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 wouldn't- I breezed through pregnancy but dd got stuck when pushing and I crashed. Had an emc and very grateful to the surgeons who helped us out

"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."

This is only true for multips (women who have delivered before). The risks are higher for first time mothers.

www.bmj.com/content/343/bmj.d7400

I had DD (my first baby) at home and usually I'm a huge advocate of homebirth but at that distance I wouldn't.

Even if nothing goes wrong as such, and you just want to transfer in for an epidural, it will be a long and painful journey there.

That's just my opinion though, you know yourself best.

The thing is there is no predicting anything.

Baby 1 - emcs.
Baby 2 - VBAC but with retained placenta but both baby and I fine, I just had to stay in hospital for 48 hours due to "op".
Baby 3 - VBAC - both nearly died but you could have argued as VBAC1 went relatively okay - retained placenta almost certainly occurred due to incorrect action by a midwife - I would be fine to have a VBAC at home.

DinoSnores - how are subsequent births safer than hospital ones? In my case. clearly not. On what grounds and what makes them safer? You can't do a c-section in a house if the baby is struggling, for example.

You have to bear in mind staffing levels in hospital versus at home, Itsfab. If we're dealing in anecdote then I can think of at one woman I know whose baby suffered catastrophic brain damage at birth but would have been fine if a home birth had been planned (because the problem was that the mother was shunted off to the side in an overstretched maternity unit and not monitored properly -- if she'd been at home she'd have had at least 1:1 care, the issues would have been picked up hours earlier and she'd have been blue-lighted to hospital for c-section. You won't get a c-section in a hospital either if no one notices that the baby is struggling.

I quite like the idea of a home birth for my next DC but I'm only considering it because we live a 10 minute drive from the hospital. If my nearest hospital was an hour away I wouldn't feel comfortable at all and any unexpected delays (such as roadworks, a traffic collision, extreme weather etc) would send me into a complete panic. Of course, it would most likely be fine but I'm the sort of person who tends to plan for the worst and hope for the best. I can imagine that some people might feel more relaxed at home than in a clinical environment but It really is such a personal decision and you need to decide whether the distance to the hospital is actually going to cause you more anxiety than being in hospital would.

In my case, home would have been safer for me at those distances. I have fast labours so being so far from a hospital would likely mean delivering at the side of the road on the way in.
I had two home births and they were fantastic. Most transfers in from home births are for slow progress or more pain relief. It's rare to have to transfer as an emergency. If you are the one that happens to though, how would you feel about it?

If I lived that far from hospital I would want to be induced in hospital but that is just me.

I planned a homebirth for my first, but ended up having to go in anyway (non-emergency though).

For my second I thought differently, "where would I choose to be born?" and my immediate answer came back "where the doctors are" so that settled it.

I'm not against homebirths, but the distance to hospital is an important factor imo.

I live over an hour away from the nearest hospital, the midwives around here are very pro-homebirth.

I tried for a homebirth with ds1 but was blue lighted at 6cm due to thick meconium in the waters. It was hell, strapped down in the back of an ambulance for what seemed like forever with the midwife next to me throwing up out of the window (travel sickness, ambulances are very wobbly)

Tried for a homebirth with ds2 - woke up in the morning with some pain, rang midwife who took an hour to come and then declared I was fully dialated. An hour later he was born, everything was so relaxed and quiet.

I would definetly have a homebirth again if I had any more dc

Don't do it if this is your first.

Often problems in labour arise very suddenly with no prior warning, and require immediate action which can be impossible outside a hospital. This happened to me in my first labour, and my ds would probably have died if I had been attempting a home birth. There was five minutes between the doctors realising that there was a problem, and being able to get him out alive. Luckily we were next door to an empty operating theatre.

You can either make the trek to the hospital in a non-emergency situation or risk having to make the journey in an emergency situation.

I'd take the long journey in a non-emergency situation any day. Just not worth the risk to have a 'nicer' birth experience. Birth is a means to an end, not the end in itself. Get the baby out safely.

I wouldn't, but that's based on the difficulties faced in my first birth.

I've had two home births, including a very overdue baby of over 10lbs - and I'll hopefully have a third home birth within a few weeks - but I'm not sure I'd opt for a home birth if that far from hospital. Why don't you have a chat with the home birth team, who might be able to address your specific worries, go through the circumstances that might require a speedy transfer and explain what would happen? Here, you will get a lot of responses where it's assumed that it's safer to be in hospital - it isn't necessarily - but I don't think you should base your decision on opinions from strangers on an internet forum - talk to your midwives and make the choice that'sright for you.

I'm curious as to how a midwife can cause a retained placenta?! Good luck no matter where you deliver.

We are planning a homebirth for our first, due in a few weeks. We're about 10 minutes from being blue lighted to hospital (around 6 miles). I'm even dithering a bit about being that far away and may well end up in the MLU. Any further and I definitely wouldn't have even considered it.

We planned a homebirth but we are v close to hospital.

One thing to be aware of is that they do whisk you into hospital at the drop of a hat (i had some risk factors so would have been v quick). I didn't want to travel in established labour which looked likely to chose to go to hospital. I'm glad I did as

As it happend I hemorrhaged in hospital -and no the drugs wouldnt have been enough to stop it, I was into intensive care as soon as they had finished saving my life. I was incredibly lucky to be in a major hospital. Unusual and anecdotal but would make me v wary of being too far from a hosptial.

I had a home birth planned with DS. I lived 50 mile / an hours drive from the nearest hospital (actually there were 3, about the same distance in 3 different directions) at the time. There was a cottage hospital closely, but the county midwives said that they could do nothing there that they couldn't do at home, so they actively encouraged home births in anyone who was not high risk, which meant that is what you got unless you were consultant led, or had a reason not to be at home. They told everyone that you would be far quicker, easier etc at home.
I was admitted to hospital after waters had been broken for 24 hours. The ambulance drivers joked that that usually meant that they would delivery the baby in the lay-by outside town! I had a c-section hours later, and the baby suffered no ill effects.
I hadn't considered that I might not give birth at home, however even knowing what happened, I would make the same choice again.
What do your local midwives say? They will be used to dealing with your circumstances, and may also be far more experienced a t what might happen. For examples, our local GPs death with very urgent obstetric emergencies as emergencies at the local cottage; I had a friend who had c-section from the GP, patched things up for transfer in extreme cases. They certainly dealt with any tears requiring stitching at the the cottage the next day. The perinatal mortality and morbidity rates were actually slightly above average when compared to those for there set of the country.
Good luck. I hope you get what you want xx

Sorry forgot to point out that, the reason I'd choose this again, even after this was that I laboured at home comfortably and effectively for 24 hours. I was fully dilated, and wandering around, cooking and making drinks when the ambulance arrived! I required no pain relief until I was made to lie on my back in the ambulance and then again at the hospital, where no-one listed to me or treated me like I had an opinion.
There were other factors in my life at the time which may have influenced my need for a section, but I can say that I was calm and comfortable and treated with dignity at home, whereas in the hospital I panicked, felt unable to cope and was treated like a piece of meat and an inconvenience.
I am now high risk, so even if I lived in the same place, I wouldn't be encourage to have a home birth, however, largely because of this experience, I am currently planning my VBAC in the local MLU.

I had a home birth for my first. The latest research suggested a higher rate of serious problems for first birth (but from a low base). But they didn't control for proximity to hospital and experience of midwives. Since both were in my favour I opted for home birth. Much further away and I wouldn't have.

Think being comfortable with where you are giving birth could be a factor in how well it goes - not always but sometimes. Also, hospitals need to control pace of birth can apparently cause some complications in first place (don't know the evidence base for this).

I would give birth wherever I felt comfortable.

For me that has always been at home, including (especially) my first baby.

So that is what I did.

But that is not what you should do.

Feel safe in your choice.

While I do understand the attraction of home births, I wouldn't do it at all at that distance from hospital (and I am a similar distance from ours). Admittedly my attitude is influenced by my own three experiences of giving birth which were as follows:

Baby 1) The only spontaneous sign of labour was a massive flood of meconium filled waters. No contractions or anything else. Hospital was the only option. My entire labour and delivery were driven by a syntocinon drip. The problem was a failed placenta, as evidenced when it was examined by the obstetrician.

Baby 2) More textbook when it actually happened, but I had high blood pressure and other signs of pre-eclampsia towards the end. So hospital was again the way to go.

Baby 3) Waters broke at 35 weeks. She was OK to start with, but soon began to discharge thick meconium. Her baseline heart rate was also on the high side. I had no contractions at all, so syntocinon was tried again but she didn't tolerate it at all and her heart rate suddenly dropped so low it could not be picked up for a couple of minutes (scary). It did return to normal after the removal of the drip, and I went straight to theatre for an emergency caesarean. It saved the life of my daughter, and I was told probably my own too.

Birth is unpredictable, particularly the first time but also subsequent ones. History doesn't always repeat itself.

In this sort of situation, statistics mean nothing to me; when it's you and your child, does it matter if X number of people are fine in that situation or does it matter if you and your child are fine?!

I wouldn't.