AIBU to want a home birth for first baby?

[User383673]

I would NEVER have had myself down as a home birth kind of person. Have always said I would want an epidural right away. But I’ve been doing a lot of research and I am now thinking that actually a home birth might be right for me. Here are the pros and cons as I see it:

pros

Get to be at home - much nicer & more enjoyable

DH truly useless in hospitals, will probably faint

I also hate hospitals

Worried about cascade of intervention

Kept in hospital for things you wouldn’t be sent to hospital for

Guaranteed birthing pool (if I hire)

2 midwives just for you

Less likely to tear & have forceps used

cons

Slightly increased risk of poor outcome

No epidural

Maybe a bit old? (30)

Likely to end up in hospital anyway

What if it all goes wrong?

Has anyone had a home birth for a first pregnancy? Does anyone have advice / experience to share?

Thank you!

We used the MLU which was actually very nice with barely any medical equipment visible. One of the busiest units in the country but I had the same midwife all day and as it was a quiet day for deliveries, I was her only patient and took up her entire shift.

Labour was nothing like I expected and I'm pleased we were there so we had handy access to the surgical team when we needed it and I didn't have to endure a bumpy ambulance trip with my baby wedged in my vagina (the walk across the hallway to the exam room was bad enough).

I had both mine at home. I was 37 and 40 yrs old, and at least an hour from a hospital, but healthy. My DH didn't want me to, but as it was my body, and I'd done the research, I knew I was low risk and the midwives would take no chances with me. For me, it was a wonderful experience and both births went well.

Sometimes things happen so quickly in labour that you may not necessarily have the time to go to hospital.
I was low risk, labour was progressing normally after my waters broke, I had a midwife with me the whole time, helping me figure out new positions to try, monitoring baby's heart beat every 15 minutes or so with a Doppler.
Then when baby came out, all of a sudden a blood vessel in my labia tore and blood started gushing out. I didn't notice, as they had put baby on my chest straight away and I was lost in his eyes. My delivery room was suddenly filled with doctors and several more midwives who quickly tried to stop the bleeding, it took several minutes and it didn't stop until they stitched me up - a tricky process as the tear was next to my urethra, they had to insert a catheter in my urethra to ensure they didn't accidently stitch that up.
In the space of those few minutes, I lost over 1L of blood. Probably closer to 2L.
Baby was fine, but I could have died.
And it all happened extremely quickly.
OP, your decision is yours, but with a first labour there's no predicting what could happen.
If you do opt for home birth, make sure the midwives have a plan for Post-Partum Haemorrage (whether through issues with the uterus contracting, or in my case, trauma to the vulva).
That being said, my experience in the hospital was different to a lot of people here because my local hospital is midwife led, and you do get 1 midwife with you the whole labour.

If you are confident in your ante natal care. I would.

It's really so much nicer at home, my dh was happier I was happier. One of them the baby was born back to back and presented badly. In hospital I guess she would have been dragged out of me, but at home it was very peaceful.

I can't recommend it enough but the main thing for me was having my husband there before, during and after.

Ina is brilliant. To whomever said about her earlier.

Mine presented badly and wasn't dragged out of me but the pain was horrific.

A birthing plan is the most stupidest thing about giving birth! A birth hope list is more like it, because each birth is different, and you can't say well I don't want this and I don't want that because at the end of the day what is most important for you baby is all that matters.
First, second and third birth which was 10 years later could of all happen at home, but then my mother would of and still nearly did die with her first at home and she was 17 and was rushed for a c-section.
Also I always thought u would love the idea of a water birth but after my first two couldn't stand the way the water felt and with the third I wouldn't get out the bath.

Snowmegeddon for sure we are all different. It hurt me too. But honestly I don't think there is a pain free way to have a baby, unless you are a man.

Seemingly it is OK to try and scare the pregnant OP? I’m not saying scary shit doesn’t happen - it does. But I can’t see a balance here.

We know that giving birth at home has risks. And that giving birth in the hospital also has risks. Why do we blame the OP for the first set of risks but the second become unavoidable tragedies? Why are people trotting out the ‘oh I couldn’t live with myself’ ‘I wouldn’t take the risk’ etc etc.

You left your home in active labour? That’s risking giving birth at the side of the road with no medical attendant. I wouldn’t take the risk. Imagine something happened. How could you ever forgive yourself?

You went to the hospital? That’s risking hospital borne infections? Don’t you know your baby’s immune system is massively vulnerable and they will be colonised by hospital bacteria? I couldn’t take the risk.

Your went onto a postnatal ward, filled with other people’s children and strangers? What if one of them gave your newborn unvaccinated baby something awful? I wouldn’t take the risk.

You elected to have a c section? That increases the risk to future pregnancies? I couldn’t take that risk.

You went to a teaching hospital and let students practice on you! I couldn’t take the risk?

You had your waters broken before they went naturally? That can just jam your baby into a position and give them no way of turning? I couldn’t take the risk.

You agreed to induction/augmentation and the drug used hyperstimulated your uterus and put your baby into distress? Why would you risk that?

See, it’s all bollocks.

Home birth is a reasonable choice supported by our health care system. Hospital birth (of all types) is a reasonable choice supported by our healthcare system. No birth it risk free. You choose the risks you are happy enough with and you make your decisions based on them. There is no right way or wrong way, no guarantees, no crystal ball. You choose what’s right for you, OP.

Oh and do people really think that statisticians and clinical researchers, professional teams of people who conduct studies like the birthplace study, can’t control for the transfers? No, the statistics are not completely skewed. They are comparative studies of women deemed to be of equally low risk prior to onset of labour, based on the planned place of birth. It’s not a difficult hurdle to overcome when compiling the data - and without this control the datasets would be totally useless.

Also re how common it is for people who have had an emergency section or forceps etc to say ‘I/baby would have died if we’d opted for a home birth’..The statistics don’t support that do they? Otherwise it would be like 25% of all home births resulting in mum/baby dying, so I wouldn’t take it at face value.
If second low-risk births are deemed statistically SAFER at home then there must be more to it. I imagine it’s very complex.

I think there is a lot of misinformation about childbirth, you see it often in conversations where a woman wants to elect for a c-section for non-medical reasons- lots of ‘why would you do that? So risky for you/baby! So expensive for the NHS’ replies. It’s also the same judgemental attitudes you get towards women who want to exercise their own choice for a positive experience.

I also think midwife led unit is a good compromise if you’ve one in your area and your low risk - it’s what me and dh came to agree on with first dc (id suggested home birth but dh was a bit nervous about the whole thing) I’m glad we went there though as it was a lovely place, much more relaxing and homely than a hospital - and partners were able to stay over night which was a big help.

Incidentally I got my home birth second time round but that wasn’t planned! Just a very eager baby who wasn’t wasting any time coming into the world!

Speak to your midwife I’m sure they’ll be able to help explore all your options and give you extra information to help decide

Good luck!

Otherwise it would be like 25% of all home births resulting in mum/baby dying, so I wouldn’t take it at face value

well, no. Because obviously those people are transferred to hospital. Looking at the Canadian study mentioned earlier, that was in the range of 20-22% of women. For the Birthplace cohort study (so relevant to a British population and our healthcare setup) the findings were as follows (I've just used their own simplified outcomes, as I'm assuming everyone here isn't a statistician):

For women having a first baby, a planned home birth increases the risk for the baby

For nulliparous women, there were 9.3 adverse perinatal outcome events per 1000 planned home births compared with 5.3 per 1000 births for births planned in obstetric units, and this finding was statistically significant

For women having a first baby, there is a fairly high probability of transferring to an obstetric unit during labour or immediately after the birth

For nulliparous women, the peri-partum transfer rate was 45% for planned home births, 36% for planned FMU births and 40% for planned AMU births

So just less than half of the women ended up in an obstetric unit/hospital. If you are in the 55% (so, arguably the slim majority), of course you'll say you had a good experience and that everyone should try it. If you weren't, you'll say otherwise. Hence why these threads never reach a consensus.

Risk is risk. For me, that's anything over 1%, but then I'm medical and regularly see the disasters. For others, that might be 50% or even 99%. It's what makes us individuals. And stating statistics is not 'scaring' anyone - it's the best measure of assessing outcomes we have!

Thanks so much to everyone sharing their insights - I really appreciate it!

I’m compiling questions for the midwife - the main thing I want to clarify is how likely it is that something could go badly wrong without there being any early warning signs. I also want to know what happens if something unexpected does go wrong, and how long it would take for an ambulance to get me to hospital in an emergency.

I also want to talk about MLUs and facilities available at hospital, so I know what the alternatives actually look like in my area.

If I feel confident in the responses to these questions, I still think a home birth could be a very positive experience. I don’t think hospitals are risk free, and it’s a different suite of risks. I mentioned my SIL earlier in the thread. She had a very difficult birth, and she thinks it’s at least partly because of the cascade of interventions. If I can take steps to avoid that I think I would like to (while, of course, accepting that some interventions may be necessary and welcome, and that I absolutely can’t plan for everything!).

Thank you to everyone sharing their experiences, good and bad. It has really helped me focus the points I want to discuss with my midwife.

@whyohwhydoibother yes so replies like ‘if I’d opted for a homebirth we would have ended up transferred to hospital anyway’ would be more appropriate than ‘if I’d chosen home birth me and DC would be dead’ from anyone who’s happened to have a section or assisted birth is what I meant really.

@clairestandish In some of those cases, yes. Arguably, using the available re-analysis of data from the Birthplace Study, 10.5% of nulliparous women who intended to deliver at home were transferred for 'urgent' reasons (which could be interpreted as life-threatening for either mother or baby) during their delivery. This was quantified separately from things like delayed progression, epidural request, retained placenta, needing repairs etc.

I could go through all the posts on here to see how many people said "we could have died" and we could try an ad hoc analysis of whether the mumsnet sample size is representative.. but more than likely we'll have multiple confounders - i.e. socio-economic factors of women who are on here, the higher likelihood of people with adverse outcomes wanting to report those outcomes, the predisposition of people to remember only the most drastic statements, the outright liars - which would render it pretty much invalid.

Nonetheless, I fully support the right of all women to make decisions about how/where they deliver their children - as long as they're making a considered judgement, aware of all of the risks/benefits, and take the responsibility of that decision.

OP I found if you have a Google you can see all the facilities local to you, so how many birthing pools, whether gas is piped in, even if an ipod dock is available! It really helped me so hope you can find out for your area.

I was a first timer in December, I live five mins from my hospital which was a big plus for home birth.

I planned for a home birth, rented my pool and TENS, had the briefing from the midwife...then at five days overdue had to be induced due to fetal heart rate. Wondered ever since if Birthplace would have considered me a Transfer!

Bottom line for me - it was taken out of my hands. And I enjoyed the epidural for the pain (perhaps because I was induced it was worse - things were going very quickly!)

NCT scared the crap out of us about the ‘cascade of intervenion’ but I had the lot and in the end I gave birth feeling totally clear headed, not in any pain at all and able to really enjoy the first few moments.

Contrast that with an hour earlier when I was in too much pain to even make a noise, trying gas and air and meptid, neither of which worked for me at all, I am glad I made the decision to have it.

To give a different point of view I had a homebirth with my first -actually suggested by my NHS midwife (like you I never thought I'd be a 'homebirth' type person) which was a huge surprise and was a really positive experience. Would recommend if your feel it's right for you and low risk, there is reasonable evidence that a lot of intervention wouldn't happen if women weren't in hospital. Sensible questions above to ask thought about hospital transfer etc.

Go for the home birth if that’s what you want. You can always change your mind at any time and go into hospital but you can’t really change your mind and opt for the home birth.
I had a home birth for my first but I decided to at 40 weeks (!!) so didn’t get gas and air delivered In time also no time for a pool so had zero pain relief ! After 10 hours of back to back labour at home I went into hospital for gas and air in a MLU and baby was born 2 hours later.. had I opted for the home birth earlier and had pain relief I would have had baby at home with no complications, I didn’t even need stitches or anything..
I also think had I gone into hospital in the beginning like I was going to they would have been pushing me into an intervention as baby took a while to turn and labour was stalling.. baby just needed more time to turn which a home birth gave me.
Midwives are trained to spot things early and send you in at the first sign of anything. going awry. Good luck!

Nope. Think all births are risky but the first one more so.
I lost so much blood with my first that I needed a transfusion . Second I was out of hospital within 10 hours of having her so a home birth would’ve been ok if I’d wanted that.

I've had both of my babies at home and I'm not the hippy type! I did my research and felt it was best for me and for them as I really hate hospitals. I had my DS on Christmas Day and my little girl in the summer. Both were amazing experiences and I loved the fact that I was at home, so peaceful and you can just take everything at your own pace.

Each to their own decision but I would make the same decision again in a heartbeat

I had both mine at home and know of 8 others born at home, three of which were firsts.

Our local trust is really supportive of home birth and roughly 25% of babies in our area are born at home.

I'd just be weary of how far away you are from hospital and where your line in the sand is, pain wise, as ime midwives like to encourage you to keep going once you're already in labour. You can have g&a and pethedine at home though.

Shift change happened just as dd2 was about to be born and everyone wanted to stay and see the baby so I had 4 midwives and 2 students looking after me when dd2 was born.

Also, I'm not a lentil weaving hippy type, I just wanted to avoid any unnecessary intervention and the postnatal ward.

Does anyone really not like the postnatal ward? I honestly loved the wards and my labour even though it was a bit shite