to plan a homebirth when 28 miles/50 mins from hospital?

[CloudiaPickle]

I'm in the final stages of pregnancy and think things could be about to start but am having major cold feet because of the distance to hospital. Would you have a homebirth if you were this far away?

I've read that some people have mentioned travelling my ambulance. Just to let you know in my town where the population is about 40,000 there is only 1 ambulance & 1 rapid response car but they don't just cover our town but all the nearby towns & villages. Sometimes there isn't any available vehicle due to sickness etc. I know this as my OH is a paramedic. Its actually scary to know! You can't & shouldn't rely on an ambulances for childbirth.

I didn't choose a homebirth because I am 'selfish' I chose it because my hospital birth was so awful and horrific the very thought of going back there filled me with panic, I had PND and PTSD after it. I also chose home because I had a very young dd1 still and she was still bf and didn't want to be away from her. I also chose it because statistically it was safer for me.
Most transfers happen long before any kind of dire emergency arises. Yes there will be times when that isn't the case, but they are rare, and women and babies die inhospitals too.

The thing is, all said and done is that it's about what your perceived level of risk is and what risks you're prepared to take. Ultimately that is a personal decision. As a previous poster has said, the risks of something going very wrong are relatively low at either location but when they do, the stakes are very high, mother's life, baby's life, mother's future fertility etc.

You can talk all you want about statistics and low risk cohorts etc but until you actually go into labour (and often not even then...the problems tend to happen towards the end), whilst you can objectively assess who is high risk and low risk and may well be fairly accurate with this, you can't ever know who is going to have a tough time or not. You can have very low risk mothers having very traumatic births (in home or at hospital) and very high risk mothers (who have previously had hideous experiences or are high risk for health reasons) having a really positive experience.

I accept that interventions take place more frequently in hospital and to a degree that had the birth been at home they wouldn't have been necessary. I can also accept that pph's for example can sometimes ( but not always) be linked to interventions. But, and this is the big but, what nobody knows is what the outcome would have been without that intervention. Most would probably be ok in the end but some wouldn't and if again if that is you and your baby, statistics don't matter one bit. We are lucky that we have the medical skills and expertise we do in this country so why you wouldn't want to be seconds away from a potentially life saving operating theatre rather than 50 mins by ambulance plus waiting time is beyond me even if the risk is minute. Again though a matter of personal choice and risk perception.

If is obviously a very emotive subject and posters feel strongly both ways. Calling those who are pro-hospital birth scaremongeres though is unfair. The OP was merely canvassing opinions.

Sorry in the third paragraph I mean that some interventions may not have been necessary in a home birth situation. In many cases they obviously are and interventions of any sort should always have some reasoning behind them.

Oh heavens, the patronising sad faces are almost too much to take.

To those making out interventions aren't necessary, how do you suppose my baby would have come out? He had turned 45 degrees to the side (after being back to back anyway) and had himself lodged firmly and was well and truly stuck. Intervention was needed. There are no 2 ways about it. So I will not have people making women feel guilty for accepting intervention. He wouldn't have come out at home and his heart rate was critically low so he needed to come out, which was done in the form of ventouse and another doctor turning him as he moved down.

This is not scaremongering, it is sharing an experience as to why I wouldn't choose a home birth so far away from the hospital.

For my 2nd pregnancy I opted for a c section. My 1st was stillborn having died just before labour started and I found out when I was in labour. I probably didn't need the section as the actual labour was fine but I couldn't cope with the thought of something going wrong. Statistics didn't come into it.

Blueberry I agree with you 100% I had an emergency forceps delivery in much the situation you described. Everything was fine until DS got stuck even with the back to back labour. I was progressing well and told that I'd be am ideal candidate for a home birth next time round. He got stuck though with the cord round his neck and they needed to act very quickly and thank goodness I was I'm hospital and they could. I too needed an intervention for there to be a happy outcome. Interventions happen because of a medical need. Where there is no intervention there is usually no medical need. Surely the priority is a healthy mother and baby at the end of the process!

Still no baby!

I do.disagree that hospital births have to mean increased intervention though. With dc1, I arrived at hospital, was checked, only 4cm and baby fine so went out walking to.encourage waters to break as her head was right on them. Went back a few hours later and was checked again - 8cm, waters still intact. Did more walking, felt head drop dramatically, returned to hospital room, waters broke within 5 minutes, baby born in ten. Just because you have a hospital birth doesn't mean you have to literally be in.hospital for the duration of your labour.

Ah good luck!! You are absolutely right about hospital births too, I know many many friends who have had easy unassisted hospital births and laboured mostly at home (does depend on the speed of your labour though )

The trouble is the statistics are not always enough to ease someone's mind either way and people do not always look at them in the right way.

A home birth would be agreed to if there were no factors that suggest the mother or baby are at high risk so of course there are likely to be less need for interventions meaning there is a lower % of medical intervention, it does not mean that the interventions used in a hospital would not have been required if the person had been at home, it may be that the intervention was not allowed to have been used at the home birth and the outcome may or may not have been the same but you would never know.

IME I found that the midwife was reluctant to ask for any medical intervention for as long as possible which resulted in a problem not being sorted in time which then caused issues for my DS. It was an awful experience and DS was eventually pulled out with ventouse which took almost 3 hours and had some horrible injuries as well as needing proper resuscitation then intensive care for a week.

TBH I probably wouldn't have been allowed to stay at home to give birth as the labour was progressing very slowly (2 cm in 9 hours with contractions every 2 mins) so 50 mins transfer would have actually been ok for me but also this would have depended on whether the midwife made the decision at the right time. In hospital I wasn't informed that there was a problem until I was actually pushing and in that case it would have been too late for DS, he was in intensive care within 40 mins also.

I think it is unwise to make a decision based on stories on MN as obviously people (including myself) who have had bad experiences will comment on a thread like this in the same way that people who have had brilliant home birth experiences will comment, you probably don't get the factual information, more emotional I think.

I hope your baby arrives soon

I hope your baby arrives soon OP good luck

I don't think anyone is saying all intervention is a bad thing, I'm certainly not, just that being in hospital increases the potential need for that intervention.

I can see how being in hospital could have increased my chances of intervention - I went in with prom and was there for the whole of my early labour. That meant three nights without sleep (due to noise and bright lights) and by the time I got to the pushing stage I was beyond exhausted. Plus every few hours a midwife came round offering me pethidine.

Out of interest, I planned a hb but had to go to hospital at the start of labour due to waters breaking - would I have counted as a homebirth or a hospital birth in that study?

Cloudia - good luck with whatever you decide

I was in same position distance wise and opted for a home birth but then transferred to hospital. They had the ambulance on standby and it came in 10 mins!

I think you would have counted as homebirth for the birth place study, but I'm not 100% sure.

I think the point I'm trying to make is that home and hospital births both bring their own risks - the home birth risks are always emphasised (to the point of blaming the women who makes that choice sometimes) whereas the risks hospitals bring aren't really acknowleged (maybe because they're more difficult to pin down/understand). But the evidence does suggest that they're there.

It seems as though a lot of the benefits of home or MLU are that being comfortable in your environment, which can contribute to a progressive labour with fewer complications. Ultimately then, one needs to choose the place they're happy with be it home, MLU or hospital.