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?

My best friend haemorrhaged immediately after delivery. If she hadn't been in hospital with an operating theatre some 40 ft away, she wouldn't have made it.

For me it is about risk and could I justify it if my child died or suffered a birth injury due to me wanting to stay at home.

If I had had 2 out of three of my children at home they would have died and with the other there were complications as well.

Not worth the risk for me.

I wanted a homebirth for my 2nd baby.
I live literally 5m/10mins from a hosp.

1st had been C-sec due to breech.
2nd was transverse (all the way through!).
Consultant informed me in detail what would happen if the cord prolapsed - not good, even if only 10m away. Also what could happen in other situations, ie placental probs, baby getting stuck by shoulders etc etc.

I had a c-sec as advised.
3 hours later than it was meant to be as a lady was slotted in before me.
She was on her 4th birth, other three quick and easy homebirths.
She haemorrhaged and they were lucky to have a good outcome, I believe.

Not worth the risk, imo.

I had a home birth with dd. But it was my 2nd delivery. My first with ds was a very smooth, straight forward delivery (water birth) in hospital. With my community midwife in attendance.

So I felt very comfortable with a home birth for dd as I had the same community midwife team who were very experienced in home births (50% of their caseload). I was less than 10 mins away from the hospital which had some of the best neonatal care facilities in the country.

My dh was on board. I had everything ready. Home birth was lovely.

For me it was a very personal choice and not one I tend to divulge to others.

But if I was a long distance away from hospital? Not a chance.

I started having a home birth with dd2 and it ended in hospital, so no, I wouldn't go for this if 50 min away (50 min on a good day, you have to allow for time to get into ambulance and out other end, could be over an hour). My dd2 had meconium in the waters and it was very important she was born in hospital and not at home or in the ambulance due to the resuscitation needed.

I like the idea of home birth or in a midwife led unit, but even being 20 min away and 10 miles away was frightening enough when in the ambulance lurching around, with the midwife shouting 'don't give birth yet, don't give birth yet' as if there were something I could do about it!

I did.

No I wouldn't, we live about 30 mins from the hospital and in my mind it was just too far. That being said the hospital we are going to is lovely and the rooms have a very homely feel to them.

I wouldn't be able to relax at home, I'd be more relaxed at hospital which would make a homebirth a bit pointless.

I had my first baby in hospital.

Entire pregnancy was straightforward, no complications, first 24 hours of labour/contractions was fine.

Went to hospital when i dilated further and continued at a steady pace.

Within 20minutes the situation changed entirely.

Baby's heart rate was dangerously high, close to cardiac arrest, also got caught in a funny position and couldn't make their own way out.

Was rushed to theatre, partner wasnt even put into theatre gown, my nail polish left on, literally threw the bed through the theatre doors, gave me a spinal block and dragged baby out with forceps the instant it took effect.

I was told by a doctor that if they had been any slower i probably wouldn't have a baby.

Im not trying to frighten you, it just hit me then how things can change so fast and being in a hospital probably saved my baby's life.

My friends have had home births and had wonderful and safe births. But they had the security of knowing a hospital was a miles drive away.

Just ensure you make a fully informed decision...

I don't think I would.

I had my second baby at home and I'm very glad I did; but the hospital was 10 minutes away.

No. Absolutely no chance.

My 3rd birth was a planned home birth (and in hindsight I wish my 2nd one had been as well).
However, I had good reasons for my choice, I discussed it with my very experienced midwife, and she agreed with me. Distance to the hospital and my history of fast labours was actually the major factor.
Why haven't you already discussed this with your midwife?

I've had a homebirth where the 3 available hospitals were all 20-25 miles away. Tbh it didn't really enter my mind. I had a MW team very experienced with home deliveries who fully supported me. I felt very comfortable and very safe with the idea throughout the pregnancy and during the actual labour.

However when I planned for a second HB in the same area 8 years later it felt a different prospect. During that time the ambulance service had cut back ambulances in the area, the local hospital had had it's A&E downgraded which meant the existing ambulances were traveling more frequently to the 20-25 mile away hospitals and not so readily available in an emergency. In the end the decision was taken out of my hands as I was overdue.

Do you know what the average ambulance response time is in your area OP. Would it help to know that?

I would have loved a homebirth (couldn't for various reasons) but have three hospitals within four miles. At 28 miles I wouldn't, unless you have a history of very quick births.

Yes I would - my third labour only lasted 18 minutes from the moment I realised it was really labour, so staying home would have been safer than trying to get to hospital. As it happened I was already in hospital for a scheduled appointment so gave birth there then went home.

Depends what your first two births were like though.

50 minutes is a long time, no way would I even consider a home birth with that as a factor.

No freakin' way, 28 miles is a bloody long way if you're haemorrhaging or your baby is oxygen starved.

I wouldn't do it. My first was undiagnosed breach, they only realised till 8 hours into labour and then I went straight into emergency c-section. This was a completely trouble-free pregnancy.

I definitely wouldn't. Too far if something went wrong.

Not if you have cold feet. My midwife was very reassuring and confident which made me confident enough to have all of mine at home.

"Once you're in the process of giving birth you couldn't care less where you are" I cared very much exactly where I was during every minute of my labours.

No I wouldn't consider it. Dd unexpectedly got into distress during labour and if she hadnt been delivered immediately by emergency caesarian she may have been brain damaged or died.

I had my first at home so I'm not against home births although evidence since does show that the risk of very serious complications is about double in first time mothers at home, compared to subsequent pregnancies when home birth is as safe as hospital/an MLU. However, I live 2 miles by a straight road from my local hospital. There is no way I would have had a home birth so far away.

Funny - I'm here thinking "no I definitely wouldn't with the hospital that far away" (I've done aim-at-homebirth-with-hospital-transfer and also homebirth, each time with hospital about 15 minutes walk away)

... and then I remembered the circumstances of my own birth - planned homebirth about 25 miles away from the nearest hospital. So maybe it wasn't that crazy an idea :) (I'm a second child, if that makes any difference)

An ambulance can get you to hospital if needed.

The thought of 50 minutes in the car when in established labour sounds awful.

I would have Home births, but can't go into labour on my own.

You must follow your gut instinct OP and do what feels right to you.

There is a fair bit of misinformation on this thread about homebirth. The evidence shows that homebirth is as safe as hospital birth for women with uncomplicated pregnancies with the added benefit of less medical interventions such as instrument delivery, c-section or the need for a blood transfusion.

Things very rarely go wrong at a homebirth as mothers have dedicated one-to-one care from a midwife who will transfer to hospital at the smallest glimpse of a problem. In hospital midwives are often busy looking after several women and cannot provide the same level of care as you would receive at home.

Homebirth midwives are trained in neonatal resuscitation and carry the same drugs to stop haemorrhage as a hospital would use. Shoulder dystocia is treated exactly the same way at home as it is in hospital. Serious but very rare complications such as cord prolapse can be fatal at home or in hospital. If an emergency c-section is required most hospitals would deliver the baby within 30 minutes. When transferring in from a homebirth the hospital can prepare the theatre while you are enroute.

If this is your second or subsequent baby then the worry of giving birth, unassisted on the way to hospital is a serious concern.

Do you have a local homebirth support group? These can be invaluable as you can hear from parents in your area about their experience of homebirth.

There is no way I would risk going to hospital if I was having a straight forward pregnancy.

I run the Greater Manchester Homebirth Support Group and we've recently made a series of short videos to provide information to parents-to-be about homebirth.

Get the lowdown on homebirth from midwives:

Midwives homebirth equipment:

Dads' perspectives on homebirth:

Hope this helps you come to a decision. Best wishes for a smooth, easy birth! x