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

Wasn’t arguing that at all. Merely pointing out that home births do carry risks so communicating these is not misinformation.

https://m.facebook.com/story.php?story_fbid=pfbid022DmCx6o96fe29tWHKNa5LP4PVYCTLxNXDotoVyMkp6VFyc5VBAasTGRwnrCe7Pacl&id=100064865192578

I’ve not read all the comments but did see there were some comments about the lady who did in June 24 of a haemorrhage whilst having a homebirth. The midwife attending to her sounds completely incompetent and I think that was definitely a factor.

Above is a link for a news article regarding the failings of Leeds Hospital maternity services which have resulted of the death of at least 56 babies… in hospital.

Home births are the default option where I live, and we have a much lower infant and maternal mortality rate than the UK. They have a much more see how it goes attitude than the UK: you start at home then move to the hospital if there is anything that worries the midwife or if you want stronger pain killers or have a bad feeling. Only 10% of first babies are actually born at home in the end, but about 50% of subsequent babies are. It means far fewer interventions and generally better outcomes for everyone, partly because everyone is less stressed. Maternity care in the UK in the UK is just awful wherever you give birth

Her post there is very different in tone from the impression the midwives gave at the inquest. She seems very open to treatment and antibiotics, she just wanted to know if they could be done while still having a homebirth, which seems reasonable to me. She seems on top of the key issues in that she seems to be reassured they can deal with the key issues if they arise again at home. And they said she turned down a GBS test at her consultant appointment but she seemed under the impression it could be rapidly tested for as labour begins (more accurate) so was that so unreasonable?

I think there is an awful lot going on here in terms of blaming her.

Yes.all misinformation
https://www.9news.com.au/national/stacey-warnecke-food-influencer-dies-from-extremely-rare-complication-during-childbirth/76f69720-f27e-4600-8dd0-1943756d2776

Well, that depends how your birth goes. After my last one we had to recarpet the whole bedroom, replace the whole bed and all the bedding. Thank goodness for insurance. It was quite the PPH.

And women die in hospitals too. The US, with it's highly medicalised birth system, has the highest maternal mortality rate out of all countries considered high income. You can Google that for verification.

If women are advised at not to birth at home, they should probably take it seriously. Especially when the issue is high risk of PPH, depending what caused it. I've had two PPHs at home. The second far, far, far worse than the first.

I did laugh trust me there is no mess half an hour after you wouldn't have a clue what happened in your home lol...all 7 of ours were born happily at home best thing ever for me having your own private midwives and just left alone, then dive into a lovely bath right afterwards. The twins coming was a little more cramped as 4 midwives had to come but soon as they were born and checked they were fine the extra 2 went back to the hospital. In our area they already have a pre arranged ambulance on alert just in case, that's all sorted by them as is the gas air, certain pain relief all delivered weeks before etc if needed which I didn't anyway. But it's all managed so smoothly no stress it was defo for me

https://www.dailymail.co.uk/news/article-15206575/home-birth-mother-died-baby-traumatic-delivery-hospital.html

It is a great post. Truth and well balanced. It also reflects what I said to my father when he was worried about the risk of home birth. "Would you feel happier if I birthed at the birthing centre or small hospital then?" He said, "Yes, that would be a much better option and I'd be happy with that." So I told him, "Then you shouldn't have a problem with me having a home birth since the midwives will carry all the safety gear you will find in a birthing unit or small hospital, so it's not really much different. If they have complications there, they also transfer them by ambulance to hospital." He couldn't say much after that.

What an amazing post.

And from a woman who isnt just repeating her own fears and prejudices borne of ignorance, but from one who actually knows how these things work.

Thank you.

My current hospital is a small secondary one. There are no obstetricians or anaesthetists or paediatricians after hours or on weekends, so if you have an emergency the team has to be called home and wait.

When I was working at a tertiary hospital often the theatres would be busy. I once had to wait 2 hours wirth a woman haemorrhaging before being admitted to OT. The midwives were the ones tasked with keeping her stable until OT was ready.

So no, necessary emergency help is not always immediately accessible at hospital. In one of the last home births I attended, the woman had a postpartum haemorrhage which myself and the second midwife managed. That woman was at the hospital in 40 minutes where they only neeed to monitor her, as we had stopped the hemorrhage and administered all the emergency drugs before arrival. The woman was really happy that she had had a home birth and the hemorrhage and ambulance transfer was just part of the care she expected from her homebirth midwives if things didn't go to plan. All HB midwives are prepared for this and can stabilise a woman and/or newborn for transfer if necessary.

Sometimes I cover remote rural areas where a hospital is over 3 hours away. Transfer may involve a helicopter rescue (which I am also certified to do). In these areas, my threshold for intervention/transfer is obviously much lower than when I am working in hospital. This is part of the hierarchy of decisions midwives and women make as part of their very individualised care and experiences.

Each woman and baby will have a different risk background and we have these discussions with them during the whole antenatal period. Midwives and obstetricians can discuss the obstetric risk with them, however the women have other risks and other factors which affect their decisions, not exclusively medical risk.

When you plan a hike in the wilderness, a skiing trip or a holiday abroad, you also consider the medical risks (you can fall and break a leg, hit a tree, your rental car can crash...) and try to mitigate them. But the final decisions will involve many more factors than medical risk only. If you only considered medical risk in your life decisions you would spend your life stuck at home and living in a flat close to the hospital just in case... in summary... you wouldn't have a worthwhile life.

The same applies to the decision about place of birth: for many families the decision to birth at home or hospital includes medical risk, but there are plenty of other factors in their individual lives which may be equally important, or even more important, than a relatively small medical risk. A risk of 1 in 500 can be very small for some people and very large for others.

Do you know what's the highest risk factor for maternal death in the UK and most of developed countries?

It's not hemorrhage, it's not infection, it's not any of the labour and birth risks you may be thinking about.

It's suicide.

All the "safety" you imagine you have in hospital will be for nothing if the woman ends up killing herself after her labour experience due to a traumatic birth or a consequent postnatal depression.

So before telling others what they should do about such an important even as their birth, please consider that other women's lives are not like yours, and their reasons to make decisions you would consider "risky" as are valid as yours to birth in hospital.

Yes but the risk actually starts increasing from 37 weeks, and becomes a lot more at 41 weeks. So even if you were technically "only" 41 weeks you'll be at a higher risk for a stillbirth and the risk climbing each day.

Also there will be errors the other way - women who think they're 42 weeks and are actually 43 or more.

The guidance is based on using the most accurate form of dating - which is using EDD from a 12 week scan, not from your last period or ovulation. Again this has been proven to be the most accurate from research into due dates.

It's all based on what is "most likely" based on studies, but I think you're a fool to ignore medical research on this matter when it literally increases your babies risk of death tbh

Exactly. My baby that was born at 42 + 2 was a scan due date given to me at 20 weeks. My own dates were a bit uncertain as my cycles weren't regular at the time. My own dates made it right on 41 weeks, which is the longest any of my babies has ever gone. They are usually born between 40 weeks on the dot and 40 +3.

The point is that the way NHS measure the length of pregnancies, it appears to be complete guesswork whether 42 weeks has elapsed or not!

Absolutely fine to say "at 42 weeks this is recommended", but you need to be rigorous about how you're dating 42 weeks - right?

Yeah the placenta monitoring tests won't tell you anything other than "it's currently working". We know placentas start to degrade from 37 weeks, and they reach a high rate of degradation at 41 weeks. Anything beyond that and stillbirth becomes more and more likely.

I know a woman who didn't have an induction, healthy baby went overdue and died. The statistics don't lie.

And I don't really understand why you would go against solid medical advice/research and keep a baby in beyond 42 weeks.

One woman proudly told me about how she refused an induction at 42 weeks, and I just kept thinking about the the woman I know who had a stillbirth because she wasn't induced.

I think women should do what is statistically most healthy for the baby, not what they want irrespective of medical advice.

My point was not that these women were very overdue, the ones I know were all term. They could all have died between the overdue checks anyway, as they don’t check every day. A healthy full term baby one day may not be a healthy full term baby the next day and there’s often not a reason, or in 4 out of 4 cases I know of anyway. You could get monitored one morning and come back later the next day and there’s nothing they can do. And the risk of that happening climbs as the baby stays in there longer. Not a risk I’d ever take past 42 weeks, and I don’t like going past 41 weeks but they won’t induce till 10 days over in the nhs, or where I was in London anyway.

My local hospital was regularly topping lists of the UK's worst performing trusts, and the local press were full of stories of women giving birth in car parks and so on.

I really felt I was between a rock and a hard place with that one.

Genuinely couldn’t pay me enough to give birth at home - I’ll never understand it, birth is such a horribly unpredictable process no matter how low risk you are and you’re ultimately putting your new baby in a situation where they won’t get medical intervention as soon as they need it, why would you do that. I understand the preferring your own space, bad hospital experiences but you’re putting yourself first and not the baby if we’re all being honest

But the best chance is being induced by 42 weeks.

I too share the feeling that induction is too widely used, but I haven’t seen anything yet to convince me going past 42 weeks is safe with the right monitoring.

I didn't end up needing the test so didn't get into the details of it, so don't have much knowledge about it other than the midwife was talking about checking the placenta was still functioning well. Regardless, you do the testing and give it the best you can to give the baby the best chance. Still no guarantees any pregnancy results in a live birth, even when we try our best to do all the right things.