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

I think it would be possible to do a MUCH better job on this with a proper statistics project.

Humans are very variable, but one thing they could do is adjust due dates by ethnicity of the parents I think? And as I said, use actual information available from IVF where relevant.

No, it doesn’t. I had this specific monitoring due to a pre existing condition that degrades the placenta quickly. It doesn’t give you the information you think it does - it gives you an ‘idea’ which is not accurate enough to reduce poor outcomes

https://www.hra.nhs.uk/planning-and-improving-research/application-summaries/research-summaries/placental-monitoring-study/

It monitors if the placenta is still performing well, and that's the important thing at that point. It doesn't directly monitor the baby, just the condition of the placenta. Babies are lost, it's a fact of life. A heart breaking and devastating fact of life. We do our best to prevent it but it still happens. They're not even safe from sudden loss after birth. And then children die throughout childhood and adulthood at all ages. You can't prevent everything but you can do your best by having the recommended testing if you go well overdue, so you at least know the placenta is still doing what it needs to keep the baby alive. If someone declines the test or isn't referred for it, then they are taking unnecessary risks, even though nothing is guaranteed.

But you don’t really get drip-drip-drip warnings that the babies are unhappy. They can be fine one minute and in distress the next - monitoring gives a snapshot of how they are at this second, not later this afternoon.

I can see where they're coming from.

DH and I were surprised by how ineffective the dating was. A cardboard curclw based on date of last period! We knew the actual date, time and age in days of the blastocysts that were implanted, resulting in the pregnancy. Would the NHS incorporate this information? Of course not. So the date was out by 4 days or 11 days (two "dating scans" that gave dates a week apart).

It turned out DH had done a forecast himself, having the skills to do so, and estimateed Christmas day (but didn't tell me as it was all stressful enough already). I went into labour at lunchtime and DD arrived 2am on Boxing Day!

I was happy how it worked out because baby decided to arrive ahead of the tests I was prepared to have to check they were doing okay. Of course mothers for whom it doesn't work out are devastated. That begs the question of whether the babies were appropriately checked out as the pregnancy went on longer.

Of course you’re happy with how it turned out for you, you got a healthy baby. The mums who didn’t are completely and forever devastated with how it worked out. And all the ones I know of were full term and healthy normal pregnancies.

please read. This data covers 3.8 million normal (non anomalous) term births. The stillbirth risk increases after 40 weeks and notably at 41. The statistics say clearly that these are higher risk. Where is the large scale data you talk about that tells us 41 and 42 weeks should be normal? pmc.ncbi.nlm.nih.gov/articles/PMC3719843/#:~:text=The%20risk%20of%20stillbirth%20at,fetal%20deaths%20occur%20at%20term.

In my observation of a lot of birthing women, it seems most babies like to arrive during week 40.

I have read several medical articles that suggest that 41 weeks (and in some 42) should be the accepted average length of a healthy pregnancy and that "full term" should be 38 to 43 weeks. This is based on the fact that far more babies are born after the 40 week "due date" than before and that very few show genuine overdue characteristics despite being overdue according to dates. Of those that do its usually due to miscalculation of dates.

Nature isn't perfect but, on the whole, I trust my body and baby to know when they are ready to be born. The only people I personally know who lost babies in the womb were at 24 weeks and 35 weeks. I know it does happen.

I had one at 42+ weeks and we were starting to talk about tests to just check baby was doing okay. Then she arrived. Some characteristics of being a bit over cooked, but I'm happy with how it worked out.

I know someone who was induced based on dates. Baby was born a good size, but with characteristics of being early and not quite ready for birth. Choosing a home birth doesn't mean you can't or shouldn't monitor and make appropriate decisions when they are needed. It doesn't have to be all or nothing.

I don’t think I could handle the stress of working as a midwife or obstetrician if women could say no I’m having it at home and walk away at 42 weeks. Mine were late, the induction took two days to organise for the first and he was born at 41+5 I spent those last few days checking very regularly for kicks and hoping nothing went wrong. Placentas age, and when he was born mine had. The second was born at 9 days over and I felt the same - I had a healthy full term baby who would be fine on the outside world but wouldn’t be fine for much longer inside me and you can’t tell when they stop being fine. I wanted them out where I could look after them. My third was born at 38.5 and she was fully ready to be born, completely reinforced my view that getting them out while you know they are healthy and full term should be a priority. I know of far far more still births where baby just suddenly died right near the end than I ever expected to and they are so so tragic.

Yes, you don't know how your midwife is going to respond until something happens. My very experienced midwife didn't handle my complications at all well and wasn't very proactive about managing them, leaving me in a much worse and more dangerous state. (She acknowledged some things needed to change herself after the fact). Thank goodness for the paramedics who gave me much needed oxygen, which I should have got earlier. That helped a lot.

Look I have absolutely nothing against homebirth at all, and probably would have chosen one if I was a healthy low risk second time mum with a straightforward previous delivery and lived within 10 minutes of a hospital. Am I bit jealous of mums who were those things, and had a lovely experience? Of course! But I’m not speaking from a place of jealousy when I urge some caution, because I can be objective and don’t attach judgements to my feelings where facts speak for themselves.

Although this lady’s risk factors and very ‘hands off’ birth plan was quite clearly unsafe, I am still shocked at the ‘care’ she received at home, and I think it’s really important this story is shared as a massive part of homebirth advocate’s reasons to choose home is ‘better care’. This lady did not receive better care in my opinion, in fact it sounds woeful. A homebirth midwife with no experience of resuscitation and no experience of postpartum haemorrhage! I mean these are 2 emergency scenarios that I would’ve thought homebirth midwives were especially trained to deal with, given they could happen at the lowest risk deliveries and have the most serious consequences.

Add to that the fact the gas and air ran out, the resus equipment was faulty, key obs weren’t recorded properly, and when the baby was born not breathing it sounds like they completely and utterly panicked and lost control. The attending paramedic said they hadn’t even switched the lights on, clamped the cord or kept the baby warm ready for their arrival - he sounded shocked that they were flapping so much they hadn’t done basic things to keep a modicum of control until they arrived.

If the care had been better they may still have died but that doesn’t excuse such woeful care - precious minutes would’ve been lost, minutes they didn’t have. I have heard repeatedly on here how experienced homebirth midwives are and how they’re trained to deal with emergencies away from the hospital, but this was very much not the case here. Ladies should be aware their care will depend on who they get, same as in hospital.

TBF it wasn't suggested. as I was intending to have a home birth and was simply using the private hospital as backup. For the last 2 weeks I trundled in to each day to check readings and would have gone for plan B if I felt it was needed.

I wish - I stopped work at 38 weeks and I'd run out of maternity leave (which was then 6 weeks) by the time DC1 was born

I have really mixed opinions on this. On one hand I fully acknowledge a women's right to choose her birth (as far as possible) and that being at home may make the birth go smoother if she feels calmer and more comfortable.

However, as a paediatric specialist, I have seen several cases of 'home birth gone wrong' where the mum was seen to be low risk, and what hapenned was hard to anticipate, but the babies got into trouble and are now severely disabled as a consequence, with very limited quality of life. I was also potentially one of these - DD1 was born when I was 32, I was fit and healthy, no concerns re me or baby and I was offered a home birth. I declined and chose the birthing centre which was on a hospital site but seperate, and calm and quiet. I had a textbook early labour, laboured in water, and then after several hours suddenly all the alarms went off and 6 drs were in the room within 2 minutes and they had to get her out quick, there wasn't time to even get me to theatre for an emergency c section so I consented to a quick forceps delivery, she came out unresponsive but they got her back within a couple minutes. I also bled+++ and ended up on HDU and needed repair surgery as tore badly. As a home birth she definitely wouldn't have made it, and I might have not.

What we need to do is make hospitals feel calmer, more welcoming, more supportive so women don't have really negative hospitals experiences and then go on to chose a home birth for negative reasons. I would never advocate removing the choice of home birth, but wouod hope that more women would chose a hospital birth if we made it a better experience.

The problem is that until Labour starts, no-one knows how it’s going to go. Some go brilliantly - no issues with either the baby or the mother. Some don’t. When they don’t, it’s safer to be in hospital. Given you don’t know how it’s going to go until it’s happening, hospital is always the SAFER option, but mothers may take other considerations into account and weigh up the risks vs benefits of staying at home.

Because low risk can turn into high risk in the blink of an eye. A text book pregnancy with no issues at all still doesn't guarantee that nothing will go wrong during labour and delivery.

No. UK. And the guidance is pretty clear.
All high risk pregnancies are recommended to go to hospital. Because it’s safer.

I don’t have an axe to grind (unlike you) and recognise that risks are to be weighed up and women can and do choose to birth at home because there are huge benefits to doing so. Safety is NOT one of those benefits.