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?

Thecraic - we don't know the impact the distance mentioned in the OP would make. The only evidence we have suggests that for a low risk mother, average transfer distances of 17 miles (as in BirthPlace study) don't seem to make any difference to outcomes.

Why speculate negatively about the risks in such an uniformed way?

TheCraic - I wouldn't make big decisions about my medical care without any reference to the medical evidence. Particularly when those decisions have implications for the well being of me, my baby and any future babies I might have.

I'm surprised by how many people do - as evidenced by this thread.

Would add, the potential of any birth to become a high risk situation is there.

Doesn't stop people opting to labour in birth environments where just walking through the door appears to double the chance of this happening.

I'd love to meet the person who, whilst lying on the floor of their home haemorrhaging would think, "thank god I listened to those statistics", rather than, "where the hell is the ambulance?!".

You've just said, "we don't know the impact mentioned in the OP would make". Well I think we can assume that waiting 40 minutes or more for an ambulance to arrive isn't going to improve the prognosis of the patients. And it's this, and the comfort that being in a medicalised environment can offer to some, that makes many people disregard the data and go with what feels right for them.

You can refuse interventions you're not happy with in hospital though, but still accept the life saving interventions you may need. You don't have that luxury with a home birth and certainly not that far from a hospital.
Haemorrhages may well be more likely in hospital for the reasons cited but they do still happen at home, even if much less often.

Thecraic - is that the only argument you can make for disregarding the evidence when choosing a setting for birth?

You think your comment is common sense - that a 45 minute journey to hospital wouldn't improve the outcomes in the case of an emergency.

My response to that would be to point out that there is no evidence that choosing a non-obstetric setting 17 miles away (as in BirthPlace study) results in more sick mothers or babies. In fact the evidence points in the other direction. Go figure.

Could also point out that the tens of thousands of women having avoidable major surgery in UK maternity units every year probably don't lie there thinking 'I may well not have ended up on this operating table had I chosen to have my baby at home/free standing birth centre'.

Minifingers - or they may well be delivering a stillborn thinking to themselves "I may well have ended up on an operating table which would have saved my baby's life when they were stuck and in distress."

Apologies for the bluntness but I'm sick of people making out you are doing your baby some kind of injustice by allowing necessary intervention!

That was supposed to say they may well be at home

I haven't said that it will increase the numbers of sick mothers or babies, rather I have acknowledged that in many instances home is the "safer" place to be. What I have said, is that those mothers and babies who are sick, and are that far away are on a bit of a shitty wicket if there's an emergency. It's obtuse to deny that.

You have yet to present any evidence that shows that a distance of over 17 miles does not have any negative outcome in an emergency situation. Therefore I can't see what evidence I'm supposed to be disregarding. OP is likely to live considerably more than 17 miles away from the hospital; those were the perameters we were asked to consider.

Blue - women who lose a baby at home are probably quite likely to blame themselves. Far more so than women who lose a baby in hospital, though in both cases choice of setting for birth may have played a part.

And it's ignorance and prejudice like yours that plays a part in the emotional suffering of women who lose a baby at home - the fact that within their communities there will be many people who will jump to the conclusion that parents who opt for an out of hospital births are taking additional and pointless risks with their babies' lives. :-(

Basically, if all goes well, the distance is immaterial and you will be fine.

Of things don't go well, due to the distance, it's quite likely that you and/or the baby could not come out of this well

It is more likely than not that all will be well but, if it isn't, you really are in the wrong side of the stats so you need to decide what risk you feel comfortable with

Minifingers did you actually read my post with regard to the posters friend who sadly lost her baby? If not I think you should before you start throwing around accusations that I am somehow contributing to women feeling to blame.

Thecraic - conversely, where is the evidence that hospital birth is safer for low risk mothers? Regardless of where they live?

I have pointed out that there is no evidence that 17 miles transfer distance make a difference.

You, on the other hand have no evidence that hospital improves the outcomes for low risk women and their babies as a group REGARDLESS of where they live.

You have a weaker case.

Re: interventions - if you put you and your baby at increased risk of fetal distress, prolonged labour, infection and haemorrhage by opting for a hospital birth then you'd be ill advised to refuse the interventions offered to rescue you from these difficulties.

Minifingers re your last post, oh so it's absolutely fine for you to say people opting for a hospital birth are putting their babies at risk, but god forbid anyone dare say that about a home birth... Unbelievable.

I think the home birth advocates are actually adding to the fear about hospital births.
The harping on about over medicalisation, the needles, the sterile unsupportive atmosphere..no wonder some women are fearful if this attitude is promoted by the home birthers ( ironically often by women who have never given birth in hospital)

THis is actually increasing the stress for some women about a hospital brith. Many hospital births are lovely. Warm, considerate, supportive staff willing to listen to a labouring mother and allow her to birth in the way she would like. All this in a very safe place with emercency assistance seconds away.
That was certainly the case for me and many others I have spoken too.
Birthing pools, soft dimly lit, comfortable, gentle surroundings,- nothing like the cold sharp steel experience we are warned about.

It becomes a self fulfilling prophecy- the more bad press about how hospital births are horrible stressfull experiences then the more women will be stressed.

I had my third at home, 15 mins from hospital. Statistically a midwife said thirds could be unpredictable but I don't know if she was trying to dissuade me. It went fine.

It's up to you and partner.

Blueberry - those risks are real and common and almost never acknowledged in common debate.

I am acknowledging them.

I believe in informed choice.

Bigblue -- most women who give birth at home have previously given birth in hospital.

well said bigblue

mini, so my back to back, stuck baby might have come out just fine and unassisted at home then? Hmmmm

Hospitals are full of good people who care deeply for mothers and babies.

But opting for it as a setting for birth increases the chance of your labour becoming complicated.

That's all.

Doesn't mean it's a bad or wrong choice. And there are some great birth centres within hospitals which have better outcomes than obstetric units.

In my case, I had planned a MLU birth due wanting an intervention-free birth, ideally in water, but I had a small bleed shortly after admission and before any interventions had happened. Was then moved to CLU as per the policy and prevented from using the birthing pool as I had hoped to. It is true to say that some (many) women have intervention-free births in hospital btw.

Inconceivable - you can't know, none of us can.

And you know, I've not made a case that all labours can and should be started or completed at home.

Home birth is safe in the uk because it is part of a system of maternity care where obstetric input is available when needed.

I forget who argued that a home birth is just about mothers' comfort but, for me anyway, they were plain wrong.

I'm scared of hospitals, I panic. This is not conducive to a good (ie probl free) birth. I was thinking about best outcome for me and my baby.

Inconceivable -- the MAJORITY of UK births now involve one or more interventions.

One large hospital near me has the following stats:
32% induction of labour
33% Caesarean section
17% assisted delivery.

Just curious mini, do you how many of the C sections are planned / elective? And what's the transfer-to-hospital rate for births that are planned initially for home?