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

[everychildmatters]

Because clearly evidence says otherwise!!

Unfortunately I have seen many recent stories where home births have ended in tragedy. It’s a stupid risk but these women are the ones that have to live with their decision.

I’ll say again, childbirth was the single biggest killer of women before modern medicine. And not all modern medicine is available in homes! Whatever risks there are in hospitals they are, very obviously, rather less than at home.

I’m another one who nearly died in childbirth.

YANBU - as you say, evidence is useful. I think it’s so important that people can make a personal choice taking into account their individual circumstances.

I planned/started a home birth for my second, ended up transferring in and having a section in the end. No less safe than if i’d gone to hospital a bit earlier.

Bloody hell, I had my 3rd baby at home, my second home birth. I was 40, slightly overweight and my 2nd baby had shoulder distocia. The midwife that delivered my first baby was more than happy to deliver my 3rd.

Both babies arrived safely.

Having had 2 home births I am of the opinion that they can be at least as safe as in hospital for the right circumstances. Would I have attempted a breech delivery at home? or twins? No I wouldn’t have done. My first labour was a shit show of interventions which ended with me in theatre for a retained placenta. Im deeply uncomfortable in hospitals and definitely felt more in control at home. I also lived within a mile of the consultant led maternity unit.

I think that home birth is a lot like co sleeping. On the statistics alone it appears riskier but with the right circumstances can, in fact, be safer but it is wholly dependent on the circumstances.

I think we also need to remember the whole story of birth and death, and how it would be for the family members if you die. I just read about that poor woman and her baby. Even though I try not to think it, my reaction is, "this man didn't take enough care of his pregnant wife who was clearly consuming some misinformation that led her to take this unreasonable risk" and "this woman's family didn't seek appropriate post partum psychological care after her crappy first birth". If someone dies in a home birth, the guilt for the loved ones is so much worse. If it happens in a hospital, the responsibility is more shared and it seems less like selfish actions that led them to that place.
I feel so sorry for that woman's little boy, the only one in this whole thing to still be alive and not to bear any form of responsibility for losing his mum.

Absolutely agree.
I imagine her instagram history is going to be quite painful viewing.

DS was born in hospital, not a particularly pleasant/unpleasant experience but the post natal infections were nasty.

DD was a planned home birth, 2 midwives and a trainee in attendance. The GP also said he would attend if there were any issues and the local hospital had a "flying squad" for emergency transfers. Instead of pacing up and down hospital corridors I was pottering around in my kitchen making cake.

Had there been a DC3 it would also have been a homebirth if I was still considered low risk.

All birth is risky.
Women die in childbirth, develop serious disabling injuries, and can never feel the same again.
I feel home birth is seen as the danger when reality is, any pregnancy is dangerous.
I wish we told women that.

My last child was an unattended birth at home as he came quickly. But regardless the hospital were understaffed and had no one to attend anyway. They did however have 3 spare midwives to come to my house in the afternoon to try to coerce me in to the hospital. Despite a history of PPH in birth I had no intention of giving birth in that hospital after a consultant threatened me with obstetric violence and threatened to force me into a GA C-section that was 100% uncalled for. Alongside a lot of other threats and accusations which she had no basis to say. All of which the head midwife agreed was lies.
My 3rd birth I was in hospital and ignored the entirety of my labour and left for 5 hours with someone popping in for 30 seconds once a hour writing down the obs that the machine had taken whilst they were absent. With a constant only I'll get you the entonox.... To never return. After I gave birth they left within half an hour of his birth, with no call button or bassinet to put him in so when I did start to haemorrhage I had to climb down the back of the bed whilst holding him to find the call button that was dangling from the wall. No one even put a nappy on him, when I woke an hour later after losing a litre of blood and passing out I was alone again half off the bed with a cold meconium covered baby. (It was COVID times so I was completely alone until I went home). So why on earth would I want to go near a hospital again. I was just as at risk there as I was at home, but I had my husband to help me.

The reason a lot of women want to avoid a hospital birth is because they are treated like shit by staff, and in many cases they strongly suspect or know that they recieved bad advise or management or that staff did not seek to manage their births appropriatly.

Just as an example: my firs birth was a section, after there was what appeared to be (or I was told) was an irregularity with the heartbeat. This was after I had been lying in bed, in one position, for hours.

The immediate recommendation of the GP on call was to give me a section. One older nurse wanted to get me up walking around a bit, which was poo pooed by the GP, and she did also try to see if I could start pushing as I was in fact a hair away from being fully dilated.

She was right of course, changing position should have been the very first thing done, and some walking and being upright. I was at the time too inexperienced and scared to really take in what was going on, but the young GP was just like an idiot mechanic following a set protocol without engaging her brain.

Women want births managed properly, hospitals in many cases want a cookie cutter protocol that does not mean staff has to stay with the mum and help her, and doesn't mean they will have mums doing things like walking the halls in labour, or taking up rooms for too long.

I think the answer is to scrap the idea of ‘Labour ward’ and ‘MLU’ and to just start again and have 1 birth centre with every room created to be homely, comfortable and with a double bed so partners can stay over and help care for both mum and baby, with a dedicated midwife who you have met before and stays throughout. What makes hospital so stressful is the constant shunting around from ward to ward, relentless staff changeovers, a lack of continuity of care and access to pools/nice rooms completely dependant on luck. Midwives need to be more proactive in helping natural birth happen - I have found they are very ‘hands off’ until an emergency when they are then very ‘hands on’, aka leaving you to it and not bothering with holistic help until it’s too late. Nobody helped me change positions, nobody offered mild pain relief - they just held off until the pain was unbearable and then I was begging for an epidural, when a pethidine shot or similar would’ve been adequate if given earlier. It all just feels quite lazy and basic.

But that's not entirely the full story either.

I'm not particularly pro home birth. I was certainly in no position to have one. However, what I can see from other experiences is that having proper monitoring of baby's progression is absolutely key. And there are situations where that will be better delivered in a home setting.

Obviously, if things go wrong then distance to hospital and so on is key.

However you can be in hospital,, surrounded by high tech equipment and medical expertise, but if no one has picked up the baby is in trouble, that's no use to you.

They did however have 3 spare midwives to come to my house in the afternoon to try to coerce me in to the hospital. Despite a history of PPH in birth I had no intention of giving birth in that hospital after a consultant threatened me with obstetric violence and threatened to force me into a GA C-section that was 100% uncalled for.

It’s hardly ‘coercion’ when the lady upthread in the article did exactly as you did, and died, and her baby also died.

I think what happens is (or at least when I last looked at it nearly 20 years ago) that the stats for unplanned home births, which includes women and girls who have had no antenatal care, and are obviously then high risk.

For me I seriously considered it with both DDs, and I may have been a good candidate as I had very straightforward pregnancy and labours, and not long labours.

But with DD1 on balance I preferred to be in hospital, because of fear of the unknown and not knowing how it would go or how long. I did have an epidural and I was grateful for that option of pain relief, but no other intervention and active labour was 6 hours. With DD2 I just went with same hospital, having had a good experience before. With extra confidence and breathing techniques from yoga this time I just had gas and air, and the same length of active labour, even though DD2 was bigger. I think we'd have ended up with a night in hospital anyway though as I wasn't sure when my waters had gone and they wanted to check for infection. So both times I thought about it a lot but felt safer in hospital.

Other women may come to a different conclusion though and they should have a say in where they give birth.

As if there's ever going to be funding for that.

I know. But given they spend £1 billion a year on maternity litigation payouts, maybe it’d save money in the long run.

Things are so much worse in the NHS now compared to 20 years ago. Whether or not a home birth was safe then doesn't mean it's safe now.

Not to mention mums are older - I don’t know a single first time mum over 36 or 37 that hasn’t ended up with a c section (actually I know 1, out of probably 10).

I had a hospital birth. Textbook delivery, everything fine. Until the placenta wouldn’t come away and I haemorrhaged. Midwife rang for assistance and within seconds there was a team of people in the room who sorted me out. If that had happened at home who knows how much blood I would have lost, and I would have probably have had to be rushed into hospital for surgery.

Friend’s friend had a home birth. Baby had an infection that wasn’t picked up on and sadly died. Outcome might’ve been different in hospital, who knows.

Yes these are only 2 stories, but they both point in one direction.

There will still be litigation payouts.

Genuine question here - ie I'm not trying to inflame discussion, and I don't know the answer! Could it be thought of as a teeny bit selfish to arrange a home birth with a midwife present, when that midwife could be in the hospital assisting more than one birthing mum? I know that ideally we would all have a midwife with us through the whole labour, and there would be enough funding for us all to have the support we want.... but in reality does having a home birth with an NHS midwife there impact on the general system for all? Or are those professionals who come to to home births actually community midwives who are separate to the hospital ones?

I think it’s easy for people to criticise home births as not enough people are aware of the set up of them, and just how good the care can be. Areas like Leicester where they have a dedicated homebirth team you’re likely to have 2:1 midwife care from early labour as well as sometimes a third student midwife. They set up a rhesus station immediately in your home just in case baby needs it, and they have injections they can administer to control excessive blood loss in a PPH until they can get you to hospital. Obviously if you were in a hospital then an emergency situation would be better there but the midwives really are well equipped in a home birth and will call an ambulance at any moment they have the slightest concern. The care and attention is much more focussed and feels like an incredible private service!

Hospitals can cause a lot of complications. Infection is a big one. Mothers are less comfortable and often under more stress, which can retard labour. Being relaxed and able to move freely is an important part of labouring. (Something vets know very well, btw. Some of the stuff they do in hospitals any vet would think was crazy and likely to result in a bad birth requiring interventions.)

Some bad management is so common they just amount to hospital risk factors. They tend to look more at monitors than the mother which leads to poor decisions. They don't give the staff and support to use the less invasive solutions to avoid complications - they want mums in beds or at least in their rooms, often aren't able to manage things like unusual birth positions or presentations and just send those to be sectioned, or even mothers labouring longer than they'd like.

They also tend to make interventions that lead to other interventions. Trying to artificially start or augment labour for example, seems simple but it can often lead to a labour that is less effective or more painful, which leads to the next thing, and so on. Some of this is related to the time and staff pressures.

Then why did this lady die?

I think it comes from a place where most people like the idea of having a trusted woman helping them through birth, like an ancestral thing? And then when you find out that you're just on a sort of production line with different people who you don't know changing shifts and so on, it feels wrong. For good reasons.

But a lot of preparing for birth in 2025 is to truly understand what the environment you're going to give birth in is like, and preparing for and adapting to it.