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

[everychildmatters]

Because clearly evidence says otherwise!!

Yes, you don't know how your midwife is going to respond until something happens. My very experienced midwife didn't handle my complications at all well and wasn't very proactive about managing them, leaving me in a much worse and more dangerous state. (She acknowledged some things needed to change herself after the fact). Thank goodness for the paramedics who gave me much needed oxygen, which I should have got earlier. That helped a lot.

I don’t think I could handle the stress of working as a midwife or obstetrician if women could say no I’m having it at home and walk away at 42 weeks. Mine were late, the induction took two days to organise for the first and he was born at 41+5 I spent those last few days checking very regularly for kicks and hoping nothing went wrong. Placentas age, and when he was born mine had. The second was born at 9 days over and I felt the same - I had a healthy full term baby who would be fine on the outside world but wouldn’t be fine for much longer inside me and you can’t tell when they stop being fine. I wanted them out where I could look after them. My third was born at 38.5 and she was fully ready to be born, completely reinforced my view that getting them out while you know they are healthy and full term should be a priority. I know of far far more still births where baby just suddenly died right near the end than I ever expected to and they are so so tragic.

Nature isn't perfect but, on the whole, I trust my body and baby to know when they are ready to be born. The only people I personally know who lost babies in the womb were at 24 weeks and 35 weeks. I know it does happen.

I had one at 42+ weeks and we were starting to talk about tests to just check baby was doing okay. Then she arrived. Some characteristics of being a bit over cooked, but I'm happy with how it worked out.

I know someone who was induced based on dates. Baby was born a good size, but with characteristics of being early and not quite ready for birth. Choosing a home birth doesn't mean you can't or shouldn't monitor and make appropriate decisions when they are needed. It doesn't have to be all or nothing.

@99bottlesofkombucha The reality is, "due"date is by far from an exact science. Few babies are born on it. Although my first was dated as 42 weeks he likely wasn't based on clues like size at birth and his general condition; he certainly didn't "look" like an overdue baby at all.
It isn't "all or nothing" as @Doggieheaven says; a placenta doesn't immediately stop working at 42 weeks. In retrospect I would have declined the induction which lead to a whole host of additional interventions, and opted for the additional monitoring and scans. I chose to have him in hospital as he was my first, but would absolutely have opted for homebirth for my second son had my ex-husband been less of an idiot!

To add, it has been suggested by a sizeable number of experts that the term "due date" should be changed to "estimated date" as a more accurate term, and also to prevent unecessary anxiety when baby doesn't arrive on it. Only about 4% of babies are born on this "due" date; the vast majority are not.

I have read several medical articles that suggest that 41 weeks (and in some 42) should be the accepted average length of a healthy pregnancy and that "full term" should be 38 to 43 weeks. This is based on the fact that far more babies are born after the 40 week "due date" than before and that very few show genuine overdue characteristics despite being overdue according to dates. Of those that do its usually due to miscalculation of dates.

In my observation of a lot of birthing women, it seems most babies like to arrive during week 40.

please read. This data covers 3.8 million normal (non anomalous) term births. The stillbirth risk increases after 40 weeks and notably at 41. The statistics say clearly that these are higher risk. Where is the large scale data you talk about that tells us 41 and 42 weeks should be normal? pmc.ncbi.nlm.nih.gov/articles/PMC3719843/#:~:text=The%20risk%20of%20stillbirth%20at,fetal%20deaths%20occur%20at%20term.

Of course you’re happy with how it turned out for you, you got a healthy baby. The mums who didn’t are completely and forever devastated with how it worked out. And all the ones I know of were full term and healthy normal pregnancies.

I was happy how it worked out because baby decided to arrive ahead of the tests I was prepared to have to check they were doing okay. Of course mothers for whom it doesn't work out are devastated. That begs the question of whether the babies were appropriately checked out as the pregnancy went on longer.

I can see where they're coming from.

DH and I were surprised by how ineffective the dating was. A cardboard curclw based on date of last period! We knew the actual date, time and age in days of the blastocysts that were implanted, resulting in the pregnancy. Would the NHS incorporate this information? Of course not. So the date was out by 4 days or 11 days (two "dating scans" that gave dates a week apart).

It turned out DH had done a forecast himself, having the skills to do so, and estimateed Christmas day (but didn't tell me as it was all stressful enough already). I went into labour at lunchtime and DD arrived 2am on Boxing Day!

But you don’t really get drip-drip-drip warnings that the babies are unhappy. They can be fine one minute and in distress the next - monitoring gives a snapshot of how they are at this second, not later this afternoon.

It monitors if the placenta is still performing well, and that's the important thing at that point. It doesn't directly monitor the baby, just the condition of the placenta. Babies are lost, it's a fact of life. A heart breaking and devastating fact of life. We do our best to prevent it but it still happens. They're not even safe from sudden loss after birth. And then children die throughout childhood and adulthood at all ages. You can't prevent everything but you can do your best by having the recommended testing if you go well overdue, so you at least know the placenta is still doing what it needs to keep the baby alive. If someone declines the test or isn't referred for it, then they are taking unnecessary risks, even though nothing is guaranteed.

No, it doesn’t. I had this specific monitoring due to a pre existing condition that degrades the placenta quickly. It doesn’t give you the information you think it does - it gives you an ‘idea’ which is not accurate enough to reduce poor outcomes

https://www.hra.nhs.uk/planning-and-improving-research/application-summaries/research-summaries/placental-monitoring-study/

I think it would be possible to do a MUCH better job on this with a proper statistics project.

Humans are very variable, but one thing they could do is adjust due dates by ethnicity of the parents I think? And as I said, use actual information available from IVF where relevant.

I didn't end up needing the test so didn't get into the details of it, so don't have much knowledge about it other than the midwife was talking about checking the placenta was still functioning well. Regardless, you do the testing and give it the best you can to give the baby the best chance. Still no guarantees any pregnancy results in a live birth, even when we try our best to do all the right things.

But the best chance is being induced by 42 weeks.

I too share the feeling that induction is too widely used, but I haven’t seen anything yet to convince me going past 42 weeks is safe with the right monitoring.

Genuinely couldn’t pay me enough to give birth at home - I’ll never understand it, birth is such a horribly unpredictable process no matter how low risk you are and you’re ultimately putting your new baby in a situation where they won’t get medical intervention as soon as they need it, why would you do that. I understand the preferring your own space, bad hospital experiences but you’re putting yourself first and not the baby if we’re all being honest

My local hospital was regularly topping lists of the UK's worst performing trusts, and the local press were full of stories of women giving birth in car parks and so on.

I really felt I was between a rock and a hard place with that one.

My point was not that these women were very overdue, the ones I know were all term. They could all have died between the overdue checks anyway, as they don’t check every day. A healthy full term baby one day may not be a healthy full term baby the next day and there’s often not a reason, or in 4 out of 4 cases I know of anyway. You could get monitored one morning and come back later the next day and there’s nothing they can do. And the risk of that happening climbs as the baby stays in there longer. Not a risk I’d ever take past 42 weeks, and I don’t like going past 41 weeks but they won’t induce till 10 days over in the nhs, or where I was in London anyway.

Yeah the placenta monitoring tests won't tell you anything other than "it's currently working". We know placentas start to degrade from 37 weeks, and they reach a high rate of degradation at 41 weeks. Anything beyond that and stillbirth becomes more and more likely.

I know a woman who didn't have an induction, healthy baby went overdue and died. The statistics don't lie.

And I don't really understand why you would go against solid medical advice/research and keep a baby in beyond 42 weeks.

One woman proudly told me about how she refused an induction at 42 weeks, and I just kept thinking about the the woman I know who had a stillbirth because she wasn't induced.

I think women should do what is statistically most healthy for the baby, not what they want irrespective of medical advice.

The point is that the way NHS measure the length of pregnancies, it appears to be complete guesswork whether 42 weeks has elapsed or not!

Absolutely fine to say "at 42 weeks this is recommended", but you need to be rigorous about how you're dating 42 weeks - right?

@MsCactus But as I said previously, EDD is just an estimation. My "42 week" baby was not 42 weeks.

Exactly. My baby that was born at 42 + 2 was a scan due date given to me at 20 weeks. My own dates were a bit uncertain as my cycles weren't regular at the time. My own dates made it right on 41 weeks, which is the longest any of my babies has ever gone. They are usually born between 40 weeks on the dot and 40 +3.

Yes but the risk actually starts increasing from 37 weeks, and becomes a lot more at 41 weeks. So even if you were technically "only" 41 weeks you'll be at a higher risk for a stillbirth and the risk climbing each day.

Also there will be errors the other way - women who think they're 42 weeks and are actually 43 or more.

The guidance is based on using the most accurate form of dating - which is using EDD from a 12 week scan, not from your last period or ovulation. Again this has been proven to be the most accurate from research into due dates.

It's all based on what is "most likely" based on studies, but I think you're a fool to ignore medical research on this matter when it literally increases your babies risk of death tbh