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AIBU?

Share your dilemmas and get honest opinions from other Mumsnetters.

why are homebirth rate so low

536 replies

McHappyPants2012 · 05/02/2012 21:41

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

OP posts:
troisgarcons · 05/02/2012 22:14

for the pedant ...Im glad im not a death statistic and grateful my children are live.##there, dear, does that clear up the confusion for you?

cocoachannel · 05/02/2012 22:17

Because carpet shampoo is so expensive. Blush

squeakytoy · 05/02/2012 22:18

statistics as always can be manipulated..

If there were more home births, there would be a lot more incidents of home births going wrong. Because there are so few, then the ones that go wrong are few also.

BadDayAtTheOrifice · 05/02/2012 22:18

Because most people do really not understand that having a baby in a hospital is just as safe for a baby as a homebirth (we're talking low risk labours here) but a lot riskier for mums.

BadDayAtTheOrifice · 05/02/2012 22:20

And they don't realise you'll get far, far better care at home Smile

cocoachannel · 05/02/2012 22:21

In all seriousness, it's not something I'd consider and thank goodness given the circumstances of DD's birth and complications which were impossible to foresee until the very last moments of her delivery, cue emergency arrival of paediatrician. I will never know what would have happened had I not been in hospital but I am damned sure I don't want to take any risks if and when I have another DC.

cocoachannel · 05/02/2012 22:21

Also, my care is a L

cocoachannel · 05/02/2012 22:22

And the pastoral care in hospital was fine.

cocoachannel · 05/02/2012 22:23

Oops

kelly2000 · 05/02/2012 22:25

the survival rate for women and babies has hugely increased since the increase in hospital births so that has probably had an influence. Even women who have home births have arrangements in place that if anything gets a bit complicated they get transferred to the hospital anyway, so I suppose a lot of women would rather be there just in case something goes wrong without having to have the transfer time. Even low irsk births can suddenly become riskier so for me I would rather have the comfort of knowing that if anything did go wrong I would have much quicker access to doctors, and surgery etc than if I was at home. I am bias though as I know a few people who were regarded as very low risk, but then had sudden unexpected complications that would have killed them if they had not had immediate hospital treatment.

cerys74 · 05/02/2012 22:25

BadDay - do you mean to say that it's more risky for a mum to give birth in a hospital than at home? I find that hard to believe... what statistics show that?

TattiePants · 05/02/2012 22:27

I am now a huge advocate of homebirths as my DD (14 months) was born at home however it was something I had never considered until I was approx. 6 months pg.

Like most women I automatically assumed I would give birth in hospital (no MLU nearby) as this is generally presented as the only option. Luckily my midwife suggested a homebirth and it was the best choice we could have made for us and our DD. There is such a lack of knowledge surrounding homebirth and when we told close family and friends about our plans almost all quoted Daily Mail headlines to us. I gave up telling people in the end due to negative reactions.

Generally most people will only research homebirth once they are considering it for themselves so the majority of women assume it is much riskier than a hospital birth (it's not, just a different set of risks).

PS. absolutely no mess although I am glad we live in a semi as I was very vocal!

Kayano · 05/02/2012 22:30

So so glad my mlu is in a hospital

I would hate a HB seriously. I worry about
Stuff going wrong all the time Confused

Flisspaps · 05/02/2012 22:31

Personally, my BP rises whenever I am in a medical setting, be that a hospital, GP surgery or having a MW check at the local children's centre. At home it is always lower. Therefore, by staying at home I deduce I am less likely to have an issue with BP than I would at hospital. But at hospital it would be said 'Ooh, it's a good job you're here, your BP is high - we can monitor it here'.

Being in an unfamiliar environment (eg a hospital) can stall labour in some women. So what happens?

Perhaps someone says 'ooh you are progressing too slowly (or not at all) since you've arrived - good job you're here and not at home! We can get labour going again with ARM/synto' and so starts the cascade of intervention - synto, CFM, perhaps an epidural so you're on your back on the bed, but then baby doesn't descend as the uterine muscles don't work so well under epidural. So someone says 'ooh baby's stuck - good job you're here and not at home, we can get baby out with forceps'.

Increased intervention leads to an increased risk of PPH and retained placenta - but that's OK - good job you're in hospital because they can whip you into theatre and get that placenta out and stop the bleed.

Now of course, for most women hospital births are safe and don't involve the cascade of intervention - and for most women that do have intervention, then it's necessary. But it's not always safe, and intervention is not always necessary. Babies still die in hospital unexpectedly. Women still die in hospital unexpectedly. And this is with all the super obstetric care of the NHS right there.

By the same token, most women who have home births it is safe, and for the majority of those who do have difficulties, problems are picked up sooner than they would be in a hospital and then the majority of these women are able to get to a hospital in time for any assistance necessary. Of course, it's not always safe. Women and babies die during homebirths as well.

It really pisses me off that women are lambasted either way for making their choice to be honest. For some women a hospital birth is absolutely the right choice for them and their babie, regardless of whether they are low or high risk. For others a home birth is the right choice for them and their babies.

Instead of sitting here going to each other 'you shouldn't do that, it's dangerous and it's the wrong choice' we should be bloody well supporting each other and appreciating that each one of us has to make the decision that is right for us and our families, whilst respecting the fact that that decision may not be the one we'd make ourselves.

TOTU · 05/02/2012 22:33

'low risk labour'. How do you know you will have one those? My first pregnancy was textbook but ended up in absolute carnage and a near C-Section at the hospital. Forceps, stitches, failed epidurals.

Second pregnancy. I collapsed 24 hours post birth and pulled the emergency cord in the hospital toilet just as I got dizzy and passed out. I had an emergency hysterectomy. My (now ex-h) was told I might not survive and I woke up in intensive care. Thank God I was in hospital after the birth, or else I could have collapsed at home and just bled to death.

Each to their own, but given the choice (if I still had a womb Grin), I'd opt for a hospital birth every time.

Juule · 05/02/2012 22:34

RevoltingPeasant "I thought there was evidence that giving birth in a hospital was much more stressful, inhibited production of oxytocin and therefore actually stalled/ slowed labour for many women? And therefore necessitated more medical interventions overall?"

So, more a possible problem with labouring in hospital rather than the giving birth?

cerys74 · 05/02/2012 22:34

This might be of interest:

www.guardian.co.uk/commentisfree/2011/nov/27/barbara-ellen-birth-marilyn-monroe

www.npeu.ox.ac.uk/birthplace

First link is to an article in the Observer about home birth, but the author is quite biased against it (TBH I'm not convinced either, for most of the reasons others have stated above). She uses data from the Birthplace in England study for her article (second link).

First link contains biased info but does summarise some parts of the study, so I have included it to give you a quick idea of what the study's about. However the actual research is NOT biased and should be of interest to pro/anti people alike....

Enjoy! :)

Moominsarescary · 05/02/2012 22:36

Lost 4 pintsbirth pod when ds1 was born
Theatre straight after ds2 was born
Emcs due to cord prolapse with ds3.

Very glad I chose to give birth in hospital each time

BadDayAtTheOrifice · 05/02/2012 22:36

Its all here but theres a lot of it
birthplace study
A basic breakdown would be
First babies born at home are twice as likely to have an 'adverse outcome' (meconium aspiration, HIE etc) although the risk is still small (6/1000 IIRC) compared to a hospital birth. Subsequent babies are no more at risk.
Hospital births are far more likely to end up with cesareans, assisted deliveries, haemmorhage, perineal trauma, infection.

Flisspaps · 05/02/2012 22:36

cerys74 That's exactly what she means, and the Birthplace Study published last year supports that.

Low risk women giving birth in hospital were considerably more likely to have intervention than low risk women giving birth in an MLU or at home. Bear in mind that these were ALL low risk women in the study, so at the start of labour there were no more reasons for intervention for either group of women (so the women opting to birth in hospital weren't induced and had no medical conditions which would increase the likelihood of intervention)

RevoltingPeasant · 05/02/2012 22:38

Fliss thanks, that is exactly the kind of thing I was thinking of upthread but too ignorant to explain like that Blush

BadDay did you mean it's riskier for the mum to be in a hospital? How's that? I can see unnecessary interventions but is that really riskier?

For me, I am not pg yet but think I would really like a HB because you just hear so much on here about rude HCPs pressuring women into choices, interventions without consent, etc. I started a thread a few weeks since about episiotomy and was shocked by the number of women who said they hadn't even been warned before it was performed, let alone asked Shock

It's things like that that make me think I'd be so much calmer at home. Nothing to do with whale music, ta Hmm

HorribleDay · 05/02/2012 22:39

^ what flisspaps said.

The single hardest thing about my in hospital highly medical birth was a few months later when the Local Mothers Group collectively slated me for choosing induction - I should have waited, the risk to DS would have been massively overstated, he won't have bonded as well, BF was probably difficult because of csec and lack of natural hormone release, it was 'such a shame' he was born after 'such a trauma'.... My birth wasn't traumatic, BF was fine from 3 hours post birth, no bonding issues, my blood sugars were extremely unstable so suspect risks to me and DS were perfectly adequately stated.

I couldn't care less how anyone chooses to give birth provided it's the right infomed choice for them and that, crucially, they don't invalidate my birth because it wasn't the way they did or didn't do it.

RevoltingPeasant · 05/02/2012 22:39

Sorry BD x post

cerys74 · 05/02/2012 22:39

By the way, I had my DS in hospital and felt comforted by the fact that if anything went wrong, the full weight of medical science was just down the corridor. So I guess different people are reassured by different environments... I HATED the part of labour where I was in my house because I was freaked out that something might go wrong!!

Moominsarescary · 05/02/2012 22:40

Bloody phone, 4 pints of blood