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.

Ang on - me being thick 2-3 in a hundred. oops! But yes more in line with my own studies.

bellissima you are right, I studied this as part of my dissertation and it was much higher than 1 in 100, it is possible it could be lower if you take out things which cause death in pregnancy rather than actually during childbirth itself though. Maybe thats the 1 in 100 ?

Warthog - I don't think it is that easy to resist pressure by hospital staff to speed up a birth. All they have to do is to imply that the baby could be at risk, if you don't let them do x, y or z - how many people will take that risk?

I firmly beleve that obstetricians tend to be more risk-averse, because of their perception of birth as a high risk experience, and this is bound to colour their decisions, in my opinion.

With my son i gave birth in hospital ,had a monitor on .My mum was with me and she went out to tell the midwives 5 times that the feotal heart rate kept dropping ,this was while my midwife was on her break , on the 5th occasion with much eye rolling and tutting ,a midwife poked her head round the door and said it was my fault as i was lying on my side ,didnt even enter the room ,i was lying on my side because ds was back to back and this was the least painful way to lie on a bed . When my midwife returned ,she took one look at the monitor and went and got a dr who put a clip on ds head ,which showed he was in distress (and had been all the time she had been on her break) ,cue ventouse delivery and general mayhem . Luckily for ds he was born ok ,lucky too for the three midwives who refused to move thier arses away from the nurses station to check ,oh and they were sitting there the whole time as my mum had her chair posisitioned so she could see out of the room and they never once moved .My dd was born without any problems in hospital and this one will hopefully be born at home ,however and this is where i think you may have gone wrong op ,if the midwife arrives and says no we need to go to hospital ,that is where i will give birth ,she is the expert . If the women in the programme refused to go to hospital ,then i think its fair to say she may have been selfish.

I am going to explain why I had a HB, you can make upn your mind to see if that is selfish, FWIW it wasan amazing experience.

DS4 was my 4th child. I hd requested a HB with ds3 but it didn't happen as my FB went low (thusproving I would have gone in should there have been any need). Two of my children have autism, meaning I cannot just drop them with a neighbour and run if needed, and my Dh worked an hour away at best (often more through traffic). We have no family etc here.

I also had a big fear of birthing alone in hospital as my birth with DS1 was horrid and that was as much due to the staff attitude towards me as the issues ds1 was having. I'm not good with people i dont know at the best of times and even little things such as food I can eat (fdairy makes me ill) was denied to me. I didn't know it then but a week after my local maternity unit (not the first one I birthed in) was declared as unsuitable for purpose and a serious concern by whoever it is that does these things so I had a lucky escape.

Also my last birth took 3 hours- less than the time it would take to get DH back and kids to Mum. I was warned that ds4 could be quicker.

So I had a HB booked,with a doula on call so that if Dh didn't make it, or
if I ahd to be transferred in i wouldn't have to be alone whilst Dh sorted the boys.

And the outcome?

Well I had a 35 minute labour / delivery; had I not booked a HB ds4 would have been born (I estimate) in the garage outside the Tesco Express. AS it was, it was a delightful birth- only one MW made it but we had the Doula as well on hand, Dh was incolced and I was able to eat suitable foods afterwards, and do a school run the next day. Far safer than the precipitous-led street alternative, no?

There is also some (but needs further study) evidence that the maternal mortality rate rose in some places in the nineteenth century as the industrial revolution led to earlier marriages which in turn led to women having more children. Women tended to die in childbirth either because (for a few) they were, to put it bluntly, simply the wrong shape pelvis wise - this would obviously happen with the first child or the first large child. But a significant number would die in childbirth after a run of children - suggesting age or simply being worn out in a sense. Of course these factors rather less common these days so I'm digressing and will shaddup.

fernie3 - the study I referenced seems to be talking about actual childbirth. I think death rates in pregnancy or indeed between out of pregnancies were a lot higher than now, for a whole host of reasons.

IMO i would rather be safe, birth even though obviously is natural can be high risk to, my sIL baby was very big and was not engaged, his head was to the side and was stuck, so she had to have a c section, no amount of pushing would have done the trick. With my dd, i was monitored constantly because her heart was slowing, it appeared later that the cord was wrapped around her neck. I was in labour for about 2 days, i was glad that i was in a place where if they needed to get her out quick they could, just my experience.

Okay I am selfish then.

I had a homebirth first time round, it was wonderful. No interventions, no tears, minimal pain relief. Happy outcome for all. DD very chilled and happy baby.

Second time round twin pregnancy, in hospital from 25 weeks, babies born at 31 weeks. Emergency LSCS. Twin 1 died after 9 hours (nothing to do with birth) twin 2 now a boisterous 2 year old.

After discovering T2 was in distress at 06:45 waters had gone at 06.20 it took until 8.59 for him to be born. I was at risk of early labour (hence being in hospital) was having hour long monitoring twice a day and alternate daily scans. Should have been ready to deliver me at the drop of a hat. Two and a half hours later.

As it was the person checking the FHR thought the decelerations were just transfers to maternal heart rate until consultant arrived and demanded this baby be got out now. Also staff had shift handover so I was left alone in labour ward holding onto twin montiors on my abdomen, having contractions, waiting for DH to arrive and having no acces to buzzer. Absolutely papping myself.

Any wonder why this time round I am opting for a homebirth. Have every faith in my MW who will assist me to get the birth I and my baby want. I will transfer as soon as she suggests it and I already have my hospital bag packed and it has been packed for weeks now.

Oh the resource thing-

When i ewnt into labour two MW's were called from home who ahd volunteered to be on a HB rota

no effects on hospital births.

HB seems tempting this time round but due to my previous experience i would rather be in hospital. No women are not selfish if they give birth at home its their choice they should not be made to feel like bad mothers because of it.

YABVU

here we have community midwives who deal with HBs, no effect whatsoever on hospital staffing. Hospital is over 40 mins clear road away, and last HB I laboured for just over 2 hours. My other dc could also stay in their own home, I delivered at 7.20pm and they were out with my friend, but came home at 7.30pm and met their sister. Best all round. Community mws much more attentive to me and DH, kids in own beds, I'm safe and happy - not selfish.

I fully intend to have dc4 at home in 6 weeks too.

Admit it Scorps, you just want someone else to lose their Christms lunch as well if you have it on your due date don't you?

Mince pies for the MW...

I think the reason that these issues of risk in healthcare decisions cause us all to go up in arms is that we are forced to face the fact that there is no perfect risk free choice - in birth as in many things. And that's scary.

So you labour at home with the tiny voice in the back of your head saying: 'what if I have a massive unexpected haemmorrhage? What if there is a knot in the umbilical cord and the baby is deprived of oxygen?'

Or you labour in hospital with the tiny voice in the back of your head saying: 'what if that midwife is so knackered that she is making the wrong call about not monitoring me? What if this epidural is slowing my labour to the point I'm going to require a C-section?'

The point is that 'what ifs' are a very poor way of judging risk for the individual precisely because they are, by nature, completely unexpected. So we have to fall back on mass population studies, looking at risks for whole populations. As people have said, these repeatly show that the risks for homebirths in a normal pregnancy are no greater than birth in hospital.

Which is fine, but a mass study is never going to silence the 'what if' voice - it can't prove 'no risk'. I think it would be better, however, if we recognise the fact that no birth is without risk, wherever it happens - and rather than chucking rocks at women who have made different choices, and adding an extra layer of distress from social bitchery, focus on trying to reduce the known risks by improving midwifery services across the board.

Peachy - yes lol. Maybe that's selfish of me wanting to HB with EDD of xmas day

Can't you find a nice little stable, something equipped with a manger preferably underneath a bright star?

I don't think you can make sweeping generalisations like that OP, but I personally prefer to have ALL the possible help that is available, right there down the corridor to give my baby the best chance at survival if anything when wrong with the birth, so that is why I chose hospital birth last time and will again this time, and would never even consider a home birth. [I'm not looking to be convinced otherwise, either - while I respect HB-ers'choice to do that, it's not my choice to do that and never would be.]

I know people have their reasons for home births and there is lots of evidence to support it etc, but it is a personal choice and mine is to make sure that if the baby or I need special care/surgery at any stage during the process, it is just a trolly ride away.

gizmo - entirely agree.

I've been worrying for weeks that at-risk DD will get SF. Now she's been offered the vaccine (next week) I'm sitting here worrying that it will have adverse effects. Nothing is risk free. We read up what we can and make our choice. And support others who have made theirs. And hope that the resources are provided so that everyone can make a choice.

YABVU
but you know that.

i would argue that HBs are safer, as there is no extra risk incurred by travelling in labour.

The Netherlands has been rated as the best place to give birth in Europe, over 50% HBs - best long and short term outcomes for mothers and babies.

so the stats aren't on your side OP.

A very intelligent and wise post, gizmo.

We are all different, and the choice that was right for me, will be utterly wrong for someone else. Pigletmania is clearly making the decision that is right for her, for her upcoming birth, and Scorps is making the completely opposite decision that is right for her.

What matters is each woman (and her partner) having all the information that they need to make the decision that is right for them, and having access to high quality maternity care, whatever their decision is.

Well, this is slightly off point, OP, but I almost died because of too many home births in my area.

I gave birth to DS in hospital by C section (he was breech, with cord around his neck). Two days later I was sent home. Unbeknown to me, I developed a serious wound infection. No midwife came to see me AT ALL. Ever. I would ring up and say 'when is one coming to see me?' and they'd make an appointment and then have to cancel because of another HB. Eventually after a week, my wound had swollen (had no idea this was not normal) and I was feeling really ill (just thought it was tiredness!) and my Mum panicked after my temperature reached 40 degrees c.

Luckily my GP agreed to come out and see me urgently and I was ambulanced to hospital - beginnings of blood poisoning. everyone agreed that the midwives would have spotted that something was wrong in 2 minutes and I could have avoided the nightmare that followed.

I never complained because frankly I was just grateful to be OK but they cancelled no less than 5 appointments 'because of home births'. This is NOT because of the selfish ladies who wanted to have home births but because of rubbish staffing, but nevertheless, it does all have an effect...

A few posters have said that their baby got distressed because they had to give birth in hospital.

Is that really the case? Is that what you were told?

Is it true that babies don't go into distress during homebirths, then?

You could also argue giving birth in a hospital with its increased risk of infection and disease, more chance of ventouse/forceps and cs just to avoid the very small chance of something going wrong at home could be said to be selfish, but to each their own.

What do you think of pain relief during birth - is that selfish too? There is a risk that it can be suboptimal for the newborn, and interfere with bf, after all.

Or is that OK because it's in hospital?

There are risks to everything we do in life. It is for each person to decide, based on their own situation, which risks are more acceptable to them.

The idea that there is a totally risk-free way of giving birth is nonsense.

Edgar - the Netherlands is indeed a very safe place to give birth. but, as previously noted, the countries next to it with much higher rates of hospital births and higher rates of take up of pain relief also show equivalent 'safe' stats. ie all choices good if resources.

(And, as also previously noted - Dutch women amongst tallest in world)

babies can get distressed during home or hospital births and i don't think anyone is claiming homebirth as a utopia where nothing ever goes wrong

during my VBAC, i was v v anxious as MW said i was one of those women who did not dilate, DDs heart rate shot right up, i also had meconium in my waters when they broke an hour or so later.. i did dilate and once it was apparent labour was underway, i relaxed and so did DD

i do think how safe, supported and in control the mother feels has an impact on teh baby and how the labour goes to an extent.

i've seen and heard from lots of women who were very distressed during their hospital births, and that is often a factor for them choosing a homebirth/doula/IM the next time