To be fed up of the "home birth is risky" misinformation?

As if there's ever going to be funding for that.

I think what happens is (or at least when I last looked at it nearly 20 years ago) that the stats for unplanned home births, which includes women and girls who have had no antenatal care, and are obviously then high risk.

For me I seriously considered it with both DDs, and I may have been a good candidate as I had very straightforward pregnancy and labours, and not long labours.

But with DD1 on balance I preferred to be in hospital, because of fear of the unknown and not knowing how it would go or how long. I did have an epidural and I was grateful for that option of pain relief, but no other intervention and active labour was 6 hours. With DD2 I just went with same hospital, having had a good experience before. With extra confidence and breathing techniques from yoga this time I just had gas and air, and the same length of active labour, even though DD2 was bigger. I think we'd have ended up with a night in hospital anyway though as I wasn't sure when my waters had gone and they wanted to check for infection. So both times I thought about it a lot but felt safer in hospital.

Other women may come to a different conclusion though and they should have a say in where they give birth.

They did however have 3 spare midwives to come to my house in the afternoon to try to coerce me in to the hospital. Despite a history of PPH in birth I had no intention of giving birth in that hospital after a consultant threatened me with obstetric violence and threatened to force me into a GA C-section that was 100% uncalled for.

It’s hardly ‘coercion’ when the lady upthread in the article did exactly as you did, and died, and her baby also died.

But that's not entirely the full story either.

I'm not particularly pro home birth. I was certainly in no position to have one. However, what I can see from other experiences is that having proper monitoring of baby's progression is absolutely key. And there are situations where that will be better delivered in a home setting.

Obviously, if things go wrong then distance to hospital and so on is key.

However you can be in hospital,, surrounded by high tech equipment and medical expertise, but if no one has picked up the baby is in trouble, that's no use to you.

I think the answer is to scrap the idea of ‘Labour ward’ and ‘MLU’ and to just start again and have 1 birth centre with every room created to be homely, comfortable and with a double bed so partners can stay over and help care for both mum and baby, with a dedicated midwife who you have met before and stays throughout. What makes hospital so stressful is the constant shunting around from ward to ward, relentless staff changeovers, a lack of continuity of care and access to pools/nice rooms completely dependant on luck. Midwives need to be more proactive in helping natural birth happen - I have found they are very ‘hands off’ until an emergency when they are then very ‘hands on’, aka leaving you to it and not bothering with holistic help until it’s too late. Nobody helped me change positions, nobody offered mild pain relief - they just held off until the pain was unbearable and then I was begging for an epidural, when a pethidine shot or similar would’ve been adequate if given earlier. It all just feels quite lazy and basic.

The reason a lot of women want to avoid a hospital birth is because they are treated like shit by staff, and in many cases they strongly suspect or know that they recieved bad advise or management or that staff did not seek to manage their births appropriatly.

Just as an example: my firs birth was a section, after there was what appeared to be (or I was told) was an irregularity with the heartbeat. This was after I had been lying in bed, in one position, for hours.

The immediate recommendation of the GP on call was to give me a section. One older nurse wanted to get me up walking around a bit, which was poo pooed by the GP, and she did also try to see if I could start pushing as I was in fact a hair away from being fully dilated.

She was right of course, changing position should have been the very first thing done, and some walking and being upright. I was at the time too inexperienced and scared to really take in what was going on, but the young GP was just like an idiot mechanic following a set protocol without engaging her brain.

Women want births managed properly, hospitals in many cases want a cookie cutter protocol that does not mean staff has to stay with the mum and help her, and doesn't mean they will have mums doing things like walking the halls in labour, or taking up rooms for too long.

My last child was an unattended birth at home as he came quickly. But regardless the hospital were understaffed and had no one to attend anyway. They did however have 3 spare midwives to come to my house in the afternoon to try to coerce me in to the hospital. Despite a history of PPH in birth I had no intention of giving birth in that hospital after a consultant threatened me with obstetric violence and threatened to force me into a GA C-section that was 100% uncalled for. Alongside a lot of other threats and accusations which she had no basis to say. All of which the head midwife agreed was lies.
My 3rd birth I was in hospital and ignored the entirety of my labour and left for 5 hours with someone popping in for 30 seconds once a hour writing down the obs that the machine had taken whilst they were absent. With a constant only I'll get you the entonox.... To never return. After I gave birth they left within half an hour of his birth, with no call button or bassinet to put him in so when I did start to haemorrhage I had to climb down the back of the bed whilst holding him to find the call button that was dangling from the wall. No one even put a nappy on him, when I woke an hour later after losing a litre of blood and passing out I was alone again half off the bed with a cold meconium covered baby. (It was COVID times so I was completely alone until I went home). So why on earth would I want to go near a hospital again. I was just as at risk there as I was at home, but I had my husband to help me.

All birth is risky.
Women die in childbirth, develop serious disabling injuries, and can never feel the same again.
I feel home birth is seen as the danger when reality is, any pregnancy is dangerous.
I wish we told women that.

DS was born in hospital, not a particularly pleasant/unpleasant experience but the post natal infections were nasty.

DD was a planned home birth, 2 midwives and a trainee in attendance. The GP also said he would attend if there were any issues and the local hospital had a "flying squad" for emergency transfers. Instead of pacing up and down hospital corridors I was pottering around in my kitchen making cake.

Had there been a DC3 it would also have been a homebirth if I was still considered low risk.

Absolutely agree.
I imagine her instagram history is going to be quite painful viewing.

I think we also need to remember the whole story of birth and death, and how it would be for the family members if you die. I just read about that poor woman and her baby. Even though I try not to think it, my reaction is, "this man didn't take enough care of his pregnant wife who was clearly consuming some misinformation that led her to take this unreasonable risk" and "this woman's family didn't seek appropriate post partum psychological care after her crappy first birth". If someone dies in a home birth, the guilt for the loved ones is so much worse. If it happens in a hospital, the responsibility is more shared and it seems less like selfish actions that led them to that place.
I feel so sorry for that woman's little boy, the only one in this whole thing to still be alive and not to bear any form of responsibility for losing his mum.

Bloody hell, I had my 3rd baby at home, my second home birth. I was 40, slightly overweight and my 2nd baby had shoulder distocia. The midwife that delivered my first baby was more than happy to deliver my 3rd.

Both babies arrived safely.

Having had 2 home births I am of the opinion that they can be at least as safe as in hospital for the right circumstances. Would I have attempted a breech delivery at home? or twins? No I wouldn’t have done. My first labour was a shit show of interventions which ended with me in theatre for a retained placenta. Im deeply uncomfortable in hospitals and definitely felt more in control at home. I also lived within a mile of the consultant led maternity unit.

I think that home birth is a lot like co sleeping. On the statistics alone it appears riskier but with the right circumstances can, in fact, be safer but it is wholly dependent on the circumstances.

YANBU - as you say, evidence is useful. I think it’s so important that people can make a personal choice taking into account their individual circumstances.

I planned/started a home birth for my second, ended up transferring in and having a section in the end. No less safe than if i’d gone to hospital a bit earlier.

I’ll say again, childbirth was the single biggest killer of women before modern medicine. And not all modern medicine is available in homes! Whatever risks there are in hospitals they are, very obviously, rather less than at home.

I’m another one who nearly died in childbirth.

Unfortunately I have seen many recent stories where home births have ended in tragedy. It’s a stupid risk but these women are the ones that have to live with their decision.

The majority of home births are now ‘birthing out of guidance’ and midwives are expected to turn up and provide care regardless of the risks: it’s a dangerous situation for women, babies and midwives. Home birth IS extremely risky for these women however for some unknown reason it’s what some women choose.
For low risk multiparous woman home birth is believed to be ‘equally as safe’ as hospital births, not safer, but a low risk Labour can very quickly change. When an emergency arises in labour you are absolutely safer in a hospital environment.
the tragic case being mentioned in these comments had the worst outcome imaginable but this was not a low risk woman birthing at home and this woman was 100% safer in a hospital. I understand trauma and fear around hospital environments but also believe this needs to be balanced with safety.

This is why studies usually compare 'planned' home births to 'planned' hospital births - so the outcomes of someone who plans a home birth then transfers 'belong' to the home birth group, and the outcomes of someone who planned a hospital birth but then gave birth at home (or at the side of the road!) before they could get to hospital 'belong' to the hospital group.

This assumes there aren't risks created by the nature of the hospital setting though, the management in hospital, or the travel to the hospital. Which are big assumptions. And not are all things that could be changed even in the best circumstances.

So then it's a matter of balancing the risks.

not sure where rest of post went…
the RCM was told that that money would go to the NHS trusts generally to make their own decision of where to spend it. Instead we’ve had more cuts and recruitments freezes throughout the country. Given that that fund was put in place against increasing failures in maternity care and ‘failures in care’ here means deaths, deaths of women and deaths of babies, you do wonder about the end goal.

Men hate and despise women so much, they’re only too keen to use women for endless promises of sex to shut poorer angry men up, only too keen to remove our rights at every opportunity and push us aside to get a new shiny tech toy or a few new votes from women-hating immigrants, only to keen to remove funding that keeps women specifically alive and refuse any chance to make a real difference to male violence against women.

Is that what this thread is to enable op? Carrying on spreading misinformation and destroying basic knowledge about the dangers of childbirth?

If they are experiencing difficulties they're probably not going to be able to get to the hospital very quickly.

I’m sorry you went through such an experience. It sounds a lot like my second birth.
However, my daughter had a homebirth resulting in an unexpected shoulder dystocia. Similar to my presentation. Something which was medically managed in hospital by drs as an automatic emergency response and subsequent triple episiotomy etc was actually managed skilfully by the two MWs present in the home birth scenario resulting in physical manoeuvring of baby in the pelvis and a subsequent non-instrumental delivery with grazing and not even a stitch required. So it isn’t always as straightforward as saying if this had happened at home it would have been worse… the issue is that midwives are becoming de skilled as medical management of birth takes over. Many babies used to be born breech and midwives could safely manage these births but now people are offered c sections for these so less MWs get the opportunity to experience the non medical management of such births. Ditto twins… so then the risk does increase for home births etc.

There are risks with all births. Anyone who thinks otherwise is deluded and anyone who thinks an ambulance will come quickly if they need help is also deluded nowadays.

I agree, and I think if she was receiving 'medical advice' directly from anyone other than her medical team, including in online groups etc they should be considered culpable. It is morally as awful but legally more difficult if she was 'just' looking at a lot of irresponsible content on Instagram etc. rather than directly corresponding with anyone.

Also, while again it feels awful to criticise someone who has suffered what he has, but I think the father claiming that they wouldn't have gone ahead if someone had used the specific phrase 'out of guidance' feels like wishful hindsight. From the report, he wasn't in the appointments with the consultant, but it seems clear they very strongly recommended a hospital birth. That one phrase being in her notes wouldn't have changed her decision to ignore that.

I'm not sure how you would gather data on this. Surely most people would go to the hospital if they experienced difficulties during a home birth. If those difficulties led to poor outcomes once the mother was in hospital, wouldn't they fall under hospital statistics (even if they delay in treatment was due to an attempted home birth)?

I hope the PP who suggested that midwives in the community can do all this reads your post. Even midwives in the hospital can’t do this. And it’s mad to think that an ambulance can just wait outside the home for an indefinite period of time in case something goes wrong with a home birth.