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.

Implying that women are having them frivolously seems insensitive to me.

My first pregnancy was completely uneventful and trouble free. Not so my labour, when an unexpected turn of events meant I ended up in theatre. Good job I was in hospital or the outcome might have been very different for both me and the baby. I became labelled high risk as a result.

That experience has led me to conclude that all first births should be in hospital. But I respect those who disagree. OP I hope your debrief is helpful for you.

Owlina I don't think people are saying "unnecessary" C-sections were chosen by the mother. Rather, that in some situations, certain things happen or various professionals intervene in certain ways which then MAKE a C-section necessary... but had those things not happened, the C-section would not be necessary. I hope that makes sense. So for example, a mother going into hospital, who is given routine monitoring, and confined to a bed, this could slow her labour, she is then deemed to not be progressing, baby gets distressed and she is given a C-section. At that point the C-section is necessary, of course. But had she had different care to begin with, it may not have been. That, to me, is a reflection on our maternity services... not the birthing mother, at all.

If statistically low risk mothers are slightly safer giving birth at home, then surely we could argue that those mothers are being selfish and irresponsible if they choose to go into hospital?

The two mothers I know who had home births did so by accident, with no problems other than shock!

As others have advised, there's research that shows that home births are not as risky as many people think. In some countries (and not just developing ones, I think they Netherlands is one) the % of home births is much higher than it is here but the mortality rate is not higher. Maybe it'd help if you read up on some independent peer-reviewed literature?

Well its true that opting for a bospital birth is taking the increased risk of an unplanned c section, but how that means women are having them frivolously is beyond me. Unplanned = medical decision not personal decision

its not women who are to blame for unncessary sections, but arbitrary rules that govern how long stages of labour are 'allowed' to be before interventions happen. my first labour was over 50 hours long. had i been in a hospital, chances are i'd have ended up with a section that was wholly unncessary because the rules dictate you must dilate at a certain pace. its not about blaming monthers. but the system.

Curly I agree that often C Sections happen as a result of the "care" given in hospital. The ladder of intervention.

More midwives doing their literal job of being "with woman" instead of having to watch a bank of monitors would probably lead to a lowering of "emergency" sections. I am damn sure that no woman trained to be a midwife in order to try and care for many women at a time, leaving them all on their own for extended periods when they need to have someone with them.

One of the main themes on this thread from the HBers is the fact that they had midwives with them alll the time that they needed them, not when the MW concerned could grab a second to check the trace and then had to dash out as another woman was delivering.

The level of maternity care in hospitals was one of the main reasons I chose HB for DC6, it was the only way I could be sure of actually receiving any care at all.

I felt a LOT safer at my home birth, with my own midwife the whole time, than I did in hospital where I was mostly left alone.

Sorry you had a traumatic experience OP

"but how that means women are having them frivolously is beyond me"

Um, nobody is suggesting women are having emergency (or any other) c-sections 'frivolously' so I'm not sure who that comment is directed at.

If statistically low risk mothers are slightly safer giving birth at home, then surely we could argue that those mothers are being selfish and irresponsible if they choose to go into hospital?

I guess you could yes.

But the issue isnt where is safest so much as the perception of HB being inherently more risky than hospital, despite the evidence showing that it isnt.

Its about respecting choices. I respect anyones choice to birth in hospital, or to choose a C Section and I except my decision to birth at home to be respected to, and yet somehow that rarely happens.

In the late 60's and early 70's there was an official push to get all births to happen in hospitals because it was (wrongly) believed that the massive drop in maternal and natal deaths was due to the increase in women having their babies in hospital when it became free under the NHS. In fact it was due to the introduction of antibiotics, the decriminalisation of abortion, the use of contraception to limit family size and better prenatal care. This campaign demonised home birth, on the basis of no evidence whatsoever and we are still dealing with that attitude today.

arrgh typos!

Expect
Too

Yabu for thinking I was being irresponsible for having home births. Obviously your experiences have led you to believe labour and birth is unsafe, but I researched and read so much about birth and took advice from my midwives and made a descion that was right for me and my family. Without knowing what the circumstances of your labour were, it's hard to comment, but were the issues picked up during labour? Was their a low heart beat? Less movements? My mw were really strict that if their were complications in a home birth an ambulance would be called to transfer to hospital.
My first birth, in hospital was far from perfect, I had a cascade of intervention that started when labour slowed right down on the drive in to hospital. I didn't have a midwife with me through my labour, they were severely short staffed and I was left alone for much of it. Ive researched and spoken to midwives and some of the issues I had would have been avoided had i had a home birth. (Slow, irregular contractions meant I was put on a drip, meaning I couldn't move, had pethidine, (which meant baby wouldn't feed as too sleepy)I tore badly and had a pph).
My home births were so different and I feel very positive about them, especially dc2, who if a hospital birth had been planned would probably have been born unassisted, on the side of the road as it was quite a quick labour.

I am truly glad that your baby was able to get the medical care he needed at birth and I hope you are able to get some closure from your meeting at the hospital and can move forward.

I had hbs. Dd2 was back to back. My dh sent the midwife flowers, she sent back a card saying it was a pleasure and privilege to have been at dd2 birth. I had ds at home too. I like having babies at home. It hasn't impacted on our health.

For those who think home births are irresponsible, what would you have women with a history of unexpected fast labours plan to do?

If I go into labour at home with 2 small DCs I've got to get someone over to watch the kids, and then get to hospital.

I've planned a home birth because I fear giving birth alone. I might do anyway. When the midwife came over for her 36 week visit she told me not to dial 999, but to ring the delivery suite, they will have me on file as home birth they will dispatch a midwife, and ambulance if necessary. Midwife told me not all ambulances will have proper trained paramedics who have adequate training beyond the basics and they will be glad a midwife is on the way.

I spoke to my paramedic friend who has had to deal with emergency unplanned home births, she said she was glad that every time she got there the baby had already arrived and she would be so relieved she didn't have to deliver.

If things are slow enough this time round I will happily go into the MLU but I'm not taking any chances by not planning a home birth. I nearly had both my other children in the car or in triage, I refuse to give birth in a car in the depths of winter!

Every circumstance is different. Hospitals are not always safe. There is risk in all ways of birth, you just get to choose which risks you take.

I think you are perhaps very shocked. YABVU to berate other people's choices.

i think home births are irresponsible. People should have personal freedom to take risks, but not with the health of the baby.

How is it anymore irresponsible to risk the health of your baby at home with one-to-one care than in a hospital that a pregnant woman knows is woefully understaffed?

We all have to try and manage the risks we bring to our children's lives. Perhaps instead of throwing words like irresponsible and crazy around about other women folks should save their horror for the fact that a lot of women don't have a real choice about where to give birth because of the appalling management of maternity services.

You didn't make a wonderfully superior decision that makes you a cleverer person or a better mother - you just happen to live in an area where the maternity provision gives you an actual choice.

Why the vitriol? Mumsnet should be a place where everyone is supported whatever their birth choices. The op has the right to her opinion, but she does not have the right to insult others who make different choices.

Clearly the op is struggling to come to terms with her traumatic birth experience. Would she benefit from a birth debrief with a trained counsellor. When I had post natal depression I used to get irrationally angry with those who had made different choices to me. It sucked the joy out of life. I hope the op is not suffering from postnatal depression.

Statistically homebirth is shown to be as safe as a hospital for second mothers who are low risk. There are certainly better outcomes for the mother and the outcomes for the baby are good as well. The biggest risk of homebirth is a prolapsed cord. However a prolapsed cord is often fatal in a hospital. One to one midwifery care means that other problems are picked up faster. A prolapsed cord is usually caused by mal presentation. Midwives pick this up before the prolapsed cord happens. Sometimes hospital care causes a cascade of intervention.

Half of home births are unplanned.

How exactly is the data on the safety of HBs compared to Hospital births compiled?

I have wondered for a long time if it could be flawed - correlation does not equal causation, and I wonder if the data takes in to account that those choosing home births are more likely to be low risk pregnancies / second pregnancies? Also, I'm not sure looking at data from abroad (even if another similar European country) is valid as there are too many differences.

I'd like to point out as well that having fewer interventions is not necessarily a good thing! If for example, fewer women who have home births have a specific kind of intervention I would not necessarily take this as an indicator that home births 'go smoother', but perhaps that the women were not offered the intervention by the midwife as it is too high risk to do at home (for example, epidural which requires an anaesthetist) or that the woman was given the option of not having that intervention or of going to the hospital to have it and decided to stay at home and do without.

I have often wondered if the data could be propaganda to encourage women to stay at home to put less pressure on the NHS? However I don't know enough about this issue to be sure and would love some more info!?

OP, YANBU to feel the way you feel and as you acknowledge, you definitely need a debrief and possibly counselling to move past these thoughts and feelings. I do disagree that mothers are irresponsible for having a HB.
Unusually, I am an experienced NICU nurse who has planned HBs (didn't happen but that's another story!). I see what happens when things don't go to plan and the devastation that it creates. However I did my own research and felt that home was safest for me and I felt comfortable with any potential risks.
99% of the babies I see are born in hospital (mainly as they are prem and anticipated and that most term babies are born in hospital). I have seen mother's have full monitoring whose babies are born really sick and die. Similarly I have seen low risk mothers on the attached midwifery led unit go through similar. Being in hospital didn't change the outcomes, in spite of full medical and nursing teams and the latest technology. However, if these women would have been at home, many would blame them for the outcomes.
In an earlier post, you mention that you had reduced movement but as the ctg was OK they didn't act. Unfortunately this is an example of medics looking and trusting machines rather than the mother - something that can't really happen in a HB as the only machinery the MW has is a handheld sonicaid and as they can provide one to one care, they can fully get to know, observe and monitor the mother for any adverse signs (something that they would love to be able to do in hospital but often can't due to staffing and the sheer number of births). This is a reason why some women feel safer at home.
Unfortunately, babies can and do die in either home or hospital settings. Neither mothers should be judged for their birth choices.

"I have wondered for a long time if it could be flawed - those choosing home births are more likely to be low risk pregnancies / second pregnancies"

The BirthPlace study 2011 (on which the current NICE recommendations on place of birth are based) compared outcomes for healthy, low risk women by parity. In particular they were assessed for risk status at the start of labour so the data can control for previously low risk women who were included in the hospital arm of the trial because they were presenting with complications at the start of labour.

Id like to point out as well that having fewer interventions is not necessarily a good thing!

The view that hospital birth is associated with an excess of intervention in healthy women without improvements in neonatal outcomes doesn't imply that ALL interventions are avoidable, does it?

It's quite wearisome having to point that out in discussions about place of birth, but someone WILL always come along with this strawman 'let's state the bleeding obvious' argument.

Thanks mini I'll go and read the study.

I love the idea of HB. My friend has had 3 of her 4 children at home and everything was fine and sounded lovely.

Me personally, I wouldn't opt for homebirth. I have textbook pregnancies and normal labours until about 8cm. All 3 of my children they have gone into distress in labour after 8cm and the heart rate has decelerated. DS1 was born by crash section (failed epidural, failed ventouse, failed forceps - no pain relief, not even gas and air. Only a general anaesthetic) and then I had a huge bleed in the operating table resulting in a blood transfusion and narrowly escaping a hysterectomy at 20yrs old. Luckily I was already at the major hospital as there were no beds available at the MW unit I had been booked to. DS spent some time in NICU for low blood sugar, jaundice etc.

DD1, all went fine and I had a VBAC (at hospital). Her heart rate did decelerate at the very end, I know and alarm went off but the Midwife seemed to force her hands down at the top of my bump and DD shot out breathing and not needing resus or NICU.

I assumed all would be ok for DS2. Text book pregnancy, text book labour however the contractions were weak yet literally on top of each other. Got to 6cm when it was spotted he was in distress and his heart rate was dipping. No real reason, I was calm, I was stood up and active, not lead flat. The midwife appeared to check on me, she summoned another and explained what was happening. They hit an alarm, the cot sides went up on my bed and they ran down the hallway with me to the theatre. I had another general anaesthetic (no time to perform a spinal) and DS2 was born. He was fine.

There is no medical reason for my children going into distress in labour. I'm not phased by hospitals and although overweight I have no medical issues which would indicate a homebirth is not a good idea. I'm fully supportive of anyone that wants a homebirth but I don't think anyone can say that they know it's the best option for them.

Sorry, that was rude.