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AIBU?

Share your dilemmas and get honest opinions from other Mumsnetters.

to be worried about taking up staff time with h/b?

23 replies

Ryuk · 02/07/2010 15:21

I'm increasingly thinking I definitely would prefer a home water birth. But last night I was talking to DP about it, and it started to sink in that the issue of so many hospital birth women having to put up with a midwife only popping in occasionally, is partly due to selfish buggers like me taking up staff time by having a midwife (water-trained at that) at my house for however long it takes to have my baby. And if anything goes wrong or looks like it might go wrong, we then have to take up a paramedic to come over as well.

So now I'm not sure whether this question should be 'am I unreasonable to want a home water birth?' or 'am I unreasonable to consider not having one to accomodate the staff/anyone else who needs their help?' DP said I was being very silly, and should go with whatver I'm most comfortable with (home water birth), but it still makes me worry about being selfish...

OP posts:
hopalongdagger · 02/07/2010 15:29

But by being at home you are (statistically) less likely to need medical intervention, and you will not need to be on a ward for 2-3 days receiving care. WOuld you consider a woman who had good reasons for an elective caesarean to be taking up resources by requiring surgcial staff and an operating theatre etc? I'm sure you wouldn't! And if all goes according to plan, you might have 2 mws but you will not be 'taking up the time' of any consultants etc.

I haven't seen any research about the costs of hb vs hospital, but I wouldn't imagine that much difference once everything is taken into account.

If you feel a hb is right for you, then go for it.

VirtualPA · 02/07/2010 15:30

I don't think you are BU. It's an option there to be taken if you so choose.

StealthPolarBear · 02/07/2010 15:32

yes yabu

detoxdiva · 02/07/2010 15:35

I had a hb so I don't think you are BY. It's an option that is open to you, and if you wish to go ahead, then the mw's will make plans to be there. Ime, the m/w's loved a hb and at no time made me feel like I was causing problems, even when the local clinic had to be cancelled because I was in labour.

I delivered in 4 hours and took up no hospital resources or beds during or after the event. I feel more needs to be done to enable mums to birth at home if they wish to and there is no medical reason why they should not.

detoxdiva · 02/07/2010 15:36

BU even!

StealthPolarBear · 02/07/2010 15:39

yes, sorry, my YABU was to your thread title! You need to do what, for you, will lead to the best outcome - for the average low risk woman that's a H/B I think.

QueenOfFlamingEverything · 02/07/2010 15:43

In most if not all areas home births are attended by the community midwifery team who are separate from the midwives working on the labour ward. They don't call hospital midwives away from the ward to go to a HB - there will be some of the community team on call at all times.

wahwah · 02/07/2010 17:20

Mine were community midwives and they certainly saved the NHS stacks of cash. They were fabulous and brought a student so that she could gain experience, so I contributed to her training too.

It's good that you're considerate of resources, but that's for your trust to work out. Good luck.

PommePoire · 02/07/2010 17:52

I've had two home births and was attended by a midwife and nursing auxilliary at the birth of our first child and two midwives and a student midwife at the birth of our second. Both times I asked in the run up to the birth how they manage to maintain staffing levels on the ward if there are several home births going on at once. Both times I was told that it rarely happened that there were more than two home births going on at exactly the same time and anyway, in our health authority, home births were attended by the community midwifery team whose rota hours are arranged separately from the ward midwifery staff. If you instinctively feel you want a home birth because that feels right for you, then most likely this will lead to a non or low intervention delivery and bonus is you may well be saving the NHS money.

morethanasong · 02/07/2010 18:26

My hb was attended by community mws as well. They don't take them off the wards here - in fact, the reverse is true: if there are staff shortages on the maternity wards, homebirths are cancelled.

cory · 02/07/2010 18:29

The most effective use of staff time is whatever leads to the best birth for that particular woman. If that is a home water birth, then that is what you should feel good about having. Save the time in theatre for those of us who were always going to need it

tribunalgoer · 02/07/2010 18:33

This reply has been deleted

Message withdrawn

Missus84 · 02/07/2010 18:36

Are you sure it will be hospital midwives coming out to you?

Where I am it's a different team of community midwives that cover home births, so it's not taking anyone away from hospital.

aendr · 02/07/2010 18:51

I don't have an opinion if you are being unreasonable or not. I do think your query is valid - but it's not the time of the hospital midwives, but the community midwives who do also do the post-birth visits, checking to see if mothers are coping and mother and baby are well, or need more help.

I personally don't want to have to take up the resources of an ambulance "maternataxi" to get hospital when it's just the beginning of labour if I can avoid it.

I would be inclined to say make the decision based on you and your family's personal needs and feelings, while weighing up the likely availability of a community midwife or two. (Ask them about that, as they will know if they have a lot of due dates the same time period as you; if so they might all be busy with other women when you go into labour so hiring all the water birth stuff might be a waste if you're short of money.) I think it's definitely worth considering how your partner genuinely feels about birthing at home, as although you're the one giving birth, he has a vested interest in the events too and how he copes will affect your reactions too. Also if you're likely to have hard to handle relatives popping in soon post delivery, then consider how your choice might help or hinder your coping with that.

"But by being at home you are (statistically) less likely to need medical intervention, and you will not need to be on a ward for 2-3 days receiving care."
The trouble with these statistics is that they are effectively screened for the likelihood of needing medical intervention. A woman who is advised to give birth in hospital, or as some put it "not allowed to give birth at home", is more likely to need medical intervention than someone for whom there is no reason not to have a home birth. I've yet to see clearly separated statistics on medical interventions for hospital births for the subset of hospital births which prior to labour were "no reason not to have a home birth", preferably broken up into birth at the more homely midwife led units and combined units where the docs are around (to see if that makes a difference).

Some people are more relaxed at home, or get tense in hospitals, and that could negatively affect their labours and therefore increase the need for intervention. Some, like me, prefer the reassurance of having the support of hospital facilities around "just in case" (plus with a nurse for a mother and some summer jobs in hospitals, I'm pretty comfortable in the medical environment). In hindsight, though I had a natural delivery last time, my son did need help and I was glad of the choice I had made. I don't really have much of a choice this time, as this pregnancy has enough complications that I would be ill-advised to birth at home, though I know that I could insist if I wanted to.

tummytickler · 02/07/2010 18:53

Well, I work on a labour ward, and we DO send midwives from the ward to h/b. We are usually short staffed, and it can be reallt tough providing m/w for h/b.
I will say YANBU, find out if the h/b midwife is from the ward. If it will be a midwife from the ward I would suggest booking a hb, but when you phone to say you are in labour if they say they are short of staff so can you go in PLEASE go. When People refuse to come to the ward when we have no staff to send them, it puts huge strain on the staff, we have to send somebody, or they end up with a baby born with a paramedic. You can go to hospital and be discharged 6 hours after the baby's birth - you do not have to stay for 2 - 3 days!
Its not just about costs - it is about the staff numbers at the time of your labour - a ward with 6 midwives will not thank losing 2 to a homebirth!

nubbins · 02/07/2010 19:01

I totally get where you are comming from, but think of it this way......

there are so many women who are pressured into going in to hospital to give birth by midwives using the 'low staffing levels' excuse. The only way we can stop this happening is by digging in our heels and demanding a homebirth. By doing so you are actually encouraging the NHS to increase the number of midwives it has thus enabling more women to give birth where they want to.

Homebirths are usually attended by community midwives, but when I had mine planned, the community midwives were being dragged in to cover the maternity ward! My birth was attended by a midwife from the birthing centre, which had been closed for the night to enable homebirths.

LynetteScavo · 02/07/2010 19:05

Where I am it's the commmunity midwives who deliver H/B so midwives are certianly not taken out of hostpitals.

Think how much money you will be saving the NHS! You are quite entitled to have what ever birth you want to have.

Firawla · 02/07/2010 19:15

I thought its usually a seperate team but if you think it may be from the labour ward, then why not do as tummytickler said? and hopefully you would still get the home birth but if its not possible then just go in, to the birthing unit if they have one so you can still have water birth?(if the pools are free..)
but i wouldnt rule out the whole possibility of home birth just because you feel guilty, there may be plenty of staff @ the time. i had 3 midwifes there when my ds2 was born! (1 was a student and the other 2 were doing the shift change over right @ the time of delivery so both just stayed), and with ds1 i dont remember ever being left alone at all either so sometimes there may well be enough people. you dont have to think you will be at home using up the midwifes and everyone at hospital suffering with nobody cos might not be the case, and the option is offered for home birth so its up to you if you want to accept it so your best suggestion would probably be just to book the home birth then hopefully when you phone up on the day there will be enough staff, and if not then remain a bit flexible/reasonable and just go in

Starbuck999 · 02/07/2010 22:56

YANBU. Nope, most midwives as others have said, that attend homebirths are not being taken off a ward for your home birth. You do not take up a bed in hospital and anaethetist / other staff are not usually needed. You are entitled to a home birth so have one if you want one! Don't feel bad in anyway.

Aendr - That annoys me too! You would not believe how many women call an ambulance when they have just gone into labour. Now I understand if it's their 5th baby, they're prone to quick births, contractions every couple of mins, complications, the few who cant drive & no money for taxi, not near hospital etc... emergencies! But women who have just started having contractions and who can quite easily jump in a taxi do not need an ambulance in my opinion.

Ryuk · 03/07/2010 13:39

Thanks all, I feel more encouraged now. Was having a bit of an 'aah!' moment. But would definitely prefer to do it here, in nice calm peaceful (well, ish) way if I can.

OP posts:
Ryuk · 03/07/2010 13:40

Forgot to add, will ask my midwife when i next see her how it works in this area regarding ward/community midwife teams, as well.

OP posts:
foreverastudent · 03/07/2010 14:29

homebirths are cheaper then hospital births but do you hear hospital birthing mothers say they feel guilty about costing the overstreched NHS extra money?

all mothers should have 1-to-1 midwife care throughout their labour, whether at hospital or home.

moonstorm · 03/07/2010 18:49

I would say YANBU.

I needed to be in hospital, ds was prem and there were other complications. After my crash cs, I was left alone for 3 hours (forgotten about - the midwife said so, I could have suffered a massive haemorage (sp?) and noone would have known). All because the hospital were short staffed (they had to shut the unit and were refusing to admit any more mothers- these mothers in labour who were turned away faced a significant journey to get the the nearest labour ward).

The midwifes from the wards are used in the community for h/b.

I have nothing against h/b, but I think there should be enough staff to go round first. Fair enough, if every woman turned up at hospital, they could still be short staffed, but the midwifes could be shared between rooms, not many miles away. And I believe (from reading another thread) tha there are 2 midwifes to a hime birth? Well that could be to two women in a hospital..

Please correct me, but that it how I see it at the moment (I was keen on a h/b the first tie round, so am definitely not anit h/b.

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