Low intervention - homebirth

.. Elaborate?

My question to you is instead what makes women on this thread hate science?

I remember when my dog gave birth alone laying alone in a corner with a towel. You could do the same with no intervention whatsoever, no midwife nosing, no one ruining the wonderful time of labour, ohh such a powerful moment as I recall it. You’ll be there listening to the lovely contractions your body will start producing for you and if you hear a ‘crack!’… no worries, it’s just a third degree tear ! Good luck!

Tbh, it was just an example. There'll be many scenarios where because of a specific issue, giving birth at home would likely resulting in mum not surviving. We're talking hypotheticals here.

I think we both agreed that providing mum has capacity she can make a decision that will result in her death. I suspect that we both actually think it's important to ensure mum does have capacity to make that decision, where a seemingly irrational decision will have such profound consequences.

Where we differ is that you seem to believe that if mum has capacity to make a decision that will most likely result in her death, that's a good decision for her to make. My view is it's a bad decision, but the law gives us the freedom to make bad decisions.

What I worry about is that if women making clearly bad decisions that put their lives at risk are not clearly told the consequences of their decisions, then that's not informed decision making for them. This is exactly what happened with the Cahill case, when no one told her clearly how high risk she was, so she couldn't make an informed decision about whether to try for a home birth.

As I said, this is a fascinating area, but it's only tangentially related to the OP. I'd quite like to continue it, but maybe we do that in another thread if you're interested?

True, it may be less likely to happen, but if it does the risk is far higher. So overall surely safer in a hospital where they can deal with it much easier.

I'd really hope that if someone was making a decision with what was most likely going to result in their death that questions of capacity are considered, even if the result of that is to decide she does have capacity.

Draconian powers should never be used to subvert consent where someone has capacity, but it would be tragic for someone to die because no one stopped to think whether their decisions were the result of mental impairment.

Someone pursuing a course of conduct which is almost certainly going to result in their death is no different from someone showing clear suicidal ideation, which most people would then need assessment.

Obviously it's a very delicate balance though.

This is a really interesting area of law and medicine, maybe we should take it up elsewhere in this forum rather than here.

Goodness me what has this thread become!!!

a woman has the right to choose. A woman also has the right to be in hospital, give birth at home, birthing centres. In a car if she wants to (or maybe doesn’t have the choice on that one !)

home birthing is perfectly safe, as safe as giving birth in hospital if you are a low risk pregnancy.

community midwives are often hospital midwives as well. An ambulance would be on priority and in all likelihood by the time you are assessed by a doctor, you’d be on the operating table a lot quicker than being in hospital.

just because you don’t want / agree or wherever with home births, you do not have a right to put other people off who do.

the OP explicitly said in her opening post she wants to connect with woman who are going through a home birthing experience, not a tirade of mumsnet misinformed wisdom.

and yes - you do have two midwives throughout. And yes you can have as hands off or hands off as you require. It might appeal to some, it might not. But at the end of the day it’s YOUR own personal decision. Back off for goodness sake.

@Babyboomtasticagree with some of what you’re saying re AN discusions around risk.

I strongly disagree with what you are saying re a woman’s capacity. We have the MH act in place for complex situations that require it. It makes my blood run cold to think that the simple act of making an informed choice for yourself (that is disagreed with by a HCP, who is guided by policies very often not backed by good evidence, and who practices defensively as they are fearful of litigation) could initiate an assessment of your capacity.

That is a very, very slippery slope that I don’t think, given the chance to fully think the idea through, in depth, all wide reaching implications considered, you would want to go down.

If that was the reality of maternity care in this country I’d very quickly be hanging my scrubs up and calling it a day as I’d want absolutely 0 part in a system like that.

For a situation as clear cut as the PPH scenario?

Firstly, the woman should be told the risks in clear language, including the high likelihood of another haemorrhage (that she's never NOT had one), and that if they were on the same scale as her previous ones she would likely die. Therefore if she goes ahead with her plan, the likelihood is that she would die. She would be asked to sign a document acknowledging this likely outcome.

Secondly, an assessment should be made of whether the woman had capacity to make the decision, as frankly that level of irrational decision making would be concerning enough to need this to be checked. If she has capacity but there are other mental health concerns (given she basically is suicidal) then consideration given to whether there are grounds to section her.

Finally, a very unlucky pair of midwives would be sent to the birth, and would document everything like crazy to cover their own backs, but realistically if the woman doesn't change her mind in labour, they wait to call the ambulance, and get ready to witness a tragedy.

Unless she lacks capacity, she can go down this path. It does t make it the right decision for her, just one that she has the right to make.

This is a deeply concerning attitude from a purported health care professional, if you were truly to advise a woman who was planning a homebirth after 5 nearly fatal PPH that having her 6th at home was a GOOD idea.

I think the law would likely call that negligent, and I hate to think what would happen if this hypothetical woman were to die.

You can support a woman's right to make risky decisions whilst still acknowledging that they are risky decisions.

I just hope that you aren't actually a midwife.

Really?

So if someone's plan is to free birth, then that's a good plan and the right one for them?
If someone wants to get drunk off their face to the extent they pass out, then that's a good plan and the right one for them?
If someone wants to give birth whilst in a hot air balloon, because that would be co, that's a good plan and the right one for them?
If someone has had huge PPH for her previous 5 pregnancies and in each case only survived as she was in hospital, would her choosing a homebirth for her next still be a good plan and the right one for her?