To be fed up of the "home birth is risky" misinformation?

[everychildmatters]

Because clearly evidence says otherwise!!

@Bigpinksweater Exactly - she would have been advised against HB. But what annoys me is then people start to falsely believe that all home births are unsafe. Absolute crap.

She also haemorrhaged before.
She absolutely should have given birth in a hospital. Such a sad, sad outcome.

@OverlyFragrant The NHS doesn't agree with you 😆

Really? What bit exactly?

“From the NHS website:
But if you’re having your first baby, home birth slightly increases the risk of serious problems for the baby – including death or issues that might affect the baby's quality of life – from 5 in 1,000 for a hospital birth to 9 in 1,000 for a home birth.
If you've had a baby before, a planned home birth is as safe as having your baby in hospital or a midwife-led unit.
It's rare, but if something goes seriously wrong during your labour at home, it could be worse for you or your baby than if you were in hospital with access to specialised care.”

Whar about the last paragraph @everychildmatters ?

My first birth required intervention and resuscitation so DD wouldn't be here. My second was easier, resulted in theatre due to a retained placenta.
I wouldn't risk it.

But if you say home births are only safe if XYZ then that means they’re not ‘safe’ as such. They may be safe for certain group of women, but not as a general rule. Does that make sense? It’s like saying ‘running a marathon is safe’. It’s safe for fit people with no exacerbating health issues but if the average person tried to run a marathon today they’d probably suffer a range of effects from pulled muscles etc all the way to a heart attack. Plus sadly even those who have trained occasionally die running one - the London Marathon usually has a death among its runners.

Plus the measure of a successful homebirth isn’t whether mother and baby are still alive. Like I said upthread I follow a very health young low risk woman who had a homebirth a few months ago. She had a very obstructed 48 hour labour, and an emergency episiotomy just as the ambulance crew arrived meant her baby technically was born at home and alive, but she has had reparative surgery since and is still in pain and unable to even push a trolley round a supermarket thanks to her 8 hour(!) pushing stage. Would you call this a ‘successful home birth’? I had an extended pushing stage with DD1, after 4 hours she was born via a swift forceps delivery without any lasting damage to her or me - I was pushing a trolley 2 weeks later and haven’t had a single episode of incontinence. Another 4 hours pushing would’ve done God knows what to me! Yet her delivery is on paper ‘successful home birth’ and mine is ‘instrumental hospital delivery’.

The elephant in the room.
People say they chose hospital birth as it is safer, and they wanted to be safe.
But unfortunately, many women do not feel safe in hospital. And not feeling safe makes birth harder.

@noworklifebalance But personally I believe things are more likely to go wrong in hospital settings in the first place. Poor care, inadequate staffing ratios, issues of time pressures, overuse of unecessary interventions and procedures etc; these all can contribute to negative outcomes and of course tend to happen less in the case of planned HB.
I would be interested to know how many of these "emergency" situation in hospitals arose because of these elements.

This is the nub of it all.

To add to this, unfortunately some women are not 'safe' in hospital if midwives are too over stretched to monitor them properly.

The value of having equipment and professionals to hand is diminished if no one actually spots that you are in trouble.

I read a lot of research at the time which suggested I was at far higher risk of unnecessary intervention (in itself risky) in hospital. Can't remember the sources but I'm sure if you did a search there is plenty of evidence out there.

The Lancet also published a report which concluded that

"The risk of perinatal or neonatal mortality was not different when birth was intended at home or in hospital."

https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(19)30119-1/fulltext

Can't get an epidural at home

The point is that should things go wrong during a home birth, it is much more risky for the mother and child than if something goes wrong in hospital.

What about morbidity?

And what does “intended to give birth…” mean? How many who intended to give birth at home decided to or had to labour and deliver in hospital (and vice versa).
Reading the article on my phone so difficult to find this info. hopefully will read it properly later tonight.

I don’t think the two parties on here will ever see eye to eye. I do think home birth and ‘natural mother’ types in general can be absolutely vociferous about defending their choices and while I understand to a certain extent, they tend to come from a place where all these things are options for them and so confirmation bias comes in as well as a lack of understanding of people whose circumstances are different. In a sense they’re a bit ‘privileged’ and will never really know what it’s like to actually have to make these decisions when risk factors come into play.

I was a low risk birth but bled out massively and needed a blood transfusion, I was very grateful to be in hospital and would never advise a home birth as you never know what could go wrong.

Well, my second birth was very quick (I was only in the hospital 15 minutes before my DS was born) but I unexpectedly haemorrhaged so that theory wouldn’t haven’t applied to me.

I don't think it's helpful to see it in terms of a conflict (and saying 'natural mother type' is just a bit inflammatory). It's obvious on this thread that lots of people have had really unpleasant and frightening experiences giving birth generally - in and out of hospital. It's no good trying to contradict people's personal experiences on either side. I think people should be supported to have home births where the risk is low and if they want to. I think people should be able to give birth and have access to a safe and dignified labour in hospital if that's what they want and/or need. I don't think either one is superior or makes anyone more of a mother or whatever. But it is simply not factual to say that hospital births are always safer than home births and women should not be frightened away from considering it.

The problem with research comparing home birth with hospital birth is that it is always done in countries where If there are any problems, women are transferred to hospital. Your chance of getting an ambulance in the UK now in an emergency is much, much lower.I find it quite ironic that the people who think hospitals are not safe for giving birth seem to have great faith that an ambulance will arrive when they need one.

And thats why when planning a homebirth and alternative back up is usually prepared, often the birth partners car. My midwife said that it is good to have a back up in the unlikely circumstances of a delay in an ambulance transfer. In my case it was my father as my ex didnt drive. He was put on alert as soon as I went into labour and didnt leave the house until it was all over.

The whole point of planning a home birth is covering the eventualities as far as possible. My midwife said that they had never needed to use the back up except in cases where women wanted more pain relief and transferred in for an epidural.

But it seems that you wont concede the point that home births can be just as safe as hospital (and in some cases more so) at any price.

And actually the further article on this very sad case today indicates medical mistakes at the home birth as well - I guess malpractice or poor care doesn’t just happen in the hospital. The midwives didn’t record her blood pressure or heart rate, didn’t follow up worrying readings etc and then lost the notes they did write because they jotted them on an incontinence pad and threw it away when clearing up afterwards. The midwife interviewed also said she had never resuscitated a baby before and was panicking, and the equipment was not fit for purpose.

Just wondering what the OP makes of the above.

Not true. I had 5 hospital births and one at home. Two were because home birth honestly didnt cross my mind. Two were because I booked for home but medical reasons required I birth in hospital, I didnt question having to change my booking as it was best for the babies. One because I was very over due and agreed to an induction.

Last one, home birth, no issues but I would have changed if my midwife had told me I should but she and her colleagues were happy to go ahead and I trusted them.

Yes but you’re an unusual case. Most people don’t have 5 or 6 children to test out the various scenarios that can arise - most people have 2, and the usual pattern is a ‘bad’ hospital birth (which may be poor care but may also just be because first babies are notoriously a worse labour), followed by a home birth (which again may have been great due to good care, but may have been smoother because it’s a second baby). They then conclude home birth is much better.

https://www.manchestereveningnews.co.uk/news/greater-manchester-news/midwife-scrawled-heart-rates-incontinence-32684929.amp

Here’s the article by the way. I’m quite shocked a home birth midwife had never resuscitated a baby before and couldn’t work the equipment which didn’t even fit the newborn baby. Although the mum did obviously make high risk decisions it sounds like they lost control.