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?!

If I every had another DC I would love a home birth and would really push for it if possible.
I've had 3 births, all awful and very heavy medical intervention so I'd love to be more in control and more relaxed if it was medically safe to do so.

DS2 would have been quite fucked in a homebirth. His cord had a true knot and was around his neck, there was also a shoulder dystocia (he was 7lb 2.5oz @ 38+3 so not a big baby either). He had to be resuscitated and spent his first night in the NICU, he was grey and floppy and not breathing when he was born.

It's a very individual thing but I would never have a baby outside of a hospital setting. I couldn't take the risk. It has been suggested anyway that if I have a DC3 that an ELCS would be a good option.

The lowest of low risk labors can become a fatal one for mother or baby or both in a matter of a few minutes. It is insane to be in a place that cannot provide the very best care available immediately, on the erroneous assumption that "low risk" means "no risk".

Argh I give up. Yep I am wrong, I obviously dreamt all those times myself and my colleagues in the MLU have resolved shoulder dystocia without a team of 6 and an anaesthetist. And yes I know it is only picked up at the last minute, by the very nature of it bangs head off wall

@VioletteValentia As I've said before, you don't instantly need an incubator for a full-term baby. As others have pointed out, you are scaremongering. Home birth in the UK is a remarkably safe option (indeed, for low-risk second pregnancies, almost a no-brainer) and this is backed up by the statistics. Incidentally, my post-home-birth vagina is lovely, thanks -- you're much more likely to avoid an episiotomy at home.

@Notevilstepmother This is absolutely the kind of thing that makes people think 'thank goodness I was born in hospital' -- but mistakenly. It's very common for the cord to be wrapped around the baby's neck and this is something that midwives can and do resolve successfully at home.

Going back to hospital births supposedly being safer, I really think we ought to be more concerned by the unnecessary medicalisation of low-risk birth. There is a difference between life-saving, clearly necessary interventions and those carried out simply because it has become routine or to save time.

If I could add something more mundane to consider...?!

I had a great HB - second baby - had a tough time in hospital on the postnatal wards with #1 so wanted to avoid that. We were two minutes blue light to our nearest hospital so that influenced my decision second time round. HB was really positive - but what I would say is that I completely failed to rest. At home the temptation after the birth to get up and get on with things, go up and down the stairs was too great for me.. and with a toddler at home straight away too. I think there's an element of enforced bed rest in hospital that is maybe needed after birth - I felt really faint and had to be made to go to bed by day 3.
If I had a third I'd probably elect for a MLU - non hospitalised environment for low-risk pregnancies but with a higher chance of REST afterwards!

Abelard, I totally agree, I had an early discharge with all of mine and each time regretted it! You miss the support with bf and as you say the enforced rest (though I appreciate some PN wards are horrendous).

Do check out the rates of shoulder dystocia and successful resolution in standalone midwife units, btw. Very impressive and reassuring.

Magna, definitely. Over 80% are resolved with a simple position change which can be easily achieved with two staff there. Absolutely terrifying when it happens, but thankfully most are resolved with no adverse affects.

Only two unforeseeable serious complications? If only. What about amniotic fluid embolism, for one? 100% fatality rate in out of hospital settings, even 50% in hospitals. Thankfully it's rare but if it happens to you, you'd better wish like hell you are in a hospital because otherwise it's certain death. And there's no way to foresee or prevent it.

I had a planned home birth with my first (and so far, only) baby. Completely low risk pregnancy. Laboured in pool with just gas and air, there was no hippy music or Netflix, just comfortable in my own home and surroundings. Had 2 MW attending me who were constantly monitoring baby's heartbeat but otherwise was left to it with no intervention. My labour was long and contractions had started to slow down. When baby's heart rate started to slow a little, the midwives suggested transfer to hospital (15 mins away). I agreed of course because as much as I wanted to be at home, baby's health came first. Ambulance came very quickly and contractions came back thick and strong once I was out of pool - actually thought I was going to give birth in the ambulance on the way at one point!
Was whipped into a room as soon as I arrived and a quick assessment revealed baby was well on his way but "sunny side up" hence the long labour. Ventouse was used for assistance and he was out less than 20 mins of arriving in hospital, very hale and hearty and shouting his head off.
Received excellent care from a lovely student midwife whilst in hospital (they made me stay 2 nights until I'd established breastfeeding) but I couldn't bloody wait to get home, it was disgustingly hot the whole time I was there, I actually think it hindered breast feeding as baby and I were so hot and frustrated (Apparently the heating was stuck on). I'm glad I transferred in for obvious reasons, but being in hospital made me realise why I'd wanted a home birth so much.
I'd plan for a home birth again in the future knowing I'll be in the care of professionals and can get into hospital quickly if needs be.
I can completely understand those have had traumatic experiences or would feel more reassured in hospital, but many women feel the opposite and home births can be more beneficial in these situations, which is what the statistics show.

Just as an aside, I have two friends who have had first (and subsequent) babies at home with no issues whatsoever :)

I wouldn’t personally - I would be too afraid if anything were to go wrong and I was too far from a hospital. It’s a personal choice though and you should do what you are comfortable with.

Lots of people going on about no risk if there's a low risk pregnancy. That is just not the case at all. Low risk pregnancies can turn into emergencies in a single second during birth ! A low risk pregnancy might well put you at less risk of complications during birth but it by no means means there is no risk. I know of a lot of low risk pregnancies that have gone badly wrong during delivery and it's been to no fault of anyone just one of those things.
I wouldn't say not to have a home birth either though. Everyone makes their own choices but I think people should be aware as with everything of the risks involved and it shouldn't be sugarcoated that because they have had an easy pregnancy they will have a trouble free labour and delivery

The variability of care, esp hospital care, is genuinely scary.

I had a HB with DD1 and it was an excellent choice as we are not that close to the hospital and it turns out I labour quite quickly! The MWs later said it would have been unsafe to attempt the journey to hospital as given the timings, I would actually have given birth on the motorway hard shoulder.

I planned a HB for my second pregnancy but it turned out to be twins. They strongly recommended hospital delivery with epidural and all the drugs, constant monitoring etc. I hate hospitals and agreed reluctantly to go in but with minimal interference - flatly refused epidural for example.

I was induced in the end. Didn't experience any contractions but I hadn't in my first labour, really. I don't think they believed me about that. They said I couldn't be in labour and fecked off to do a shift change. Left on my own I went to the loo - and delivered DT1 myself. Bleeding heavily - the hospital cleaner later swore in shock when she saw the state of the loo - I ran back into the fancy Dan delivery room with its tens of thousands of pounds of lifesaving equipment - to find it empty. I had a team of 2 MW, a consultant, a registrar, an anaesthetist, 2 paeds and nurses. Not a blessed one in the room. I was too shaky to push the red button myself so stood in the middle of that vast gleaming delivery room holding a blue unresponsive 3 and a half lb baby and just yelled till someone came.

My point - hospitals are only as safe as the staff are on the ball/ not overstretched. I had far more care from one HB MW who used only a pair of gloves to deliver DD1 compared to the care from a 10-strong team in a large teaching hospital.

@sycamore54321 not to get into detail about specific risks (not really the point of this thread) - but your post about amniotic fluid embolism fails to mention that a factor that significantly increases the risk of one occurring is induction. Additionally, a risk factor for this occurring postnatally is a caesarean. So by having a minimally interventionist labour you would be significantly reducing your risk of this even happening.

Go for it :) I'm having a hb and I'm "high risk". Can't wait :D

Johnny that's not good, but the point is, you were in a hospital, you called, someone came. In my situation (a 40 minute drive to hospital and the life saving treatment my baby needed, not the mention the wait for an ambulance) and he would be dead, regardless of how attentive the midwives at the home birth were.

I do find the trope that women who have homebirths are idiots who don't understand research evidence and make informed decisions on that basis very trying (also see: mentions of homeopathy, crystals, chanting and yoga).

The idea that women seeking autonomy over their own bodies are labouring under some sort of collective hysterical delusion is exactly the sort of nonsense that has removed women's rights in childbirth (which incidentally extends to the right to an elective section, which most women who choose homebirth would also passionately support).

@Fishinthesink 🙌

I had my first in hospital and for various reasons, it was quite traumatic.
It meant that when I was having my second I was quite apprehensive. I had a water birth which wasn't possible at home but it was wonderful.
I had my daughter at home and it was fantastic. My own bathroom and getting into my own bed afterwards.
My fourth was a home water birth and it was probably as perfect a birth as I can imagine.
Your own space, familiar things and all your comfort items. The added bonus of your own bathroom and your own bed with fresh bedding, makes for the most relaxing space I could ever envisage.

I agree fish

But what I dislike is the sort of brain washed mantra that hospitals are bad and automatically lead to bad intervention.

The hospital didn't cause friends placenta Praia to go, or unexpected amount of fibroid causing emergency section etc. Or another ladies hematopia.

As consultant said these things are chicken and egg.. Most of the time.

Kitten no absolutely. But everyone's risk profiles are different. You sound like hospital was right for you but it won't be for everyone.

DT1 was born so fast and forcibly that the cord snapped. He wasn't breathing and needed massage. He also may have hit the floor on the way out.

I do not regret going to hospital but I do think his birth would have been better managed at home. The hospital staff didn't think I was in labour because their monitors said not. A HB MW would have been listening to me, not a monitor. A HB MW wouldn't have been down the corridor doing shift change paperwork. She would have been close at hand so he wouldn't have hit the floor, as he potentially did. And the resus they performed could have been done at home.

The thing is women who stay at home for as much of their labour as possible and turn up fully dialated and about to push at the hospital are usually really praised and there isn't the same negativity about being away from hospital and monitoring ect

It is insane to be in a place that cannot provide the very best care available immediately, on the erroneous assumption that "low risk" means "no risk".

It's also insane to only assume that the very best care is only possible in a hospital.

It entirely depends on the standard of care in your hospital.

Locally here I was left unchecked, unmonitored and disbelieved that I was in labour, despite being a high risk twin pregnancy, until my grandmother screamed at them that the first baby was crowning. Had I been alone (entirely possible as my ex was away) I wouldn't have been loud enough to shout through the door and over the din of the ward. However, with my HB I had one or two midwives with me the whole time. At no point was I abandoned to fend for myself.

Instead of attacking each other with accusations of insanity people should be getting het up over the fact that for some people in some areas their hospital is so shit that a home birth is the very best option.

A lot of women get sent home again, because they are not considered to be in established Labour. With your first, it's not easy to tell how far on you are, but especially for those who have already had a baby and have an idea of how they are progressing, IMO if the woman feels in need of support she shouldn't be turned away. Again this probably comes down to staffing.

As a PP said, she felt staffing was the key. I do too, and I think we took something of a wrong turn in promoting hospital over home, instead of trying to consider the quality of the attendants and getting the right one(s) for each woman. As we have seen from some posts, it doesn't matter how spankingly new the equipment is, it's only as good as the people operating it, and if they are too rushed off their feet, it might as well almost not be there.