Home births are irresponsible

[LadyShapes]

Did anyone see the start of Lorraine at about 8.30? They were talking about what's in the news and one of the stories was about how more women should have home births. The delighful guest they had on to talk about it said that she thought home births were irresponsible and dangerous. She also said she thought natural births were a load of rubbish and she just wanted to be in hospital and have medical intervention (paraphrasing). Oh and she wouldn't have a home birth because she has cream carpets. The other guest just agreed with her, so the that was the extent of the discussion.

Is it me? AIBU to think they shouldn't discuss news stories unless the guests have some kind of informed opinion (I mean, all the infomation I have had from my midwife tells me about the benefits of home births and a natural birth as well as the risks), or they should have read more than just the headline. Or AIBU to be watching Lorraine and hoping for some kind of balanced discussion.

I had an episiotomy and a tear but it was still classsed as a normal birth because there was no ventouse or forceps used. Do women who have home births not tear then?

I really did love my home birth with DS2 and as I've said I'll certainly be having another one. 2 hours after he was born I was tucked up in my bed with my now XH and my son.

But I do understand they aren't for everyone. Personally I'd never have an epidural because I am terrified of needles but I'd never preach to anyone about it.

I didn't really have pain relief with DS2 either as the gas and air thing was broken so I just had my tens machine. He was 10lb 5oz. Believe me no matter how proud I was and still am of myself for being able to do it. I'd never ever suggest anyone does it because it bloody hurt!!!

I hate the way hospital vs home birth threads seem to descend into such angry debates. Surely one of the best things is that every woman gets to make her own decision and I personally respect them even if I wouldn't do it myself.

Hairy - I think Spud has a BIG chip on her shoulder about hospital births, especially seeing her last comments. We will have less PND if we give birth at home......

The facts that are borne out on this thread are that lots of women are allowed to do whatever they like during labour, walk around, use balls, get into birthing pools, have no pain relief, lots of pain relief, pay for a private room (that was my big issue with my 1st) and horror be allowed to do all of this in a big bad hospital. Riven has an experience that she has kindly shared with us all. Her experience counts as much as anyone else's - to dismiss it as being 'unlucky' is disgusting.

Kayzr - thank you for putting a balanced view. You had a good HM but are not preaching to us all.

Both my girls were homebirthed. Both under 3 hours of labour and not a single problem, except that the first one came early and we didn't have the crib set up yet.

A problem with the system in the UK is that it isn't set up to benefit the mother; it seems you see whom ever is available at the time. Here, you ring around for a midwife, (they take on only so many women) and that is who you get throughout your whole pregnancy, birth and six weeks after. Rarely does two births coincide leaving one woman with a midwife they don't know.

I'm not familiar with this Lorraine woman, but the show sounds dreadful and desperate for sensationalism.

"Why does it have to be a case of either flat on your back in hospital OR an ambulance ride away from emergency care?"

I know there are some great hospitals out there and fantastic midwives. I'm all for improving the hospital environment and practices. And actually, when you look at the stats for different hospitals you see that some have VASTLY lower c/s rates than others serving similar populations, which is a good indicator of the quality of care (in my view) as long as neonatal outcomes are also comparable.

But however good you make it, going into hospital still changes the relationship between the mother and her care-givers, can disrupt the normal hormonal physiology of labour and unwittingly expose the mother to unhelpful protocols - which ALL hospitals have out of necessity, because they are dealing with such large numbers of women. Labouring women behave differently in hospital. It is harder for some women to let go and behave instinctively in an environment which is primarily set up to provide surgical and medical support in the case of complicated births.

Although I have no problem with anyone wanting a hospital birth, I do have issues with the medicalization of birth, a perfectly natural experience as a living being, and how 'fear' is used to make women give birth in the hospital... people make more money off you if you give birth in the hospital.

Spud - oh god hormonal physiology! Can you not let us decide for ourselves. Changes the relationship between mother and caregiver? I had never met my MW before I arrived at hospital. Why on earth would my relationship change with her. Sounds like a load of nonsense. Again - think you need to take up a few hobbies rather than rant about hospitals.

For some women it may be harder to let go in hospital, but personally I relaxed once I got to hospital and knew all kinds of pain relief was available. I just wouldn't have felt relaxed if I had stayed at home. The majority of women in the UK give birth in hospital so I would say that hospital are geared up for all kinds of birth, not just complicated ones. It's very unusual to give birth at home in my area, but the local hospital has a home from home suite which aims to provide a homely environment, but help is at hand from the main hospital if it's needed.

"I hate the way hospital vs home birth threads seem to descend into such angry debates"

Well - have to say, I do have a problem with people coming onto these threads and insisting that homebirths are a) more risky b) more expensive and c) an unnecessary and pointless self-indulgence.

And carrying on insisting without any reference to the facts.

"especially seeing her last comments. We will have less PND if we give birth at home......"

No - that's what the evidence says!

Not going on personal experience. I had two babies in hospital, one at home. Didn't experience PND or PTSD after any of them.

"Her experience counts as much as anyone else's - to dismiss it as being 'unlucky' is disgusting."

Get off your high horse.

I didn't dismiss her experience.

Or read the story about what happened to her and then make tactless and nasty comments about how I could never put my own baby at risk by opting for a home birth, as others have done on this thread.

What was Riven if not 'unlucky' to have such a rare and terrible thing happen to her and her dd?

Anyway - I can feel this is getting quite unpleasant and personal here so I'm going to duck out.

I'll leave you to ponder on the RCOG (those well-known hospital and doctor bashers....) statement on homebirth, which says:

"There is ample evidence showing that labouring at home increases a woman's likelihood of a birth that is both satisfying and safe, with implications for her health and that of her baby."

Well I would want to look at ways to design labour suites and other ways to minimise the difference in home/hospital environment. It shouldn't be the case that women should have to be an ambulance ride away from emergency care should they need it.

Spud I've really enjoyed your posts, thanks. I don't read them as preachy at all, just well-informed. I find it odd that posters are demanding to be left alone to make their own minds up but seemingly without the benefit of the facts

If we're doing anecdotal stuff, then in 100% of my hospital births so far (just the one, thank goodness) I've been forced to lie flat on my back with my feet supported by MW and DH though not actually in stirrups. MW was also pissy about me wanting a physiological third stage, presumably because it would take longer. Oh yes, and second degree tear. No experience of home birth yet but hoping to be able to report back in the next couple of days ... :)

My first hospital birth was not optional as I had pre eclampsia (that went to full eclampsia, rarely). The way the ibiorth entr we WOULD still be here if we hadn;t had the medicalised birth (bit of a comedy of errors, no real one person's fault) but there was no way of knowing that.

My lst birth would have ahd to be induced early to ahve been a hospital birthwhich clearly is an additonal risk factor.

The two in the middle- one born in a MLU where I could not have got better are, and one born the same place as ds1- had been booked for home but iron counts a bit low so we transferred prior to term.

There isn;t a one birth fits all option. It is sad what happened to Riven's DD but it is obvious that ahd ds4 been born en route he would have faced greater risks than in a warm home with proper midwife care and full birthing kit. Women ae different and their care needs vary; by closing off options we let down the person who dosn;t fit the stereotype- the expected precipitous labour. Like my friend who ahd a HB the newly single mum trying to cope alone with the fact she is about to be a mum of two whilst her H is on a plane to his new partner in Honk Kong and not feeling able to do the whole hapy family thing in hospital (she did actually deliver whilst he was in mid air).

You do need to recognise the risks but crucially to me the key is that at all times Mum should be happy to transfer if it is medically warranted. I know ahd I refused Dh would have simply carries me t the ambulance (had told him beforehand that was OK), but when I was in with ds3 there was someone who ahd refused a trnasfer and that i don't comprehend.

So hairy what about women like me who knew they were likely to have a precipitous labour but whose chidlcare was over an hour away at best?

Do we have to accept then that we have to be induced or risk birthing in a car en route, or alone awaiitng cover? or is that OK as long as it's a nice hospital unit?

Mine was classed as a medically advised HB by the MW.

This is fascinating to me. The percentage of home births in Australia is so tiny as to be almost non-existent; it's about 0.5% of all women. The c-section rate is around 40%.

Home birth, in my state, isn't even covered by Medicare (=NHS) OR by private health insurance, so I'm paying entirely out of pocket for my care. This is utterly crazy; if I had a low-intervention birth in a public hospital, as I did with DD1, it would cost the government around $5K. If I had a high intervention birth at a private hospital, it would cost my private health insurer close to $20K. And yet neither of them will cover even part of my $3K home birth - that figure, by the way, covers all pre-natal and all post-natal visits as well as the birth itself, with a private midwife.

So, clearly, I'm a bit fringe, and therefore it's not hugely surprising that the home birth 'debate' is incredibly biased over here. But I'd always assumed that in the UK, where it's far more common, there'd be more understanding of some of the really uncontroversial basics; it's cheaper, and there's no evidence that it's any less safe. Is it really so controversial? Is it really so common that people conflate 'home birth' and 'unassisted birth'? Really?

I think it depends very much on where you live in the UK Tortoise, we were in Brighton which is very pro-homebirth so it was always presented as an option if circumstances allowed. Most of my friends had at least one homebirth, one managed 4/4. I couldn't believe it when I arrived in Sydney and the only conversations around childbirth seem to be "which private hospital are you booked into".

DD1 was born in a small public hospital near where I live, rather than a big teaching hospital or a private - I chose it partly for proximity but partly because their C rate was only 10-15% which is incredibly low for here - and I kept getting "but what if something goes wrong?" like not going private was taking an incredible risk. You know what I thought would be risky? Booking into my nearest big private hospital, where the C rate for first time births is 60%.

If I had received better care when DS1 was born then DS2 probably would have been born in hospital too. But it was rubbish and unless there is an emergency or the baby is wrong way up etc I'll never give birth in that hospital again. Most mums where I live give birth there and I'd say 75% of them have said it was horrible. I was told that it has one of the lowest breast feeding rates in the country because the staff dont care.

I wouldn't have got there with DS2 anyway as he was born in Dec 2008 and the road was closed due to snow.

Well obviously you should have a home birth then Peachy - providing that's what you wanted. I'm for choice. I don't think spud is - she's obviously very pro-homebirth to the extent that she thinks hospitals shouldn't be the place for low risk births at all.

I don't see why Spud is getting such a hard time. All she has done is link to actual statistics regarding birthing at home or in hospital. Yes some hospitals are good and some people will have great experiences of brithing in hospital and that is still a choice. But there seems to be a lot of misinformation about homebirths constantly on this thread. Hb have better outcomes, as Spud has demonstrated. That doesn't mean that everyone should hb but that it should be seen as a genuine option (as it has been in both trusts I've been in). I don't see why some people on this thread are bothering to argue so ardently against them - noone isforcing you to have a hb!

"I'm for choice. I don't think spud is - she's obviously very pro-homebirth to the extent that she thinks hospitals shouldn't be the place for low risk births at all"

No - not at all!

You have to go where you feel safe.

And given that the prevailing birth culture in the UK at the moment sees birth as being akin to having a medical procedure which necessitates the constant presence of doctors and birth technology, choosing to got to hospital is going to be always going to feel right to the majority of mums, even those who have had completely healthy pregnancies.

I just object to hospital being presented to all women as the 'default' mode, and that the pros and cons of all birth settings aren't discussed as standard antenatally.

There are midwifery practices in the UK that don't require low risk women to make a decision about where they'll give birth until they go into labour. Then their (known) midwife comes out to them and asks them whether they want to carry on at home, if they feel ok to do so, or whether they'd prefer for her to go into hospital with them and deliver the baby there.

I wish they offered this system of care everywhere to those women who want it!

BTW - I fully acknowledge that for some women lying on their backs is the best and most comfortable position. But it's really telling that almost everyone in hospital ends up giving birth on a bed, whereas almost nobody does at home!

Tortoise, where are you in Oz? They certainly have Medicare funded home birth in Western Australia. There is a fantastic scheme in Leederville (and other parts of Perth but that's the one I know best), via the Midwifery and Natural Childbirth Centre where if you have a low risk pregnancy, you can join the programme, have midwives allocated, and these are the MWs who look after you throughout your pregnancy and the birth. It's free, but you get a level of care for which you'd have to pay an IM in the UK. (I mean the continuity of care. Where I am in the UK there's no guarantee you'll see the same MW from one check-up to the next, never mind get a MW you've met before at the birth.) I am a bit envious, frankly!

I haven't read the whole thread but it is deeply concerning to me that this focus on home births is just a cost cutting exercise.

Reducing maternity wards means that women and their families will have to travel further. Women shouldn't be expected to feel that a hospital birth is some kind of a privilege. If you want a home birth fine go for it and good luck to you. Personally if I had a home birth I'd be dead and my baby too, it was touch and go as it was. IT should be all about choice, not about cost cutting

Mitmoo I could have written your post. Except that I would have lived. I almost was send to MLU and I am so relieved I never went.
I only want to give birth in hospital. I know that generally things go ok for people but the shit can hit the fan quickly during birth and I'd like the pros to be at hand if needs be.

I really don't see where the hostility towards homebirthing and, in particular, towards Spudulika's posts is coming from.

If you don't want one, don't have one. Assuming that you have a choice in the matter.

I had a straightforward pregnancy with DS, a relatively pain-free and extremely fast labour and only minor grazing. The hospital environment did nothing for me that could not have been done at home. In fact given that rooms were in short supply, I probably took up resources that could have been better used. I arrived at the hospital because my waters had broken but I wasn't actually in labour - no contractions whatsoever. They stuck me in a room on a monitor which was faulty so kept losing DS's heartbeat which meant that they kept re-starting the monitoring. While this was going on I could hear people discussing the shortage of rooms. They then decided to send me home as nothing was going on but during the faffing around I started contractions.

There was then about an hour of people telling me I couldn't possibly be as far advanced as I was saying I was in such a short period of time. They eventually decided I might be further than they thought but still not as far as I thought so they moved me to a delivery room. 10 minutes later DS arrived after 2 deep breaths and no real pushes. The only thing the midwife had time to do was catch him.

So I was in hospital, taking up a room while not actually in labour for 2 hours. For another hour I might as well have been on my own given no-one believed what I was telling them, and the MW's role in the actual delivery could have been performed by a passing postman if necessary. I was trying to go home from less than 2 hours after delivery. They told me I could and then couldn't find anyone to do the final checks so I was stuck there for nearly 12 hours, again taking up a room for no good reason.

I don't have any gripe with the hospital environment or staff. I probably wasn't forceful enoough about what I was feeling and experiencing and quite possibly made their jobs that much harder by constantly conceding that they were probably right. But I don't see that there was any need for me to be there.

This time round the midwives have strongly advised a HB. This area has more HBs than anywhere else in the UK and they are vey well set-up for it. I will not be taking up resources that could be used elsewhere - the community midwife team will handle it. I won't be taking up a delivery suite or hospital bed. And I am far more likely to be listened to when I tell them what is going on.

Yes, there are risks. But there are always risks. I am choosing to manage the risks by choosing a HB. If someone else wants to do differently, good for them. But there seems to be a complete lack of respect for choices like mine. Someone up thread even made the ludicrous comparison to freebirthing which is, quite frankly, insulting to all those who have made an educated choice for a HB.