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?!

missduke yes I was told this by a health care professional. Infact by seperate ones. My home birth midwife, my consultant, and the anetheatist.

I am very lucky that my home birth midwife picked up my issues very quickly (I think it was fate she was on call as 2 other midwifes of the home birth team with 27 years experience between them had never seen a cervical tear).

I am still a great believer in home births under the right circumstances. If the person will feel more relaxed at home this can only help labour.

@MissDuke I think that's a tricky and interesting one. They were most definitely concerned about me, they thought I would lose a lot of blood given how long my uterus had been contracting plus potential infection and they thought ds would come out in a far worse state than he actually did even though he still ended up in NICU. As it happened they were wrong about pretty much all of that.

However the reason I say "half killed" is because I attempted suicide within 48 hours of his arrival for reasons which were 100 percent linked to the circumstances/delivery and could have been prevented by being listened to/intervening earlier. Obviously trying to kill yourself in a hospital isn't the smartest move ever so I'm still here but it's true that ds's arrival nearly caused my death.

In general though, despite being totally rubbish at giving birth myself, I think options are a good thing. I think more MLUs should be built attached to hospitals and I think we definitely need more midwives. Quite often our local MLU is closed because the Labour ward needs them. I think attached to hospitals simply due to logistics.

Secondly vaginal birth carries substantial risks of incontinence and prolapse, which are rarely mentioned. Women should be consented on these as part of the birth process IMO.

I went to free NHS antenatal classes and this was mentioned along with all the pros and cons of the different types of births and birthing assistance. Are these course not made available to all across the UK? Might explain the confusion over here about evidence and women's choices.

I had a low risk, easy, textbook first pregnancy. Lots of midwives tried to persuade us to have a home birth including the one my DH spoke to when he called the birth centre to tell them we were on our way in. DS1 was back to back, got stuck and I pushed for 5 hours, unsurprisingly he went into distress and had to be resuscitated. As the birth centre was in hospital, it didn’t take much to wheel me down to the labour suite. And with one press of the emergency buzzer the room filled with people. I didn’t have to wait for an ambulance and I never panicked that he wasn’t going to be alright, because everyone that he needed to help him was already on site. The team at our maternity hospital can get a baby out via crash section within 7 minutes if required. You won’t get that with a home birth even if you live across the road from the hospital.

Baby and mum benefit from a vaginal birth Violette. It has been shown to be better for the baby's gut and also to establish breastfeeding.

There’s very little evidence surrounding the gut bacteria theory. And if it were true, just use a vaginal swan on the baby. Job done!

To all the posters who believe that they or their babies 'nearly died' in childbirth - were you actually told this outright by a HCP?

Yes. And my son nearly died even with having the cesarean, and had I not have had it he’d have either died or been starved of oxygen.

Yes, you do have medical equipment there, generally dropped off in advance -- including a resus kit, and midwives trained in coping with emergencies. Just wanted to correct this in case it gives other the wrong impression of what a home birth is.

That’s not the same as having an incubator, a CPAP machine, and blood on hand for a transfusion though.

Maybe I’m a diva, but I can’t thibk of anything more reassuring than lying there pain free and having my baby safely lifted out, without pain or damaging my vagina and with a team of doctors all focusing on me and the baby. I only had to say “I feel sick” and my meds were adjusted instantly, and for the next few days I had my own private room with care on tap showing me how to breastfeed, bringing me drinks and generally caring for us. Even after what happened, I was made to feel safe and that my son was being cared for.

I cannot imagine choosing the painful way tbh.

@TwittleBee Think it varies on who is taking the class. I went to NHS ante-natal classes when I was pregnant with my first. We weren't allowed to discuss forceps, c-sections, tears or anything negative and we did ask.

The focus was entirely on positive normal birth with limited drugs and breastfeeding.

Out of 7 of us, we ended up with 3 c-sections, 3 forceps deliveries and one normal birth.

Violette - have you considered whether there may be benefits for research (here and elsewhere) showing benefits of c section rather benefits of vb? Just wondering because I'm a bit dubious. I can see where the money is made. Just thinking.

Personally I had 2 fantastic home births, baby on me and bf within minutes, meeting sibling within 15minutes, at home nice and cosy. And I have very empowering memories of my births even though I am still working on my pelvic muscles/have to be careful jumping on a trampoline :) I take that over a c section and incubator if I have the choice. And it is about choice of course! Women should have the choice and make an informed choice.

@VioletteValentia Neither an incubator nor a CPAP are needed right away (particularly for a home birth, which would never be pre-term).

In terms of the need for a blood transfusion after a PPH, being at home actually reduces the risk of the interventions that make post-partum haemorrhage more likely.

But, you know horses for courses. I fully support the right of every woman to choose the birth that's right for them including elective caesarean check out Birthrights' great campaign for equality of access to elective c-sections.

And it's not just c-sections that can be a great experience, either. I had an amazing and pain-free birth at home last year in my kitchen with just a TENS machine! No stitches afterwards. And of course the reassurance of a great midwife, one to one the whole time, and an emergency kit and resus equipment right there if needed.

Personally I think that for a low-risk pregnancy, going into hospital is much riskier than staying at home!

Twittlebee - that's great, not usual though. Also it's not a choice unless NHS hospitals are routinely offering maternal request caesareans; which they aren't.

OP: having said all that, it is your choice to give birth however you like.

I think it's important that we support the rights of women to give birth in whatever setting they want, however they want, to choose and reject the interventions they want.

However this must come from a place of truly informed consent.

Oblada; there are benefits of CS over expectant management, I posted the link.

VioletteValentia Sounds like you also had a good experience second time and it was without doubt what was best for you and your baby.

I don’t like anecdotal evidence but my friend after a elective section ended up pulling her own cathertar out guided by her retired dr mother over the phone. So not so nice.... and was told off for the bloody mess she made in the shower bleeding.

I am sure for every good story there’s a bad. That’s why we draw on our own experience and statistics and risk and choose.

I would never force anyone to birth the way they didn’t want to. I hope you feel the same. I can’t help thinking you however are too skewed to “medicalised birth should be the norm” though. Not sure why as even those with bad experiences like you had with dc1 are open. Maybe you have experience of birth in another country where it is and everything else just madness.

Who knows but just because a midwife can’t do a c section at home it doesn’t mean hb for some are as safe as being in hospital.

@VioletteValentina Did you have your baby privately? There is no way you would get that care here! There are very few private rooms available (even for payment) and they are used for people who for whatever reason can not be on the ward, this doesn’t include c-sections. If you have a c-section here you will spend several days on an understaffed post-natal ward with many other women and their crying newborns getting no sleep, DH allowed only during visiting hours and so no-one to help you move and pick up your baby when they cry in the night. Limited help with breastfeeding, some leaflets and maybe a flying visit from an overworked specialist midwife.
I was fortunate that because I had an uncomplicated delivery I was discharged in less than 12 hours straight from the MLU. My friends had a range of horror stories about the post natal ward, which here is unavoidable if you have a c-section.

*are not

Just realised that wasn’t very clear, I mean there are very few private rooms here and you can’t pay to get one, it’s purely medical need.

Sounds like you also had a good experience second time and it was without doubt what was best for you and your baby.

It was the same time, it’s just that the care I received made what was a scary experience initially much much better. My birth was “horrible” in that he was unwell but the management of it was excellent.

I wouldn’t force anyone to either, and I support the right of a woman to choose what I might personally think is a crazy choice. But if asked for my opinion, like this thread, I’ll say I think it’s a crazy choice.

Your friends experience does sound awful. I hope she complained

Did you have your baby privately? There is no way you would get that care here! There are very few private rooms available (even for payment) and they are used for people who for whatever reason can not be on the ward, this doesn’t include c-sections.

No, NHS. I was in a separate room because my son was in the NICU for a few days and I requested to keep it when he came out and was told that was fine. It was great, I had a private bathroom and everything. Partners could stay all hours too.

Not sure how I would feel about a ward, in fairness!

I wanted a homebirth for my first, we only lived 5 mins from the hospital, but after a long long labour ended up exhausted and going to hospital for the birth.

My second we lived 45 mins from the hospital, so at first thoughts of going into labour went to the hospital, had on-off contractions for 3 days for which they refused to let me go home as I lived so far away. When labour kicked off properly it was 2 hours to giving birth, and I have to admit I would have hated to be in a car/ambulance during that time.

On my third, I was told due to strep B I would need to have a hospital birth. However, the baby had other ideas, I had 3 painful tightenings, before I thought oh I wonder if I will have another, and started the contraction timer on the computer, while keeping busy on mumsnet. After another three I looked at the contraction timer, and they said the contractions were 5 mins apart lasting a minute, whoops I was in labour, by the time I woke up my mum and husband, I was ringing for midwife and ambulance, and knew it was happening fast. Less than an hour later the midwife delivered the birth at home - she said it was too late for ambulance transfer, baby was on its way....

Of the three labours, I loved the being able to get into my own bed after the homebirth. However neither the midwifes nor the ambulance crews gas and air was working,,, so giving birth with no pain relief was not great. But it was over so quickly that it was not an issue.

As well as my husband being there, I had a doctor, a midwife, two ambulance crew, and my mum (who previously worked as a paediatric nurse) watching, so it was nothing like I imagined with the lovely birthing pool and slow build up, to a romanticised gentle birth..... but as I said, the own bed and bathroom immediately after, was bliss.

DrWhy I can only assume care is really different depending on where you live?

Our OHs were allowed to stay with us 24/7 but it didn't make it pleasant spending 7 nights on an open ward. Especially when I had to share my single bed with OH if he wanted sleep!

But again, this is exactly why women should have choice

VioletteValentia - apologies I hadn’t remembered your post correctly about your birth.

Another friend recently had a nicu baby and had first class care in a single nhs room.

I get why you think it’s a bit mad. I guess for the same reason given MY exact circumstances I wouldn’t have chosen a section. Just no need to put ourselves through that.

@VioletteVioletta and @Twittlebee
Sadly I think care does vary hugely, our maternity hospital and MLU is very dated (new one meant to be coming some time in 2019/20) hence only having one birth pool for the whole city. They are desperately understaffed, on top of the general NHS understaffing the city has been hit over the last couple of years with a big drop to its major industry - many people have left chasing jobs in this industry elsewhere taking their partners (mainly wives) who worked in other jobs, including the public sector with them. In 2016 when I had mine they were intermittently closing all the MLUs including the one at the hospital due to staffing problems and to have a homebirth you had to go into labour between 39 and 41 weeks to have a midwife on call. I’m not sure it’s much better now.
The postnatal wards sounded horrendous, I would do all I could to avoid having to stay on one. Partners are allowed 9am to 9pm so you are on your own overnight, but then I don’t think I’d want a load of strange men around when I was trying to sleep so I’m not sure allowing them to stay is that great either.
Urgh, I’m not sure I really want to think about the choice I’ll have to make again.

Violet I agree.

I don't believe these studies. I'm sure my first birth was ticked as an astounding success but it wasn't.
Who records the women struggling on with intimate issues who go and get help months after the birth? Prolapse etc.

I was far far more ready to deal with baby, nurse and take the challenge on after my elc than my first labour.
In fact we bf for four years... Because I was in so much better shape and rested and not in pain to concentrate on it and her..

I'd like to see how many risks to mum and baby are removed by a planned ELC.

DrWhy is there more than one MLU in your area? Where I live I have access to 2 really well rated ones. With #1 I had been planning on going to one of the MLU but unfortunately I had PPROM so that option was out. Reason I am not choosing them this time round is because their risk level is same as HB and I'd much rather my own surroundings than any medical setting, would remind me too much of #1s traumatic birth.

You don't have to go to your closets MLU

@DrWhy From your above post, I suspect we are probably geographically quite close and I have been assured things have improved.

Although in 2015 when ds was born, I only got 3 meals in 4 days including the tea and toast and had zero help with ds when he was with me on the ward so the bar is quite low.

Maybe in a utopia of unlimited NHS resources we would all have first class one on one care, but the reality is that you have to choose your birth experience based on what is available and what you think will be likely to result in the best outcome for you OP.

For me, for my second child, that was a home birth - I absolutely felt totally reassured by the two experienced midwives who were present, much more than in a hospital which was in a worse state staffing-wise than when I had my first two years ago.

Also, if you don't have a lot of help close by and it's your second, it's great to know that you're good to go. Those of my friends who had a CS with their second really found it hard in the early days looking after a newborn and a toddler. It's easy to say that the only thing that matters is a baby that is alive but decision making in real life is a bit more nuanced than that.

Maybe I’m a diva, but I can’t thibk of anything more reassuring than lying there pain free and having my baby safely lifted out, without pain or damaging my vagina and with a team of doctors all focusing on me and the baby. I only had to say “I feel sick” and my meds were adjusted instantly, and for the next few days I had my own private room with care on tap showing me how to breastfeed, bringing me drinks and generally caring for us. Even after what happened, I was made to feel safe and that my son was being cared for.

And if that level of care had been offered at my local hospital I may have considered birthing there...

Instead what was offered - as someone with a twin pregnancy so automatically classed by them as higher risk - was a labour room with a closed door, ignored buzzers and only medical attendance when my my grandmother screamed at them that the head was out. Their treatment was based on an assumption I wasn't near delivery from ONE conversation.

The aftercare was just as bad for some. I was lucky - I was able to walk to the breakfast area and get food. I also had my babies with me. There was a poor woman on the ward (4 bed) whose baby was in a very serious condition in NICU and she was stuck on a ward with 4 babies and staff that were too busy to give more than a cursory chat.

With a home birth I actually had medically trained support. Rather than the unplanned and unwilling almost free birthing I had in hospital. So branding all choice of home birth as 'crazy' is rather 'crazy'.

@Twittlebee
We have one MLU attached to the main city hospital, there was one an hour to the south of us, it was closed in June 2016 due to staffing issues and I believe remains closed. There was a well publicised case where a baby died there in May 2016 after it took 2.5 hours for a specialist neo-natal ambulance to arrive and a regular blue light transfer wasn’t called.
There is another 1.5 hours to the north of us but it’s the wrong side of the city and you could easily end up stuck in rush hour traffic.
I’ll see my midwife for the first time next month so I hope that as Dinosaur suggests above the situation has improved.
It actually worked out very well for me last time but mainly by luck and because my wonderful community midwife was working bonkers hours.