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.

blimey framey. Hope your friend's daughter will be ok.

Framey .... what a frightening experience!

Sorry - I didn't mean to offend. You're completely right that previous history is fundamental to the decision you make. My personal history is that DD was breech and born vaginally after DH and I did a lot of reading and thinking - it makes me so sad to hear so many women who were told they "had" to have a CS becuase their LO was breech. Depending on their personal circumstances that may have been the case, but from what I've seen its fairly standard practice to present hospital policy as unavoidable dictates that must be obeyed. As I say, its become one of my pet hate phrases now and I struggle not to respond when I see it

(btw - I was trying to say that we're all mentally competent adults and, as such, we all have the right to make our own decisions)

sorry heavily pregnant and hormonal here!!!!!

She seems fine, she's a beautiful baby but the doctors have said that there will be brain damage and they have to wait and see if she hits her milestones in developmemnt terms.
It is actually the Grandma of the baby who is my friend, she was totally against the idea of homebirth for a first baby.

She went to clear up the house after the birth and she was shocked at the state of devistation left after this emergency had happened in their living room as they all had to rush to hospital and leave it behind.

Not that it matters if there is a mess but it really upset my friend to see this scene.

devastation* oops

Warning - this post became long and emotional while I was writing it. Probably best avoided.

My last HB would have been decreed high risk. I was told I could not have it. A hospital MW actually rang the community MW team without my knowledge to tell them that the HB was cancelled and I was being induced. Before getting my consent to the induction, which I witheld.

Seriously. Hospital SHO obstetricians thought that the best management for my pregnancy was to chemnically induce. I had just had a major asthma attack and could barely walk the length of the room, let alone push a baby out! Baby was absolutely fine, BTW.

I had agreed that if there were no signs of labour, and if a scan showed that the baby needed to be born with artificial assistance, I would be admitted at 43 weeks. Luckily for my sanity, I managed to find a senior MW who was actually willing to listen to me, and was able to have a damn good cry and sensible discussion of risk without shroud waving. I don't think it was a coincidence that I laboured only a few hours after talking to this MW - I was so tightly wound up about the birth and frightened of being admitted that I don't think I could get the hormones going until I let go of some of the adrenaline.

We shouldn't have to fight. I was not being bloodyminded or stupid. There was a statistical increase in risk by going post 42 weeks. I read the studies this was based on. I also know my own body and mind - and family history, which is that my mother and maternal grandmother both had extended pregnancies - my mum was induced at 41 weeks with her twins, which is pretty unusual. I had a scan, I had all the checks - baby and I were both fine (aside from my asthma). Setting foot in the hospital would have increased my risk of C/S to 25% and of an instrumental birth to over 50%. Being induced increased those risks further. The drugs used to induce can cause problems for the baby, and it is much more difficult to cope with the pain than with a natural labour. The unfamiliar environment causes the body to release adrenaline, which inhibits the production of oxytocin, slowing labour. As soon as you are admitted, you are "on the clock." In the local hospital, you have to start off on the ward and are not moved to delivery until 3cm - in my specific case, that would have left approximately 10 mins before the baby came, as even my PFB was born 15 mins after I hit 3cm.

Every fibre of my being was telling me that hospital was the wrong place to be, and that I was endangering myself by being there.

Maybe an induction would have been speedy and painless, I wasn't willing to take the risk. I was unwilling to take my asthmatic-and-on-steroids self into a place full of unfamiliar people with new and interesting infections. I was unwilling to be treated as someone who was ill, rather than someone who was experiencing a natural process.

Anyway, upshot of this stream of consciousness rambling - I feel that people have a knee-jerk reaction that HB is unsafe, and that it irresponsible to have one. And the same attitude prevails towards going post dates. I can assure anyone who is wondering, I did plenty of reading and took plenty of advice. Probably more than most women who merrily go and get induced at 40+10 as an automatic thing, and then thank the hospital for "saving" them when a cascade of intervention endangers them and their baby. Although that opinion is only based on convos with people and not any actual research.

If I have any more kids, I will probably go overdue again. If I ever did need to go to hospital, I would opt for a planned section, as that is the only way I could feel safe in a hospital birth.
All just my opinion, of course.

Yes just your opinion but a very strong one!!!! Good on you for sticking to what you want but I think inferring that hospital births are not particularly safe could scare many ladies who have opted or HAVE to have a hospital birth. The wonderful staff at my local hospital are amazing!!!!!!!!!!

waves back to Page62

naccety, I agree with you. The medical establishment is far too keen to induce pregnancies early(ish) in my opinion. I was induced at 41+3 - all I can say is that I wish I had had the balls to tell them that I did not want it. I did not feel ready for labour and my body was telling me I wasn't ready but everyone else was so bloody keen for me to have it. It was awful - one of the painful and undignified experiences of my life so I can completely understand why people would want a HB.

I would have another hospital birth because I would worry about safety at home but maybe next time I will be more careful about letting the hospital tell me what they want and be more assertive about what I want.

Have followed this thread with interest and I am trying to analyse my own feelings and instincts. I had two very different but equally good experiences at a very large CLU which is a major specialist unit for a huge geographical area. 6000 births a year, something like that. I'm going back a few years and some of my antenatal care was there. I was not high risk, but that was the system. From the moment I set foot in there, I felt privileged to live near such a centre of excellence and was very happy with every aspect of care.

Re: 'If you lived equidistant between two hospitals, one which had 24 hour consultant cover (as some do) and one which didn't (as some don't), would you choose to go to the one with 24 hour consultant cover, even if the evidence showed that going to this hospital was considerably more likely to end in you having a c-section, failing to breastfeed, getting PND, getting a postnatal infection, and having a baby with low apgar scores, and that there were no benefits to you or your baby in terms of the likelyhood of maternal and infant death rates?'

Well, yes I would still choose the first option. That's my instinct, regardless of evidence. I felt safe there. There is no way I ever would have had a home birth.

I think I am not alone in feeling this way and if, as many posters are saying, these perceptions are unfounded, how do you go about changing perception? For me, the endless quoting of statistics and research makes no difference.

I have had two hospital births and two home births. I was happy with both sorts, but enjoyed the HB more, through no fault of the MW at hospital, but the 'system' that means they are run ragged trying to see to everybody. They did keep trying to push various drugs onto me, but I kept saying no, not unless it was medically necessary. I figured that having had uncomplicated pregnancies and births, I could just as easily do it at home. Then I read up on it, spoke to my MW and went for it.

If I was to say now why I preferred the HB, it would come across as selfish, as it is now an emotional response rather than the well thought out decision it was at the time.

"Whether or not this would have happened if the birth had taken place in hospital I don't know"

Actually s/d is no more likely at a homebirth than at a hospital birth - less likely, because women are more ambulant during homebirth than in hospital. In hospital or at home, it would always be the midwife who would be the one trying to resolve the shoulder dystocia initially in a normal birth. There is nothing an obstetrician would do that would be different, unless it was such a bad S/D that it ended up with a doctor having to perform a Zavanelli manouvre, (shove baby back up through the birth canal and do c-section). That only happens about a dozen times a year n the UK . It's harder to deal with a S/D if the mother is in water of course - but that is true of women having waterbirths in hospital too.

Just out of interest - is your friend very overweight? It's just you say she was 'very heavy', and I'm wondering if she had a high BMI. This was be a contraindication for a waterbirth usually, because of the higher risk of shoulder dystocia.

"but those precious minutes lost while waiting for the ambulance to come and driving to the hospital may have made a difference".

Yes - once the shoulder dystocia has been resolved and the baby freed it would be important for the baby to be seen by a paediatrician if he or she is still struggling. This is one of those situations where being at home might result in a poorer outcome for the baby.

Just wanted to point out though, that when a baby is born after an event like this, the first line of resucitation is usually done by the midwife with a bag and mask and with room air (though they also carry oxygen) - in home or at hospital, while waiting for the paediatricians to come. In my personal experience (this happened to me - but my baby was fine), I was very grateful to be looked after by a midwife who was extremely well-drilled when it came to the manouvres used to resolve s/d - but she is an IM who only really does homebirths, so she considers it very important to regularly review her skills in neonatal resucitation (which actually all midwives do annually as part of their normal training I think - but it's easier to be complacent about it if you know you're never going to have to deal with a situation like this alone).

Must have been a horrible experience for the mum and everyone involved in the birth.

"I think I am not alone in feeling this way and if, as many posters are saying, these perceptions are unfounded, how do you go about changing perception? For me, the endless quoting of statistics and research makes no difference"

I think that's a very good question!

I do think it's important to challenge people's ignorance about the facts - though I can see that women make decisions about birth in an intuitive way, and won't be swayed by the evidence. I know I wasn't (I was strongly advised to have a hospital birth because I was high risk, but chose a homebirth because I believed it was safer for me and my baby).

I think one of the key things is to widen out provision, so that those people who are interested in homebirth have more of a chance of having one - it shouldn't be as much of a struggle as it is in some areas organising a birth out of hospital.

I think that once more women know other people who have had a homebirth they may be more likely to consider it themselves. I remember the thought of homebirth crossing my mind when I was pregnant with my first. At that point I didn't know anyone who had had a baby at home, and thought of it as a very 'fringe' choice - only for die-hard earth mothery types with total confidence in their ability to give birth without interventions. It took me years of reading and talking to other mums, and a very bad hospital experience, to change the way I felt about hospital and homebirth.

I don't think anyone is saying that homebirth should be the default choice for childbirth. Surely that's the opposite of choice, and it could produce awful stress for a lot of women.

But it would be helpful if it became mainstream enough for those who wish to have a homebirth not to have to spend time justifying their choice to the ill-informed.

"I don't think anyone is saying that homebirth should be the default choice for childbirth. Surely that's the opposite of choice, and it could produce awful stress for a lot of women"

But if hospital birth hasn't been proved safer for low risk women and their babies, why should that be given as the default choice?!

Sabire - I think you are forgetting that the vast majority of women would prefer to give birth in hospital. Poor deluded souls that they are! So to say home birth should be the default choice is just crackers. I can't imagine where my stress levels would have been had I been forced to give birth at home!

Home birth will never be the default position because the litigation costs against the NHS for births going wrong would be astronomical. Childbirth is one of the least predictable things in the world, so what's the point in taking risks, even for 'low risk' women?

OK, so lets imagine that the default was for all women to give birth at home. Do you really think that would make it 'safer'? I don't. Lots of women and babies died without the interventions we have these days. There is a feeling in this thread that in hospital they are just intervening needlessly which I don't think can be true.

Can I just go back to this programme I watched again?! At the end of the programme, the midwife said 'I would be a happier midwife if that happened in hospital'. Also - they phoned an ambulance and 15 minutes later it wasn't there yet.

Another thought I have had - midwives ime can be very blase about whether you are fully in labour or not. If you have a home birth do they rush out to you?

I'm all for pregnant women feeling empowered by giving birth in the home. If I'd gone for that option, I'd hate to imagine the state my third degree tear would have been in by the time I got to hospital and how incontinent I would have been due to the delay of being sewn up under a spinal, plus the volume of blood that I lost....sadly for many it's just not a viable option doing it at home.

Inmylittlehead that's a logical way of looking at it and I agree with your statement.

'I think I am not alone in feeling this way and if, as many posters are saying, these perceptions are unfounded, how do you go about changing perception?'

personally I have no desire to challenge your own beliefs

We should all be able to do what is right for us; if we feel that is a CLU birth then the stats for a HB become irrlevant, they are only truly relevant if we are considering it ourselves, or if we would wish to deny other women that right- which most people would agree to be extreme.

A CLU isn't an option for everyone- we knew beforeds4'sarrival that me making it to hospital wopuld be unlikely, therefore my options switched to HB or unplanned delivery in the car or an ambulance- at which point a HB becomes common sense.

Situations differ immensely, and a range of birth options is essential to ensure this.

bibbitybobbityhat - in a way that's the real question, though. Why do the vast majority of women prefer to give birth in hospital when all the research seems to show you get don't get better outcomes by doing so (assuming you're low risk, etc)?

To me educating HCPs is a key step. When I first started talking about HB to my CMW and GP (shared care round here) I got every reason under the sun why I shouldn't consider it for a first birth - untested pelvis, might be a shortage of midwives... When we went ahead and booked it anyway things got more serious as the CMW is "a very cautious person" and so she felt it necessary to go into great detail about all the things that could go wrong at home that would have been handled much better in hospital (funnily enough I never got any info through the NHS on the benefits of HB or the risks of hospital...). She also told me how she didn't have any training in water birth so I'd need to hope the other MW had those skills and she couldn't remember the last time she'd sited an IV line so, again, I'd better hope the other MW had those skills. None of which gave me confidence in her as an individual or, by association, the CMW team. I did start to question why, with so little apparent confidence in her ability to attend a HB, she was a CMW!

One of the first questions we were asked at our booking appointment was what hospital we wanted to go to to have the baby. Why could that not have been phrased differently to include HB? If more MWs treated HB as a viable, sensible and safe alternative, wouldn't that help women start to see it that way, even if its a choice that they don't want to go for at that time?

'If you have a home birth do they rush out to you?'

It no doubt varies, but for me one was there in 10 minutes, the opther just missed the birth- I think she took 30. So yes, pretty rushed.

Speaking for myself, I preferred to give birth in hospital because I had no idea whether or not I was low risk. I had an uncomplicated pregnancy with nothing to suggest I could not give birth at home. But I didn't know whether or not anything would go wrong during labour! Who does? Am very glad indeed I made the choice I did.