To wince at people who have homebirths?

[TheCatsMeow]

I never used to, I used to say that everyone should have the birth they want and mean it. But my birth went wrong and I ended up with a baby who would have died had it not been for NICU. If we had been at home, he wouldn't have survived and I may not have.

Every time I hear someone say they want a homebirth my head screams "YOU'RE BEING IRRESPONSIBLE". I get visions of myself and my son lying dead. It frightens me and every time I see a woman who is pregnant I think "I hope they both survive". I don't say any of this unless someone asks and then I just say that I ended up with complications so was greatful to not be at home.

But I feel like people are risking themselves and their babies and it makes me uncomfortable. I think IABU but don't know how to deal with my feelings on this. Please don't be harsh.

Surely if there is an intervention it's because it's actually needed?

As others say - protocol driven management for one. I also think pressure on the labour wards leads to speeding things up where they can e.g. diagnosing 'failure to progress' sooner rather than later or an injection for the placenta rather than waiting for a physiological third stage. It would be hard to prove except that two different hospitals with much the same demographic can have widely differing intervention rates. Then there is the Place of Birth study which matched the demographic intakes of home/MLU/CLU and found that there were more interventions in the CLUs. The easy answers that 'CLU's get all the high risk cases', or 'transfers to hospital get recorded as hospital births' (they don't) were accounted for with the Place of Birth study because it dealt with low-risk births, matched as far as possible on a like for like basis.

I would just be curious to know whether those women who say they prefer to be in hospital 'in case it goes wrong', etc. have more interventions than others? I wonder if that piece of research has been done?

Re labour rooms without windows - I felt the same. It's hard to describe but being able to look out of the window, where the view overlooked gardens, enabled me to keep calm in what turned out to be a rapid home birth. For my first birth, I very much felt incarcerated in a windowless box with strip lighting, and no, a splash of pretty wallpaper on one wall did not make it 'like home'. Nor did I have people barging in and out of my bedroom for my second birth either.

Peregrina, you're right that it could have something to do with the mindset and expectations of the mother in a hospital birth vs a home birth.

Why are interventions seen as negative? If it makes labour quicker and easier why not!

Here's an example, Peregrina:

For DC1 I was induced for PROM at term (PROM at 40+4, induction at 40+5, birth at 40+6). The hospital's policy was to induce within 24h of PROM if labour was not already established, on the grounds that 90% of labours are established within 24h of membrane rupture.

The policy of the HB team (DC3) was to recommend induction as standard only after 72h from PROM, based on the balance of risk to mother and baby of induction itself v infection risk.

Two evidence-based policies, two different conclusions. My induction was gruelling and I can't help wondering if we would actually have got there on our own if we had been given another couple of days, given how easily I birthed DC2 and DC3 after natural labours.

If it makes labour quicker and easier

Because that's a big if! I crossed posts with you to show that my intervention, although medically indicated, almost certainly made the labour far, far harder and contributed to a PPH and knock-on effects on bf etc.

When I was reading 100s of birth stories the worst, nightmare ones pretty much always involved having to be induced. Something about the unnaturalness of it causing uncontrollable and unmanageable levels of pain.

MrsHathaway its different for everyone I suppose but my intervention (spinal and cesarean) was "easier" and I don't think I'd like it to be viewed as something negative

But you're right sometimes they make things worse

I had a home birth for my first baby and would definitely recommend it to others. It was a wonderful experience and I actually enjoyed giving birth. With respect the number of people on these threads who say they/ the baby would have died had they had them at home does not reflect reality. Or if it does there must be an equal number who are in the opposite position (so baby would have lived if they'd been at home) - otherwise we'd expect to see much higher numbers of dead babies at home births.

Because interventions don't make labour quicker and easier, quicker maybe but more painful ie drip to speed up contractions and episiotomy or forceps etc result in more pain and stitches etc.

I have been offered c sections and had to send away Dr's (with midwife backing) who wanted me flat on my bsck monitored etc for no real reason. In all cases yes I was overdue but laboured fine, baby was fine and I think by remaining upright and mobile I was able to deliver my big babies Easily with no intervention. Had I listened to Dr's I would have had a X section for ds1 just because of my spd and with no 5 they thought I would need a c section as they wrongly thought she was big. Ignoring the fact thst I delivered a 10lb 13oz baby in birth pool previously they wanted me to have a section as they thought baby was 9lb...

I have had good hospital births but I had to be bolshy and stand up for myself and luckily in some cases had midwives who also did the same, had I followed Dr's advice I don't think my births would have gone as smoothly at all. But many many women won't be bolshy or feel they can stand up to Dr's advice. Tbh why should I have had to battle to remain mobile etc. None of what they recommended was based on best practise or evidence but it likely would have led to increased intervention and a worse birth for me.

Why are interventions seen as negative?
It depends on how necessary they are. If they turn what could have been a straightforward birth into say one with forceps/EMCS without any benefit to the baby, can it be said that it has made labour easier, and this is ignoring the risks associated with instrumental/EMCS births? Is a quick birth on a drip better than a slower labour where mother and baby are both observed to be fine?

I had forceps with my first - could it have been avoided? I would have said, that we could never tell, until the 'Place of Birth' study reported and said that MLUs/homebirths had significantly fewer interventions, so I suspect the answer might well have been 'yes, it could have been avoided, or been much less likely', especially since the labour ward was heaving when I had my first birth, and the birth was very much clock driven.

I can't recommend home water births more highly either, especially as the latest birthpools are inflatable and can double up as a high sided paddling pool

It's different for everyone I suppose but my intervention (spinal and cesarean) was "easier" and I don't think I'd like it to be viewed as something negative

Certainly. It's neither necessarily negative nor necessarily positive.

The survival rates of mothers and babies have improved vastly with each innovation in intervention.

But every intervention comes with risks (eg wound infection, nerve damage, increased pain, etc) just as every refused intervention comes with risks. Assessing where the balance of risk lies is by no means scientific.

The survival rates of mothers and babies have improved vastly with each innovation in intervention.

Is that necessarily so? For just one example, EMCSs are much safer now, and numbers done have rocketed over the past 20 years, yet I believe that it hasn't made a significant difference to the stillbirth rates.

Peregrina

It depends on your point of view. I think I'd rather have the drip and get it over with than a natural but longer labour BUT I find the whole process terrifying so that colours my view. To me it's not an experience in itself it's something necessary and unpleasant and so anything that can get it over with quicker is positive in my book

I understand not everyone feels this way and I was terrified of forceps so again understand that

The survival rates of mothers and babies have improved vastly with each innovation in intervention.

Is that necessarily so? For just one example, EMCSs are much safer now, and numbers done have rocketed over the past 20 years, yet I believe that it hasn't made a significant difference to the stillbirth rates.

I was thinking longer term, tbh. Limited introduction of forceps about 450 years ago and more widely about 150 years ago; epidural in the 1940s onwards; intrauterine imaging; etc. Major rather than incremental innovation.

Kitty I think that's the thing it's hard to know what you would do naturally unless you know you can't give birth naturally or something.

CatsMeow - you say it depends on your point of view and I think you highlight something important there. How the woman herself feels does matter - we are not just bits of machinery carrying a baby. You might be comfortable with the idea of a CS, for another it's her worst nightmare.

How the woman herself feels does matter - we are not just bits of machinery carrying a baby.

I totally agree with that. I think to me it's alien to feel safer by doing it at home

I think where a women feels safe is more important than many women realise. The whole point of giving birth at home is that it's a familiar place with familiar smells and sounds and people. It's a place we usually think of as safe. It's this feeling that allows the hormones that are released in labour to do their job. If you don't feel safe at home then they won't do their job as effectively - your body doesn't want to birth a vulnerable baby in a place that isn't safe. I think it's important to raise awareness of the facts around home birth but if a woman feels safer in hospital then that is where she should be IMO.

My first was a home birth. It was very long. Had I been in a hospital they would have wanted to use a synto drip, or break my waters. As it was none of those things were needed as I was fine, baby was fine, it just took its time.
I chose to have my children at home because of a hospital phobia after awful care following a miscarriage when I was young. The staff were judgemental and one nurse told me I was a 'silly little girl' when I begged for help as I was bleeding so heavily. I ended up needing a blood transfusion and stitches in my head after passing out. It was awful.
So for me hospitals hold bad memories and stressed out and anxious are not conducive to a good birth.

When I had my second baby we transferred in after the birth as he was small and grunty. One night on the post natal ward was enough to convince me I was better off at home.

Yes it's very much about how the woman feels

I have had five straightforward vaginal deliveries. Am now 28wks with Dc6 and may need a c section due to placenta previa, really hoping it's moved, have a scan next week...

If I need a c section for a safe delivery fine but I would really rather avoid major surgery. I have a friend who almost died due to c section. As I said I have been offered c sections for two of my others but it was my worst nightmare. Though my births wrre painful and ds1's was a three day drawn out affair the others were all positive. I was on a natural high each time afterwards. I recovered quickly ie home within hours of birth and have had no long term issues.

Tbh I an also nervous of giving birth vaginally again as you have no guarantees with birth but I know I have done it before and so chances are it will be straightforward if my placenta has moved. The thought of a section is scary and the recovery after is an unknown to me. I am researching and so if I need one I will be mentally prepared but it's not what I would choose. I would choose a nice easy pool birth t home or at local mlu. With a good helping of gas and air!