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.

Because the people most likely to need to go to theatre are generally advised to birth in hospital. The vast majority of women put forward for homebirths and their babies are fine statistically. But I would imagine it is of little consolation to anyone who does need hospital specific expertise and facilities that 99% of OTHER women and babies were fine.

Would like to ask, are all the people on this thread who are concerned about the risks of homebirth in favour of closing all free-standing birth centres as well?

Because if you give birth in one of these places you will need to be transferred to hospital for a c/s or assisted delivery.

WineAndPizza
"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 completely agree - unassisted birth is taking a risk and accepting medical assistance at this time does result in more babies and mothers being alive. (It's not an option I'd want to take, but I'd defend a woman's right to choose an unassisted birth.)

However there is no research to show that, for low risk women, medical intervention in hospital improves outcomes over medical intervention in a home environment - and there is research to show that if you are a low risk woman and choose to birth in hospital you are twice as likely to "need" a CS than if you plan a HB. And that CS will have a profound impact on your options (and possibly life) during future pregnancies.

HairyFrotter - would you offer an explanation of why it is that homebirths aren't associated with higher rates of death or serious injury for mothers and babies?

There are 1000's of homebirths every year in the UK - if it really was more risky, wouldn't you expect to see some evidence of this?

Well I wish I had been in a hospital like that spud because I would have given my right arm for an epidural and they wouldn't bloody give me one!

I would not b here if I had home birth with first child. Also 2nd child would not b here if I was at home!! I would not advise anyone to have home birth as I was fit healthy with no problems during pregnancy.

DC 1 .... expected to drive over 90 miles (@2 hours) to nearest large hospital as in a very rural location and 'first baby (that's the 'norm' around here) ..... VERY luckily met a lovely midwife on first (local) hospital appointment who asked 'why?'. That gave my DH and I confidence to opt for local 'cottage' hospital (NO epidural, NO C-section etc, last resort is Helicopter service if emergency ).

DC1 born after very quick labour - we left hospital less than 4 hours after birth (naughty I know, but I was feeling GREAT and champing at the bit to get out of the maternity unit.... despite having the whole place to ourselves and the uninterrupted attention of familiar midwives).

DC2 ... routine midwife appointment at home ... I said 'I think I'm in labour' ... she agreed - less than an hour later baby arrived as I was standing in the kitchen clutching the sink Midwife arrived back at house JUST in time to catch DC2.

We had just re-carpeted the ENTIRE house in gorgeous CREAM carpets .... kitchen had wash 'n' wipe slate floor so all good.

Damn lucky and we know it, for both births.

Horses for courses, there can't be the one size fits all plan for birth, and for the record - Midwives ROCK

Does anyone know how Lorraine Kelly delivered HER daughter?

Spud I absolutely accept that there will be women and children harmed in hospitals that would have been ok at home. The difference from my point of view if that ever happened to me would be that if I had something go wrong in hospital I would feel that I had done the best I could by surrounding myself with medical experts and the best technology available and if they fucked that up then I couldn't have prevented it. I wouldn't think, oh if only I had stayed at home on the off chance that this doctor is going to fuck up, I would be ok now. My attitude is to trust the medical profession to do their job properly which I do appreciate is not always the case.

But if something went wrong at home I would forever think I wish I had been in hospital to have given them a fighting chance. I don't know if that is rational but it's how I feel and I don't think I am alone in that.

I have explained spud - because they don't advise the people most likely to need hospital facilities to have a homebirth and most don't. So looking purely at stats the outcome for homebirths looks fine. You do take a chance that you are not one of the unlucky, none average, minority who does unpredictably have an emergency situation though. Those people would be better off in hospital. And the fact that there are very few of them would not make their experience any less devastating.

HairyFrotter
"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."

IMO and from my experience - if anything, HB MWs have a lower tolerance for risk than their hospital counterparts. They are likely to recommend a transfer far sooner than a hospital MW might call in a member of the consultants team. IMO there are 2 main reasons for this - one is that they are very aware that transfer time to hospital needs to be factored in, and the second is that because they are focusing on just one woman they are likely to pick up any developing problems at an earlier stage.

The biggest problems can occur when members of the (what should be a seamless) team in hospital do not trust the HB MW's assessment of the incoming problem and put everything on hold while they repeat her analysis.

I find it remarkable, and almost frightening, that even with these limitations, women who plan a HB and the babies of those women have, statistically, better outcomes than their contemporaries who plan a hospital birth.

Exactly flakemum. The stats say you were just as safe at home. But people are more than groups of stats. You, personally, were better off in hospital.

"Does anyone know how Lorraine Kelly delivered HER daughter?"

yes I do

Saw it once when she talked about natural birth and how brave some people were and how she was epiduraled up to the eyeballs.

Hairy that is prob because the person who would have to administer it was busy saving someone's life... Not to be flippant!

"I would feel that I had done the best I could by surrounding myself with medical experts and the best technology available and if they fucked that up then I couldn't have prevented it"

I don't think you understand what I'm saying WineandPizza. Doctors and anaesthetists do a GREAT job at getting women out of trouble. They're not botching anything.

It's the normal interventions which happen in a hospital environment that cause the problems, not the doctors.

One example of this: mothers who give birth in hospital are less likely to have met their care givers, they are less likely to have one to one care, and less likely to have continuity of care. They are less likely to have full mobility in labour. They are more likely to give birth lying on their backs. Because of all these things their oxytocin and endorphin levels tend to be lower, therefore they experience more pain and their labours tend to be longer. Following on from this, they're more likely to need syntocinon, which is linked to higher rates of fetal distress, and also to higher rates of epidural use (linked to higher rates of forceps and ventouse deliveries) and pethidine (associated with higher rates of respitory distress and SCBU admission.

It's like a line of dominoes.

Glad you have acknowledged that your reasoning is not logical though. Because it's not. But I won't hold it against you!

I think - listen to Riven. She has to live with the decisions she made forever. I agree that some people have unrealistic expectations about their birth, what they think will happen, what they want to happen. The MW's are not your enemy.

If you feel so strongly go off and have your baby with NO help, no intervention, just let your body do what it needs to do. No - I didnt think so.

And if you really want the birth of your dreams pay for an independant midwife. The fact is your baby will come in its own way ready or not!

I agree Tangle but I still think that the unknown risks are too great for me - you may be low risk all through your pregnancy but you never know what will happen on the day. My DSIL has had two home births - very healthy and normal pregnancies and two reasonably straightforward births but both have resulted in her and the baby having to be taken to hospital - once an issue with the cord and breathing and the other an unforeseen genetic problem.

I will never forget my DM telling me about a friend of hers who was in labour in hospital and very suddenly got into enormous difficulties - a surgeon was immediately available, it was very much a 'slash and grab' job (shudder) and she was in a mess afterwards but the baby was alive and had she been at home it 100% would not have been. The midwife on that occasion told the woman that if she had had a homebirth they would have told her that even if she had been in hospital the baby could not be saved - what would the point be after all in making somebody feel terrible - but it would not have been the truth - because she was in hospital her baby is alive. That kind of sums it up for me.

Would like to add, that almost every woman who experiences problems in labour in hospital says 'thank goodness I was in hospital - if that had happened at home it would have been a disaster'. I experienced a shoulder dystocia with an 11lb baby at home. Everyone I know who experienced this very serious complication in hospital is convinced that there saved their baby's life. I came out of the experience thinking 'so bloody glad that didn't happen in hospital - it would have been much, much more frightening and brutal'.

So when I hear the 'me and my baby would have died if we'd been at home' stories I don't usually swallow them whole, because actually people who give birth in hospital have no way of knowing how the labour or birth would panned out if they'd been at home.

Not having a go Orb - I didn't think they were playing dominoes . Just pointing out that some hospitals don't have the epidural in your back as soon as you walk through the door.

WineAndPizza, given that quite a few serious emergencies happen to low risk women giving birth in hospital, how do you account for the fact that low risk women giving birth out of hospital - as a group - have outcomes which are just as good?

That's a serious question!

Spud thank you for that patronising post. Much appreciated.

I didn't acknowledge that my reasoning was not logical. I said that my feelings may not always be rational but I would rather end up in a situation where I believed I had done the best for my baby. Clearly you are the same, our views on what that involves are different.

No worries Hairy, we haven't got that similar to America yet then?

Each to their own although I'll be honest I don't think it's a great idea for your first child. The women I know who've wanted one have all ended up in hospital, the midwives were very cautious and opted for the risk averse strategy of taking them in if there was even a hint that things weren't progressing as they should be.

I don't blame them, I work in healthcare and I'm pretty risk averse too you have to be these days.

personally I'd be terrified, I like the reassurance of knowing resources are on hand although I'm not naive and know maternity units are under staffed hellish places at times. I had 2 great delivery experiences both times, even though dds birth (my first) was a bit hairy. Brilliant midwives, very competent and reassuring, encouraging, positive, friendly, calm, everything you could want. they consulted me throughout both labours about pain relief, positioning, and never once did they "force" interventions on me.

The trouble is some of the pro home birth lobby can be as bombastic and dogmatic about is as the breastfeeding lobby (I speak as someone who bf both dcs til 6 months each). My yoga teacher was a case in point, ranting on about the horrors of hospitals and the cascade of interventions to pregnant women or girls who'd not yet had a baby. Unpleasant, misguided and irresponsible.

Just because YOU had a great experience at home doesnt mean that others will, just because your birth was quick, pain free, the best experience of your life doesnt mean that others will have the same. Had two hospital births - one NHS and one private. I would fight for women to have a choice but you have to take the consequences of your decision.

You are oddly aggressive. I have said several times that this is how I personally feel. I haven't tried to argue with you repeatedly bashing people over the head with stats that I haven't checked and therefore don't know if are accurate.

I am telling you that story happened and that is what the midwife told her. If you feel, having not been present, that you know better, then of course you are entitled to that opinion.

^

Spud