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

"Or, alternatively, they are and know they are small."

I don't think having double the chance of emergency abdominal surgery is a 'small risk'.

Unless you think major surgery is akin to having a small mole removed or something.

Note: it involves catheterisation, regional or general anaesthesia, prophylactic antibiotics, cutting a 10 cm hole through skin, fat and uterus, layers of stitches, and at least a couple of weeks recovery. And leaves a permanent scar. And makes you a 'high risk' case in your next pregnancy.

"I don't get this whole "natural everything" crap, seems to be espoused by masochists and those unable to pick the good bits from living in medieval times from the bad and ugly."

Duh - homebirth involves highly trained health professionals equipped with modern monitoring equipment, within the context of a sophisticated system of medical care should mother and baby need it. It's not in any way 'medieval'.

Are you a man by any chance Whatmeworry? Maybe a very young man? Who knows fuck all about childbirth? Or women?

on a similar topic , if u are unfortunate 2 b involved in a medical situation (not childbirth) outwith a hosp. and no hartbeat , amb. people will work on u 4 20 mins , if nothing, once at hosp. 2 mins then its all over !!! just done my 1st aid course , what an eye opener !!! everyone should do even a one day course !!

Probably when you get people like me who would always choose a hospital birth.

Perhaps a course in spelling properly and dropping the txtspk would be helpful too if you actually wish to impart any useful information

Are you a man by any chance Whatmeworry? Maybe a very young man? Who knows fuck all about childbirth? Or women?

I happen to disagree with you on homebirths, therefore, logically, I am a man? (Why is it that whenever you take issue with the frothers on MN they call you a man btw?).

I have had 3 kids, in hospital, it was fine thank you. The first was a bit difficult, it was nice to have specialists on tap.

Agreed Shagmund, I bet at all my homebirths I have had way more actual contact time with a Midwife. the majority of Doctor input on Labour Wards is from Juniors on rotation who have to call a Obs if they don't know what to do anyway. I would never choose to have a hospital birth, for me it would be madness as I don't labour for long and it would take longer getting there and getting out again.

Specialists on tap? yea unless it is the weekend or they are in theatre - the point is that planned homebirth is as safe as a hospital birth - and you also have to factor in that in the HB figures there are the precipitous labours that are unplanned home births too which can often be because there is a problem with the Mother or baby. I feel like an experienced Midwife who knows you well is an expert. When you are monitored as closely as you are at home with teo midwives it is very rare for something to go wrong very very quickly, it is normally a series of things that contributes to a problem, a chain of events and being so closely monitored means those problems can often be prevented and a transfer happens.

It is daft to talk about hbs in terms of 'risking it'

The only time I was in hospital with a baby she came out with MRSA which was terrifying, these are real risk factors when you are sharing space and equipment with others and they have to be considered. It wouldn't put me off going in if I had to I just assume all will be well at home.

I don't really get the degree of hostility on this subject. I gave birth in hospital because I thought that I would probably have a long and difficult labour (I was right there!) and I also was genuinely unsure of my ability to cope with the pain until I experienced it. But I have several friends who have given birth at home (often because after the first one, they know they labour quickly), who have had lovely births and it's been an incredibly relaxed and happy experience compared to the impersonal and clinical nature of a hospital birth. Why does this seem to make people so angry? People who give birth at home do so in the company of one or two properly trained, well-equipped midwives - would the NHS allow this to happen if they thought it was going to be incredibly dangerous?

Hackmum I think people get shirty about it because they think people who have nice hbs are being smug or claiming to be a superwoman. (I am neither I just labour quickly and feel fine in myself). It is not a competition about who can handle pain or not - we are all different. My Dh pointed out to me the other day what a massive cow I am when I have a bad cold and how panicky I get when I am ill ut how together I am when I give birth. People are quite hostile about it, or try to make out I am mad for foregoing loads of drugs etc. My experience with those was not good for me or my bub so I have no wish to repeat it.

Crucially I think when you say about the impersonality of a hospital birth that is the crux for me. My Midwife is such a wonderful person, this is a deeply personal time for me and my family and I think I guard it from too much intervention. It is such a joyous occasion for me to have a new baby with people I know are really invested in that going well. I don't see it as a medical thing either, it feels much more emotional for me.

It is down to personal choice.
I like to know that I am in a place where everything is 'on tap' for an emergency. I have no experience of hospitals so it is interesting. I like the fact that I can just concentrate on the baby and not have to worry about anyone else-particularly my other children.

I think one issue that might not have been mnetioned (and correct me if I am wrong) is the shortage of midwives. Only low irsk women can have Hbs, and they get two midwives to themselves. However women in hospital who are therefore not guaranteed to be low risk do not get even one midwife to themselves. So for each homebirth two midwives are taken from hospitals where they may be needed more by women who are more at risk and given to women who are low risk just so she can give birth at home. This also goes for C-sections (that need a midwife present as well as a surgeon etc) that are doing simply because someone wants one rather than needs one. It would be great if there was enough staff for these, but there is not.

maybe,
if you have no heartbeat you are not just worked on for two minutes in hospital.

Kelly2000 - Are you speaking about a particular area there? I am not personally aware of any areas where home births are staffed from the labour ward. They are generally staffed from a dedicated team or amongst the community midwives. Those midwives wouldn't be doing a hospital shift even if not at a home birth.

tbh it feels like some of the posters on here espousing home birth are basically telling us that any woman choosing to have a birth in hospital is misinformed and thus wrong. I think it is up to any woman to choose what they want to do. I actually researched it and chose to have hospital births.

two midwives are taken from hospitals where they may be needed more by women who are more at risk and given to women who are low risk just so she can give birth at home

err no, mine are community midwives they very very rarely work on Labour Ward only as cover for sickness

I don't think anyone is misinformed by having a hospital birth, it is just not for me, not at all. Research it all you like but for me it is a gut thing. I feel like I am doing the right thing and for me it works. If you want a hb then have one, but i don't, I really would like to avoid it if at all possible.

No, two midwives aren't taken from hospital - homebirths are dealt with by the community midwives. There should normally be one with you when you are in established labour and the second is called when delivery is getting imminent.
It's more likely that the midwives are called in from the Community to bail out the hospital when there is a shortage, thus denying those in the community of care.

I agree that women in hospital should have a midwife to themselves - all that technology is only as good as the people operating it.

BTW any woman can have a homebirth - there is no law against it. Whether it's advisable for some women is a completely separate issue.

I realise now that I have never researched anything to do with giving birth. I have worked in a Labour Ward which gives me a great insight but the decisions I have made have been on advice from those who know me, have expertise in their area and my own gut feeling about it.

Kelly2000 Actually, not only low risk women can have homebirths. Any woman can choose to have a homebirth. After my hospital birth I am considered high-risk (third stage issues so risk comes to ME after baby is born) and I am planning a homebirth for DC2 with the support of my community midwife team. I will have two CMWs with me for the entire labour rather than having the standard 1 MW for the labour and 2 for the birth that a low-risk mother would have. In a hospital I might be lucky to get one to myself for the majority of my labour but it is more likely that I would be sharing with at least one other woman.

Homebirths are almost always staffed by community midwives who do not work on the labour ward, so women choosing a homebirth are not removing women from a hospital. The shortage of midwives is indeed an issue but only in so much as hospitals should be able to afford to employ more of them so that every woman can have 1:1 or 2:1 care throughout her labour.

I've skim read the thread so apologies if I'm repeating anyone. I would think that a big reason homebirths are 'as safe' for second births is a lot to do with the type of women who would opt for a homebirth in the first place. all the women I've known who've had homebirths are very educated, look after their health, none smoked in pg for example, and are fairly affluent. Most are older too. They are by definition low risk. I know that a lot of them chose to go this way after an awful hospital experience first time around. I think being armed with positive information about labour and birth actually makes homebirth a far nicer prospect, and it maybe takes a bad experience to make you realise that. I had an awful induction with my dd, purely for being late, and it led to an epidural and horrible posterior delivery. I bled a lot afterwards, my birth partner still goes cold when she talks about having the midwife ask her to press the emergency button after dd was born. Because of that birth, I was more compelled to read up on birth second time around, havign stuck to the standard Miriam Stoppard shite the first time round. Yes, a lot of the books I read are quite hippyish and maybe offputting to some. But in my second pregnancy it made me consider a homebirth as a real possibility. But I was still scared by my first experience, and actually thought I needed to be in hospital where I could have an epidural if I needed it. In the end, I had a birth in the MLU with a brilliant midwife there the whole time, who didn;t do a single ve and didn;t make me get onto the bed. This time round I'm still juggling the options of homebirth or going into the MLU again. I don't feel I'm putting anyone in danger by doing so. It irrationally terrifies me when I hear of people going into hospital having no real idea that they have a choice in the interventions that happen. My friends sister is booked for induction this week for being overdue, even though she knows the scans have dated her wrong and rather than 8 days late she'll actually be induced when she's one day before her due date. For no medical need whatsoever.

Whatmeworry - apologies for assuming you were a man.

It was just your lack of empathy and understanding led me to the conclusion that you've never been pregnant or given birth yourself.

Your comments reveal that you think people who give home at birth are not only masochists, but also don't care very much about their baby's safety. Nice.

"I don't really get the degree of hostility on this subject". See above!

"I gave birth in hospital because I thought that I would probably have a long and difficult labour (I was right there!)"

Ironically though, going into hospital appears to make many labours longer and more difficult!

"and I also was genuinely unsure of my ability to cope with the pain until I experienced it."

This is true of all mothers who book a homebirth, because every labour is different. Most first time mums who book to have their baby at home do so on the understanding that they can transfer into hospital for an epidural if they find the pain too much to bear.

On a personal note, I've had two long and difficult labours: first and third. Both well over 24 hours in active labour, both very, very painful (big posterior babies). I can honestly say that NOTHING that happened in hospital made my labour easier. It was more tiring, more boring, more worrying, less mobility. Just stuck in one room waiting for the birth to happen. Listening to other women screaming in next door. Horrible. The long labour I spent at home passed a lot more easily, despite being JUST as painful.

lesley33

Yep, I've been lurking, and feeling the same. Some posts appear to boil down to "if a woman feels safer at home, then her labour might stall in hospital. She should homebirth. Go sister! If a woman feels safer at hospital, then her feelings are not valid or acceptable. She's misinformed, and her LIZARD BRAIN wouldn't feel safe in hospital! She just doesn't even know her own mind."

"If a woman feels safer at hospital, then her feelings are not valid or acceptable. She's misinformed, and her LIZARD BRAIN wouldn't feel safe in hospital! She just doesn't even know her own mind."

By 'lizard brain' I mean the ancient parts of the brain which govern the instinctive responses which impact on the hormonal cascade in labour. Not the higher consciousness or 'mind'.

It's perfectly understandible and reasonable that a woman will feel safer in hospital when she's grown up in a culture which promotes the view that hospital is the only safe place to have a baby.

But she is misinformed if has been led to believe that it's true. Because for healthy women it's not. In fact the evidence points to hospital births putting women at risk of avoidable surgery.

Can't believe people calling others 'men who know fuck all about
Childbirth'

Totally now dismissing any posts
From that poster. There is no need for plain nastiness like that!

Agreed Kayano

Is it perhaps a generational thing - like breasfeeding?

Both my grandmothers had all their children at home (1940s/50s). By her 6th, my gran didn't even get a doctor (possibly due to having 5 kids pre-nhs) and instead summoned the woman next door (hoping she hadn't been at the whiskey). My Nain lived in the depths of WAles, a long way from a hospital.

My mother (late 70s) went to hospital, followed by some kind of convalescing place, where midwives brought your baby to you for a bottle feed. This was apparently normal. Homebirthing was seen as antiquated; just as breastfeeding still suffers from the days where only peopel too poor to wetnurse/buy formula did it.

Subsequently, I grew up with the idea that hospitals are where you have babies, and that homebiths are from 'the olden days'; why do it at home when you don't have to?

In spite of all this, I was tempted by a homebrth for ds, but bottled it as he was my first and I'm 30 mins away from hospital.

I was all set for a hb with dd, but bottled it as dh never came round to the idea and I didn't want him twitching throughout the whole thing.

I regret not having hbs thoguh, as both births were easy. THe worst part of both was having to stay on a ward, not getting any sleep and having to wait 3 hours for a doctor to sign me out. No more dcs for me (I think), but if I did, 'twould defintely be at home.