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

[everychildmatters]

Because clearly evidence says otherwise!!

I agree, if you make the informed decision then that means accepting the consequences.

I think it gets tricky when people claim they weren’t informed properly beforehand. There was a high profile case of a pregnant woman who was discussing birth options with her consultant and whether or not to have a cesarean. The woman had some risk factors and the doctor knew that this meant statistically she had about a 1 in 10 chance of shoulder dystocia occurring in a vaginal delivery. However, she purposely chose not to disclose this information as she felt the patient should opt for a vaginal birth. The woman did end up having shoulder dystocia and her child was severely disabled as a result.

Yes in that case she absolutely should’ve sued.

They’ve updated the article on the current inquest, it is again a very sad read. I can’t imagine how unwell she must’ve felt - I lost a lot of blood after DS was born and had to have iron tablets, I don’t know if it was technically a haemorrhage but I felt so shaky and weak that when they forced me into the shower I had to press the emergency buzzer.

I think you're referring to Montgomery v Lanarkshire - went to the Supreme Court.
The Claimant (Nadia Montgomery) later qualified as a lawyer and is a big advocate for birth safety and consent stuff, and her son, while diagnosed with cerebral palsy due to the dystocia, is I believe doing very well and went to uni!

Planned home births with experienced midwives and a solid backup plan worked for me. I used independent midwifes with backup from a good obstetrician. DC1, a month late with back to back presentation until the last minute, was born in hospital. The rest (same presentation but we felt from DC1 that they would probably turn) were home births. All went smoothly but my midwives were very experienced.

Your first baby was born at 44 weeks?!

I don't deny that the cascade of intervention is real and does cause complications, but that is a separate issue.

In birth, things do and can go wrong. There have been a number of births that were unassisted (a different discussion to midwife attended home birth, but no intervention is the point) and things went wrong to the point of death.

I had a midwife present who didn't do a single intervention, other than occasionally listening to the baby with a doppler in whatever position I happened to be in at the time. One of my births is an example of what can go wrong. Reasons:

High parity - this can increase the risk of the type of complication I had.
Large baby - can also increase the risk.
Cord issues - probably the ultimate cause.

Unassisted, midwife at home or hospital, I would have had the same problem. I don't regret that it was a home birth. All the while though, I can acknowledge I would never have got as close to death as I did had I been in hospital. If I'd had a c-section, in hindsight, it would have been very justifiable, even for me who is against any unnecessary intervention in birth.

Yes, interventions can cause problems and complications, but let's not stick our heads in the sand and pretend it's the only cause of problems. Sometimes things happen all on their own during birth.

I am still very pro home birth and comfortable with the idea, I would have no problems with my daughters choosing to birth at home, however I am realistic and birth carries risk. Otherwise why did you have a midwife present in the first place? Because we know that sometimes, things don't go to plan.

Misinformation is not the same thing as information you don't like.

@Switcher To believe that all home births are riskier than being in hospital is misinformation.

44 weeks snd 3 days. My first appointment with the midwives was 9 months before DC1 was born

So shortly after conception?

@notquiteruralbliss Fair play to you on not accepting an induction ❤️ I was induced with my first at 42 weeks (I was only young at the time and felt huge pressure to be) but in hindsight I wish I'd have declined and waited.

No, it’s not.

@Swiftie1878 You clearly know more than the research, the NHS etc.

I don't know if people are discussing the recent case where the mother and baby died in a homebirth, but from what I've read, it seems like the mother may have had appointments discussing risk that her husband did not attend.

The other thing is that I had a previous PPH but wanted a birth centre birth the next time around which is outside of their guidelines. I didnt know this until I booked. Anyway, the midwife did not go through risks with me extensively, the consultant did at 34 weeks and because my PPH was due to trauma and not tone, the consultant was actually fine with a birth centre birth. Midwife just explained why she was referring me to the consultant for this appointment much later on in pregnancy.

My midwife just continued with her normal care and that felt right to me. I wouldn't have wanted her to keep going on about it from booking to 41 weeks pregnant.

No, but I know you are determinedly misinterpreting it to suit your own narrative.

@Swiftie1878 Rubbish. Read the guidance. Are you US btw?

No. UK. And the guidance is pretty clear.
All high risk pregnancies are recommended to go to hospital. Because it’s safer.

I don’t have an axe to grind (unlike you) and recognise that risks are to be weighed up and women can and do choose to birth at home because there are huge benefits to doing so. Safety is NOT one of those benefits.

Because low risk can turn into high risk in the blink of an eye. A text book pregnancy with no issues at all still doesn't guarantee that nothing will go wrong during labour and delivery.

@Swiftie1878 Did you miss the word ALL home births? This lady was high risk and therefore advised against HB. Many times.

The problem is that until Labour starts, no-one knows how it’s going to go. Some go brilliantly - no issues with either the baby or the mother. Some don’t. When they don’t, it’s safer to be in hospital. Given you don’t know how it’s going to go until it’s happening, hospital is always the SAFER option, but mothers may take other considerations into account and weigh up the risks vs benefits of staying at home.

I have really mixed opinions on this. On one hand I fully acknowledge a women's right to choose her birth (as far as possible) and that being at home may make the birth go smoother if she feels calmer and more comfortable.

However, as a paediatric specialist, I have seen several cases of 'home birth gone wrong' where the mum was seen to be low risk, and what hapenned was hard to anticipate, but the babies got into trouble and are now severely disabled as a consequence, with very limited quality of life. I was also potentially one of these - DD1 was born when I was 32, I was fit and healthy, no concerns re me or baby and I was offered a home birth. I declined and chose the birthing centre which was on a hospital site but seperate, and calm and quiet. I had a textbook early labour, laboured in water, and then after several hours suddenly all the alarms went off and 6 drs were in the room within 2 minutes and they had to get her out quick, there wasn't time to even get me to theatre for an emergency c section so I consented to a quick forceps delivery, she came out unresponsive but they got her back within a couple minutes. I also bled+++ and ended up on HDU and needed repair surgery as tore badly. As a home birth she definitely wouldn't have made it, and I might have not.

What we need to do is make hospitals feel calmer, more welcoming, more supportive so women don't have really negative hospitals experiences and then go on to chose a home birth for negative reasons. I would never advocate removing the choice of home birth, but wouod hope that more women would chose a hospital birth if we made it a better experience.

@Bushmillsbabe I personally would still chose home over hospital (unless advised otherwise by a healthcare professional with an overview of my care), but I do agree that maternity care in the NHS should absolutely be improved.

I wish - I stopped work at 38 weeks and I'd run out of maternity leave (which was then 6 weeks) by the time DC1 was born

TBF it wasn't suggested. as I was intending to have a home birth and was simply using the private hospital as backup. For the last 2 weeks I trundled in to each day to check readings and would have gone for plan B if I felt it was needed.

Look I have absolutely nothing against homebirth at all, and probably would have chosen one if I was a healthy low risk second time mum with a straightforward previous delivery and lived within 10 minutes of a hospital. Am I bit jealous of mums who were those things, and had a lovely experience? Of course! But I’m not speaking from a place of jealousy when I urge some caution, because I can be objective and don’t attach judgements to my feelings where facts speak for themselves.

Although this lady’s risk factors and very ‘hands off’ birth plan was quite clearly unsafe, I am still shocked at the ‘care’ she received at home, and I think it’s really important this story is shared as a massive part of homebirth advocate’s reasons to choose home is ‘better care’. This lady did not receive better care in my opinion, in fact it sounds woeful. A homebirth midwife with no experience of resuscitation and no experience of postpartum haemorrhage! I mean these are 2 emergency scenarios that I would’ve thought homebirth midwives were especially trained to deal with, given they could happen at the lowest risk deliveries and have the most serious consequences.

Add to that the fact the gas and air ran out, the resus equipment was faulty, key obs weren’t recorded properly, and when the baby was born not breathing it sounds like they completely and utterly panicked and lost control. The attending paramedic said they hadn’t even switched the lights on, clamped the cord or kept the baby warm ready for their arrival - he sounded shocked that they were flapping so much they hadn’t done basic things to keep a modicum of control until they arrived.

If the care had been better they may still have died but that doesn’t excuse such woeful care - precious minutes would’ve been lost, minutes they didn’t have. I have heard repeatedly on here how experienced homebirth midwives are and how they’re trained to deal with emergencies away from the hospital, but this was very much not the case here. Ladies should be aware their care will depend on who they get, same as in hospital.