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!

Just in reply to everyone of the “why would you ever consider it” persuasion, the point of homebirths is, I think, generally considered to be that although you are obviously less well equipped to deal with an emergency at home, the very fact of being at home does actually make it less likely that something will go wrong. The “cascade of interventions” risk in hospital maternity wards is real.

I am the most non-woo person ever, I am a very sensible lawyer with a degree in economics, and I had my third at home for that reason. Hospital isn’t always safer.

That said, I had already had two completely straightforward labours by which I mean I didn’t even need stitches and my request for a home birth was completely supported by my midwives. It doesn’t really sound like you are in a straightforward situation at all OP. If I were you I think I’d go to hospital.

Have you considered an elective caesarian, instead of consenting to induction? You have a right to one but would need to push for it.

@AutumnInBustletown

Have you considered an elective caesarian, instead of consenting to induction? You have a right to one but would need to push for it.

I've briefly considered it but I wouldn't opt to have a caesarean unless it was an emergency. My three vaginal births have for the most part (excluding the prolonged process of getting the induction going and the midwives yanking at the cord to get the placenta to detach prior to a haemorrhage) been wonderful experiences.

@Astreamrunsthroughit

Just in reply to everyone of the “why would you ever consider it” persuasion, the point of homebirths is, I think, generally considered to be that although you are obviously less well equipped to deal with an emergency at home, the very fact of being at home does actually make it less likely that something will go wrong. The “cascade of interventions” risk in hospital maternity wards is real.

I am the most non-woo person ever, I am a very sensible lawyer with a degree in economics, and I had my third at home for that reason. Hospital isn’t always safer.

That said, I had already had two completely straightforward labours by which I mean I didn’t even need stitches and my request for a home birth was completely supported by my midwives. It doesn’t really sound like you are in a straightforward situation at all OP. If I were you I think I’d go to hospital.

I certainly feel that if I'd chosen to labour at home with my third baby I would have been so much happier. She was born within 40 minutes and in the hospital car park, but the stress of being in public whilst at my most vulnerable will always stay with me and made it so much more stressful and harder to get through.

I would choose to go to the hospital (unless it’s very far away). But I wouldn’t want to be induced unless there are other reasons besides your age.

I wouldn't if I were you its not worth risking a baby's life over stick with the hospital

I am very pro home birth and had one myself due to previous precipitous labour. However there are two reasons I wouldn't choose it in your case: the previous haemorrhage, putting you at higher risk of a second; and the distance to hospital if something does go wrong. Also remember the home birth midwives have to get to you (possibly from the hospital) so if your births are that quick they are unlikely to get there in time. Mine took an hour to turn up and I like 15 mins from the hospital but they have to find 2 midwives, get their stuff together and get to your house.

The planned induction seems like the best choice to me, however I would make preparations at home for a possible home birth alone if the baby happens to come early, and I would probably leave the house as little as possible in the 2 weeks leading up to the due date. Giving birth in the car is my nightmare (nearly happened with my first)

@LemonPeonies

They didn't know my boy was back to back til quite late, I had been pushing 5 hours and needed emergency episiotomy and forceps delivery. Its not worth it in my view. You never know what will happen.

They wouldn't let you push for 5 hours at a home birth, you would be transfered to the hospital long before it for to that point. And the "emergency" c section would have been on the cards for a while surely, they don't go from 4 hours 58 minutes pushing, everything is peachy to 5 hours pushing, quick start organising a crash c section.

@UndertonesOfCake

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

Yeah obstetricians, like all people, come out with all sorts of bullshit don't they.

That is a tricky decision. Giving birth at the side of the road is the most dangerous option for both you and your baby though. So you want to avoid if you can!

How big was the haemorrhage? Mine was borderline, so I was happy to go ahead with home birth for the next child. The midwives almost didn’t make it in time but even though it was quick, there was someone on the way with the right drugs from pre baby being born which might not be the case on the roadside.

Can you at least have a conversation with the home birth midwifes to get their thoughts?

But the state of the ambulance near you should also be a factor.

Good luck whatever you decide.

Some people are just anti home-birth whatever the circs, in the face of evidence.

Yours is a tricky one. I had both of mine at home. Labours very quick, had a bleed on the first all dealt with at home. So some similar history, but was younger and closer to the hospital and crucially had dedicated and experienced home birth team.

I would want to really dig into all the options for you with consultant and midwife team, including the risks of induction and increased follow on complications. Sometimes advice is based on general guidelines rather than tailored to that individual. Once I was confident I had the latter I’d feel happier following the advice against my first preference if needs be.

Best wishes for whatever you decide, OP

@Draineddraineddrained

Nowhere in that post does she say "ignore your consultant". She says she wouldn't have a hospital birth unless she had to, not opining on whether the OP "has to" or not.so precisely the sort of post you approved actually.

She’s actively encouraging the op down home birth

Very very actively

And I think that’s irresponsible

By all mean describe very positive home birth experiences

But no one should be denigrating the alternative, which is what the OP’s consultant is “urging” her to do

Aged 41 years, previous precipitate labour, previous PPH and retained placenta, absolutely not to a homebirth. Go back to Consultant and ask for options for induction if needed.

I definitely would have a HB

I had a home birth for first DC. Midwife told me in response to DH questioning my sanity that a home birth was the safest place to deliver your baby.

Second birth experience was an emergency caesarean it was a multiple birth with a known problem for which I was already in hospital when my waters went at 31 weeks.

After that I was consultant led care for the third pregnancy. I had to sign off that I was happy to go against my consultants advice in having a home birth after CS but my midwife was supportive and I was happy to go ahead and it all went smoothly. Although my waters did go two weeks early whilst on holiday so I had to get back home promptly.

In your case a home birth sounds like the ideal solution. It sounds like the complications were as a result of the induction and midwife interventions. You have 2/3 labours although quick were straight forward. Any sign of any issue your midwife will get you in hospital pronto.

Good luck in getting the birth you want.

Women who aren’t consultant led are more likely to die in a NHS hospital birth because the hospital staff are less likely to prioritise them. Women who are consultant led like OP are more likely to come home undamaged and with a baby at hospital

Is there actual evidence for that? Intuitively and based on my one hospital experience itt seems credible, but if its statistically true its pretty damning about hospital maternity care.

But no one should be denigrating the alternative, which is what the OP’s consultant is “urging” her to do

People are not denigrating the consultant's preference for induction in hospital - they are saying get further advice, including from expert midwives.

The average obstetrician has never seen a home birth and the GP at my practice who was the key obs/gynae doctor told me they were illegal.

Its astonishing how few doctors have seen a home birth, or even normally progressing births which makes it difficult for them to assess effectively.

@C8H10N4O2

* I would never have a hospital birth unless there was zero other options. Much more likely to die or have complications in hospital than at home. This is a statistical fact. You get a much better level of care at home.*

You don’t regard this as denigrating?

* The average obstetrician has never seen a home birth*

No, they haven’t
What they have seen is the many home births that have resulted in blue lights to hospital and the obstetrician having to perform emergency surgery or save the life of the baby

[quote Oftenithinkaboutit]@C8H10N4O2

* I would never have a hospital birth unless there was zero other options. Much more likely to die or have complications in hospital than at home. This is a statistical fact. You get a much better level of care at home.*

You don’t regard this as denigrating?[/quote]
How is stating a statistical fact denigrating?

You are more likely to have serious complications or die in hospital. That’s simply statistical fact based on numbers and the fact that more high risk births happen in hospital.

I missed the statistical fact.

What is it?
No statistic included in that post at all!
Just a statement with the assurance that it was a statistical fact. Two very different things

Saying that something is a statistical fact
Is meaningless
Unless you actually… post the statistic and source!

No, my labour turned to an emergency very quickly and I would never recommended a planned home birth for anyone. Just isn't worth the risk for you or the baby.

I was actually born at home in the bath but that wasn't my mum's choice. I just came too quickly!

@Oftenithinkaboutit

Saying that something is a statistical fact Is meaningless Unless you actually… post the statistic and source!

Says you chucking around that obstetricians will have dealt with “many” women needing life saving surgery after attempted home births.

You don’t like home births. Fair enough. Not everyone is obliged to have your blind faith in one opinion.

And as you well know the statistical fact is that you are more likely to have complications in hospital.

@JustLyra

And as you well know the statistical fact is that you are more likely to have complications in hospital.

But what’s the actual statistic?!