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

[everychildmatters]

Because clearly evidence says otherwise!!

All of this! Avg cat 1 response for my entire region is 11 minutes, would be longer where I am. It's then over an hour to the hospital assuming no traffic issues. My region has the slowest response times in the UK afaik.

Air ambulances won't take women in labour.

My mum had to be driven by my dad to hospital when she was well into DKA.

I had to drive my dad, twice, when they thought he might be having a heart attack. Another time they ended up sending a taxi after 12 hours of waiting. I shit you not.

So yes, I would most certainly have died, as would my son.

@CremeBruhlee Birthing in hospital, for me personally, is not something I would want to do unless I was advised against HB. So many reasons why.
Not that I will have another one - I'm 45 with one fallopian tube and a husband who has had a vasectomy! Bit rubbish really as my last birth was height of Covid so not the mat leave I'd hoped for. At least I got a great birth experience though which I look back on with great memories, as does my husband. Especially significant to him as our little one is his only child ❤️

I'm glad you'd not have a home birth if advised against it.

My main concern with home birth is that, from my observation of long involvement in the community, the discussion isn't very balanced. Then, in my experience, when something serious does happen, it's swept under the rug and down played.

I think you can support home birth while acknowledging that birth does carry risks, shit happens, and women need to know about that sort of thing when deciding where to birth. Birth is never risk free.

I am pro home birth. I had a good number of them myself. I'd be comfortable if my DDs decided to birth at home. However, any future births I had would be in hospital because, on balance, that is now the best place for me.

@everychildmatters Started this thread because she was pissed off with the misinformation floating about has descended into a thread full of people saying that anyone who chooses a home birth doesnt understand (or worse, care) that their baby may die. As if we dont all know that sad fact from the second we see the blue line. Like homebirth is somehow guaranteeing neonatal death if there is a complication.

This is EXACTLY what she is talking about.

Why cant there be a discussion about this without those of us who have chosen home, for our own reasons, having to defend our choices?

I respect people who choose hospital. I have done the same myself as I posted above. But I have also chosen home. Why is it only the choice of home I am expected to defend? I personally think that opting to give birth in a hospital that is failing (easy to look up via CQC) over home with qualified and attentive midwives is a stupid decision. But I dont expect anyone to defend that. They chose, I chose.

This thread wasnt about defending positions, but that is what it has become.

The problem is that there are so many factors to consider and anecdotal evidence describing either home or hospital births don't quantify risk overall.

The problem is the lack of balance on both sides. Both sides seem to be all or nothing in favour of their choices. A more balanced approach would acknowlege the pros and cons of both sides and conclude that nothing is risk free. In my opinion anyway.

Anyone who chooses the less mainstream approach in anything at all usually finds themselves in a position where their choices are called into question. Not saying it should be that way, but it is.

I'm not even particularly pro home birth, but there are aspects that get overlooked by people

A) The threshold for transferring to hospital is very low. Far lower than the emergency situations in hospital that people tend to compare this with. Chances are the mother would have been transferred long before that.

B) Monitoring by the midwife is crucial and one advantage of a home birth is that you have one midwife (at least), entirely focused on you. That's not necessarily true of hospital births and the most catastrophic birth outcome I am aware of personally, was a result of over stretched midwives not monitoring the mother sufficiently on the hospital ward.

C) It may be that giving birth in hospital increases interventions, which, in turn increases likelihood of poor outcomes. Here, I'm on less solid ground as I think this is hard to accurately measure. But I take the point.

Then all of this needs to be considered in relation to what happens of things go wrong, distance to hospital, etc, etc. The risks need to be weighed up in every individual case.

Personally, I was not even close to being a candidate for a home birth, so it wasn't an option for me and I think all women should be sensible in the choices they make.

However, for a low risk, second time mother, home birthing outcomes are (better?) at least in a par with hospital outcomes, so that feels like a very legitimate choice to me, assuming the home is within reasonable distance to the hospital.

I don’t think people do respect hospital though. From reading this thread you would think they were barbaric torture chambers for the unimaginative and ultra conventional. I haven’t seen a single positive about them from the homebirth crew.

As I said this sad story shows the medical care at home is still just an extension of what the hospital provides and they may be inept, lazy or careless. While the woman in the article made a very high risk decision it seems contributed to by the inexperience of the midwives present.

My experience of the hospital was that it was a barbaric torture chamber when unnecessary routine interventions were carried out that started the cascade of interventions. The midwives were great, this is all on the doctor attending.

If you want a positive about hospitals, when I was transferred with my last baby, every paramedic, nurse, midwife, doctor was fantastic and supportive. Very competent, communicated well, friendly, and didn't do a thing more than needed (which was a lot but if it's needed, it's needed). For a birth that could have ended so very differently, I am still able to say it was a positive experience and they were part of it. Hospitals do have their place.

Okay, in the interests of balance

1. DS 1's birth was in hospital, extremely traumatic, my waters broke, I never went into proper labour, was induced (awful), but birth didn't progress. The midwife and then consultant suspected serious complications, they were right, I was in theatre in minutes (GA), all fine in the end. I am immensely grateful for the HCPs that spotted the signs and got my baby out in time.

2. DS2's birth, planned c section, wonderful experience.

But equally, my friend was the fabled low risk, second time mum, who had a homebirth which sounded fantastic. She was very close to the hospital and lucky enough to have two midwives in attendance. Her circumstances were very different to mine.

I feel strongly that there is no one way to have a good birth. My planned c section was great. As was my friends home birth. I hope all mothers get to make choices that feel right for them in line with the medical guidance.

Well I have done both. Decisions made with solid information and the support of medical professionals each time.

So yes I do respect those that choose hospital. That others dont is not my, or the OP;s, fault.

I’ve just had a little look on statistics and it seems, for low-risk mums who have given birth before, there is literally no difference at all in outcomes, yet lower rates of intervention. So it really isn’t riskier at all to opt for home birth if you’re in that category.

For fist-time or high-risk women, it does seem like adverse outcomes are higher with a home birth so I wouldn’t personally choose one in those circumstances.

@PyongyangKipperbang Totally agree and you've summed it up so beautifully. I think people (women especially) who don't do what most other women do are often unfairly "had a go at" and are challenged to defend themselves. Examples: I bedshared from birth (all three of mine) following the Safe Sleep 7 = my baby will die from SIDS. I breastfed until 3 / 4 years = I am abusing my child. I am a married Ms = I am disrespecting my husband. I refused to put my August-born in Reception year as he wasn't emotionally ready = I am holding him back unfairly (he just got three A stars and an A in his A-Levels so think I've disproved that one?!) The list goes on, despite none of these being the truth.
I did not put my baby at risk by electing a home birth; in fact, quite the opposite, especially considering that we were in the height of the Covid pandemic at the time (even though I'd opted for a home birth before this was even known about).

I think it would be very difficult to travel in a car if you are in the process of giving birth and something goes wrong..

Er, YABU and when something goes wrong, you’re taking a consultant out of a hospital full of people who need them!
https://www.mirror.co.uk/news/uk-news/midwife-spotted-something-unusual-before-36069583.amp

@Pikachu150 Unlikely you'd actually be giving birth whilst in the car. As @PyongyangKipperbang said, you tend to have a travel plan in case you need to be transferred in (although my midwives said it very rarely happened). Mine was my husband as of course quicker than waiting for an ambulance to come out. The transfer would be made at the first slight indication it may be needed. My IM was with me right from the very early stages of labour so she could monitor closely.

@TooManyFools Eh? No - I was freeing up the overwhelmed NHS midwives (Covid).

Why is it unlikely that you would be in the process of giving birth in an emergency?

My midwife said that, in her experience, labour tends to stall during transfers.

Well, you still aren't doing it right, because the earlier stuff is good, but you didn't home school. Dropped the ball when he was 5. ;-) (tongue in cheek)

You haven't had reason to lose trust. My midwife told me that as soon as x was needed she wouldn't hestitate to... Guess what she didn't do? I trust no-one to do the right thing in birth care now.

If I hadn't been in hospital when I had DS1 I wouldn't be alive now.

Home births are not safe for everyone.

I am sure you are right. But as I know you know, that is not the point I was making.

No one has suggested for a second that they are.

That isnt the point of the OP. Her point was that there is so much misinformation and fearmongering out there (ok, I added the bit about fearmongering but this thread has proved that bit) that some women for whom home birth would be a valid and safe choice are not even considering it as an option.

"But what if something goes wrong!" is the standard argument trotted out against home birth and just proves the lack of education of those saying it. They assume that a home birth is the same as a hospital birth just....at home.

It isnt. The protocols, the care, the risk assessments are completely different. Thats why I said earlier that saying "my child would have died if I hadnt been in hospital" is an unproveable point in many cases.

It’s a very UK thing NOT to consider VE during birth not necessary 🙄
(also apparently nordics and NZ)
in the rest of the world it’s routine monitoring practice and they would consider it negligence if they weren’t done

so it’s not the gotcha doctors are bad moment you think it is