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 am having a homebirth this time round. The midwives have been quite clear that it is the safest option given DS's rather speedy arrival.

Harryfrotter - you would almost certainly have been at the hospital long before the crash section was needed in that circumstance. It's not like a woman is labouring beautifully, everything going to plan then suddenly wham bam into theatre and baby out within seconds.

The key word there is almost. There's no denying that the distance from theatre is a risk with homebirths. Maybe not a big risk but a risk all the same. It's a risk some people are willing to take for the benefits of a homebirth. I couldn't do it which is a shame because everything else about a homebirth appealed to me - I'm not precious about my carpets, I had childcare issues which a homebirth would have resolved, I don't like the uneccessary hanging around for when you can be found a bed on a ward/discharged in hospital and the bfing support was non existent in my local hospital.
As it happened. I'm sure a homebirth would have been fine for both of mine - I had no complications. But I'm still glad I didn't take the risk - and it is a risk. Of course cock ups can happen either at home or in hospital but I can't think of a situation where you would be looking back thinking that your baby might have been OK if only you had been at home with a couple of midwives.

Apologies for the source but there's an example right here from today - normally preg, was planning a homebirth and luckily was sent to hospital instead...
www.dailymail.co.uk/health/article-2014689/Difficult-birth-Baby-survives-losing-85-blood-horror-birth.html

Oops

normal pregnancy
and miracle baby

You miss my point wine. You are saying its not safe because some midwives told you they wouldnt do it. I am saying its safe because some midwives told me they would do it.

Neither proves anything.

hairy having spent nearly two whole years in hospital with my DD I can imagine thinking that very thing.

I had a homebirth with DS2 and it was amazing. Any further children I have will be born at home unless there is a medical reason why I need to be in hospital. DS1's birth was fine but the after care was horrendous. By giving birth at home I know I am in comfortable environment surrounded by people I know.

MrsDeVere, I did not say it's not safe. My post said 'why I personally would not have a home birth' not 'why nobody in the world should have a home birth'. I personally would feel better knowing that in the tiny chance something horrendous went wrong, I was within minutes of expert surgical intervention.

I am not arguing stats on whether or not homebirths are generally considered less safe.

Sorry to hear that MrsDeVere but was it a result of a fuck up that shouldn't have happened (which can happen at home too) or a result of being in a building with high level expertise and facilities? No probs if you'd rather not say - none of my business.

Not read whole thread but I'm sure there's been heated debate about different types of birth and no doubt circumstances under which a c-section is deemed 'acceptable' have been discussed.

Aaaaanyhoo...I've had a forceps delivery and an ELCS and I can tell you right now that the most important thing is for people to treat women's birth experiences with RESPECT.

I'm about as likely to elect to give birth at home as I am to elect to a full frontal lobotomy but I ABSOLUTELY respect the reasons why any woman would choose to do so. If what was said on the show is that natural birth is a load of old toot and you have to go to hospital blah de blah de blah then that is offensive to me as all the "you don't really need an ELCS/ you're too posh to push/you're a wimp" bollocks I got second time round when I ELECTED to have a planned c-section.

Therefore, OP, YANBU.

I can't think of anything worse than giving birth in hospital with people coming and going, not having the same midwife, not having a midwife I know, not being able to control my surroundings and being served shit food afterwards.

hairy no I dont mind.

Different circs - not around birth. DD was ill for two years. During that time I learnt to be constantly vigilent because of all the things that can and do happen in a busy hospital environment. I have said this before on MN - I have an almost unhealthy regard for nurses and drs. I would like nothing better for my boys to all become nurses or drs - so no axe to grind re HCPs.

But when you are in hospital you are vunerable. There is a shift of power and a likelyhood of treatments because 'they can'. The way drugs work is one needs another to treat the affects of the first and so on and so on. Each of those drugs can be dangerous in their own right.

There are also lots and lots of staff at a hospital. They do not all communicate properly. This can lead to a lot of problems from annoying to potentially fatal.

If someone is in YOUR house they are more likely to listen to you. They are more likely to know you too.

I take everyone's point about being near to emergency treatment but you are also away from 'wait and see'. Lets wait a bit and see if you really need this potentially dangerous intervention.

It may sound odd but not everything about illness is medical but everything about a hospital is. With birth the difference is even more stark.

Over the two years I spent in hospital with DD I witnessed several 'near misses' that would NOT have happened at home. A few times it was more than a miss.

All of these things contributed hugely to me having home births. I now have PTSD.

I am NOT against hosptial births and do not think they are inherently dangerous or selfish, but nor are home births.

Children are[birth] injured in hosptials every day through inadequate care. I work with children who suffered brain injury at birth and all so far have been born in hospital. I would argue that mws attending homebirths are paying a great deal more attention.

I have had two hospital and two homebirths and I know which ones felt safer and more controlled. Less panicky (not just me - the HCP) and which ones I recovered from quicker despite being 17 & 15 years older.

Women MUST do what they chose to do as long as its safe. It is not for me or anyone else to project our fears and 'what ifs' on to them.

LeQueen:
"But, then neither should MWs jobs be made intolerably more stressful and harder because they're faced with women who insist on ignoring professional medical advice because I know my body best, and I trust my intuition."

"I think some women go into labour, already with a huge chip on their shoulder, and view the MWs/medical profession as Da Enemy, and thinking 'No one with a uniform, a stethoscope and years and years of medical training is going to talk down to me no Siree...I've researched this all on the Internet and I know my body best.'"

"I'm all for women being able to express their desires and wishes during labour. But, when they insist on followoing their desires and wishes in the face of professional medical advice that's when it's wrong."

I agree with you up to a point. But I'm no sure what percentage of women go in determined to stick two metaphorical fingers up at the medical staff and go their own sweet way, and how many wind up feeling that the only alternative they have to a "yes sir, no sir" approach is to get quite assertive in their approach.

At the end of the day it comes down to trust. Hospital MWs have a hugely difficult task as they have a very brief window of time in which to get labouring women to trust them. If they breach that trust it will be very hard to earn back.

I'm currently having issues with trusting the HCP's at my local hospital. I've seen 2 obstetric consultants in the last 18 months. One lied to me (over something stupid and trivial, and when I couldn't reconcile what I'd been told with other information and asked for more clarification she back-tracked without even an apology or explanation). If they'll lie to me over something so silly, how can I trust her to answer my questions honestly? The second was fine until I asked about HB (politely), at which point I wasn't permitted to get a word in edge wise as they talked over me for the next 15 minutes - behaviour that in other circumstances would be considered rude and bullying. Its very easy to transfer lack of trust in a senior representative from a hospital into lack of trust in the hospital staff as a whole (even though I have also had experience of an incredibly supportive and respectful hospital MW so know that not all individuals have this attitude).

I want to trust my HCP's. I do respect their skill, experience and training. But that does not mean that I'm going to take everything they say as gospel and not ask questions. I also need to understand the reasoning behind the advice (assuming we're not in an emergency situation) - and the quickest way to loose my trust, and thereby cause me to become a very difficult patient, is to dictate my care and not let me be involved in the decisions. The consultants I've seen so far have left me feeling like I can either go my own way or I can follow what they say without question - but I cannot have a discussion and try and reach a middle ground we're both happy with as they will either lie to my face or refuse to engage with me in a polite and mutually respectful fashion.

If medical advice is being based on research that is outdated and discredited, why should women be expected to shut up and do what they're told rather than trust their instincts?

I have a friend who had what started out as a very straightforward first labour. Then she got into the 2nd stage and had a very strong feeling that something was wrong. Her MW didn't listen ("what do 1st time mums know"), and after a significant period of time she wound up with something between an emergency and crash CS. She developed PTSD and was still suffering flash backs > 2 yrs down the line and it had a huge impact on her 2nd pregnancy - not because of the emergency situation but because she was ignored and not listened to.

None of the options available during birth are risk free. In many instances the risks are not directly comparable. If I am going to have to live with the consequences of whatever happens, why should I not have a very big say in which risks I'd prefer to be exposed to?

WineAndPizza
"I would be willing to bet that more mammals survive or are healthier being born with human intervention than in the wild."
Possibly. But its also worth bearing in mind that even domesticated mammals will seek out somewhere private in which to birth - and if they are disturbed then the birth process will often stop. Certainly with horses they may be watched through CCTV, but humans will only intervene if there appears to be a serious problem - otherwise the mare is left to get on with it until such time as her foal is born, at which point a human will make sure the afterbirth is complete, dab iodine on the cord stump and ensure the foal suckles. If you put a human in the foaling box the mare is extremely unlikely to labour at all.

This is a long thread, so I haven't read all (sorry).
Has anyone mentioned birthing units as a happy medium?
I really think there should be more. Far more personal than a hospital, but a feeling that it's more 'safe' somehow than home.

"If I am going to have to live with the consequences of whatever happens, why should I not have a very big say in which risks I'd prefer to be exposed to?"

Amen to that Tangle. That is exactly what I felt during my second pregnancy and struggled to articulate in the face of snide comments on what I chose.

Yes Nanny - I wanted to use our local one but they closed it down. It was literally 2 minutes up my road and had a great reputation. One of the reasons I moved here actually. 6 years before this they shut down the antenatal unit at the adjoining hospital too.

In effect they have phased out any chance of giving birth in my home town, unless you do HB. I've already stated my reasons for not wanting to travel to the next town (don't drive, friends can't visit and low beds for some eg's).

"But I'm still glad I didn't take the risk - and it is a risk"

There are risks attached to both options:

have a homebirth and end up with a placental abruption/cord prolapse/baby who unexpectedly doesn't breath at birth.

have a hospital birth, end up with a c/s you could have avoided by being at home, and a scar rupture and a very poorly baby at your next birth. Or (more likely) end up needing synto, which sends your baby into distress and necessitates a crash c/s which doesn't happen in time because theatre is already full of other low risk women having preventable c/s.

There is NO, I repeat NO additional risk to giving birth to your baby at home if you are a low risk mother. All the facts bear that out.

"And spud, when we gave birth like other mammals (i.e. at home, alone, in fields...whatever) more babies died. And I don't know stats but I would be willing to bet that more mammals survive or are healthier being born with human intervention than in the wild."

Humans have harder, longer and more perilous labours than other mammals, which is why they need the support of midwives and the back up of a medical system which can step in if things become complicated.

Doesn't change the fact that many of the same basic principles apply to women as to cats - disturb their labours at your peril!

maiow!

Iggly you can't think of anything worse? I can. I would be prepared to put up with any amounts of shit food to avoid situations like those discussed here.

Tangle fair point about the domestic animals - but the point remains that whilst it might be more natural, comfortable, even easier to go it alone, medical intervention results in more babies and mothers being alive.

I get you. More chance of confusion/miscommunication and maybe they are more quick to medically intervene where it's maybe not necessary.
While I don't doubt these things happen they shouldn't and there is the potential, you would hope, that improvements could (and should) be made in these areas. There is, however, never going to be a way that you could safely have an emergency section at home if that was what was needed. The lack of surgical staff, environment and equipment will always be a feature of even the best homebirths.
I wouldn't try to convince anyone not to have a homebirth but as a very anxious person there's no way I could have one (unless a very quick labour made the decision for me!).

"If something went wrong at home I feel like I would blame myself for not having gone to hospital whereas I wouldn't feel the same the other way round"

There will be women and babies who will suffer serious harm BECAUSE the mother chose to go to hospital to give birth.

If almost midwives and doctors accept that this is the case, why do you think it is that mothers turn away from this information?

Surely the logical solution would be to discourage risky intervention in hospitals unless it's strictly necessary rather than keeping women away from facilities they might need in case medics are too quick intervene.

"medical intervention results in more babies and mothers being alive"

Yes. But women who have their babies at home aren't denying themselves the opportunity to access sophisticated medical care should they or their baby need it.

They are simply ensuring that emergency situations and problems with the labour are less of a likelihood.

"and maybe they are more quick to medically intervene where it's maybe not necessary"

Possibly - but actually hospital care CREATES the problems that it then is needed to solve.

"The lack of surgical staff, environment and equipment will always be a feature of even the best homebirths"

But they're not, are they? Otherwise we'd see a higher infant and maternal mortality and morbidity rate associated with homebirth, when in fact THIS IS NOT THE CASE!

Seriously - if you really think it's true that homebirth is ACTUALLY more dangerous, why is there no good quality evidence that this is the case?

Also do hospital and homebirth midwives have different criteria for what is an emergency. I would imagine that if someone would be considered to need a section at hospital the midwife would call an ambulance to take them there if they were a home - if not before it became that serious. They would then be subject to the same intervention as everyone else in the hospital environment.

Haven't got time for all posts sorry but here is why I had a HB

I was warned I might have a fast labour and live 30 minutes from the hospital by car. Dh worked an hour away but wasn't always contactable by phone at work. I already ahd 3 boys 2 of whome have autism and no family or friends who could help ( family don't drive and are over an hour away).
Social services refused to provide emergency respite for the boys so going to hospital not an option
.
So we booked a doula. And as it happened DH was home when i went into labour at night (had booked night off, should ahve been on shift). Doula made it with minutes to spare, mw walked in when I was 10 cm dilated andn second did not make it. Whole labour lasted 35 minutes. Had i tried to get to a hospital he'd have been born in tesco carpark on a cold April night.

That was three years ago and it was by far the best decision for me.

Butyterbur there was a thread while back showing that HBs did not cost more wasn't tehre? Lots of savings in terms of rooms / etc.

"Surely the logical solution would be to discourage risky intervention in hospitals unless it's strictly necessary "

Labours in hospital are more likely to go wrong, and are therefore more likely to need surgical intervention.

Once the problem has occurred it needs to be dealt with.

If women are going to have epidurals, syntocinon, opioids in labour, ARM, continuous monitoring, supine labour, and all the things which go hand in hand with hospital births, then you better have doctors, operating theatres and instruments on hand, because you're damn sure to need them!