To ask you to help me make a decision re. home birth?

[user124765]

Posting here for traffic after no response on the Childbirth forum.

I'll try to keep this brief. Fourth child due in January. I'm aged 41.
Because of my age I'm being consultant led throughout this pregnancy. I'm otherwise fit and healthy.
The consultant is urging me to be induced on my due date. I'm not overly keen on this idea, having been induced at 12 days overdue with DC2 and it was a really unpleasant experience.
One of the main reasons, beside being 'geriatric', is that I labour very quickly. My third child was born in the hospital car park after a 40 minute labour. They seem to be getting faster and faster.
Would you have a homebirth in my situation? I'm being told it's too dangerous. Is that really the case though?

I've had a retained placenta and haemorrhage after the induction with DC2, but other than that I've had normal easy births. Just very quick!

And now it appears that in addition you have no local friends or available childcare...........

I want to add that in addition to my hospital birth, I have had one home birth, planned for another but she was a Covid baby so had her in hospital.

DP is shitting himself that he'll end up delivering his son without the help of any medical professionals.
He's suggested taking the motor home and plotting up next to the hospital around my due date, which I thought was amusing at first. Now I'm wondering if he might be right.

He's also strongly against the idea of a home birth in our situation.

@viques

And now it appears that in addition you have no local friends or available childcare...........

I've explicitly stated this. I've just moved here about three weeks ago.

Where in the country are you? We have a very active HB team. They spoke to my husband when he was unsure about it (actually thought it was a crazy idea) and now he would see it as the sensible option unless there were medical reasons not to. Good thing as well as the baby came very quickly!

If you have any questions about home birth I would happily answer them. I would also suggest joining some FB groups for homebirths.

I wouldn’t want to be induced, however given your being consultant led, higher risk of bleeding, speed of delivery and distance from hospital/childcare situation I think being induced is the most safest option. The safe delivery of your baby and your health should be too if your agenda.

Good luck ❤️

@AlistairCamel

Where in the country are you? We have a very active HB team. They spoke to my husband when he was unsure about it (actually thought it was a crazy idea) and now he would see it as the sensible option unless there were medical reasons not to. Good thing as well as the baby came very quickly!

If you have any questions about home birth I would happily answer them. I would also suggest joining some FB groups for homebirths.

I'm in Cambridgeshire.

Thank you. I'll do some research, but given the general consensus here that I'd be foolish to risk a home birth, I think I'm discounting it as an option.

I've had a few home births, and I would have all my children at home if I could, but if I'd previously haemorraged, or was at risk of it, then I'd not want to take that chance at home.
I also have quick births, and was told I could be at risk of haemorraging due to the amount of births I'd had, so for my last baby, I did go for an induction. It took 30 minutes from having them placing the line in to birth and I was home a couple of hours later. I had her last year during lockdown, so chose the induction a week before my due date so my parents could come to be with the other children so my husband could be with me. I live 45 minutes away from the nearest hospital, so I'd have possibly had her mid journey if I hadn't.
I'd not be comfortable in your situation and previous history to go for the home birth.

“I’ve explicitly stated this”.

Yes, seven minutes before, not in your original post.

No i wouldn't. I had very fast births too. My third was faster than yours and his head got stuck. No way would i have wanted to be at home with limited help.

I am an advocate for home births. I had my 2nd as a home birth and had a PPH at home. Ambulance was there in less than 5 minutes. This would not likely be the case if it happened today with the pressure services are under.

Given your history, your quick births and the current pandemic in your situation I would be looking for an ELECS. It would give you time to plan childcare, get to the hospital in a relaxed way and be a lot less stressful overall.

Ok, so now we've had more info re: childcare, distance from hospital and having babies in car parks I can see why induction has been offered!
It sounds a sensible and practical approach and an option I would accept due to the circumstances.
I can see how a HB would solve the childcare/ logistics but seem a more risky option.

I had one hospital birth and then one home birth. But I was very low risk for home birth and my previous hospital birth was horrific and dangerous and I'd have felt safer in the Asda car park next time round.

Rationally:
If the only risk is your age, then what exactly is that risk?

What's the relative risk of being induced on your due date vs having a spontaneous, planned and managed home birth?
And what's plan B for if you go into labour at home before your induction date?

Emotionally: if you opt for home birth do you have the emotional strength to carry the weight of disapproval, and the guilt if something (however unlikely or trivial) does go wrong?

I had a homebirth (unintended free birth) with my third.

I'd certainly recommend it if the midwives etc sign it off as safe.

There's quite an extensive list of reasons why they would take you into hospital for example, if labour isn't progressing fast enough (doesn't sound like that'll be an issue for you) or if the baby gets distressed etc.

You can really set up your own birth space, get a birthing pool if you want, move freely. I found it much more relaxing being in my own environment and not worrying about baby popping out en route.

Bare in mind that planning for a home birth doesn't mean you'll get a home birth if medical intervention is needed an ambulance will be called to get you to hospital. Also, if you change your mind at any point (up to the transition stage) you can still go in to hospital.

@user124765

It's really hard to know what to do. I'm scared that if I allow myself to go in to labour naturally I'll end up just repeating history and deliver this baby somewhere public like a car park or a lay-by. The hospital is 25 minutes away by car.

25 minutes is more than enough time to bleed out.

You have 3 other kids who needs their mother alive and well.

Why risk it?

4th pregnancy
Previous retained placenta and haemorrhage
Precipitous labours
Age

All risk factors for a further haemorrhage
Add in state of the NHS, lack of on hand childcare, distance from hospital and massive shortages of midwives and I would be recommending a planned induction.

And I say that as a midwife who also had a homebirth with my second.

Good luck with it all, I hope it all goes well

It's not worth the risk, plus with your history it's even more of a chance you'll need to get to hospital quickly. And like others have said what if you're stuck waiting for an ambulance while baby is in distress?

I needed an ambulance for my second - my waters broke and I just started haemorrhaging. The ambulance was there in minutes but all I kept thinking was what if this is a placental abruption and my baby can't breathe? Once in hospital you're monitored and a doctor can respond to you immediately.

And could your DM stay with you from a week or two before your due date?

If I’ve understood correctly the problem is you labour fast. So the consultant wants to take you into hospital and then induce.
You don’t want to be induced, or risk delivering on the journey to the hospital.

Is there a middle option of being admitted to hospital and allowed to labour naturally? (Or am I the reason the nhs is on its knees with suggestions like that!)

I think your dh’s suggestion (or an air b&b or hotel nearby) might not be a completely daft idea.

Well, all I can add, (and it probably won’t be helpful!), is that my second (of 3) births was at home by choice, and was by far the easiest, quickest, most relaxed experience of the 3. I was 38, and I think they were reluctant to let me have a home birth, but I’d had such an awful experience in hospital with my first, when I was almost 36 (induced at due date + 14 - wish I’d had the confidence to say no, not yet, as baby not in the least distressed - then ended up with epidural and forceps, horrendous), and my Dad had died just before no. 2 was born, so I think they thought it would be better for me in the end to let me go ahead at home. No problems with the pregnancies for either 1 or 2.

My 3rd, at 44, was an emergency C-section due to haemorrhaging at due date -5, but I had placenta praevia, so was never going to have a home birth. I was v lucky that all three dc were healthy.

Hope you manage to have the birth you eventually decide on, and that all goes well, op. Maybe proximity to a hospital would be a factor? I was 5/10 minutes drive away.

@user124765

It's really hard to know what to do. I'm scared that if I allow myself to go in to labour naturally I'll end up just repeating history and deliver this baby somewhere public like a car park or a lay-by. The hospital is 25 minutes away by car.

If you're 25 minutes away from the hospital then are you also a similar distance from midwives? If so then if you opted for a home birth you may end up labouring on your own at home and giving birth on your own which certainly isn't a risk I would take given your situation.

If it was me I would have an induction or section to avoid the risks you mention. Childbirth is all a big game of chance and guesswork anyway and you never know how things will go but if you're most worried about giving birth on your way to the hospital then making sure you are already in hospital when you go into labour and give birth is the only way to mitigate that risk.

As I once heard an obstetrician put it, "home deliveries are for pizzas"

Why are you so easily influenced by some strangers on the internet, versus your experienced consultant?

I have fast labours. DS2 was bba, with paramedic support for the last 30seconds. Midwife told me if I was to have a third, I should plan to home birth. HOWEVER given your history I think a planned induction may be your best bet. But also have a pile of "homebirth emergancy" stuff somewhere, so if DC4 ends up being born on the bathroom floor, your DH doesnt bring the cat blanket to wrap him in.........

I wouldn't have a HB in your situation OP. I did try for one with my first but very quickly had to transfer for a crash c-section. Thankfully hospital was 10 mins away. The induction I'd hate the idea of but I think placental insufficiency is a much greater risk at your age which means going over term is a risk to your baby (don't trust me on that, I'm not a medic but I guess you want to ensure you really do understand why they're recommending induction).