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

[everychildmatters]

Because clearly evidence says otherwise!!

The question being asked here: ‘Am I being unreasonable to be fed up with the ‘home birth is risky’ misinformation?’ is ridiculous.

All birth is risky, wherever it takes place. In most cases, the risk will be extremely low and we live with it in order to reproduce. But the exact level of risk in any individual woman’s case can only be estimated in advance on the basis of best practice & medical knowledge, not known with certainty.

In the event of a home birth, IF the risk transpires in an individual case to be higher than estimated, emergency assistance is highly likely to take longer to be obtained than would be the case in a hospital (particularly given the state of ambulance services), and the risk of an adverse outcome will therefore be increased.

Again the likelihood of this happening can only be estimated in advance in an individual woman’s case, not known with certainty.

The choice for any individual woman considering where to give birth is the extent to which she is willing to live with uncertainty about the degree of risk in her particular case, and the extent to which she thinks it is ethical, in terms of the welfare of her unborn child, to do so. The relevant factors and appetite for risk will vary in individual cases.

Trying to pretend that talking about risk and uncertainty in the context of childbirth is ‘misinformation’ deprives women of the information they need to make their own choices. It is not supportive of the right to make free & informed choices.

We understand this in the context of investment advice, which is subject to regulation to clarify risk and uncertainty & assess the prospective investor’s appetite for both, and their circumstances. Why ever should the advice given to pregnant women abour birth be held to a lower standard than is the advice given to a person by a financial adviser?

This attitude is exactly how maternity care treats women like non sentient pieces of flesh in this country. Your argument may stand in a strictly statistical sense if you are looking at whole populations and writing an essay about it.

However, pregnant women are human beings within that system. As a woman who is having a low risk pregnancy with her second child I can look at the reported risks - as long as I'm informed of them properly - and say 'I am less likely to experience medical interventions that snowball than I am to have a straightforward birth if I have a homebirth so that's what I'll do' rather than having somebody bellow IT'S ALWAYS SAFER IN HOSPITAL which in my (imaginary) case is not true at all. It is not always a purely emotional decision (although it is worth mentioning that emotional factors have a practical effect during childbirth).

Not bothered to RTFT as I am sure I am not the first person on the thread who had unexpected complications that would have killed me if I had stayed at home in the birthing pool I had set up.
Just be flexible and do what the experts suggest.

I had one hospital birth which was horrific. I was left to it and no pain relief. It took 12 hours. Second birth was unplanned at home with a paramedic car just making it in time. That was scary but I had more care there than in hospital.
Third was planned home birth as consultant (had scans as baby had small legs) was concerned i wouldn’t make it to hospital after quick second birth. He was right, baby was born five mins after midwives arrived.

However, I was low risk. My planned home birth was absolutely lovely. I was relaxed and felt safe in my home. I would choose it over hospital every time, but not if I was advised that it was a high risk.

I would like to recommend a book called ‘Reckoning with Risk’ by Gerd Gigerenzer.

It is fascinating & will assist anyone who ever needs to make a decision (such as one about medical treatment) that involves thinking about risk & uncertainty.

This lady did have quite substantial risk factors but they’re risk factors I see ‘holistic doulas’ urge women to ignore all the time.

A shoulder dystocia is a shoulder dystocia though.

If it's going to happen, it will happen regardless of place of birth.

No longer practicing Midwife here - decades ago when I did my training we were told -despite the medical advances - pregnancy and childbirth is still one of the most dangerous things a woman can do. Advances in care have mitigated a lot of those risks, but it's still a risky thing to do.

And good luck getting the home birth activist to listen to or react to the actual medical facts you are all quoting, let alone admitting she has gravely misunderstood the facts.

As stated above "Nobody is saying giving birth at home necessarily increases your risk of something going wrong, but what it does increase is the risk of a bad outcome if & when something does go wrong."

Yep, irrefutably so.

And as was also stated, the only people having home births have been assessed as being extremely low risk so cannot be compared to the general population for risk.

And sometimes they still die.

Anyway, I'm off, good luck getting through to her, it would all be very silly if it wasn't so serious.

I’ve just read today about a mum in Manchester who insisted on home birth despite high risk. Sadly both the baby and she died.
the husband then claimed that they were not told verbatim that this is “against medical advice” and “out of guidance” even though they were told about the risks and were referred to a consultant.
and midwives said they are discouraged from saying words “against medical advice”, talk about risks of death because they have to RESPECT WOMEN’s CHOICE (to die, I guess).
as a result they see more and more high risk births in home setting.

your rhetoric is plain DANGEROUS.
home births are safe for absolutely straightforward pregnancies (and even then things can go wrong and hospital might be too far away).
for a lot of women - including straightforward pregnancies. Let alone high risk ones - home births ARE more risky

Surrounded by medical teams, testing, equipment.... It is safer

There are different risks.

Home births have lower risks of needing escalation/interventions etc, and generally progress quickly and more calmly than hospital births. You will have a midwife with you at an earlier stage - meaning earlier gas and air if that is what you want.

But in the event that it does turn into an emergency situation you are better off at hospital.

I took notice and glad I did as there was an issue and lucky I was at the hospital.
A F had homebirth a few years ago and there were issues and unfortunately her baby didn’t survive.
Bettet to be near help if it’s needed rather than making a point and then people looking at you thinking that if you had your baby in hospital it might have survived.

But the funding ultimately comes from the same pot, taxes.
Home births are only considered safe when there is adequate one to one midwife care.
If the same ongoing individual support was provided in a hospital setting then it would negate some of the risks of a hospital birth.

I know! She had horrible experience because she has medical issues during birth, not because she was in a hospital. Very sad.

I’ve just read the article and I think it has to be made clear she chose a home birth despite significant risk factors - her first baby had group B strep and sepsis, but she declined to be tested for group B strep in her second pregnancy and declined to be in hospital for an antibiotic drip. She’d also had a large haemorrhage in her first pregnancy and again declined hospital where these can be managed more quickly and efficiently.

I take issue with the fact the inquest is now making out the doctors hadn’t explicitly warned her by saying ‘you could die’ and ‘this goes against all our advice’. They explained the risks to her and she made her own decision - if they’d said the former no doubt they would’ve been criticised somehow for scaremongering or ruining women’s bodily autonomy etc.

I feel like they can’t do right for wrong really

You've got irritated that you felt somebody shouted at you and I can understand that. But talking about somebody in the third person and saying they are 'silly' is really rude and belittling. This is clearly a highly emotive issue for women who have had either terrifying births or horrible dehumanising experiences in hospital, or both. You can take a purely statistical stance if you're planning maternity services. Maybe you've had your own horrible experience that makes you do that. But birth is a human experience as well as - often - a medical one. It is never a statistical one. Calling another woman silly is really out of order.

An 8hr 2nd stage? At home? That's negligent, I'm sorry. After 3hrs (absolute max), she should have been transferred to a Maternity Unit. As an ex-Midwife I'm appalled at that standard of care.

To be fair you can have both - I did. I fully accept the things that happened which were unforeseeable, and that nobody could’ve prevented them. But I also received very negligent ‘care’ to the extent my entire labour went unnoticed (for 12 hours) on an induction ward (I posted story upthread).

My first delivery I felt cared for and always privately wondered if those slating ‘poor care’ were blaming unforeseeable events on the doctors and midwives because it’s easier than facing the fact their body hadn’t done what they wanted it to do. But now I feel humbled as I experienced first hand just how appallingly negligent and inattentive some hospitals can be with my second child.

How far are you from your local hospital?

I had an emergency c section and we both could have died earlier this year.
My second child after a perfect birth with my first child, I was fit, healthy, age and bmi both 24. In fact I was lead to believe baby would fly out after being told a thousand times “second babies come out a lot quicker”

My friend's daughter had her first baby at home and had to be blue lighted to hospital after the birth due to a post-partum haemorrhage.

Birth is always unpredictable, particularly for first babies, so I would deem a home birth for a first baby to be more risky than a hospital birth. Subsequent pregnancies when the first pregnancy and birth were unproblematic and straightforward could possibly be safer than a hospital birth if planned well and as long as the expectant mother lived near enough to a hospital to be able to get there in time if an emergency situation arises.

I personally wouldn't have risked one as I had complications in my second and third pregnancies after an unproblematic first pregnancy.

Yes, I agree.
i don’t think the doctors can be blamed here.
Re warning about risk if death - damned if you do, damned if you don’t.

Im sure however she listened to someone like the OP or some untrained “doulas” peddling the garbage that home birth is always safer and hospitals medicate births “unnecessarily”. There are lots of “crunchy” woo-woo communities which peddle this crap

If something does go wrong, a home birth is definitely riskier than being in hospital, no argument. There are several reasons for this:

• Limited staff: Often, only one midwife is available, and they’re usually on call. This means they’ll need to travel from home/another visit or their office, which can take time. Until they arrive, you’re essentially on your own without any professional support.
• Delays in backup: If complications arise, that midwife will need to call for a second midwife, who is also likely at home or on another call/in the office. Again, could easily take 30 minutes or more for to arrive, and in an emergency, that’s a long time.
• Limited equipment and emergency support: If you experience a haemorrhage, a cord prolapse, or another emergency, an ambulance will be needed. Midwives attending home births generally have very limited equipment to manage severe complications, so you’d be waiting for paramedics and ambulance response times are not quick. During that wait, even the most skilled midwives can do very little without the necessary equipment or support team.
• Doulas: It’s worth noting that doulas don’t need any formal medical training or qualifications to practise - the only ‘requirement’ is having given birth themselves. While some are wonderful and supportive, many I’ve met have given dangerous or inappropriate advice during labour when medical help was needed.
• Access to pain relief: At home, options are limited. In hospital, you have access to epidurals, stronger analgesia, and anaesthetists if needed.
• Monitoring: Continuous monitoring of the baby’s heart rate and your vital signs is much easier and more reliable in a hospital setting, which can help catch early warning signs before they become emergencies.
• Emergency facilities: In hospital, if something suddenly goes wrong, you’re seconds away from obstetricians, surgeons, and full resuscitation equipment. At home, you have none of this.
• Unpredictability: Even the most low-risk pregnancies can develop unexpected complications during labour, which require immediate intervention.

So yes, the fact of the matter is home births are riskier than hospital births. The very sad story in which the mother and baby died recently is devastating, but this woman was told the risks of a home birth and advised against it. She chose to ignore this advice.

I don’t understand what you want from this thread. It’s different for every woman. How on earth could you know what’s best for any birth experience other than your own? Or are you a midwife or obstetrician struggling to convince women to choose an alternative care pathway to leave space free for more high risk pregnancies?

It would be more or less impossible to work out the statistics but I’d love to see how many of the people who “works have died in a home birth” had complications DUE to the fact they were in hospital. Obviously the quality of care can vary wildly but I’ve heard way more horror stories about being totally neglected Oar being forced to have interventions, in hospital.

i get it that people want to be near emergency measures just in case but so many don’t take into account that labour can stall / become much more complicated when you’re trying to give birth in a hostile environment (bright light, strange place, unknown people) when we are all mammals who would naturally find a quiet dark private place to birth in.

I’m sorry to hear that :(