To think about a home birth for my first baby?

[consideringhomebirth]

Trying to decide. Initially I thought home birth was a crazy idea and that things can go wrong in a split second, but I have seen research online which says there is actually no increased risk. Now I am thinking twice.

I know I either want a no-interventions birth, or a planned caesarean. Two extremes but I don’t think labouring for ages in my hospital would be ideal for me and I would feel quite stressed, plus the recent enquiry into UK maternity services is not great. 45% of all births in the last couple of months at my trust were C-sections, majority being emergency ones. A large proportion of women seem to end up being induced and there is a high rate of induction being unsuccessful and leading to emergency section or assisted deliveries, which would be the worst of all worlds for me.

I am low-risk and baby measuring on the 60th centile. Is home birth the gamble everyone says it is? We are 10 minutes from the hospital by car. If we went for this option we would have midwives at home from the homebirth team and you get transferred to hospital should anything be not quite right.

I’d be so much more relaxed at home- but only if everything went right, obviously, and I understand birth is quite unpredictable.

I’m speaking to my midwife about the options I’m considering soon. In the mean time any thoughts or experiences welcome. :-)

Things can change in an instant. The first thing to consider is how close to the hospital are you? Because if the baby goes into distress if it cannot fit through the birth canal which you will not know until in labour, you could have a matter of minutes to get the baby out. If it's a 10 minute drive for example even with blue lights and an available ambulance your talking 15 minutes before they can rush you down to theatre. Reality is you may want a planned section or a no intervention birth but would you rather let your baby not survive if an intervention was required? Personally I always think the domino method is best, go into hospital once contractions about 5 minutes apart, have baby where you know in an emergency they can do what's needed, then head home in a few hours time.

It's a no from me. I was no risk and ended up with massive PPH, so I was lucky I was at the hospital and got blood transfusions and help immediately. I don't want to think about what would happen to me and DC if we were at home.

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This was us too, even for second baby. Best case scenario - the idea of 10min transfer by road + then say another 10min in hospital to get to wheeled to ward, to have drugs administered, theatre ready etc, both could have been born with hypoxia induced brain injury.

Both of mine had extreme decelerations - one when I was ready to push (had forceps), second during pushing (had ventouse). Both born blue and acidotic based on cord bloods. The decelerations came on really suddenly and were pretty severe, their heart rates just did not recover. I'm really grateful for a) continuous monitoring and b) assistance. Possibly was due to back-to-back position with both.

Those who had lovely home births have survival bias. I'm happy for them, but I would never recommend people to take the risk, no matter how small and unlikely. The outcome just could be too bad for words.

Stating the obvious, but... nobody would choose an emergency c-section but if you're in a situation where you or the baby needs it, it's the best option in the circumstances.

There is no way I would have a home birth at the moment. If you needed an ambulance you may have to wait for hours even if the situation was life threatening.

If you think the ambulance would get you to hospital within 10 minutes of calling you obviously haven't tried getting one recently.

@apples24 but you have the same bias. We are all just giving our own experiences, which vary hugely, as all labours are different. I think referring to those who had successful labours at home as having 'survivors bias' is rather melodramatic

But not obligatory. You don't have to agree to it

But the reality is that in most trusts ambulance waiting times are now hours, not minutes, even for life and death situations.

It just seems like a big risk when you have a free birth healthcare service (less so if we had decent ambulance times). People are just sharing their opinions - if you'd rather accept a greater risk to your baby then up to you

But the thing is, that for second and low risk births the outcome for the baby is the same and for the mother slightly better. So the idea of ‘survival bias’ in these circa is not correct. It’s not taking a greater risk, but maybe a different one. Would people blame the choice to have a baby in a hospital if the baby had a hospital acquired infection, for example? I would hope not.

Overall though, it’s such a scandal that maternity care is on average so shoddy that we have to consider where care is likely to be the least worst.

Having said that, shoddy ambulance service would give me second thought now as compared to when I had mine. Again, depressing.

I tried to have a home birth with DC3 which looking back was batshit because my first two births went badly wrong. I think I was just terrified of going back to the hospital and convinced myself it was the hospital’s fault it went so wrong. I ended up being transferred to hospital after about 8 hours at home, the midwife said it wasn’t progressing quickly enough. She was born maybe 4 hours after we got to hospital and it was the first birth where nothing dramatic really happened but I did lose slightly too much blood and I was kind of glad that amount of blood wasn’t at home.

For me it would depend how quickly you could be in a hospital if things do go wrong because it does obviously happen and quite quickly with first births being the highest risk. If you’re miles away from the hospital, I wouldn’t do it but a 5-10 min drive then maybe.

That would be the biggest worry for me, especially with OP being a first timer. Knowing you're not making a decision in a society where you can reasonably expect a prompt emergency ambulance.

I had a textbook perfect home birth with my third. Contractions started 9pm, baby born at 1am (so 4 hrs start to finish). Water birth in the kitchen. No stitches. Everything was covered in dust sheets and we were sipping tea with the whole family in a clean house that afternoon. No hint of what happened that morning.

I was low risk, experienced, and lived next to ambulance station so this doesn’t apply to everyone.

The best part was big brother and sister waking up the next morning for school and finding a new baby in our room!

EDIT TO ADD: I’d say consider it for subsequent births but not first time. Just in case. Also, give birth in an upright position to help reduce likelihood of intervention!

I was home within 3 hours of my hospital birth with my second. Her big brother woke up to find her at the bottom of our bed.

I home water births with both of my DC. Both were fantastic and calm. It was a lovely way to birth my children but I wasn’t at all scared. If I was in any way anxious I would have birthed in a hospital.

@wombat15

The midwives told me they always have one on call for them when they do homebirths.

You can plan for it , but be prepared that plans may need to change quickly , which is the same for any pregnancy / birth. Make sure you have a hospital bag packed for you and your baby ready just in case.

Research on safety for home v hospital births is mixed, mainly due to parameters of the different researches being inconsistent.

There was a very sad post on here some time ago, from someone who’d been bent on a home birth for her first, and later bitterly regretted it, because there were complications, without the necessary specialist help quickly available, and her baby was born with brian damage.
Personally I think you’d be mad.

When was that? I don't believe there will be one hanging around doing nothing while someone has a home birth. They aren't getting to people having heart attacks or strokes for several hours in a lot of areas.

Not anymore, they don't have the resources. They will send one as soon as is possible but there is not an ambulance on standby for a homebirth.

Maybe they aren’t getting to strokes or heart attacks for hours because they are parked up reading a paper outside Mrs Jones’s and her NCT groups houses waiting for WhatsApps from midwives!