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Childbirth

Share experiences and get support around labour, birth and recovery.

Original poster

Homebirth - should any woman be allowed the choice?

63 replies

mears · 19/02/2004 14:35

Me again looking for mumsnetters opinions. I have been asked to list why women who are condsidered not to have normal pregnancies should be 'allowed' a homebirth if they want it.

I personally think that women should be given all the information they need to make a choice. If the midwife is going to say that they will not be supportive of homebirth, the woman is going to feel they are in a conflict situation.

However, if the midwife is supportive and problems do arise in labour at home, the woman is more likely to trust the midwife and agree to transfer to hospital if necessary.

What do you think? Anyone been told they couldn't have a homebirth and then did?

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hmb · 19/02/2004 20:22

I felt the same way Countess, and needed sections both times.

Do you feel that women intuitivly know what they need Mears? Or do you think that it was a basic feer of mine that predisposed me to a chain of events that led to a section? (not being in any way argumentative....rather interested in your views)

I have a friend who is very fatalistic about pregnancy etc, and had very easy home births. I suppose it is a bit of a chicken and egg situation.

I'm also 100% happy with both my birth experiences. Very positive, both times.

Original poster
mears · 19/02/2004 20:18

Can I also say that I wouldn't have wanted a homebirth but I have every sympathy for women who do.

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Original poster
mears · 19/02/2004 20:17

Once also had an experience of a woman who did not want female midwives - so much so that she laboured in a room by herself for a long time as we had no males available. Eventually she consented to assistance but it was a terrible situation. It is amazing the experience women have had in the past that informs their decisions. i felt her situation could have been managed better earlier in her pregnancy but she had to fight the establishment. That is what I think should be avoided at all costs.

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CountessDracula · 19/02/2004 20:16

BTW Mears I think dh was involved in the cave case, if not then one very similar.

CountessDracula · 19/02/2004 20:15

I wouldn't have one as I would worry that if anything went wrong and I couldn't get to hospital in time the baby and/or I would be compromised.

hewlettsdaughter · 19/02/2004 20:14

Thanks, zebra.

Original poster
mears · 19/02/2004 20:14

You have it in one Zebra

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hmb · 19/02/2004 20:13

That is a very intersting story, Mears. I find it hard to understand how a woman could risk her child because she has a needle phobia. I'm phobic about hights (very much so). You could have dragged me up the Eifel Tower if my child had needed it.

I suppose that i can't understand how a womans need for a particular type of delivery can be more important to her than having a healty child.

zebra · 19/02/2004 20:12

Placenta blocking the birth canal -- over the baby exit, you could say! Can be partial, complete, or just very very close to the birth canal.... I'm not an expert, but basically, if the placenta is born first, the baby has to follow very fast or baby dies... and there is a high risk of excess bleeding in the mother (I guess Mears would know why?).

hewlettsdaughter · 19/02/2004 20:06

What is placenta praevia exactly?

hewlettsdaughter · 19/02/2004 20:04

I don't think I agree with women being told they are not 'allowed' to have a homebirth - since different medical professionals will have different opinions on what should be allowed and what shouldn't and it ends up being a bit of a lottery.
There's nothing wrong with professionals voicing their opinion and explaining why they think a homebirth might not be suitable, though.
I want a homebirth but if I thought there was a genuine reason why it would be better to have the baby in hospital, then I would go for that. I agree with what you say, mears, about conflict arising from the withdrawal of support.

kiwisbird · 19/02/2004 20:01

I wish I had insisted with no 2 but there was tiny chance that I had cholestasis and they were panicking abit not knowing a lot about it, as it was I delivered in 24 minutes, drug free and toddled off home running two hrs later.
Had HB first time round, was 22 my mw was right behind me and it took 37 minutes, was MAGICAL
Next time I'll insist within reason!

Original poster
mears · 19/02/2004 19:56

I have to say I had a problem the other night with a woman who had a needle phobia and I actually wanted to punch her!!!
She had come in with high blood pressure and her waters had broken. Unfortunately she had meconium staining in the waters and I explained why it was a good idea to check her bloods to see if the blood pressure really was a problem. Also, where there is meconium staining we usually cross match blood incase the baby shows signs of distress which might mean a C/S.
She looked a me and shrugged her shoulders saying 'I'll think about it'.
Anyway, she had no contractions so she agreed to a drip to get induced.
So for all my great ideas I was actually pretty annoyed with myself for getting so annoyed with this woman (not that she knwe of course).
I gave her the information and she chose not to comply. She actually delivered OK in the end and that in a way demonstrates what i ultimately think.
Women who are dead cert on a decision regarding delivery are usually right. Those women who absolutely insist on a homebirth are usually absolutely right.

Just as a point of interest, there are varying degrees of placenta praevia. Where the placenta completely covers the os (neck of the womb), the baby would not survive delivery and the mother would have a massive haemorrhage. i don't know any instances of woman insisting on a homebirth in those circumstances.

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zebra · 19/02/2004 19:09

I stumbled across a placenta previa board the other day... I always thought it was fatal to baby, probably to mum, too, to attempt vaginal birth when you have full PP. But there were several people saying that they themselves had been undiagnosed placenta previa babies but still born vaginally, or granny had had a few, etc., usually baby died but it wasn't the automatic death sentence for both I thought it would be.

Some people have immense hospital phobia, that's one reason they know they'd be better off taking a bit more risk at home rather than needing serious tranquilisers to cope with being in hospital. I have needle phobia, and don't think I could be relaxed through birth hooked up to an IV or similar.

hmb · 19/02/2004 19:04

I refer the learned ladies to the Mumsnet e-mail on things I learend about giving birth, specificaly Motherinferior's comment. That was one of Shiela's wasn't it?

hmb · 19/02/2004 19:01

Why did she want to go to Wales to give birth in a cave??? I come from there, and there are lots of houses she could have gone to???

The cave bit makes her sound a bit loopy, tbh. And I do support a womans choice, that bit just sounded a bit crazy.

bundle · 19/02/2004 18:46

interviewed Sheila Kitzinger once, amazing woman

aloha · 19/02/2004 18:46

I hate women being told they are not 'allowed' X Y or Z as seems to happen all the time. I think sections are pretty great, but do think women should have the right to a homebirth, except possibly in extreme cases, eg placenta preevia like me. Don't know what you'd do with a complete loon who refused to go to hospital with PP though.

zebra · 19/02/2004 18:35

I suppose I support any woman's "right" to homebirth precisely because the alternative is a mechanism that can force the manner of birth, such as the C-section case Mears linked to.

wilbur · 19/02/2004 18:19

Fascinating mears - what an extraordinary story.

Original poster
mears · 19/02/2004 18:13

CD - the very interesting thing about these statistics is that they were skewed to show that hospital births were safer and drove the radical change of predominatly births at home to birth in hospital. Marjorie Tew is a statisician who looked at archived stats from the 50's and discovered that they were skewed in favour of hospital confinement for women. It is a really interesing book. She has no connection with obstetrics at all and was amazed by the information she gleaned.

Anyway, a bit off topic now but this is an interesting famous case here

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CountessDracula · 19/02/2004 17:57

Ah but Mears is it not possibly the case that as usual these statistics are skewed. As you say women with serious potential problems would not choose a home birth, these are the ones who usually run into difficulties and therefore hospital is a more dangerous place!

If half of all women regardless of probs were to give birth at home I bet the statistics would have a different outcome!

Sorry got to go and see dd now but will come back to this later....

Original poster
mears · 19/02/2004 17:53

CD - I should have been clearer saying normal pregnancy - meant pregnancy where mother is deemed to be 'low risk' ie has no known obstetric or medical problems.

Women are often told that they are 'not allowed' to have a homebirth eg if they are a previous C/S or have have previous retained placenta - there are loads of reasons actually.

However, a woman has the right to choose and a midwife cannot refuse to give care (a GP can).

In reality then, a woman can refuse to go to hospital to give birth. For women who request homebirth, I think it is giving them the informed choice and making sure they understand any risks involved. If they still want a homebirth, then I think it is better for the midwife to build up a relationship of trust and try and support the woman. That way, if anything does start to go wrong, the woman will co-operate regarding transfer.

Often women are persuaded not to have homebirth 'incase' something goes wrong, however the riskiest place to have a baby is hospital statistically (read Safer Childbirth? by Marjory Tew). That is because there is still a lot of intervention, especially induction of labour.

Women who want to deliver at home will relax better and labour better there. A natural labour is by far the best option.
It is unlikely that a woman with placenta praevia would ask for a homebirth - that would mean certain death for her baby and possibly for her.
However, there are women who do not want to give birth in hospital but are bullied into doing so. My argument is that these women should not be put into a conflict situation with the midwife telling her that she is not 'allowed' to give birth at home. Better that she gains support from the midwife who she will hopefully become to trust. That way. 'if' complicatios do arise, she will be more likely to agree to transfer in.

A woman who has been informed of all the fact cannot then sue the midwife if all does not turn out well. She is taking the reponsibility of her own decision.

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coppertop · 19/02/2004 17:04

I think it does depend on what the (potential) problems are, and also how practical it is to get to the hospital if the worst happens. A home-birth wasn't something that really appealed to me but from reading MN posts I can see how important it is to a lot of women to be able to have the choice.

It turned out that I was right to have a hospital birth. Both my boys were large babies and got their shoulders stuck. It was also suspected that ds2 might somehow have turned himself round into a breech position as the heartbeat could only be heard at the top of my bump. Luckily he was the right way round but bizarrely his heart could only be heard through his bum!

I think the majority of women would make a reasonable decision if informed of all the facts. However, I think it must be a tough decision for a MW to make about whether to assist in a home-birth when he/she knows it would be a high-risk birth.

hmb · 19/02/2004 16:47

Everything else being OK I think that women should have the right to choose a home delivery. And with that comes the responsibility to make a rational decision based on the facts of a case.

If the mother has, as others have said, placenta previa, then I would think that the midwife has the 'right' not to help with a home delivery in those cases. I don't think that a mothers right to choose should override the mw's prefesional duty of care IYSWIM.

ds was a section because he was a footling breach (also dd had been a section and I had pre-eclampsia.) I was very happy to have a section! However, should I have had the right to demand a home birth? Even if that went agains a MWs professional assessment? Would I have had the right to effectivly coerce the MW into going along with something that she felt was dangerous to me and the baby? I don't think that I did. What do you think Mears?