luck

[TheCraicDealer]

I think you should go for a home birth because you want a home birth, not because you're worried about giving birth in a particular hospital. Better to make your peace with going there now, if you can, rather than put pressure on yourself to try and successfully give birth at home, potentially have to transfer in, and then deal with all the emotions and stress of that on that on the day.

I've had a section and personally I just wouldn't feel comfortable having a HB with a VBAC, no matter how many successful labours id had in between. You might feel differently, but I do think you have to go into it for the right reasons (see above). Just from your OP though you don't sound really sold on the idea.

How much of a gap between no.1 and no.4 will there be? Do you know anyone who has given birth there recently who could tell you about their experience?

[footprintsintheslow]

How many years ago was DC1 born? I'm sure many things have changed since then.

[BeMorePacific]

Could you give birth at an MLU instead? x

[Grumpy19]

Thanks for all the replies. The MLU won't accept high risk women so that is not an option sadly.

My DC1 was born 10 years ago. The midwife put monitors on me to check on baby and refused to take them off even when I cried that I needed a wee! I was given a bed pan and told if I really needed it I would use it
The monitors didn't work though and nobody bothered doing anything about it.
The idea of going back there is just terrible!

I'm 30 mins away from the hospital.

I am going to be having regular growth scans for low papp-a and the consultant is managing my thyroid.
The chances of another successful VBAC I have been told is around 90 to 95%.

I feel the care was so crap there that the idea of being there with limited support from DH is just horrific.

[footprintsintheslow]

What's the reason you can't go to a different hospital?

[EllieJai44]

10 years is an awfully long time in terms of staff and even procedures! So much has probably changed and you'd likely find that they would be similar to the other hospital you have given birth at!

[Grumpy19]

@footprintsintheslow the only other drivable hospital only has a MLU and I was told they won't accept me.

10 years is a long time but I have had to go back for other reasons and it's not filled me with any more confidence. My dad had a heart attack this year and said hospital gave him a stent and sent him home the same day only for him to suffer a stroke!

[Upsydaisyy]

If you aren’t even able to go to MLU then I personally wouldn’t have a home birth as that is for very low risk pregnancies. Do you know anyone who has recently gave birth at the hospital who could give you some insight? Or even post on a local mums Facebook group

[longcoffee]

I understand your reluctance to go back somewhere you're uncomfortable with, especially without much support from your DH.

I would try the argument that if you're low risk enough for them to be happy for you to crack on at home, then a birth centre can't really question risk level...?!

[JemimaTiggywinkle]

I would think that if you are too high risk for a MLU, then you would definitely be too high risk for a home birth.

If you had a home birth, would the midwives be from the same hospital that you don’t want to go to? If so, I don’t think there would be much benefit in it.

I completely understand your reluctance to go back, but in 10 years it is likely that a lot has changed. If you go on the CQC website you can look up their last report. That might give you some more information to help you decide.