why are homebirth rate so low

[McHappyPants2012]

www.walesonline.co.uk/showbiz-and-lifestyle/health-and-beauty-in-wales/2011/02/05/wales-delivers-on-home-birth-rates-91466-28109298/

after watching 'call the midwife' it seems to me homebirth was quite common in the 1950.

when did hospital birth become a common

"There is no need for plain nastiness like that!"

Oh I don't know.

Implying that women who have home births are putting their own and their baby's life at risk is nastier, wouldn't you say?

Anyway, dismiss away.

"all of what has been said previously....and.....have you seen the crap that comes out of you when you give birth, I certainly wouldn't want that all over my carpet!"

I think a lot of people worry about their carpets when it comes to homebirth.

Personally I wouldn't trade off a guarantee that my carpets won't get dirty for the halving of the likelihood of c/s etc, that comes with opting for an out of hospital, but then maybe my carpets aren't that impressive.

Perhaps if I had really good quality home furnishings I'd feel that massively increasing my risk of ending up on an operating table was worthwhile in order to protect them.

"Some people can birth quite easily. Some can't. I'd rather not be a statistic, or rather Im grateful I'm not."

I've never had an 'easy birth'. Still booked home births though with dc's 2 and 3, and benefited from doing so.

In my experience, just not wanting to fight/argue/be patronized/deal with the emotional blackmail of trying to book a homebirth with an unsupportive midwife is enough stop many attempting. Especially when the community midwives doing antenatal care are the same people doing the homebirth care so if you don't feel you can trust their support (or want to hear another ten minute scare speech done in front of and partially to my kids) you can at least hope for a clean slate at a hospital if you think you'll likely be treated badly either way.

I've had a wide range of births, 2 at hospital and 2 at home: 1st & 4th at hospital, 2nd was BA homebirth, 3rd was a homebirth with unsupportive midwives. I had my second at home due to horrible treatment with my first and I had my 4th in hospital because of horrible treatment with my third and didn't want to argue with antenatal midwife about it any more (and yes, she did try to scare my kids to convince me to go to hospital even after going on about how I was low risk enough to be eligible to MLU).

All mothers want to be healthy - physically and mentally -- with healthy babies. Dividing & arguing about where does little to to help when we need to focus on how to get more midwives to cut down on stress and more training on people skills, appropriate support, and better information for women to make their choices for a really vulnerable time in her life.

Shagmund, avoiding unnecessary major abdominal surgery is not the only factor women should consider! It's certainly a factor worthy of consideration, but it is certainly not the only one that affects the safety!

There are tens more, that a woman may decide are more important to her, as an informed, competent female human being.

..also babies born from planned HB or MLU were much less likely to be admitted to neo-natal care and have an Apgar of less than or equal to 7 after 5 minutes...

I have had one at hospital, the following two at home.

DD1's birth should have been very simple. She was in a good position, I was progressing normally and pushing was going well on my hands and knees. Until the midwife came back in! She called a collegue and when I refused to get on my back they flipped me over and put a foetal scalp monitor on her head as she was crowning. When they did this I felt her twist around and then her heart rate dropped as she had tangled herself in the cord. She was born very blue and whisked away for recuss for 45 minutes. We thought she had died. I still have PTSD from the experience.

DD2 was born at home, slightly long pushing stage but considering she was brow presentation it would be expected. Simple uncomplicated birth for both of us, she was hard work to push out though, took lots of faffing about to find a position I could do it in.

DD3 also born at home, textbook simple birth. Which made a nice change.

For me, giving birth at home

Well of course they would if they were low risk births

buggy sorry, you mean they asked you to switch position,a nd when you said no, physically manhandled you into position?

..that was from a study comparing only low risk births in CLU, MLU and HB!

All the home birth propaganda research shows is that that low risk births have the same outcomes at home as in a hospital.

To get to that conclusion, all of them exclude high risk births, because, guess what - those would have have worse outcomes outside of hospitals.

This is one of these First World Ishoo things where you believe you are having a "back to nature" experience, but can't see that it only happens because of an army of high tech support services is behind the scenes.

A "natural home birth experience" in a non First World country is a different matter.

"Well of course they would if they were low risk births"

In the study Edgar refers to, low risk women who booked to give birth in a CLU gave birth to more babies with an apgar of less than 7, and who needed admittance to neonatal care, than similar mothers who booked to have their baby at home or in a MLU, regardless of actual place of birth.

In other words - the study compares like with like. Low risk women labouring in CLU's with similar women labouring at home or in MLU's.

Have to say, it's astonishing how many times this point has had to be made on this thread. Leads you to the assumption that there are people out there who have no idea at all about the way health research is conducted. Which rather disqualifies them from having an informed discussion about health issues, IMO.

What why do you think it's about back to nature? I think I want a home birth and it's nothing to do with that - and everything to do with firsthand experience of the incompetence of my local hospital!!

If I am a low risk case, I don't want some arrogant consultant deciding that if I've been pushing for 2 hours I automatically have to have interventions, or someone telling me what position to be in. Nothing to do with back to nature, everything to do with having some control.

And if it doesn't work and you effectively become high risk, you can just go to hospital. Why are you so against people trying?

"All the home birth propaganda research shows is that that low risk births have the same outcomes at home as in a hospital."

What - you mean the homebirth 'propaganda' published in the British Medical Journal? Because we all know that doctors and the medical establishment are huge fans of homebirth and will do anything to promote it to women.

"To get to that conclusion, all of them exclude high risk births, because, guess what - those would have have worse outcomes outside of hospitals."

You really have no idea about any of the research that underpins this issue do you? Not read it? Any of it?

"This is one of these First World Ishoo things where you believe you are having a "back to nature" experience, but can't see that it only happens because of an army of high tech support services is behind the scenes."

A "natural home birth experience" in a non First World country is a different matter."

I think you're trying to turn this into an ideological issue, but it's not. It's about the health of women and babies.

Homebirth advocacy have hard clinical evidence to back up their support of out of hospital birth as a safe and healthy option for mums and babies.

Who here is advocating birth without the input of midwives and without the back up of doctors and hospitals? Nobody! You are having an imaginary debate all on your own.

Seriously - you are talking nonsense. Just give up.

peasant yes. A few other teen Mums I know have had similar treatment there too.

Anyway, to finish my post (distracted by DD3!) home birth is by far the safer option for me. Obviously it won't be the same for all women.

To answer the OP, from the women I have spoken to about home birth it seems that either they had no idea that HB could be safe and found the idea risky or scary or they quite liked the idea but had little family or DP/H support.

Certainly in my area, the possibility of home birth has never been mentioned by mws during any of my pregnancies, I have had to do the running myself so I imagine there is also an element of women just not having information about HB in their area.

You really have no idea about any of the research that underpins this issue do you? Not read it? Any of it?

So, Shagmund - are you claiming that the research shows that medium, and high risk pregnancies have the same outcomes at home as in a hospital?

Please read it Whatme. It would really help.

No. Not at all. There is no research comparing outcomes of anything other than low risk pregnancies in out of hospital settings.

I'm really not sure why you've suddenly thrown that into the debate here. Nobody is arguing that women who need medical input and additional monitoring should give birth away from hospital. Why would they?

No, shagmund is clearly NOT claiming that, ffs!!!

buggy Oh. My. God - that is horrific. Did you not say anything, or get up afterwards? Did they just hold you down?

that anyone could treat a labouring woman like that.

This and the woman upthread saying the consultant said he would just have done an episiotomy without consent as labouring women don't know their own minds are the things that really make me want a HB.

I was dead set on a home birth last year but as I reached the end of my pregnancy I had some problems with blood pressure and my heart, so it was ruled out and I had to have a hospital birth (only birthing centre type place in my town is attached to the hospital).

As it was my bp and heart were fine throughout the labour but my DS became stuck and I ended up having an assisted delivery and a (very welcome) epidural as i was in unbelieveable agony after hours of pushing to no avail.

I have to say this has turned me off the idea of home birth all together, because had my bp and heart problems not occured and I had gone ahead with my homebirth my baby would still have got stuck and I would have ended up being hauled out of my living room birthing pool and transfered to hospital whilst pushing/exhausted and in incredible pain. The whole experience was scarey enough, but to add a blue light hospital dash onto it would have been horrific.

Following the birth i was really unwell and very weak, I could not have got through the night without the fantastic support of the midwives on the ward and when my husband asked when was able to come home, I had to admit to not having even thought about asking about timescales for discharge.

I know the stats very well as i did all my research before deciding on a home birth and I respect and encourage a woman's choice about where they give birth. It certainly makes sense to me to look seriously at homebirths if your town only has a midwife led unit because then any complications mean a blue light transfer to the nearest hospital anyway, so why not take the chance to stay at home if you have it.

I suppose my point (if I have one is) that even low risk pregnancies can become complicated labours and women who choose to labour and give birth in hospital should not be dismissed as fools who do not understand the statistics. And my problem with statistics is that you just never know whether you will be that one in the million.

Sorry that's a bit rambley

And also I hate when this subject gets all bunfighty, all that conflict just makes us look like a load of hysterical infighting women who can't be trusted to make sensible decisions about ourselves or our childen

the birthplace study involved the participation of some 36 CLUs (well actually i think 41, though 5 were disincluded and re-sampled so only 36 were usable)
and every trust with a home birth service, and the huge majority of MLUS

it cost £800k appx, and was funded by the NHS.

it collected a huge amount of data about all locations and resource-use for policy makers to consider (cost, staffing, resources) that had nothing to do with HB

i have read much of that part which has been published online, and as pro-HBer i actually thought it showed no pro HB prejudice whatsoever. it was v. factual (in actual fact i should say i found it slightly anti-HB in outlook, though very true to the data discovered..and to be fair i was reading it looking for prejudice)

such as....did you know only 8% of CLUs have consultant cover for more than 60 hours a week?

That the majority of women that give birth in Clus were only midwife-attended ? (those men in white coats aren't there unless bleeped for most of the time!)

that a consultant cost 4* more than a midwife!

"To get to that conclusion, all of them exclude high risk births, because, guess what - those would have have worse outcomes outside of hospitals."

As far as I am aware no one here has argued that all women should have home births - there will always be some who need the assistance of a CLU.

I don't know it can be argued that all high risk births have worse outcomes outside hospitals - I am not sure if anyone has actually collected any data on this. For one thing some women defined as 'high risk' will have home births either by accident or design but with a perfectly satisfactory outcome.

It's interesting that in Call the Midwife, which is based on real life, a number of the women, like Conchita and the one having the breech birth, would now be regarded as high risk and yet they were delivered safely. By the same token, the woman with rickets was able to give birth safely by CS because she now had access to hospital thanks to the NHS.

The Place of Birth study was specifically looking at 'low risk' women, and after all, they are still the majority. Why shouldn't a maternity service consider their needs as well as the high risk cases?

because IME

An unsupportive MW can put huge problems in the way even in area publicly saying they want more home births, with low risk pregnancy and with parents who had one home birth before, a home near to the hospital in case a transfer was needed and a rapid labour being a definite possibility.

We had to complain about our MW in the end after we had her lie to me about blood work results, in attempt to recategorized the birth to high risk found out when we dared asked in writing for the actual results,and many other things she lied about.

I get home births always wanted or advisable for many woman but I wonder how many woman have my experience and give up.

I had baby No. 4 at home. Mainly because No.3 was nearly born on the hospital steps, as my labours were very fast and getting faster.

We weighed up the risks - 3 normal, easy deliveries, live 5 mins by ambulance from nearest Matrenity unit - it made sense.

It was lovely - extremely quick, (the GP, 5 minutes away, mmissed the event!) and I loved every minute!

the community midwives attending my births were very definitely not 'naturally' occuring phenomena.