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

[everychildmatters]

Because clearly evidence says otherwise!!

My current hospital is a small secondary one. There are no obstetricians or anaesthetists or paediatricians after hours or on weekends, so if you have an emergency the team has to be called home and wait.

When I was working at a tertiary hospital often the theatres would be busy. I once had to wait 2 hours wirth a woman haemorrhaging before being admitted to OT. The midwives were the ones tasked with keeping her stable until OT was ready.

So no, necessary emergency help is not always immediately accessible at hospital. In one of the last home births I attended, the woman had a postpartum haemorrhage which myself and the second midwife managed. That woman was at the hospital in 40 minutes where they only neeed to monitor her, as we had stopped the hemorrhage and administered all the emergency drugs before arrival. The woman was really happy that she had had a home birth and the hemorrhage and ambulance transfer was just part of the care she expected from her homebirth midwives if things didn't go to plan. All HB midwives are prepared for this and can stabilise a woman and/or newborn for transfer if necessary.

Sometimes I cover remote rural areas where a hospital is over 3 hours away. Transfer may involve a helicopter rescue (which I am also certified to do). In these areas, my threshold for intervention/transfer is obviously much lower than when I am working in hospital. This is part of the hierarchy of decisions midwives and women make as part of their very individualised care and experiences.

Each woman and baby will have a different risk background and we have these discussions with them during the whole antenatal period. Midwives and obstetricians can discuss the obstetric risk with them, however the women have other risks and other factors which affect their decisions, not exclusively medical risk.

When you plan a hike in the wilderness, a skiing trip or a holiday abroad, you also consider the medical risks (you can fall and break a leg, hit a tree, your rental car can crash...) and try to mitigate them. But the final decisions will involve many more factors than medical risk only. If you only considered medical risk in your life decisions you would spend your life stuck at home and living in a flat close to the hospital just in case... in summary... you wouldn't have a worthwhile life.

The same applies to the decision about place of birth: for many families the decision to birth at home or hospital includes medical risk, but there are plenty of other factors in their individual lives which may be equally important, or even more important, than a relatively small medical risk. A risk of 1 in 500 can be very small for some people and very large for others.

Do you know what's the highest risk factor for maternal death in the UK and most of developed countries?

It's not hemorrhage, it's not infection, it's not any of the labour and birth risks you may be thinking about.

It's suicide.

All the "safety" you imagine you have in hospital will be for nothing if the woman ends up killing herself after her labour experience due to a traumatic birth or a consequent postnatal depression.

So before telling others what they should do about such an important even as their birth, please consider that other women's lives are not like yours, and their reasons to make decisions you would consider "risky" as are valid as yours to birth in hospital.

What an amazing post.

And from a woman who isnt just repeating her own fears and prejudices borne of ignorance, but from one who actually knows how these things work.

Thank you.

@MsCactus Well all I can say is that I wouldn't be induced again as the labour was absolutely horrific and definitely caused a dangerous cascade of intervention; I would opt for additional monitoring. Induction carries risks as well we know.
But that's by the by as I will never have another pregnancy. My second son was 10 days "late", my third child (home birth) a few days' "early" (waters partially went about 3 days before she made an appearance!)
Each to their own. For example, I think opting for a C-section is not a great idea (unless medically necessary) but it's completely up to the pregnant woman ateotd.

@aurynne Everything you have said 💐
I don't think one person has really talked about the mental health of the pregnant woman on here as a factor. And by gosh, that matters. So many people will say (after the birth): "Well the only thing that matters is that the baby is OK." It absolutely isn't.

It is a great post. Truth and well balanced. It also reflects what I said to my father when he was worried about the risk of home birth. "Would you feel happier if I birthed at the birthing centre or small hospital then?" He said, "Yes, that would be a much better option and I'd be happy with that." So I told him, "Then you shouldn't have a problem with me having a home birth since the midwives will carry all the safety gear you will find in a birthing unit or small hospital, so it's not really much different. If they have complications there, they also transfer them by ambulance to hospital." He couldn't say much after that.

https://www.dailymail.co.uk/news/article-15206575/home-birth-mother-died-baby-traumatic-delivery-hospital.html

I did laugh trust me there is no mess half an hour after you wouldn't have a clue what happened in your home lol...all 7 of ours were born happily at home best thing ever for me having your own private midwives and just left alone, then dive into a lovely bath right afterwards. The twins coming was a little more cramped as 4 midwives had to come but soon as they were born and checked they were fine the extra 2 went back to the hospital. In our area they already have a pre arranged ambulance on alert just in case, that's all sorted by them as is the gas air, certain pain relief all delivered weeks before etc if needed which I didn't anyway. But it's all managed so smoothly no stress it was defo for me

And women die in hospitals too. The US, with it's highly medicalised birth system, has the highest maternal mortality rate out of all countries considered high income. You can Google that for verification.

If women are advised at not to birth at home, they should probably take it seriously. Especially when the issue is high risk of PPH, depending what caused it. I've had two PPHs at home. The second far, far, far worse than the first.

Well, that depends how your birth goes. After my last one we had to recarpet the whole bedroom, replace the whole bed and all the bedding. Thank goodness for insurance. It was quite the PPH.

Yes.all misinformation
https://www.9news.com.au/national/stacey-warnecke-food-influencer-dies-from-extremely-rare-complication-during-childbirth/76f69720-f27e-4600-8dd0-1943756d2776

Her post there is very different in tone from the impression the midwives gave at the inquest. She seems very open to treatment and antibiotics, she just wanted to know if they could be done while still having a homebirth, which seems reasonable to me. She seems on top of the key issues in that she seems to be reassured they can deal with the key issues if they arise again at home. And they said she turned down a GBS test at her consultant appointment but she seemed under the impression it could be rapidly tested for as labour begins (more accurate) so was that so unreasonable?

I think there is an awful lot going on here in terms of blaming her.

@Goldencoast2 You can't argue that because this lady sadly died after birth that all homebirths are unsafe. Fact. Unless you are also going to argue that all hospital births are unsafe as well of course?

Home births are the default option where I live, and we have a much lower infant and maternal mortality rate than the UK. They have a much more see how it goes attitude than the UK: you start at home then move to the hospital if there is anything that worries the midwife or if you want stronger pain killers or have a bad feeling. Only 10% of first babies are actually born at home in the end, but about 50% of subsequent babies are. It means far fewer interventions and generally better outcomes for everyone, partly because everyone is less stressed. Maternity care in the UK in the UK is just awful wherever you give birth

https://m.facebook.com/story.php?story_fbid=pfbid022DmCx6o96fe29tWHKNa5LP4PVYCTLxNXDotoVyMkp6VFyc5VBAasTGRwnrCe7Pacl&id=100064865192578

I’ve not read all the comments but did see there were some comments about the lady who did in June 24 of a haemorrhage whilst having a homebirth. The midwife attending to her sounds completely incompetent and I think that was definitely a factor.

Above is a link for a news article regarding the failings of Leeds Hospital maternity services which have resulted of the death of at least 56 babies… in hospital.

Wasn’t arguing that at all. Merely pointing out that home births do carry risks so communicating these is not misinformation.

We’re just going round in circles. We don’t know whether this lady could’ve even been saved in hospital although it probably would’ve given her the best chance possible given the emergencies that ensued. It seems very likely she would’ve ended up with another forceps delivery or C-section however, and then she would’ve been left with a second bad experience.

Sadly there has been another

https://www.dailymail.co.uk/femail/health/article-15207837/amp/Stacey-Hatfield-natural-spoonfuls-death-melbourne.html

It was all I cared about. 🤷🏼‍♀️

I do often wonder what the reaction would be, if it were decreed by the NHS that in future, unless there were already contra-indications, all births should take place at home.

Both of my babies needed obstetric help to get them out, and yet no difficulties were expected either time. I have always been so grateful for being in a hospital with expert help available when it was needed.

However little mess is leftover I still preferred getting a shower in a nice big wet room and all that blood being swilled away and not caring about wrecked towels or sheets.

Someone asked earlier why I was so scared of blood. I'm not, I'm not even particularly squeamish about it. It was just part of my preference for wanting a hospital to have all that separate from my home. Very much a secondary concern ro the safety aspect but it does make a homebirth undesirable on every level to me.

There would be a lot more deaths and injuries.

@Swiftie1878 You wouldn't care if you became so mentally unwell after you had your baby that you took your own life? It happens more than you want to even imagine.

@Paaseitjes This is amazing! 🌟 Where do you live?

Nope, not with proper staffing. Many EU counties do this and we have far better outcomes than the UK

A certain percentage of all births will result in complications that require immediate medical attention. If all births were to take place at home there would undoubtedly be worse outcomes in the event of an emergency, meaning there would be more avoidable deaths and disabilities overall.

Really not. Obviously you need caveats like distance to hospital and maternal/baby risk factors, which can mean home birth isn't advised. It takes a few minutes for a theatre to be set up, and here they do that while the mother is in the ambulance if something has gone wrong at home. For birth emergencies, the ambulance is there within 5 mins and the midwives phone the ambulance before it gets to an emergency so there's normaly plenty of time. If there's any question of problems, there's a paedeatric ambulance standing outside the house which will get the baby to a neonatal unit as fast as from a hospital. Keeping simple cases out of hospitals means that the hospital midwives are really specialised in difficult cases and can provide much more intensive care because their time isn't divided. It means better care and less stress for the mother because they have the sole attention of one midwife in the calm of their own home, massively reducing the need for intervention. That's partly because with undivided attention, any problems are identified well before they become an emergency. As a result, our c-section rate is less than half of the UK, forceps are no longer used and considered mediaeval and we have far fewer deaths. BUT it requires enough midwives so that there can be a midwife at home with you rather than herding women into cattle pens.