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.

I've recalled that labour tends to slow when a labouring woman reaches hospital. The "intervention" of arriving at hospital makes things slower, not quicker or easier.

In evolutionary terms hospital delivery is the blink of an eye. Even if we on this thread were born in hospital, chances are our mothers or certainly our grandmothers weren't. Although we have been nurtured to expect to deliver in hospital, our genetic makeup hasn't.

I haven't got past page one but I think people replying are really patronising. I had a really traumatic birth with DC1 of 3, 11 years ago, and absolutely totally agree with you. I've worked through my trauma but still think people having home births are irresponsible. I would never ever say it to them but once you know what you know (about how birth can unexpectedly go wrong) you simply do have a different perspective. YANBU. AT ALL.

If you were telling everyone you knew not to have a home birth it might be different, but you are within your rights to think what you like.

Was yours a home birth mrsplum? If not, I suggest you find time to read the whole thread.

I was booked for a home birth with DC3. Didn't happen because labour began prematurely.

But, during the planning period, I asked MW about 'what if anything goes wrong' during the birth and she said

(a) You live 10 mins drive from the hospital. In an emergency situation we would ring ahead and they would get a surgery room ready for you while you're en route. It would take that long to get the room ready anyway, so you wouldn't lose any time.

(b) It's very rare for things to go catastrophically wrong with no notice whatsoever. There are warning signs ahead of time. At a home birth, there are two midwives concentrating on you the whole time (unlike during a hospital birth) and we are looking out for any of those signs. We are also very conservative during a home birth i.e. we would send you to hospital as soon as there was even a possibility of trouble ahead, rather than waiting and seeing (which is why a lot of home births do transfer to hospital).

So I felt secure with my decision. And not irresponsible.

The only person being patronising is the person who couldn't be arsed to read the whole thread but still thinks that everyone else has to hear their opinion because they are so much more enlightened than the rest of us.

It is not irresponsible to give birth in the place you feel safest, whether that is in hospital or at home.

Home birth isn't right for everyone, but it isn't wrong for everyone either.

I've now read the whole thread and my opinion is even more strong. So perhaps now I'm no longer patronising. What was patronising were the posters who indicated the op needed to deal with her trauma before thinking she could have an opinion on the topic. Mostly posters who had no experience of a birth going wrong in any way (and therefore totally naive).

In my view when there are hospitals available it is not sensible to just decide not to use them. It puts added pressure on services to support a woman in labour, especially if a transfer is needed. More importantly is that it places the baby at a higher risk of harm, when there is not immediate access to back up resources; there is a very modern view about childbirth that puts the focus on the mothers experience rather than actually simply delivering a healthy life. Yes women did deliver babies at home years ago but deaths were far more common and they had no option of a hospital, access to doctors etc.

I did not have a home birth, thank goodness as it would have involved a very uncomfortable transfer to hospital (but in my case probably unlikely to be death of me or my dc as I lived only ten mins away). My second 2 were elcs so it obviously wasn't an option.

msrplum2015, congratulations! In just a single paragraph (your middle one) you have managed to contradict years of evidence-based research carried out by people who have massive experience in home births, hospital births, emergencies and things "going wrong" in labour.

Enjoy your opinion, but please consider that it is based in an amazing amount of self-inflicted ignorance.

I have had 2 hospital births and a home birth. 1st and 3rd hospital, 2nd elective home birth. My first was a difficult birth, and an awful experience for me. Baby presented spine to spine but this was not detected until she crowned, resulted in a protracted and excruciating labour and delivery, forceps delivery, both baby and I were very distressed, resulting in a long hospital stay post birth. I trusted the doctors and midwives to give me the very best advice and care but felt at the time and on reflection that I was just another one on the conveyor.

I swore I wouldn't have my second in hospital. Elective home birth. I listened to my own body and communicated with my midwife (who was excellent btw) what was happening throughout the labour. The delivery was not without difficulty (shoulder dystocia) but baby was safely delivered and the experience was far calmer, more natural. Had I been in hospital I have no doubt that much greater intervention would have been used, which in the event we managed without.

My babies are big and third was induced in hospital. Uneventful birth, and we were out of there in less than two hours after delivery.

I do think YABU OP. you have had a difficult experience but you cannot project that onto others, or judge them for holding different views. I chose an elective home birth because I had an awful hospital experience. You would never choose a home birth because you had a frightening delivery. Each to their own.

@aurynne you are comparing apples and oranges. Statistically the risk of having a healthy baby at home or hospital is the same (remember only for a second or subsequent uncomplicated pregnancy and it's more dangerous Statistically for a first baby).

What I'm talking about is the unforseen immediately dangerous circumstance which requires a crash section or immediate intervention. Totally rare but agree with the previous poster near the start of the thread who said that women opting for a hb do have a confidence that those things won't go wrong for them. Doesn't matter to me if it's a 5 in 1000 chance its still not worth the risk.

Intervention one - induction at 36 weeks
Two - second pessary after first failed
Three - drip after pessary failed
Four - prone in bed on back being permanently monitored
Five - no sleep, lots of stress, unnatural environment
Six - c section due to failed induction

All uneccssary, all avoidable. Intervention begets intervention.

"Doesn't matter to me if it's a 5 in 1000 chance its still not worth the risk."

Considering you have a similar chance of having a traffic accident or been killed in a home mishap, I expect you to live in a hospital permanently.

But that's the thing, there's a viable alternative to hb that is free and not particularly more difficult in most cases. There isn't a sensible viable alternative for me to travelling around by car so I am happy to take that risk. However I am quite conscious of what car I would let my dc travel in and who will drive them. I have already begun to educate them about who it may not be safe to travel with as they get older and more independent and reassure that I would always pick them up or pay for a taxi if they felt their planned mode of transport was too risky.

Anyway the fact that you've resorted to such a ridiculous argument shows that there is no right or wrong answer. You, however, are entitled to your opinion as the op is entitled to hers. She has at no time suggested she would share her views with mum's planning a hb and nor would I. Doesn't mean I'm wrong to have the view.

"Anyway the fact that you've resorted to such a ridiculous argument shows that there is no right or wrong answer."

You only consider it a ridiculous argument because you have a biased opinion of home birth risk which is not supported by evidence. Hospital birth is not "a viable alternative" to home birth. It is one of the options women have to deliver their babies, and for a normal pregnancy it is a safe one, and not riskier than hospital birth.

"However I am quite conscious of what car I would let my dc travel in and who will drive them. I have already begun to educate them about who it may not be safe to travel with as they get older and more independent and reassure that I would always pick them up or pay for a taxi if they felt their planned mode of transport was too risky." --> this is very similar to the risk assessment many women perform in order to choose where to give birth. For many of them, the safest decision after their evaluation is a home birth. For others, it is a hospital birth.

None of the previously exposed is "my opinion on home birth", but the current scientific and medical consensus. If you want my personal opinion, here it goes: home birth is a perfectly reasonable option for mums who feel safe birthing at home and have had normal pregnancies, and have well-trained midwives available to facilitate the birth.

The main difference between your opinion and mine is that I am both a scientist and a midwife, who also happens to facilitate both home and hospital births. Of course this does not invalidate your opinion, but does give my opinion the strength and support of research and professional experience. If you want to keep calling it "ridiculous", you may need to re-evaluate your own opinions and back them up with a bit more than that.

Doesn't matter to me if it's a 5 in 1000 chance its still not worth the risk

So, why do you think the overal rate of risk to babies for second births is the same?

FWIW I had my first at home too. This is because after reading the studies I noted that they didn't control for distance from hospital (I am very close) or experience of midwife team (mine was a dedicated hb team). Plus I don't like hospitals at all so thought that, plus journey, was likely to impede labour.

So even within the research you need to consider your own circs and evaluate accordingly.

@aurynne - the ridiculous part of your argument was likening choosing to avoid the risk of a hb to choosing to avoid the risk of travelling in a car. Totally different levels of risk vs reward.

I'm not calling your overall argument ridiculous - it was very clear from my previous post. And if you read it, I actually said that there are very strong arguments to suggest both points of view are valid so to write mine off as uninformed is uneducated at best.

My view remains the same and is based on the fact that, in the case of an unexpected issue, such as a pp haemorrage, or other need for an absolute emergency response such as crash section, a woman would be safer in hospital. Rare as that is, it's not worth taking the risk when there is a valid alternative in my mind. And the fact that in some of these cases (at least 2 reports on here from women who have experienced them) these events follow a perfectly normal first birth, and are not foreseeable, mean that I think it is irresponsible for anyone to take that risk.

It's the same as I chose to drink a glass of wine once a week during my second and third pregnancies despite the fact that the NHS guidance had changed to say don't drink at all (the guidance said it was fine to drink one or two units once or twice a week during my first pregnancy). Many would consider me irresponsible for not avoiding that risk and I wouldn't disagree with them. I still chose to do it and it was a considered risk but it would have been better to have no alcohol at all.

It may be the case that a women would be safer in hospital but there may be a lot of cases where the outcome would have been better at home too.

The studies are pretty large, and I think large enough to include incidences of exactly the type of scenarios you highlight. Yet still the outcomes are overall the same.

So, including evaluating my own circs I maintain that I was not irresponsible to give birth at home.

Out of interest, would you call the mother of a baby born at hospital who acquired a hospital related infection irresponsible?

Sorry, my first para should read 'may be the case that the women and baby may be safer in some of the scenarios you mention'

@binkybix Like I said, the overall stats aren't what I'm basing my argument on (because they are the same). I just think it's not sensible to take the riskier option when you do not know what unforseen circumstances are going to arise such as the highly rare case of a serious need for immediate medical resources that aren't available at home.

I'm sure you personally researched it really carefully, and took into account many other factors, such as the distance to hospital. Many other women have cited being too far from the hospital to be a good reason for home birth. I have friends who have home birthed and I wouldn't dream of sharing my views with them - they would have no idea. But to say I (or the OP) is wrong for having a view is not appropriate in my opinion. When you have personally experienced a birth that very quickly got out of hand with a baby in distress (such as my first) - it does affect that viewpoint whether you accept it or not - and I never intimated my baby would have died if I'd been at home but I don't see why I would have needed to even get close to that risk.

I also think it's all well and good for midwives to support home birth. They may well be good midwives and their view based on their own practice. There was a lady in my local community who died after a birth at home due a midwife's negligence. I'm sure it also happens in hospitals but there are more safeguards and more layers of professionals, more equipment etc.

Anyway, like I say we could argue back and forwards forever - I have my view and you have yours. I'm sure some people on this thread would (and have admitted that they do) believe that women who birth in hospitals are irresponsible. Like I say, I do many things others would see as irresponsible (drinking wine in pregnancy, only using a rear facing car seat for the first 12 months) but it doesn't really bother me if I have evaluated the risk myself and made the decision accordingly.

But there isn't a riskier option if the stats are the same, if you assume the stats incorporate some of the births that go rapidly wrong which I think they do given the numbers involved. Or rather there is no way of really knowing beforehand which is the riskier option for any individual (for low risk pregnancies) so I don't really see the logic of thinking other people are irresponsible.

Of course you are entitled to your view and your choice of where to give birth. And you know how you feel about each setting, so it may well be irresponsible for you to choose a home birth if you fear them.

What about the infection scenario?

Mrsplum, what riskier option? Are you being deliberately obtuse?

You are wnttled to your opinion but you are ignoring the evidence.

"I just think it's not sensible to take the riskier option"

The evidence doesn't support your belief that out of hospital births are less safe.

Yes it is true that a massive placental abrupt ion or a cord prolapse is likely to have a worse outcome if it occurs in an out of hospital setting (including a free standing birth centre). The fact then that outcomes are NOT worse for these settings suggests that some poor outcomes are more likely in hospital.

When things go wrong, I'm sure that no midwife goes home afterwards and thinks "oh dear, just another day at the office", wherever the birth takes place.

If home births (that have been planned after taking into account all relevant facilities and information) were genuinely more likely to increase the chance of something going wrong, I really don't think midwives would be voluntarily attending them.

In my hospital birth, my third stage lasted over 3 hours. I was left with a student MW (who was lovely) whilst I waited to go to theatre because there were two theatres both with emergencies in.

Luckily I was ok and by the time another MW was available to come and see me a good tug stopped me from needing theatre. Minimal blood loss which just required an extra night in hospital and a course of iron tablets. It was really fucking uncomfortable though.

I know that if something had started to go really wrong that the care would have been there. I don't know what would have happened, what with there being no available theatres and seemingly not many MWs but it would not have happened at home. And it didn't. When I discussed this issue with my MW prior to my home birth we both agreed that it was not something that would occur at home, and if there was any trouble with my placenta I would be in hospital and in theatre much quicker than 3 hours.

It was busy. I don't blame the MWs for what happened but my care was not as good as it should have been in hospital. I didn't want to risk having inadequate care in hospital so I chose to have a home birth.

Anyway, my point above still stands. mrsplum - if you feel safer in hospital due to your previous experiences then that is the right lace for you to give birth. You admit that your opinion is affected by your own personal experiences, in the exact same way that those of us who have chosen home births did so because of our personal experiences. And because we feel safer at home, our births are safer. You would not feel safe in a home birth (total assumption, sorry) therefore it is not the safest option for you.