To want a home birth?

[InMemoryOfSleep]

I’m not pregnant (yet), but chatting to my mum and some friends recently I mentioned I’d like a home birth next time. Their reactions weren’t positive, to say the least - despite me explaining that, for a 2nd baby, home birth is as safe as an MLU, and both are safer than a hospital. They’ve made me really doubt myself - having read the research and stats I was convinced it’s the best option, but am I missing something?!

I think the reason that home birth midwives are generally seen as more supportive and attentive is that they are not as busy as a hospital midwife, they are only looking after you and not a whole ward full of women.

If they are 'not as busy' as a hospital midwife, although I think that is debatable, isn't that a poor reflection on the staffing levels in hospitals? Should one or two midwives be looking after a whole ward full of women?

I recollect that David Cameron before the 2010 election promised 3,000 more midwives. He soon forgot that once he became PM.

Staffing is appalling.

VioletteValentia something we agree on there for sure.

More MWs are needed to ensure all women no matter their choice can have a well supported birth with risks caused by failure to spot or wrong decisions are minimised. Just such a shame the massive cuts Tory gvt have implemented. There needs to be more incentives to be a MW. Their pay is shit and so are their hours and pressures. They deal with new life which is so precious. I'd certainly pay more tax if it went to MWs wages.

More MWs are needed to ensure all women no matter their choice can have a well supported birth with risks caused by failure to spot or wrong decisions are minimised. Just such a shame the massive cuts Tory gvt have implemented. There needs to be more incentives to be a MW.

Yeah I completely agree on that. The NHS in general at the moment is awful, I have noticed a marked difference. It’s a deliberate policy aimed to destabilise it and make privatisation look better to the public. It’s disgustingly transparent, if you know anything about the government, however the everyday person doesn’t necessarily realise it.

More MWs are needed to ensure all women no matter their choice can have a well supported birth with risks caused by failure to spot or wrong decisions are minimised. Just such a shame the massive cuts Tory gvt have implemented. There needs to be more incentives to be a MW.

Yeah I completely agree on that. The NHS in general at the moment is awful, I have noticed a marked difference. It’s a deliberate policy aimed to destabilise it and make privatisation look better to the public. It’s disgustingly transparent, if you know anything about the government, however the everyday person doesn’t necessarily realise it.

I think more everyday people realise it more than ever actually. I think it’s becoming wide spread now that the Goverment are underfunding the NHS to bring it to its knees and pave the way for privatisation of our wonderful health service. Of course th NHS does work and is wonderful with enough funding meaning enough staff and efficiently run services. Slash the budgets it begins to crumble and look inferior next to private firms. Sooner there’s a re-election the better.

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If they are 'not as busy' as a hospital midwife, although I think that is debatable, isn't that a poor reflection on the staffing levels in hospitals? Should one or two midwives be looking after a whole ward full of women?

It's absolutely a poor reflection on the staffing levels in hospitals.

It's disgraceful that one of my considerations when I gave birth in 2016 was staffing levels. The hospital is under-funded, under-staffed and busier than they can often cope with. The MLU is slightly better funded, but also under-staffed. The community team is also somewhat under-staffed, but not by as much.

However, if you are insistent (as I had to be when I called to say I was in labour) they send someone. They just try and persuade you to go elsewhere first (which enrages the community midwifes, and is baffling given aforementioned staffing levels), but then they send someone. You then get that person to yourself, and when the time is near they call for a second midwife. You don't end up with your Grandmother delivering your baby in the hospital because the half dozen staff have 20 women in various labour stages.

Is using that consideration somewhat selfish? Absolutely it is, but we can't expect people to say "Oh I'll not bother with the homebirth because the health board say it's expensive" if it's the best care available for their situation.

The NHS is being absolutely destroyed and women's care was always pretty shit anyway so it's just getting worse.

Oh I'll not bother with the homebirth because the health board say it's expensive" if it's the best care available for their situation.
Home births cost the NHS less than a hospital birth, even with the dedicated attention of midwives.
The chronic underfunding of the NHS (and all the other essential services, police etc) is an absolute disgrace, think everyone will agree on that point at least!

‘Home births cost the NHS less than a hospital birth’

This arguably dependent on the given situation and whether there’s need for an ambulance due to any complications.

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Talking of ambulances, response times do greatly vary across the UK.

Although the stats show risk is exactly same between planned homebirths and planned hospital births this might vary if you did live in a poor response time area (haven't got any stats to back this up btw)?

www.ambulanceresponsetimes.co.uk/

Just another thing to consider.

I live in a fast response area which is another reason I feel pretty chill. I know I am likely to get to hospital well within 15 minutes

Let's hope your baby doesn't have shoulder dystocia then, in which case if you were in hospital you would be rushed to the emergency room with reams of professionals hopping around you with less than 5 minutes to act. This is only one scenario in which something can go wrong very, very quickly . Plenty of stories online about shoulder dystocia experiences during homebirth. Midwives are not always able to do the manouvere themselves. Sometimes it takes up to 6 people to manouvere baby out.
amartin030.blogspot.co.uk/2015/01/my-true-feelings-regarding-my-home.html
Of course, it's your decision.

This arguably dependent on the given situation and whether there’s need for an ambulance due to any complications.

Clearly I meant, on the whole. Which they do.

www.nhs.uk/news/pregnancy-and-child/study-says-home-births-cost-effective/

It does say in the study:

‘ The findings should not be misinterpreted as meaning that home birth is always the most cost-effective or most low risk option. This study did not look at women with complicated pregnancies or those expected to have birth complications’

I guess it’s like anything it depends on the situation and it’s the Mother’s choice to do what is best for herself (whether that be home birth, hospital or MLU), her baby and her family.

I had an uncomplicated first pregnancy. Planned a home water birth. My waters went early and I was induced in hospital. DS1 had a shoulder dystocia and was stuck in my pelvis. It was a hairy experience, and I am now so glad I was in hospital as DS needed rescusitating and I had the doctors and midwives there to help. (DS2 got stuck too, I must have a small pelvis)

Before I have birth I believed all the home-birth hype. I felt evangelical about it. The home-birth websites are very good at spinning the positive and if you are not careful you can start to disregard logic (I did it myself!)

I look back at how I was when I was planning a home-birth and realise I was a complete dick. I blame hormones.

ScrumpyBetty and I hope that no one in hospital has a complication missed due to MW not being 1:1 constantly or that medical intervention occurs in which results to complications/death. These both might not happen at a home birth.

There are pros and cons to all birth scenarios and when comparing home birth for #2 with hospital birth the risks are at the same level. Therefore it doesn't matter which I choose because I could face issues (of the same degree) at either, and neither would be my fault.

For me I am choosing home birth because I believe I will be more relaxed there which will aid in the release of oxytocin which has been proved to be needed for an efficient birth.

I understand that for some women they would feel more comfortable in a medical scenario though so they will have a more efficient birth at a hospital.

It is each to their own, especially when the risk is the same.

ScrumpyBetty

The link does not apply to this thread. It’s in Texas. That’s a whole different thread.

Not sure I would have a homebirth in the USA.

Lots of people quoting the Birthplace study as proof Homebirth is safer for 2nd babies.

The Birth place study is rated as low quality by NICE, it has a lot of methodological issues (including how Midwives filled in the outcomes, who was low/high risk). It only looked at midwife led care. Recent malpractice claims have been coming ~50% from MLUs, despite their lower risk patient base.

Secondly there's low risk and then there's low risk. Only the very lowest of the low risk women will (usually) be considering a home birth. There's not some kind of magical low risk/high risk dividing line.

Out of interest why would anyone want to have a baby at home?! I can’t think of a least relaxing scenario!

The only benefit I can see is not having to get a babysitter?

NICE recommends home births for some mums

www.nhs.uk/news/pregnancy-and-child/nice-recommends-home-births-for-some-mums/

"NICE has compared the outcomes for “low-risk” women giving birth in four different settings: the standard hospital maternity (obstetric) unit, alongside midwifery units (separate midwife-led units alongside an obstetric unit), a freestanding midwifery unit and birth at home.

When looking at rates per 1,000 women, they found that most outcomes were generally similar or slightly better in the home, compared to the hospital setting...

birth in a hospital obstetric unit is generally associated with slightly higher rates of interventions and lower rates of spontaneous vaginal birth, compared to the other settings....

NICE concludes that for low-risk women, whether having their first or subsequent baby, birth is generally very safe for both mother and baby, and they should be free to choose any of the four birth settings and be supported in their choice "

lower rates of spontaneous vaginal birth

Why are higher rates of vb the goal? Surely the goal is a healthy baby?

VioletteValentia I will certainly be sending DS round to his grandparents still!

For me being at home is more relaxing. For you it isn't. We are all different people which is why we should have choice. If a woman feels stressed then they are more likely to have a complicated birth.

I can see the risks are exactly the same level and then when added that I will be more relaxed in my own environment that makes sense for me.

Everyone's different and as long as everyone can support and respect women's choices then that is all that matters.