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'm further away and I'm having a home birth... But then I'm on no.4 and no.3 arrived 37 minutes after the first "oohch, things may be happening" pain. Hence it's sort of my only option :-D

23 miles and an hour from hospital here (bad roads) and I would say in your position, with it being your third, then plan a home birth.

I didn't for my second, and I am glad as I had an EMCS due to deceleration of her heart rate, then the third one was EMCS due to getting stuck!

I still would in your position though, having managed two successful natural births and a fairly simple road.

An ambulance would do it a damn sight quicker than you would.

The new NICE guidelines for intrapartum care are going to recommend birth outside of a hospital for low risk women on their second or subsequent babies - so midwife led unit or at home.

Complications happen - undoubtedly, but being in a hospital is a major risk factor for some complications happening. in hospital we 'do' things to people, start a cascade of interventions. all of the people posting about how they/their friend/their sister etc nearly died... would they have been low risk and suitable for a homebirth? Unlikely. i am always surprised wherever this comes up anywhere abut the sheer numbers of people who were seconds away from death and would have died had they not been in hospital. the research and evidence just doesnt bear this out.

So go for it! you will be looked after and recommended to transfer in at the first signs that things are deviating from normal. PPH at home? midwives can deal with this - they have the drugs and can manage/ start the management at home as transfer is arranged. newborn resus? a newborn from a low risk pregnancy if they needed to be resuscitated then the midwives can do this at home while ambulance is coming. shoulder dystocia... midwives can manage this.

Not in a million years. What's more important to you? An idyllic birth experience or your baby? Sorry to put it in such blunt terms but childbirth is potentially risky. If the birth is going well they will leave you alone but if not you have help. I think access to hospital has to be a deciding factor in a home birth decision and in your case I think you are taking an unreasonable risk on the life of you and your baby.

c-sections for decles - decels are picked up by CTG's, if it is recommended you have a CTG it is probable you are not low risk.

No way. Apart from all the the 'what if...s', I wanted to be close to that drug cupboard

In your shoes I wouldn't do it. Too far away from hospital in case of emergency.

Even though it's your third baby (I think that's what your second post says?) and you presumably have a straightforward obstetric history if you are even thinking about a home birth, I just wouldn't, and I'm speaking as someone who is pro-home birth and had my third baby at home.

However the distance to hospital was one of the most important factors in making my decision. I was literally five minutes away from the hospital.

Whatever you decide to do, I hope it all goes well.

I think it is difficult , i attempted a home birth with my third , unfortunately due to a placental abruption , had to be transferred to hospital for a EMCS . However if i hadn't chosen a home birth there is no doubt in my mind that one or both of us would have died or suffered catastrophic injury .The ambulance journey took a very long 6 minutes in the middle of the night !

And also homebirth isn't 'no technology' the heart rate is monitored in exactly the same way as it would be in hospital for a 'low risk' pregnancy, and at the first sign of a decel you'd be transferred in, at hospital, on a ctg, you'd be looking at 30 mins of decels at the minimum before it was decided to intervene (likely not to be a section, a pathological ctg would be an indication for an FBS, a suspicious CTG - different type of decels - can go indefinitely). Also drugs are carried in case of haemorrhage, neonatal resus equipment is carried in case of neonatal compromise, shoulder dystocia is managed exactly the same way at hospital or at home. There really is very little that can happen that would have a massively adverse outcome just because the location was home as opposed to hospital - out of the blue anyway.

Of course for many people homebirth is not recommended, because there is an existing risk of maternal or neonatal compromise and I can even understand those who say the risk is too high for a first baby as its a bit of an unknown. of course I'm coming at it from having seen hundreds of deliveries, both high and low risk and not being able to recall reliably a single instance where being in hospital for someone who wasn't already recommended they be there has been of any great benefit. Having said that, where you are most comfortable has to be the most important thing and so someone trying to convince you to give birth somewhere you believe is unsafe is never going to be conducive to a positive experience, which is why we should live and let live and go with your own personal choices.

No way. I wanted a homebirth with Ds at first - low risk, easy pregnancy with no complications.

Thank God I changed my mind in the third trimester. Ended up with the full emergency works, DS pulled out with forceps and rescuscitated, me losing a lot of blood.

He wouldn't be here if we had been 50 mins from a hospital. We were told it was a very perilous situation as it was.

I was so, so pro home birth, but in hindsight I was naive.

We're similar MrsJoss- I was intending a hb both times, and after my huge pph (wchihc drugs didnt solve btw - needed various other interventions) I'm so glad I was where I was. I would still have liked to have laboured longer at home/ nicer environment, but being alive is good.

I wouldn't. The odds are in your favour that things would be fine. But in the unlikely event of a major problem with you or baby...nightmare to be that far from hospital.

Me too mrsJoss

Ds1 lovely water birth in MLU, Ds2 low risk pregnancy, seriously considered home birth and didn't in the end as DH not comfortable, hands off, no intervention delivery in MLU, major PPH, lost several litres of blood, collapsed, ended up with emergency surgery, blood transfusions then high dependency unit. There were 10 people working on me within seconds of the MW pulling the emergency cord. A shot of syntocin was not going to cut it and if I'd been 50 mins from a hospital I might well have died.

Births can go wrong very quickly, even when everything should be low risk. It probably won't happen but even the possibility would put me off being so far away from help in the event it was needed.

Another one here saying no way. I had a textbook first pregnancy, was young fit and healthy. Live rurally and a good 40 mins from hospital but planned to deliver there. Got to hospital in labour and progressed well on g&a. I was told throughout that I was an ideal candidate for a home birth and during labour was even considering it for next time round... Anyway, things got fraught right at th end cumulating in an emergency forceps delivery - c-section was out of the question as DS has descended too far. He was literally out in minutes of things going pear shaped with the paediatric team waiting to grab him at the end of the bed! I am forever grateful to the hospital staff for everything they did, I really don't like to think of what would have happened if we would have been at home when things went wrong (bearing in mind the situation changed really quickly from me being 10cm and merrily pushing with just the midwives in attendance to an emergency with about 10 other people coming running in). I was once told that if you are in hospital, in a true emergency they can get you into theatre and the baby out and ventilated if necessary in about 6 minutes. Not sure how much truth is in this but most places you would be waiting more than 6 mins for an ambulance.

The very best of luck with whatever you decide but for me, I wouldn't even consider it plus DH would probably divorce me as he is the most risk averse person I have ever come across

What manchester said, but then I planned a home birth for DS against medical advice, but the high risk rating was in relation to me post birth, not to the baby.

Actually I think it's quite wise to prep for it. If you are that far from nearest hospital you might be better off staying put.

Also, to point out that for me it wasn't about 'the idyllic birth experience' as one poster put it. I hate hospitals, would have been tense in one, and the journey can stop or slow labour. So, for me, I felt it was the right choice in terms of a successful birth as well as making it a better experience for me.

Agree!

My daughter gave birth to my granddaughter at home.
Then she haemorrhaged.

The journey to the hospital takes seven minutes when roads are quiet. The ambulance made it in three or four minutes.

She arrived at the hospital with two to three minutes to live. She had most of the rest of that day in surgery.

She survived.

She wouldn't have lived if they'd been a 50 minute drive from the hospital.

That's my baby. She was nearly dead. My son in law thought he would have to bring up his daughter alone. He thought he'd have to register his wife's death.

Rent somewhere very close to the hospital!

It seems thees a few of us who have haemorraged badly. I'm almost tempted to stat a thread.. other than I think I would find it too difficult.

Not the slightest chance.

I ended up with an entirely unanticipated emergency CS for foetal distress under GA with no.1. The delivery room was literally next door to the operating theatre.

I have never been so relieved.

Sorry - my mumsnet stopped working earlier. This is number three. Number one was long, slow but uncomplicated. Number two was 17 hours from first contraction to birth but was extremely quick after my waters broke - if I'd been in hospital (it was a homebirth but we were only 15 mins from hospital then) then I may well have been sent home and ended up with an unplanned homebirth, which is why I've chosen a planned one for number 3.

As well as that reason, practically a homebirth would be better as we have absolutely no childcare besides PIL who are a few hours away so not guaranteed to be able to make it in time. If I go for a hospital birth I may well be doing it alone..I'm ok with that but DH really wants to be there.

The midwives have reassured me that they'd call an ambulance without hesitation should they need to but then I'd still end up alone but with baby and I at risk because of the long journey and the kids possibly upset. Whereas at least if I headed in the direction of hospital with DH and kids in early labour then there's a chance PIL would make it in time, or at least that DH and dc would be allowed in soon after baby is born.

No way. A friend of mine died following the apparently uncomplicated birth of her 2nd child - her womb ruptured. she was in a little cottage hospital where she worked - they didn't usually do deliveries but had made an exception in her case. She had to be rushed by ambulance to a hospital 100 miles away but died a few days later

I wouldn't.

I had one hospital and one home birth. The deciding factor for the hb was living 3miles away from the hospital. I would have been very nervous to be almost an hour away.