to think that SIL is silly to want a home birth??

[catinboots]

I know I'm probably going to get a flaming - so let me first clarify that I am not anti home-birthing !!

SIL is 41, single and expecting her DC1 this year. She has stated she is going to request a home birth. Am I right in thinking she is a bit bonkers - due to both her age and the fact it's her first baby. Surely both these factors put her in a higher risk group?? She just keeps quoting caesarean rates and says she definatley knows that nothing will go wrong because she has a positive outlook!!! She said that health professionals are scare-mongers.

I have several friends who have had very successful home births. It is also something I would consider if I ever had a DC3.

Maybe my opinion in coloured - my mum had a full-term stillborn baby, and my DS1 was born in hospital after a very long labour and various forms of intervention. DS2 was also born in hospital - but the experience was very positive.

SIL currently lives with MIL (who is not keen on the idea either). She is 30 minutes drive from the hospital.

Fairly obviously, a positive outlook doesn't guarantee you a perfect delivery. No-one's saying that.

Look.. both hospital birth and home birth carry risks.

Hospitals are good at sorting out problems but they're also very good at causing them. You have to take a choice.

In my case, I knew the hospital would have caused a problem so I put my bet on a home birth which happily went very well. A hospital birth would have guaranteed me a caesarean which would have meant a much longer recovery time plus trauma. So I made the right choice and I was lucky.

But either way, it's a gamble. It is for your SIL to decide where the odds are best for her and if you want to help improve her odds and stay on good terms, it's better to be supportive because you're unlikely to change her mind.

Plumm.. I had a waterbirth in my living room in a rented house with cream carpets.

Not a mark afterwards. Midwives cleared everything away.

Never saw any mess and I was running about the house like a headless chicken (couldn't keep still) with broken waters, heavy meconium staining and bloody show When I eventually plonked myself to give birth it was too late for towels, mats etc so I gave birth straight onto the cream carpet. MWs cleaned it up in less than two minutes with a cleaning spray and old towel. No trouble. Still have the carpet.

I have had:

Hospital birth with lots of intervention DD1
Home birth - perfect with DS1
Home birth - very fast, nearly on my own but also perfect with DS2
Home birth that turned into traumatic and necessary hospital birth with DD2 and where a crash section was called after about 24 hours of labour

I'd still opt for a home birth if I were to have another but would be far more accepting of the possibility of needing hospital intervention. I also accept that if that intervention becomes needed whilst at home, then the time delay may bring serious consequences such as death or disability.

The reason that I can accept this is because my life philosophy is deterministic and that all choices kind of lead to the same conclusion.

Carmen, can I ask why you think a hosptial would have guaranteed a CS for you?

My labour was a doddle, just gas and air, but ended up having ECS because of foetal distress. I'm still not really clear on why things went wrong.

"Even then, 30 minutes is enough time to get to theatre. It is not much more than the time it takes to prep theatre when you are already in hospital."

I'm sorry, but this simply is not true. When I was advised to move to caesarean and the second I said "Let's do it", there was a form under my nose on clipboard and a pen in my hand. Cords were ripped from monitors, and I was shaved in a matter seconds. I was in the theatre surrounded by team of doctors in less than a minute. I remember I could still feel my belly and the consultant said "We can wait one minute." I could still feel my belly, and was knocked out. When they knocked me out, DH was asked to leave the room. I obviously don't remember anything after that, but DH told me that he heard the baby cry 3 minutes after he was told to leave theatre.

If a baby is deprived of oxygen, EVERY minute counts. I'm not sure of this so feel free to correct me if someone knows more than I do, but I think it's only about 5 minutes until brain damage begins if the baby is deprived of oxygen?

I should also say,I agree with the comments from posters who say it is her baby and her choice. I personally would never want a home birth. But, I believe very strongly in a woman's right to choose. So, you might express your concerns to her (politely!) once. But, then, back off. It is her choice.

Wubbly, because I'm in the US and have had a previous caesarean. Local hospitals have time limits on how long you can labour for and I was in labour for 24+ hours. With the foetal monitoring and restrictions on movement, eating, drinking etc. that they impose, I'd have never done it naturally.

Wubbly, if you don't mind me asking.. what was your baby's APGAR like? Was s/he visibly distressed when born?

You have to be within 30 mins of a hospital so she is perfectly within the limit.

I had an unplanned homebirth 11 months ago, we're 50 mins from hospital, it was an amazing experience, and was actually an insight to how capable the body is, I am 40 yrs old, very healthy, I think that if your SIL is in good health she will be fine. I know what you mean about it being her 1st, this was my 2nd. 1st time was very drawn out for me, but that said it was all going great until I went into the hospital, there things went pearshaped. Of the two births there is no comparison the home birth was special and not at all painful, just fast and intense.

It's your niece/nephew to be, I understand your worrying but it would be best to just support her, it's her baby.

My sis had two home births, she was in her early 40's for both, all went perfectly.

It is certainly not 'bonkers'.

I think people who haven't had a homebirth grossely underestimate how much medical equipment they bring with them.

For instance, when my DD stopped breathing they had an oxygen tank and neonatal sized facemask ready and waiting, just as in hospital. I dont see how this is more dangerous than when I was left totally alone when DS was crowning during my hospital birth. At least HB midwives cant disappear off down a corridor to have a tea break check other mums.

Re: shoulder dystocia- they bring big episiotomy scissors and forceps to deal with this if it happens

If your sil is not in a high risk group and if you follow stats, a home birth is no less risky than a hospital birth.

And as for mess, the midwives clear everything up behind them. It doesn't have to be that messy anyway.

Plus you get two midwives - one for you and one for the baby should either of you need more help than is usual.

I had a home birth with my ds2 - it was fine.

I think people need to be able to weigh up risks, pros and cons for themselves and consider where they feel safest.

If you're not going to be supportive and express doubts, then you'd better make sure you've done all the research too because if you're just spouting from your gut instinct, then that's simply not a good enough reason to put someone else off.

30 minutes from a hospital is on the assumption that the ambulance will appear at your door instantly. In Riven's case this did not happen.

I have never had to call for an ambulance in labour, but have called ambulances for other potentially life-threatening matters and know very well that "it takes 30 minutes to drive from my house" is not necessarily the same as "if I get into trouble I will be in hospital within 30 minutes". First an ambulance has got to be free. Then it's got to get to your house.

Personally, I would not try to change anybody else's decision once they had made it clear that they had thought the issue through. But I would not be making this decision either.

I have just had first DC nearly 6 weeks ago and had been giving serious thought to a home birth. Overall I think it's none of your business, but I can see why you are concerned so I don't think YABU.

If I had opted for a home birth I think there would have been a risk for my DD. I coped very well with very manageable levels of labour pain and was in advanced labour by the time we went to hospital (unknown to me, obviously). On admission I was 9cm dilated and felt pretty good, had a bit of gas and air and was coping fine but when they checked on DD her heart rate was very low and erratic. The doctor was called and he whisked me straight off for a crash section under general anaesthetic. DD was out within 40 minutes of our arrival at hospital.

I do wonder what would have happened if I'd chosen a home birth. I probably wouldn't have called the midwife until the point at which we decided to go to hospital. I would then have had a wait for her to arrive, followed by a further wait for an ambulance and a 20 minute drive to hospital once DD's distress was discovered. It's possible that it would have all been okay, but I am very glad that I didn't opt for a home birth as my labour was very very fast (contractions started about 9.30pm and doctor examined me and confirmed fully dilated and head at station +1 at around 2am) and I was never in terrible agony so I had no idea how far advanced I was and would not have had any midwife care until it would probably have been too late.

If you're very worried then tell her, once and nicely in a non-patronising way, and then leave it.

Don't mind at all Carmen. I can't recall his APGAR off the top of my head and it's faded from the copy record I have, but there was no cry for ages, that has stuck in my head. He was taken straight to SCBU (didn't even get to hold him ). He had to stay there for about 4 days, but now I'm not sure that was related to his birth or if it was precaution because my waters had broken so long before birth .

Actually, it's ridiculous how little I actually know about what happened and why.

I get the impression that UK hospitals are a little less geared towards pushing you into caesarians/very medicalised/passive labours than US hospitals. I was encouraged to move around as much as possible in labour, despite the fact that I was intensively monitored (you can always strap the monitor on and off).

And while I know they hadn't exactly planned on my labour (which ended in caesarian) starting just before my order of Lancashire hotpot and Bakewell tart arrived, noone tried to whisk the food away from me either. I was well fortified by the time they rolled me into theatre

Her birth, her choice.

Tell her you opinion (I guess you already have), then leave it.

And if it doesn't all go to plan, what ever you do, don't say "I told you so"

Honestly ? i think the distance from the hospital would be the only major factor for me , i chose a homebirth for ds3 and like riven had a placental heamhorge (sorry spelling) ,i was lucky ,the midwife had an ambulance at my door in no time and then i was at the hospital in 5 minutes ,straight into theatre and the rest is a blank due to GA. I was low risk and am very very lucky to be here and to have a baby that wasnt affected . The midwife stuck to me with the foetal monitor all the way though ,like a particularly well qualified siamese twin, so we knew he wasnt in distress and it was only when the registrar with the biggest hands in the world walkied the room did the trace go off

Personally, I don't blame her for wanting a HB. When you are in hospital medical staff can't resist having a good prod, which probably is counter productive to having a good labour experience and also having a c-section.

I was 38 when I had my ds and it was my first birth and a home birth. Midwives completely ok about it after I tentatively suggested it, very encouraging.

I like to think that I had a 'positive attitude' but for me this needed to include planning for if things didn't work out. I am also only 5 mins from hospital.

I say be supportive to SIL and let her work it out.

Having had a similar experience to Riven (tho' hadn't ever intended to have a home birth), I personally think a 41 year old having her first at home is pretty risky.

It's not so much the statistics of everything being fine against those of something going wrong, but the life changing tragedy of what happens when it DOES go badly wrong.

DS's apgar score at birth was 0. They estimated he'd been without oxygen for at least 15 mins.

I would never advise a women to have a home birth with their first child.

I wanted a hosp birth with no intervention. Ended up with an emergency csection as DD1 was stuck and was very distressed. Later my midwife advised me to have pelvic x-rays and it turned out because of the angle of my pelvis I would NEVER beable to give birth naturally.

I dread to think what would have happened if I was at home

A baby is too precious to risk.