to be a bit perturbed at the hospital antenatal classes pushing homebirths to such an extent?

[rocksandhardplaces]

I am 30 weeks pregnant with my second child. I didn't have a straightforward birth last time, though it was not the most traumatic in the world either. Basically, my baby got stuck (back to back/brow presentation), had to go to theatre, failed forceps, emcs. Had a lot of the typical problems that follow this: a long slow recovery, poor breastfeeding, weight loss in baby, supplementation, poorer breastfeeding, guilt, PND, lots of flashbacks and anxiety though not what I would call PTSD but you get the general picture.

I have done a lot of antenatal reading/education this time as to be honest, I was a bit clueless last time. I live in Leeds, home of One Born Every Minute, and am booked into the hospital on OBEM. I have done Parentcraft and Active Birth sessions through the hospital and I have also had a debrief and birth planning session with the supervisor of midwives.

I feel there is a BIG PUSH on for homebirthing. Actually, a MASSIVE push. I was really surprised to be in hospital faced with a senior midwife essentially telling me that the fact of being in hospital probably resulted in all the complications in my last birth and essentially repeatedly, over 3 hours, saying: "wherever you want to give birth, it's not here". It didn't really instil confidence, if you know what I mean? The supervisor of midwives was similar.

The theory makes sense to me: physiologically, women weren't meant to labour and give birth around strangers in brightly lit rooms while people chatted to them about nonsense when they couldn't tell them to shut up remembers wanting to kill student midwife going on about how much she hated the rats in I'm a Celebrity Get Me Out of Hear while I politely nodded in horrendous pain. If labour is low risk and progressing normally, there's no need to be in hospital potentially putting up all these blocks to the hormones that make for a good, straightforward delivery. So far, so good..

The bit I am a bit about was the most pressing argument for me: that at home, you get more regular monitoring and better continuity of care (2:1 midwives) because a) surely if this is what's best and safest for women and their babies at this time everyone should get it regardless of where they give birth and b) I've read on here a lot about midwives not making it on time to homebirths.

There's just something profoundly shocking to me about it being pushed. I don't know why. The stats seem to say it's relatively safe, especially for a second timer like me. The Royal College of Obstetricians and Gynaes and Royal College of Midwives support it. The NHS supports it. It can't be that dangerous I guess and it must confer some benefits.

I know, too, it is a lot cheaper for the NHS. And I know that at least part of that is because adequate pain relief in hospital costs, and increases the likelihood of expensive interventions like cs and forceps...

BUT

what if? what if? what if?

I feel really at sea because I am not at all interested in the "experience" of birth right now. I just want the safest birth for me and my baby... if it is really true that the safest birth is at home, then so be it.. I am going to the consultant in a few weeks to discuss options for delivery and I will discuss this. It just doesn't half feel like a cost-cutting exercise that might potentially put women at more risk and means I can't have adequate pain relief in labour.

AIBU to find it all a bit strange? Or should I just accept at face value that a homebirth is the safest birth?

Homebirths are cheaper for the NHS. Planning a Hb reduces your chance of a CS by 50%.

Don't accept it at face value - go to www.Homebirth.org.UK, join the yahoo HB forum linked there... do your own research, decide what you want - personally having a MW for me and not shared with 3-4 other women, well what's not to like?

I kind of see that Friday, but it still makes me uncomfortable. I work in the NHS albeit in a very different area and I suppose it has made me sceptical because I see how it is All About The Money right now.. It also just sounds so middle class, too. I suppose I am prejudiced. I think whale music and gongs and I wonder if it's just enabling women who are middle class/educated etc to have a better birth than women who won't go to those classes etc.. there must be some resourcing cost in having 2:1 care at homebirths if it can't be done in hospital surely? So it's basically like: labour at home and if you feel like you can't hack it, transfer in but you will have had all this extra care and attention in your own home first, or go to hospital and take your chances on how much continuity of care you get even though you might not get the epidural there anyway? Seems.. shoddy.

It's an odd thing really.

My Mum had all 5 of us at home (1957 to 1969)

My Sister was virtually forced to have her DD in hospital in 1979

She was warned she'd be struck off by he GP if she insisted on her second DC being born at home in 1981...she went ahead and was indeed struck off.

I had my first 2 DCs in hospital in 1992 and 1999.

When I had my last DC in 2002, the MW's suggested and homebirth (which I gladly accepted)

I think these things just go round and round in circles to be honest.

I understand your concerns and I'm from the same school of "what if". I had all three of mine in hospital and wouldn't have had it any other way, in fact it was a good job I was in for the second as I was 17 days over and had to have a emcs but all turned out well, that was 14 years ago however.I then had a vbac with my ds3 and probably could have had him at home as it was so quick and straightforward. Trust your instinct and discuss with your Consultant but don't be fobbed off. Good luck.

Its wrong that you are feeling pressured to give birthing any way that you don't feel comfortable with, and that's really all there is to it. If you want a HB,fine, they should enable that where it's safe and possible, and if you want a hospital birth, the that should be fine too.

Don't allow yourself to be pressured either way, just go with what makes you most comfortable.

Incidentally, my community midwife encouraged me to have a homebirth for both of my pregnancies, I was young, low risk ect ect. She was lovely,and I know she liked doing home births because as a community midwife that was the only chance she got to actually deliver babies. Even though I knew how much she recommended a HB for me, I never felt pressured and she supported me in wanting to give birth in hospital where I felt safest.

They're just trying to save money, I'm guessing

Midwives have to push HB's now as the NHS is trying to save money.
I had a HB with my 3rd DCand will never regret it. It was so much nicer than being in hospital, 2midwives helping me, in familiar surroundings, being comfy on my own sofa afterwards and absolutely no bloody whale song!
Not sure where you get the middle class thing from though...

I had the opposite - signed up for a homebirth, but was warned that it probably wouldn't happenf for staffing reasons. It is "cheaper" in the sense of reducing c-sections, but more costly from a staffing perspective. In hospitals, midwives look after several women at once, which isn't possible at a home-birth, where there are two midwives looking after you exclusively.

I wouldn't have got it in the end as I went overdue by 12 days and was induced, so there's no point my feeling hard done by.

It's a tricky thing really.

I really liked the idea of having a home birth, more comfortable environment etc but DH was really scared about me not being in a hospital 'just in case'.

I the end I had to have drugs to kick start labour so home birth was ruled out anyway but when DS1 was born he had the cord round his neck and wasn't breathing. He was immediately whisked off and had to be resuscitated and put on a machine to breathe for him, where he remained for the next 12 hours.

If I had decided to have him at home he could well have died :(

Not saying this to scare you into having a hospital birth :) I just think it's a decision only you can make and you can only go with your gut!
Don't let anyone pressure you into giving birth somewhere you don't want to.

the NHS spent £798k on a study that found the safest place to have your second or subsequent child presuming you are low risk - for both you and the child - was at home.

do you want them to ignore their own research?

Although i am surprised that they are pushing it in your case as you are a VBAC.

I think it's a shame you feel pressurised into having a home birth. I think that you should really do whichever option makes you feel safest. I had opted for home birth with ds1 and ds2, however with ds1 I was induced and had a lovely hospital birth. I did have ds2 at home and had a fantastic experience, so much so I am hoping for a home birth with Dc4. I must say I'm not sure where the idea of whale music comes from At ds2 birth there was no inflatable birthing pool or whale song in sight, in fact when the midwife arrived I was watching Sweeney Todd on DVD

Extremepie, the midwife would say that having had the drugs to kickstart the labour would have increased the likelihood of that outcome. In my case, I would have said the same originally - if I hadn't been in hospital we'd have been in trouble - but having gone through the whole physiology of labour I can see that maybe actually having been induced post-dates and having the epidural/being still/on my back and all of those things made my son get stuck which led to the forceps which led.. etc, etc. Her thing was that our bodies are designed to get our baby out in a certain way, and if labour is augmented or sped up in any way, that mucks around with that and can throw the pretty delicate balance off kilter.. e.g. it might make your baby move differently and wrap their cord round their neck, or come out faster with the cord round their neck than nature intended causing the breathing difficulties you saw. I don't know if this is true, I am no midwife, but it made sense when it was explained.

She also said that they have sufficient resus equipment to take care of these situations until an ambulance arrives, and they have the whole kit and caboodle. I know (because I have had a variety of severe asthma attacks over the years) that it takes about 5 minutes for an ambulance responder to get to my house.

In terms of the whale music, I guess it's a prevailing idea when it comes up for people who don't know about it that it is all about the "birth experience". Don't get me wrong, I'd love a good one.. I just don't have it as a key priority now, will accept just getting to the other side of pregnancy with us both more or less whole.

I can?t see any problem in encouraging women who are low risk to consider a home birth. In my opinion, given the severe cuts happening in the NHS, what is wrong with promoting a safe but cheaper service? This seems more honest than pretending that all is well within the hospital service and that they are properly staffed to cater for the number of births happening. How many women choosing a hospital birth because ?it?s all there when it goes wrong?, would think again if they knew that for much of the time they would be unattended because one midwife, however good she is, can?t properly attend 3 women at once, so no-one really knows how that woman's labour is progressing. Or that when/if it has gone wrong, if it?s out of hours, there isn?t a consultant on site, so the help isn't immediately on hand?

I would just love the emphasis to be put on a minimum entitlement to care than the emphasis on place.

"I would just love the emphasis to be put on a minimum entitlement to care than the emphasis on place."

absolutely. 1:1 midwife care should not be just for low risk women that are therefore fine for MLU/Home birth.

I think Domino care - that is, you go into labour; you call MW, MW comes to your house and you then do whatever you want to do, at that point, and what is safe for you at that point, and Mw stays with you, whether you stay at home or go to hospital.

I agree, I would be much more comfortable with the idea of Domino care.. because I would like to be at home if I could but if I really wasn't managing I wouldn't want to feel guilty I was robbing the NHS!

Also, hang on, does this mean high risk women get less one to one care than low risk women at home? How can that be right?

I too felt pressured by the NHS to have a home birth second time around. I was astonished. And the emphasis seemed to be on me explaining why I didn't want one, rather than on the midwife explaining why she thought I should, and I found that irritating. I don't want a home birth, end of. Why should I have to repeatedly spell out why not?

"Also, hang on, does this mean high risk women get less one to one care than low risk women at home? How can that be right?"

I don't think it means that. I do think that low risk women can draw a very short straw - being sent away because they are not deemed to be in established labour, even though they have gone to hospital because they need support, or being told that they have got hours to go yet, and ignored and then delivering within the next half hour.

OP, do what you want
do NOT get pressurised into a HB

FWIW I had a nice, fast and (cheap!) 2nd birth in hospital

Ignore their agenda if does not feel right to you
just change topic, and dont get billied into anything

I know they can be lovely,
that said my mate had one and she was pissed off as found herself washing up about 4 hours later, LOL!

Before I had DD last year our local NHS were quite 'pushy' on homebirths too - I was an ideal candidate, being young, easy-as-pie pregnancy etc. I didn't fancy it as it was my first birth and I didn't know how my body would act in labour.

I went to the local MW instead when I went into labour and ended up being rushed by blue light ambulance to the main maternity unit for the county - when my waters finally went they were full of meconium as DD was very distressed. It was a horrific experience as I was in the 'can't talk to anybody as it hurts too much' stage of labour - hate to think how things would have gone had I been at home instead.

Please don't be put off by my experience. :) But guess I'm trying to say that even the 'easy' pregnancies don't necessarily result in low-risk births too.