to think home births are selfish?

[woozlet]

I just watched a 'desperate midwives' that I had recorded and there was a home birth on it which went wrong. It worked out ok in the end and the baby was ok. But I was really scared watching it, it just seemed like an unnecessary risk to take.

Well, we're all selfish for having babies anyway. Maybe the NHS shouldn't cover childbirth at all. Or restrict us to one child policies like China.

Honestly. If the NHS are going to cover birth, women should have the right to be supported in a reasonable birth experience in the place of their choosing. This whole 'selfish' argument is silly.

The whole business of having babies is 'selfish', let's get over it.

I'm not going to go saying women that homebirth are selfish, each to their own! I wouldn't want to go to all that hassle and money to set it up myself. I prefer to be in a hospital having the facities and equipment incase something could go wrong, homebirths have never interested me.

Question - can they preform emergency c sections at home if it's needed - or you got to hold on till you get to the hospital?

'one group of women who are more likely to have bba's are women who've had no antenatal care (particularly women who've recently arrived in the UK, and very young women), and this group has the worst outcomes for their births of all - whether they give birth at home or in hospital'

That's true, but another group is that ofmothers who have had precipitate labours previously, for whom (IME as one of them) a home birth with all the equipment,ambulance on call, MW etc has got to be safer overall. Even the hypothermia- better at home with radiators blazing on an Aprilnight than in a car.

I s[ent a few hors in the local hospital for various rasons- low FB pre birth and then when ds4 was screneed for heart murmur in SCBU at one day. Everything I saw, from the single toilet (city hospital- all others out of order) to women I would guess had MH problems screaming in corridors told me that would not be a safe place for my baby and I unless he needd something that could not be provided at home such as a C-s.

The hospital where I ahd ds1 has improved immensely sine I delivered there- they let us down badly and a friend mroe so (her baby was born too early and died, she had a history of premmies and the MW on duty laughed and told her to goaway when she called in to say she was labouring preterm, I have seen the apology letter from the Trust).My sister had PET some years after me, and was treated wonderfully, but I don't have the same trust here- and when the palce is actually declared a severe risk due to the number of maternal deaths eprhaps it's not worth the risk. I only found out that when ds4 was 8 days old, but I got a pretty good idea during my brief trip there at 36 weeks.

'I'm with woozlet - women can give birth wherever they like but they shouldn't expect streched NHS resources to help them unless they are in hospital - it is so expensive and very very selfish to expect people to run round after them and then have to patch them up in hospital if it all goes wrong

I repeat:

I could not deliver in hospital

I wouldn't have made it, I ahd a 35 minute labout; that waspredicted by my MW due to baby 3 being 3 hours. The options were Tesco car park,or home.

Or an induction, which was discussed, to aopid the risks if there ahd been any, that would have cost medical support plus socialservices care for 2 children with autism whilst a neighbour cared for the NT child. After my messed up first birth, I wpuld not have delivered in a hospital without Dh there, simply not.

There's a jusgement you are making that it is black or white for everyone, it isn't, the availablitlity of homebirths is widely recognised as the safest option for people like me who don't fit the 4 hour labour model.

"it is so expensive and very very selfish to expect people to run round after them and then have to patch them up in hospital if it all goes wrong"

But you don't have any proof that a homebirth costs more or uses up more NHS resources. In fact - given the lower rate of serious complications in hb, all the evidence seems to point to their being less costly than a hospital birth!

And if going into hospital makes it more likely that you'll need a cs (it appears to), isn't it selfish of low risk women to opt for it - given that there are high risk women who need ready access to obstetricians and operating theatres who are having a bad time of it because obstetric services are so over stretched?

anonymous85 - if you're at home then, no, they can't do an emergency CS if required. However, there's a very big difference between what is usually referred to as an "Emergency Caesarian" (one that wasn't planned) and a Crash Section (one that needs to be done ASAP and is so performed as a genuine emergency). For a straightforward pregnancy with no additional risk factors the chances of needing a true Crash Section (where the situation does deteriorate very fast and there are no warning signs), especially if you have 1 to 1 MW care, are very small. The possibility of it is something that should be considered if you're thinking about a homebirth, though.

sabire - I agree, the current system doesn't work. It doesn't work for women who would like a homebirth but don't realise they don't have to accept "no". It doesn't work for women who don't accept "no" but then have to spend the last few weeks of their pregnancy fighting tooth and nail to get the support they need. And it doesn't work for women who go into hospital and are left without sufficient MW care. But how you change it without a big injection of capital I don't know .

Sorry - should add, I'm saying that by way of making a point. I don't for one minute think it is actually selfish to opt for a hospital birth!

Tangle - we need many, many more midwives, and we need to make midwifery a less stressful occupation. I've been shocked by the difficult working lives so many midwives I know have to endure. They're put under such ridiculous pressure.

That said, if non means-tested bursuries still existed (they're being phased out along with the diploma, for those of you who don't know), I would train as a midwife myself!

You're a midwife aren't you Tangle?

If you are - just want to say, all strength to you. You guys work so hard!

Well I've not read the whole thread yet, I'll come back to it after work but I'll say this from my expierence.
Everything was going great with DS's labour. Constantly reassured he was nearly there and felt quite happy. However things quickly turned and the baby went into distress. Thank God a back up team came in immediately. I went from being told he will be with us any time now to a life threatening situation and complications for me. Thank God I was in hospital and thank godness everything turned out ok with immediate intervention.

I thought about home births. I am so glad I didn't. I paid for a private room for a few days afterwards to recover and had everything I needed.

Here you go, Ferncottage - a UK study.

"The Cost of Home Birth
The available evidence suggests that there is no case for refusing home births on grounds of cost. Because of fewer interventions, complications and hospital stays, planned home births cost less, on average, than planned hospital births. Costings for planned home births include the cost of transfers to hospital, and of hospital treatment thereafter.

The National Birthday Trust report on home birth in the UK found that the average cost of planned home birth to the NHS was less than the average cost of planned hospital births. In that study, Henderson and Mugford reported that:

? Costs for antenatal visits and tests, staff presence in labour and delivery, procedures and pain relief in labour, perineal damage, and most importantly, days in hospital, all confirmed the greater cost of hospital delivery.? [1]"

I agree, I work in a hospital and we provide the midwives for all types of births in the area. There is a huge shortage at the moment and no suitable candidates are coming forward despite massive recruitment campaigns. Home births require two midwives to be present which puts and enormous strain on the system. If women were prepared to come to the midwifery led birthing unit, it would free up midwives to deal with all women, not isolate two in one home for god knows how many hours. It's incredibly selfish to strain an already struggling system for individual wants. Plus it's a nightmare if anything goes wrong, whereas the birthing centre is next door to the consultant led unit.

YABU and misinformed.

indieangel - i had 2 midwives with me for the whole of the final 12 hours of my labour in hospital despite the unit being very busy at the time. was i being selfish using up resources like that? or because i was in hospital, was that okay?

anonymous, by the time a most home birth transfers gets to hospital, they can be wheeled straight into theatre for an EMCS.

if you are in hosp and you need to have an EMCS you are left there waiting and being monitored.

surely you don't intend to patronise midwives' knowledge by suggesting that they will wait for the last moment before organising a transfer?

the one to one care given in home births reduces the risk of being left to labour on your own when unfortunately for some women they discover things have gone very wrong in the absence of human care and some women needing crash sections as a result. i realise that there are occasions when a crash section is the only alternative but that is thankfully a very tiny rarity.

When I had my homebirths, the midwives were from the Community Midwife team, so no resources were taken away from the hospital - I can quite understand how much strain this puts on hospital midwives, as indieangel describes, and using the community team seems to make much more sense to me. Also I only had one midwife, even at the actual birth. Clearly the guidelines vary from one area to another.

I was lucky that our community midwives were very pro-homebirth, as was my GP.

So by that argument, indieangel, do you consider all non-essential health services such as IVF or reconstructive breast surgery selfish ?
There are pleny of NHS resources that could easily be used somewhere else.
Are you a midwife ?

If you have enough community midwives that's great, we have 5 for the whole area. If two are in one home at any given time, it's a real struggle, given that they work a shift system to cover 24 hour care and the no. of births we see in the area. They're angels and nothing is too much trouble but they're out in a really difficult position.
megonthemoon, no of course you weren't being selfish, but if your labour had gone on for 24 hours and you were at home, that would have been 3 shifts of midwives over the 24 hours, if you'd been in hospital, it would have been easier to manage. Obviously I don't know how your labour went. But homebirths put an real strain on the system of midwives and I don't think people realise how few there are around.
Is it not better for people to have to compromise slightly in a midwifery led unit, rather than staying at home so some get homebirths, but some don't.

filibou, it's probably for a different thread, but I do debate the use of all non-essential health services. I haven't come to any conclusions yet, but I am keenly aware of how stretched the resources are and think that sometime people have to compromise for the benefit of many, rather than not compromise for their own personal benefit IYSWIM.
I'm not sure it's clear cut what non-essential services are though, I understand the longing for a child and can see the arguments for IVF treatment, and certainly the arguments for breast reconstruction.
As I say, it's probably for another thread.

indieangel: 2 midwives and one trainee showed up together (late) at my HB.

I only wanted 1 midwife. It is hospital policy to send two. I had to fight tooth and nail to get one midwife. They stayed a couple of hrs waiting for the placenta to arrive.

One of them commented on how peaceful everything was when the room was quiet and the only sound was of dd2 drinking at the breast.

The student MW who I had invited along actually fell asleep when waiting around for the placenta.

My hb cost the NHS about 5 hrs of their time, all told (oh, seven including the hour + the taxi fare it took for the 2 of them to arrive.)

I am wondering how many or which of those studies include things like the long cost for things such as repair of perineal damage, medication and treatment for PND/PTSD, loss of work caused by the greater risk of damage which many may not see as extenuating expenses by botched births in hospitals.

As I said, I only had one midwife, who popped in and out during the labour, and was there for about an hour when I gave birth.

It's hospital policy to cover the hospital. If there's only one and something goes wrong, the hospital has a greater risk of being sued and losing. It would be mother's word against midwife's.
So you had 2 midwives for 7 hours, out of how many nidwives in the area? How many other women wanted home births at the same time and couldn't because they're weren't enough midwives to go to their house.
I'm not having a go at you, but you must see that it's a big resource. If you'd been at hospital, you would have had one and possibly one other if needed, but that one other could have covered several other births at ths same time.

I haven't read the whole thread, but although I think the OP is BU to say people who choose home births are selfish, I do understand why some people may have misgivings about them. If you are lacking in depth information about home births (as I was), it's easy to be critical.

BUT, since having my first DC (in hospital) I have had a chance to learn more about home births and chat to people who have had them. All the stories I have heard have been extremely positive, although none have involved any serious complications which resulted in a transfer to hospital. I would love to have a home birth with my second DC, but had quite a complicated first labour (was induced at 37 wks due to OC, long & painful labour, epidural and forceps) which has made me feel quite nervous about being an ambulance ride away from the hospital should anything go wrong.

However, I do think that women should give birth where they wish and that the majority of low risk mothers do extremely well at home (better than they would do in the artifical environment of the hospital).

I don't think HBs are at all selfish.. but yes, if the baby was in distress, it would be selfish to insist on staying at home just because there was a preexisting dream of a perfect HB. I'd imagine that's pretty rare, though.

I don't think that it's highly likely that people want to birth at home just to improve their sleeping rates, though. I am due a week today and wish I was having a homebirth, mainly because I am quite scared and nervous and would be more relaxed here, which I think would be better for my baby. I had to go to the maternity assessment centre last week and could feel my BP/HR rise as I walked through the door!

HBs typically require less intervention which is actually a good deal better for the majority of babies. I didn't choose either a HB or a waterbirth as this is my first baby and to be honest, the midwife didn't even discuss these as being options with me - automatically booked me in for the standard hospital birth.