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?

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

I haemorraged badly after my homebirth. Paramedics, ambulance, blue lights, surgery, more surgery, huge transfusion, etc.

And look! Here I am to talk about it. Despite it being a homebirth...

I lost a baby after a straightforward pregnancy. I was low risk and had been offered a homebirth. In my case it wouldn't have made in difference to the outcome as my baby died just before labour began but in some cases it will make a difference. Way too risky.

Fwiw I am very pro home birth and had my first at home (quick, no problems, really pleased I did) but if I were thirty miles away from nearest hospital I would probably not have chosen to be at home. Unless I had a helicopter at my disposal! :) Or maybe knew an obstetrician and paediatrician in my local village who could help in case, and could get an ambulance on stand-by? Can you find a really smashing mwl unit with birthing pools?!
Am sorry for you though, having to make the decision. It will in all likelihood be fine especially if you've been okay-ed by the team so far, but a sensible approach is probably best with that distance in mind.

No way, never, no way. Tertiary level paeds on site or I won't give birth there. Ask your midwife how many neonates she's intubated. I can guess what the answer will be.
Also wouldn't be anywhere without a theatre. What if is a big question in my book.

Personally, no I definitely wouldn't. If you do need to transfer for whatever reason, that's a very long time between an issue being noted and getting the help you need.

Obstetricians consider distress of a child due to lack of oxygen the most serious complication - e.g. as the consequence of umbilical cord wrapped around the baby's limb or neck, umbilical cord knots, etc.
www.cmcpraha.cz/en-US/news/complicated-delivery-does-not-have-to-be-the-reason-for-caesarean-section
Delivery must be quickly completed in such cases to prevent irreversible damage to the child's brain due to the lack of oxygen.

I'm due in December and was really attracted to the idea of a home birth or a birth centre. But both are about a 20 min drive from the hospital and I wouldn't risk it.

My friend planned a home birth and she ended up being seriously ill before labour and it had to be induced. She said afterwards that she really appreciated being in hospital with lots of people to look after her and her dd.

I'm not sure how much I'd base any real opinions on that webpage, it's a business, trying to entice people into using their services and not exactly a peer reviewed article.

Babies are born with the cord around their neck and limbs all the time. That's not to say in some cases it can cause problems, but that presents itself in decelerations in the heart rate, which are picked up and referred in, studies actually show that electronic monitoring does not improve outcomes.

Agree with Seattle. Most - not all - cords around the neck are not problematic. If the cord is too short due to multiple tanglings for the baby to get completely out via the vagina it can cause serious problems incl suffocation and placental abruption, but these things can be picked up with a scan. DC had a nuchal cord picked up on scan but I still did a HB and the midwife just slipped the cord over the head as soon as it appeared.
Still however of the opinion that OP is too far from hospital for HB.

There was 15 minutes b/w ds1's heart rate starting to drop because of cord compression and the doctor having to snap it to get him out of me (head delivered but cord multiple times round neck and too tight to let body follow). By that time I was already in theatre prepped for a c-section.

Prior to that no sign of a problem (other than 4 hours fruitless pushing).

I think homebirths for women with a record of straight-forward deliveries, or home births within easy reach of a hospital are both very low risk choices. First births 50 min away? The odds are still in your favor but personally I wouldn't recommend it.

If you're happy to accept that if something goes wrong at the last minute, your baby's chance of surviving with an intact brain (or your chance or surviving if you have a big bleed) will be greatly reduced then go ahead. You'll probably both be fine, but personally though the risk is small, the potential damage is so horrendous and irreversible that I wouldn't do it.

Childbirth is a natural thing, but most mothers/babies coming through it intact is a relatively recent phenomenon.

Our county is very rural, with some areas further away from the hospital than you, yet it has one of the highest rates of homebirths in the country. Talk it over with your midwives, and see what they say. A blue light ambulance will cover that distance in a lot less than 50 minutes!

Just to counterbalance all the horror stories: I know someone who started haemorrhaging (placental abruption I think). She lives 20 miles/ 45 mins away from the hospital. Yes, they got her there in time. Jumped on her with the anaesthetic syringe as she was pushed through the doors apparently (according to her DH!), but mother and baby were both fine .

Personally I wouldn't take the risk, DS wouldn't be here if we had been 50 mins from the hospital or if he had then he possibly would probably have been severely brain damaged.

I am not sure that really counterbalances the horror stories stubborn its a huge risk and presumably they were lucky, she may not have got there in time, a big risk IMO but my experience probably makes me feel that way I guess.

Such a lot of scaremongering and 'mother guilting' on this and most homebirth threads. You rarely hear of someone telling you that you'll be to blame if your baby ends up brain damaged if you give birth in a hospital but that has risks too!

I haven't seen anyone saying that the mother would be to blame at all on this thread, it isn't scaremongering either, it is purely posters own experiences.

I wish I could have come on here and said differently as our experience was extremely traumatic of course but the outcome would have been much worse had we not been in the hospital, that is just factual.

I am 50 minutes/28 miles (thereabouts) from my nearest hospital. I chose a hospital birth because I knew that if labour went wrong, it would have been catastrophic for me/baby/both. Also as every birth is different, and it being my first, I had no idea how I was to cope or what could have happened therefore having the drugs and the interventions at hand was a big plus for me.
As it turned out, it was the right decision: baby's growth was greatly reduced and not picked up until I was 36 weeks and only then because I had a 'routine' scan to check my placenta had moved from my cervix. I had half the amount of fluid I should have had, lost half of what i had the following week, a poor placenta so I was induced. I had a rare reaction to the pessary, suffered violent contractions, a placenta abruption and a uterine tear that just so happened to occur during the EMCS to get my son out who was in foetal distress (heart rate

No. My first labour was fine. I considered a home birth for #2. Thank goodness I chose to deliver in hospital, otherwise the complete placental abruption I had would have killed both me and DS.

I obviously believe everyone's stories here, but just don't understand how this can also be comparable with the huge studies that show that there is no difference between bad outcomes between home births and hospital births for everything but first births.

I guess hospital births must bring their own risks?

junk - but you wouldn't have had a pessary at home, so wouldn't have had the reaction and subsequent issues there. That's exactly the reason why an induction takes place in hospital.

A spontaneous labour is not comparable.

No, I couldn't risk it. I wouldn't have a home birth anyway but 50 mins from a hospital really seems like too much should there be an emergency. Just not worth it surely.

I'm guessing that for many on here who have had seriously adverse outcomes their labour was 'interfered' with in some way by virtue of being in hospital, eg CTG, ARM, syntocinon, prostin, epidural, instrumental delivery or were in hospital for a specific reason, eg premature labour, bleeding or other reasons to make a high risk pregnancy, thus they would not be included in any low risk groups in studies. It's that whole cascade of intervention thing isn't it?

seattle Nope. 2nd healthy pregnancy after normal first delivery, spontaneous labour, no interventions, baby delivered safely, natural third stage, all lovely, then went horribly wrong extremely quickly - was holding DS and having a first feed and collapsed haemorrhaging. No warning and no obvious risk factors whatsoever.

Any planned home births that transfer in become part of the hospital birth stats, so almost by definition the only ones that appear in the home birth stats are those where it all goes to plan. Any births that are deemed high risk for whatever pre-existing reason will mostly be in hospital anyway. Most transfers won't be emergencies because the MW are risk-averse and will transfer early if they are concerned, but the point is that births can sometimes go catastrophically wrong very quickly and though it's unlikely you really don't want to be 50 mins (plus an ambulance getting out to you, plus loading time) away if it does.

Binky Does a study really matter? Do numbers really matter? To me, all that matters is that I am ok and my child is ok. Fuck statistics when it's me in the driver's seat. Obviously, I am not the OP but that's my opinion and she asked.

IMO, midwife led units based next to hospitals are the best possible scenario, yet they appear to keep closing them. Such a shame.