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

[everychildmatters]

Because clearly evidence says otherwise!!

Well what complications do you think the hospital would actually cause?

Thank you for the support - I think I'm the 'silly' one and the 'home birth activist'. Ironically, I have never had a home birth - I planned one, and then happily changed plans and had a hospital birth when things changed and it was no longer the safest option for me and the baby. That was my second birth - my first I didn't even consider home birth as I felt the chances of transfer were too high. I am absolutely not some sort of pro home birth zealot.

I have never, and would never, claim that home birth is appropriate in all cases, that it would always be a safer option or that it is without risk. However, it is simply not true to say that it is always safer to give birth in a hospital, and despite what the poster who thinks I'm 'silly' says, it is not proven medical fact. Her 'common sense' doesn't trump the outcome of multiple medical studies which are used as the evidence base by NICE. These are the actual facts, which I have not 'gravely misunderstood'.

I wanted a home birth after my very uncomplicated first birth in a midwife led unit, the only reason I changed my mind is our renovations weren’t finished in time. Lucky for me and DD2, as I had a placental abruption during labour and because I was in the midwife unit at a major hospital, I was transferred to the labour unit, no time for an epidural so had a crash c-section in about 8 mins. All I know from my experience is I am really glad I wasn’t a 15 min car ride away from a hospital.

I had a straight forward first pregnancy and my midwives discussed a homebirth with me as the risk factors were really low. I was really keen on the idea, my husband was very nervous (he's naturally more cautious than me) and felt we would be safer in hospital. We opted for a hospital birth.

After a very straightforward labour our DS was born unresponsive and not breathing. It took a team to get hm breathing again and then he had to be transferred to a different hospital to have treatment to reduce the risk of brain damage. If we had been at home he wouldn't have survived.

I am thankful every day that my DH's caution meant we were in hospital, I can't actually let my mind go to where we would be if I hadn't taken his feelings into consideration.

I think it’s an odd thing to be annoyed about. The risk is different for everyone, and women certainly don’t need more shame for choosing a hospital birth whether they are high risk or otherwise. Home birthing advocates do seem to be mostly very young and healthy and low-risk, great for them.

Each to their own, minus pressure that one is better than the other. I’m another who’d have died along with my baby without medical intervention so

Yes I completely agree. If we knew a birth would be complication free then I would be all for home births. But we don’t. So I agree the unpredictability makes every home birth risky.

The problem is risk is just probability based on various known factors but can't take unknown factors into account. Me and my DD nearly died having a home birth, but our risk was assessed as low and we'd been with the lovely home birth team all the way through with full support and several midwives in the house. And the midwives came round right at the start of labour too, and I didn't have to travel and had a lovely birth pool. But you can't know what dangers will occur. For us luckily the ambulance was fast enough, and we were able to have an emergency C-section and my DD got treatment in special care baby unit. I couldn't have known in advance I needed them. Whereas there will be plenty of hospital births that are the opposite, everything goes perfectly fine and they'd have been fine to have a supported home birth but this is only obvious afterwards. The advantage of a hospital birth is this emergency treatment is available as an option. Given the choice of my traumatic hospital birth or a lovely easy home birth of course I'd prefer a home birth, but you can't choose for the home birth to go smoothly what happens happens and you can't know in advance whatever the risk assessment it's still just a type of guess.

It is absolutely true that hospital births have some risks that home birth doesn't (infection, cascade of interventions). It is also true that the unexpected can happen (in my dd's case, cord round neck). There are also other key factors like how far you are from a hospital.

We'll have the maternity services we deserve when the ghastliness of maternity services is not a factor in decision-making.

This case is quite astonishing. Unlike others, I think every member of medical staff who met this lady did need to tell her ‘your decision, with your history, may well kill you’. She needed to hear this very clearly.

But their liability does not mean that this lady herself can be absolved of responsibility. It seems very cruel to criticise the dead, but for the sake of other women & their babies I think we need to be honest about the fact that she was astonishingly irresponsible- both to her son left motherless, and her daughter, deprived of any chance at life. I simply cannot understand what on earth she was thinking & think the inquest should look at the online influences she was subject to with a view to exposing them.

It reminds me of the Shemirani case.

I would have bled out if I’d birthed at home. As earth mothery as I am, I can get that fix elsewhere. Personally there’s no way would I risk my or my child’s life for a home birth. Did I love the hospital atmosphere? Nope. But I’d be dead if I had opted for a home birth. Even in the hospital they had a hell of a time to get the bleeding stopped.

You are right OP, if we are talking evidence based medicine it's very positive towards home births having very good outcomes for low risk mothers, often more so than in hospital bitrgs. Similarly in terms of low risk mothers the best outcomes are typically for mums being managed by midwives, GPs, and OBs, in that order.

These aren't strange stats, they make a lot of sense both within the context of labouring mothers' responses to environment, and how differernt kinds of medical practitioners manage a birth.

However there has been a massive shift in the population across the English speaking world, from the center-left to the progressive left, against evidence based medicine and towards a differernt kind of thinking that it's difficult to charachterise, but which i would say is a kind of authority/control/expert driven thinking and practice. You see very much the same thing in people's thinking about education, despite the fact that it's not evidence based. People want some expert, in authority, to control situations, and they believe that must give better outcomes. A lot if fear based I think.

I suspect a lot is the aftermath of the pandemic, many people's need to take actions that give the illusion of expert control was pumped up and never really went away.

no but you can argue that the bare stats don't tell the whole story

Given the reduced funding for maternity care I do wonder about that.

A key maternity fund was recently slashed from £95 million to just £2 million, which is an absolute joke. That fund was put in place to help the increasing failures of maternity care in this country.

The issue is spelling it out this clearly had been discouraged because women don’t like feeling heavily criticised (or ‘coerced’ as they call it) for their bodily autonomy choices.

I’m part of a birth trauma FB group after the birth of DC2, and the sheer number of posters who are convinced they were heavily pressured into hospital/CS ‘for no reason’ is so high it’s probably 80% of the posts. When you read on, they then say ‘they wanted me to do this as I had group B strep/a haemorrhage before/baby has a heart problem… BUT my doula said this wasn’t a reason I couldn’t have a home birth’.

Either we are autonomous beings who just need facts laid out without emotion to make our own minds up, or we need full counselling and steering by medical professionals who use scary words like ‘death’ (if applicable). Everyone seems to want the former then switch to the latter after it’s all gone wrong.

In yesterday papers a young mum and her baby died when she chose to have a home birth when allegedly she was told there was risks to them both . How sad and possibly avoidable 🥲

I hope the PP who suggested that midwives in the community can do all this reads your post. Even midwives in the hospital can’t do this. And it’s mad to think that an ambulance can just wait outside the home for an indefinite period of time in case something goes wrong with a home birth.

I'm not sure how you would gather data on this. Surely most people would go to the hospital if they experienced difficulties during a home birth. If those difficulties led to poor outcomes once the mother was in hospital, wouldn't they fall under hospital statistics (even if they delay in treatment was due to an attempted home birth)?

I agree, and I think if she was receiving 'medical advice' directly from anyone other than her medical team, including in online groups etc they should be considered culpable. It is morally as awful but legally more difficult if she was 'just' looking at a lot of irresponsible content on Instagram etc. rather than directly corresponding with anyone.

Also, while again it feels awful to criticise someone who has suffered what he has, but I think the father claiming that they wouldn't have gone ahead if someone had used the specific phrase 'out of guidance' feels like wishful hindsight. From the report, he wasn't in the appointments with the consultant, but it seems clear they very strongly recommended a hospital birth. That one phrase being in her notes wouldn't have changed her decision to ignore that.

There are risks with all births. Anyone who thinks otherwise is deluded and anyone who thinks an ambulance will come quickly if they need help is also deluded nowadays.

I’m sorry you went through such an experience. It sounds a lot like my second birth.
However, my daughter had a homebirth resulting in an unexpected shoulder dystocia. Similar to my presentation. Something which was medically managed in hospital by drs as an automatic emergency response and subsequent triple episiotomy etc was actually managed skilfully by the two MWs present in the home birth scenario resulting in physical manoeuvring of baby in the pelvis and a subsequent non-instrumental delivery with grazing and not even a stitch required. So it isn’t always as straightforward as saying if this had happened at home it would have been worse… the issue is that midwives are becoming de skilled as medical management of birth takes over. Many babies used to be born breech and midwives could safely manage these births but now people are offered c sections for these so less MWs get the opportunity to experience the non medical management of such births. Ditto twins… so then the risk does increase for home births etc.

If they are experiencing difficulties they're probably not going to be able to get to the hospital very quickly.

not sure where rest of post went…
the RCM was told that that money would go to the NHS trusts generally to make their own decision of where to spend it. Instead we’ve had more cuts and recruitments freezes throughout the country. Given that that fund was put in place against increasing failures in maternity care and ‘failures in care’ here means deaths, deaths of women and deaths of babies, you do wonder about the end goal.

Men hate and despise women so much, they’re only too keen to use women for endless promises of sex to shut poorer angry men up, only too keen to remove our rights at every opportunity and push us aside to get a new shiny tech toy or a few new votes from women-hating immigrants, only to keen to remove funding that keeps women specifically alive and refuse any chance to make a real difference to male violence against women.

Is that what this thread is to enable op? Carrying on spreading misinformation and destroying basic knowledge about the dangers of childbirth?

This assumes there aren't risks created by the nature of the hospital setting though, the management in hospital, or the travel to the hospital. Which are big assumptions. And not are all things that could be changed even in the best circumstances.

So then it's a matter of balancing the risks.

This is why studies usually compare 'planned' home births to 'planned' hospital births - so the outcomes of someone who plans a home birth then transfers 'belong' to the home birth group, and the outcomes of someone who planned a hospital birth but then gave birth at home (or at the side of the road!) before they could get to hospital 'belong' to the hospital group.

The majority of home births are now ‘birthing out of guidance’ and midwives are expected to turn up and provide care regardless of the risks: it’s a dangerous situation for women, babies and midwives. Home birth IS extremely risky for these women however for some unknown reason it’s what some women choose.
For low risk multiparous woman home birth is believed to be ‘equally as safe’ as hospital births, not safer, but a low risk Labour can very quickly change. When an emergency arises in labour you are absolutely safer in a hospital environment.
the tragic case being mentioned in these comments had the worst outcome imaginable but this was not a low risk woman birthing at home and this woman was 100% safer in a hospital. I understand trauma and fear around hospital environments but also believe this needs to be balanced with safety.