To go against DH and labour how I want?

[ListenToYourself]

DH is dead against me having a home birth and shuts the topic down very quickly.

He doesn’t want me to have one and thinks it’s just too dangerous as the hospital is 30 minute drive away anyway.

It’s what I really want. I would feel so much better labouring in my own home, preferably in a pool, which MW has said I’m guaranteed to have access to, unlike the birthing centre where they may not be one available.

DH isn’t keen on the birthing in water idea either, even in a hospital. And says “but if you really must”.

I can’t really afford to rent one out on the off chance the birthing centre don’t have one available.

I’m willing to go into hospital at the first sign of trouble, no issues there at all. At least I got what I wanted - to try a home birth.

But it’s not practical, apparently. And he says even though I am the one in labour, how he feels counts too, since he’s my birthing partner and I don’t want anyone else there.

I agree how he feels does count too, but he won’t even listen to my MW who agrees that it is safe and it isn’t a big risk.

He just feels too anxious about it.

Where do I go from here, since he just won’t listen?

I would feel just so much more relaxed knowing I can try a home birth. I would love to

And on a less mardy note (sorry bertie) does anyone know what a planned hospital birth that doesn’t make it into the hospital is classed as in the studies? It is it so rare that it doesn’t often make it in?

My friend ended up delivering her own baby in the back seat of a car whilst stuck in traffic!

And that probably would have been me (except for it would have been a bus) if I’d not opted for home birth of my second.

If your dh isn't comfortable it is unfair he is the only one there. That's a huge pressure.

The rest of course is your choice. But I would pay a lot of attention to my partners opinion as it important to him too and it won't be more relaxed if he is freaking out.

"he is the only one there"? You do know that midwives attend home births, right?!

I'm sick of poorly executed studies being used to justify the most dangerous part of a child's life being reduced to a fulfilling maternal experience.

The 2011 Place of Birth study, was pretty rigorous as far as I recall, and didn't reduce it to fulfilling maternal experiences. It did point out that the mother was less likely to need drugs and other interventions, which in turn could have a bearing on her own physical and mental health. Far from being 'the only thing which matters is the baby', the mother's physical and mental health does matter, and matters very much.

It's a long time ago now for me, but as one who had what amounted to hospital phobia, (particularly the high tech one which I thought erroneously, was the only option available), telling me how good it was when this that or the other went wrong reinforced the phobia rather than allayed any fears.

bertiesgal and binkybix

To settle your argument, it's worthwhile reading the evidence. There's no shortage of it re perinatal morbidity and mortality in home births vs hospital births in low risk pregnancies.

I highlight low risk, because that's key. In this group, the largest study to date on the subject (the Dutch study of nearly 530k women - de Jonge et al, BJOG 2009) shows no difference between the two groups.

Previous studies (Australian, North American, UK ones) have demonstrated a superiority in the hospital group but the fatal weaknesses were not identifying 'low risk' women appropriately for home births. So these studies often had women with breech deliveries and even bearing twins in their 'home' group, and these are obviously high risk women. The difference in the Dutch study was a highly accurate stratification of women into low risk and high risk groups because of the particularly medical way in which Dutch midwives operate.

I don't know if OP is low risk or high risk. Only her obstetrician knows that. What I do know is that a woman can very quickly go from low to high risk for a number of reasons in a very short space of time. Which is why we stuck with a hospital birth for our child, and will be doing the same with the second.

True, it increases the risk of medical intervention in hospital but as a medical couple who've both read the evidence, we're in a position to refuse it if we don't feel it's necessary - we'd make a joint decision nearer the time depending on how the labour is proceeding.

@bertiesgal I’m surprised, being ‘medical’, that you’re not aware two midwives attend a homebirth?

I’m also surprised that you’re not aware of the methodology of the Birthplace Study 2011 which is what most people refer to re risk and on this thread. Or perhaps you are and consider it poorly executed? What about this major study of data relating to 64,000 birth, funded by NIHR and Department of Health and co-ordinated by the perinatal unit at the University of Oxford, do you consider poorly executed?

I also think that people with a medical background may well be more comfortable and familiar with a hospital environment which would play a part in consideration of risk.

I base this totally on a family member who’s a surgeon (not related to obstetrics) and is always very quick to that option. She says if she was pregnant she’d opt for elective caesarean.

Yes, I know the stratification of the risk groups and made my decisions based on that. Obviously data from other countries tells us some things, but I would rather use UK data when making a decision in the UK given different systems etc.

I think the figures for complications/ negative outcomes in home Vs hospital are really fascinating (particularly for second births).

However, I think if you are going to make a truly informed decision about where to birth you have to look pragmatically at all the factors involved, and this included the reliance on the ambulance service if things don't go to plan.
The timeliness of the service provided by most ambulance trusts have significantly deteriorated since the studies being quoted were carried out. It is easy for midwifes to quote how long an ambulance "should" take to be with you, the reality in many areas is quite different. If you want to believe in a utopian NHS where everyone gets an ambulance within 8 minutes 100% of the time you are be very very naive. Equally midwifery services are not what they ideally should be, so you can set your heart on a home birth and then find that the second midwife required just doesn't exist/ isn't available, thus throwing plans into disarray, forcing a hospital birth on you, which may as a result turn out to be more stressful than of it was originally what you planned.

And as other HCP have said, I've seen first hand the negative outcomes where birth goes wrong, not a statistical number, but a little human being that will never live the kind of life we are all privileged to have.

I felt far safer giving birth at home. You get two experienced midwives. It's a good job I did. I wasn't sure I was really in labour and wouldn't have gone to hospital but called the midwife 'just in case'. I'm a nurse and believe me she brought more kit than is as easily available on a ward.
I had the miserable experience if delivering the next baby on a delivery suite (moved areas midwife refused homebirth) and I actually delivered the head without either the consultant or midwives noticing. Even though they were in the room. (Telling me I wasn't progressing) fortunately for me DH thought they were talking crap and went to investigate and found DSs head!

And also, I would say that if labour is disrupted and stops due to moving to a new environment then an intervention may be the best option, but it may not have been needed if there was no interruption.

But of course I can understand people being happier with hospital - I would probably have been the same if a lot of factors hadn’t been in my favour.

I had a hospital birth with all of mine but would have liked a home birth with my first (2nd and 3rd were induced so no chance) my first started off very straight forward and I would have been fine at home until the pushing phase when little progress was made- the thought of having to have been transferred to hospital at that point (and we were half hour from the nearest hospital) is pretty horrendous to be honest and I'm pretty sure is what would have happened so I'm very pleased I was in a hospital.

I do take the point about deterioration in ambulance response times - I would have looked long and hard at that in my area if making the decision again.

peregrina
I agree the mothers mental health is also important.
I was bounced into an unnecessary csection with my first. It traumatised me so badly I wished I'd never had the baby.

It seems so wrong that some posters are saying that this is your body and your choice and he gets no say in it. This is his full term baby as much as it is yours. He’s worried about the baby not surviving if there are problems which, in a maternity ward as opposed to a community MLU, could be dealt with very much faster than waiting for an ambulance then travelling up to 30 mins to get there. You don’t know what the traffic conditions will be like either.

Personally I would suggest compromising with a hospital water birth.

I'm a HCP and I don't recommend being in hospital.
But then, Ive had poor experiences there, and working in one, I realise just how poor some HCPs are.

Tricky one OP. If you were a bit closer I'd say go for it.

But one of the biggest advantages of home births I can see is two midwives (at least one very experienced) constantly monitoring you.

That's not a given in hospital and the worst birth outcome I've come across was a result of inadequate monitoring by midwives. The baby was in severe trouble that wasn't picked up, so proximity to services didn't help in that situation, the damage was done.

However, the distance would make a difference to me so in your case I'd probably chose hospital.

Personally I would suggest compromising with a hospital water birth.

But I thought that OP's partner had shut down any discussion of water birth. His unwillingness to discuss is one of her problems.

As for not knowing what traffic conditions are going to be like, that applies to all spontaneous onsets of labour, and as at least one person has already said, she might go to hospital and get sent home again, so she might well spent a good part of her labour at home, or in the car.

I had to stay in an antenatal ward with one of my pregnancies. Bleeding heavily. When I went into labour it took more than 30mins to get a porter and attempt to get me to the delivery suite. I didn't make it there in time and met my midwife afterwards. I think id have been better coming from home.

I think the flaw in the attitude of everyone who is seriously anti home birth and pro hospital birth is in assuming that labouring women will a. be admitted to hospital when they want/need to be (as opposed to being told to stay at home or sent back home) and b. receive good care while in hospital - as Headofthehive has pointed out, it's not always the case sadly.

The answer is not necessarily more home births (we need and deserve better hospital care) but it is understandable that some women opt for home birth in these circumstances.

My back of an ambulance birth with #2 was classified as unaccompanied, so neither home nor hospital.

Tbh, I don't know where I stand on this. I've had 3 very different births, one of which (#2) might have had very different outcomes for me (massive tear and pph) were it not for having arrived at hospital shortly after his birth. Outcome for #1 may have been different were it not for speedy transfer to surgical unit.

#3 was the smoothest despite various factors throughout pregnancy, and tbh that was because I was very honest with the HCPs throughout pregnancy about my Various concerns and put my trust in them. In return I felt totally supported in all my decisions and deliberations, and was lucky perhaps that they were hugely supportive as I mulled over my options throughout.

The birth was quite medicalised in the respect that it was on the labour ward, with me lying down and two lovely senior midwives peering at me nether regions with a big lamp as he made his appearance. But I found that hugely reassuring. I labour hard and fast, and suffered with the aftermath after #2. So having them keeping a close eye on proceedings, telling me to take it easy/go for it etc made me feel so much more comfortable. Obviously that level may have the opposite effect on others, and many may not be as lucky as to feel as able to trust the setting as I did.

One thing I will say is that when I started out having kids I was way more "lay off the intervention etc etc" and a little more wary of HCPs etc after reading various horror stories. But by #3 I felt able to put trust in the team around me and make use of them and it paid off.

Witsender
I'm glad you had excellent care and a positive experience with your third birth. But I think you were very lucky to have two senior midwives with you as I believe it's rare. I also wonder if they took you more seriously because it was your third child and you had raised concerns based on previous births. It is my belief (and experience) that midwives can be extremely dismissive of women who are giving birth for the first time.

OP, while I want to say 'your body, your birth' I do need to point out that if you don't feel supported by your DH, it will affect your labour. If you're worried about how he's feeling or if he's obviously stressed out, your labour will suffer.

Stress hormones will prevent your labour hormones from working effectively, increasing the potential for you to transfer to hospital. You've got to have someone with you who is comfortable with home birth and who can minimise their own stress and feelings to support you. Can your DH do that?

With home birth, you will get two midwives. With home birth any deviation from normal labour progression will mean a transfer into hospital and home birth midwives have a very low threshold for what constitutes deviation from normal.

The midwife will know how long it will take to transfer and it's likely that she would be calling earlier for transfer rather than later no matter where you live in relation to the hospital.

Ambulances are not in standby for home births in any area. The ambulance service nationwide are incredibly stretched. However, maternity calls will take priority and the service will send 2 ambulances -one for you, one for baby- if called out to a maternity call.

However, you have to take into account that with the best will in the world, with early recognition of a deviation, with early action, with a rapid response from the ambulance, there will always be a delay in access to help when compared to labouring in a hospital. That is one of the risks of home birth.

All labour and birth is unpredictable and you will have to balance the risks and benefits to you and your baby and your DH should have his opinion heard too.

I think you need to speak to your midwife again, with your DH present and get him to actively voice his concerns and ask questions. If the MW can reassure him he may come around, but he may not and you will both need to come to a compromise somehow. This decision affects him too.

But don't birth at home under the impression that there's an ambulance sat somewhere waiting for you to transfer if needed, because the NHS and ambulance services just cannot facilitate that. You'll get the nearest free ambulance, the same as you would if you had a cardiac arrest.

The ambulance standby thing - don't they have locations away from the ambulance station where ambulances and crew can wait for a call? So they're not necessarily having to drive 30 mins from the station to the house. Could that be what she meant?

However, the chances of one idling at the standby location at exactly the time you need it is pretty slim.