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.

I don't think she's wrong to want a home birth. I do think she should just bear in mind that we don't ALWAYS get the birth we want. I couldn't deliver DS in the water as he had meconium in his waters.
There could possibly be complications that may mean your SIL would need to go to hospital. I think it's important to accept help when it is NECESSARY.
It's one thing thinking positively, but it should be done with your eyes open, aware of the possibility of complications IYKWIM

www.cmaj.ca/cgi/content/abstract/181/6-7/377

"Planned home birth attended by a registered midwife was associated with very low and comparable rates of perinatal death and reduced rates of obstetric interventions and other adverse perinatal outcomes compared with planned hospital birth attended by a midwife or physician."

The studies talked about by the Guardian article include unassisted childbirth or childbirth with an unqualified assistant which carry significant risks.

I think you are correct to feel her decision is unwise. Having had an emergency C section DS1 and elective C DS2 following complications at 1st birth, I would fear for anyone having home birth. I was your typical healthy best case scenario for a home birth and all went tits up whilst in hospital. I was sooo glad to not be at home. I will always be eternally grateful to the midwife who was on duty that night who told the docs to butt out and perform a C section immediately.

You can never tell how it is going to pan out. All the best for the new arrival anyway.

Bollocks... Try that link again...

Personally I think that YANBU.

I chose to deliver our first child in a local midwife led birthing center, given I was healthy, 25 yrs old, no problems in pregnancy and I felt it was a happy medium between home birth and hospital birth. The nearest major hospital was about 1/2 hour in a speeding ambulance.

I had an extremely positive attitude and the birth went really well in the birthing pool, but at the very last stage the midwife noticed our daughter had her chord around her neck and then her shoulder. She was delivered easily enough, but had to be rushed away from me instantly to be given oxygen etc then rushed to the hospital to the SCBU. I followed in another ambulance, and didn't arrive until about 7am (having delivered at 3.20am)to be told she had never taken a breath on her own and had passed away at 5.20am.

Despite the above being as awful as it was, I did feel that I had an amazing birth experience until that point, and would never change the choices I made, as she was also much smaller than they had thought (5lb7oz)from my measurements, and they later found from blood tests that I had pre-enclampsia, so the result may have been inevitable. However, I was also still far young enough to recover fully and grieve for a year, before trying again and giving birth to our beatiful daughter by elective section.

Obviously, all the choices we make in life have some impact, but as long as you don't live to regret the choice, whatever the outcome, your ok.

Sorry, long post, but felt I needed to input on this xx

I can't say whether YABU or YANBU, but I do think more comes down to the attention ans skill of the midwives than whether you're in hospital or not.
I was induced in hospital, was monitored twice for 20mins at each insertion of gel at the beginning, then I was basically left on my own. DH was chucked out because it wasn't visiting hours, so I was totally alone and unchecked for 2 hours at one point. I was rushed to the delivery suite at the very very end when I was already pushing - DH had tried to get the MW because he thought I was in transition, but she told him I couldn't be yet, without even seeing me.
If anything had been wrong no one would have noticed, whether the facilities were just down the hall or not.
I was checked on once in the first night after DD was born at 7.30pm and told off in the morning because I'd bled so much on the sheets. I could've easily bled out and I don't trust anyone would have noticed.
We were very lucky.

Angel - that made me cry my eyes out.

Your SIL needs to think not about her rights but her responsibilities.

YANBU.

CarmenSanDiego, ok I know there are always many sides to a debate, but bollocks is not very constructive. Catinboots asked for our thoughts, every single one is valid. Evolution has given us the opportunity to have our precious babies in a safe environment which will cope with all eventualities. There are tragic outcomes to childbirth, it all comes down to what scenario you feel individually will give you the best back up in an emergency. Kids discuss many things but I cant imagine home birth v hospital birth would come up much, they cant remember.

I had two well-managed home births, including my first.

My second I had in hospital (2 weeks overdue)and, like, RobynLou was not monitored well.
I was induced at 6.30 pm and told I wouldn't be giving birth until the next day.
Things started off and they didn't believe how much pain I was in and told me to have a bath! I spent 2 minutes in a lukewarm bath and got out because of the pain.

Then they bothered to find out how dilated I was and whisked me into the labour room. Dc was born 3 and a half hours after the induction. Worst midwife care I received.

30 mins is too long for a transfer, bearing in mind you have to add on the time it takes to scramble an ambulance.

When thing go wrong, they can go wrong pretty quickly. That is presuming you are monitoring the baby's heartbeat in the first place.

Isn't one of the criticisms of home birth the lax attitude towards monitoring.

mummy2 - I think Carmen said "bollocks" because her link didn't work the first time..

mummy2, I was saying bollocks to myself because I screwed up the link.

x-post

personally would not have a home birth because both my boys needed ventouse and the intervention of a medical team to get them out. No reason to suspect this would have been the case before delivery, so very very glad I was in hospital

Blueshoes, one of the criticisms of hospital birth is that there is too much routine monitoring that has been demonstrated not to improve outcomes. Because the monitor is slapped on, the MW goes and does the other 43782943824 things she is responsible for, comes back, takes cursory look, etc. In my HB experience, the baby was listened to using a doppler in between contractions and during a contraction about once an hour or so. Plenty.

I would worry about her too, op. But what can you do?

blueshoes, quite the contrary... home birth is generally very well monitored, both with technology and observant midwives. You're more likely to be left alone for longer periods in hospital.

I'm so sorry for anyone who has had a bad birth experience in any way and there are some awful stories on this thread.

Bad things can happen in any setting. But we have an odd relationship with home birth and the comment about thinking about responsibilities really highlighted this.

If something goes wrong at home, we blame ourselves, yet things go wrong in hospital all the time and a large amount of those things are iatrogenic (caused by unnecessary or inappropriate medical attention or intervention). There are also specific hospital risks like MRSA. Yet we don't blame ourselves for choosing to go to hospital - just because it's the 'normal' thing to do.

If you are low risk (and the OP's SIL probably does fit this category), you or your baby are as likely to die in hospital as at home. The risk factors are slightly different but the overall mortality risk is the same. The most recent, well conducted studies all show that.

It's a sensible and reasonable choice. It's just a matter of what you feel is best for you. No-one else can make that decision for you, but also no-one should blame themselves if a home birth goes wrong. A hospital birth can also go wrong.

BigWeeHag - In my HB experience, the baby was listened to using a doppler in between contractions and during a contraction about once an hour or so. Plenty.

That is not plenty at all in many instances, my dd's heartbeat dipped extremely swiftly at the end of my labour and I had to have emergency forceps to pull her out, it was the scariest thing I have ever heard, the deceleration from the happy fast HB that we'd been hearing all through labour to this awful thudding slow beat - thank god for continuous monitoring. God knows what the outcome would have been without it, it certainly improved the outcome in our experience.

I'm 38, and I had a homebirth in February.
I chose to do so because the evidence suggested it was as safe or safer than a hospital birth for low risk women. I have not changed my opinion despite my experience.
I had two MWs throughout my fast and intense 5 hour labour.
My 9lb baby was born with his hand by his head, causing me a third degree tear.
I also haemorrhaged instantly, quickly losing 2 litres of blood on my bedroom floor.
I live around 30 minutes drive from the hospital.

And, as planned, emergency contingencies were employed. I was stabilised quickly at home, given fluids by the paramedics and rushed into hospital for repair and eventual blood transfusion - but the crisis had already been dealt with - exacly as discussed beforehand with my MW when we went over the potential 'disaster' scenarios.

People often say "but what if XYZ?" without realising those very questions have been asked by the mother of her caregivers, and answered to her satisfaction.

I'd choose a HB again under the same circumstances, however I am now a higher risk because of the PPH and tear, so would assess the situation diferently, perhaps.

(Oh, and when I eventually returned home from hospital expecting the bloodbath that was once my bedroom, everything was immaculate. The midwives were amazing.)

If you are worried, OP, don't guess the risks, don't make assumptions. Take time to become properly informed, and share information with your SIL. I'll bet she's thought things through long and hard.

IIRC NICE guidelines indicate the foetal heart beat should be monitored every 15 to 30 minutes - and I've never been able to find any research that demonstrates CFM improves outcomes over this level of intermittent monitoring. Low risk women are not offered CFM as standard, and CFM is no use if there's no one looking at the output.

verylittlecarrot - that's the problem. I don't think SIL is well-informed or has thought about HB long and hard. I think she has an idealistic, romantic idea of childbirth which is what worries me so...

But it's quite honestly not your problem.

She's 41. She's no doubt got midwife care and is being supported.

She's not planning on unassisted birthing. Home birth is a reasonable, rational choice. It has risks, as does hospital birth. It is NOT wildly risky. Plenty of women choose a hospital birth without any education whatsoever.

Leave her alone. I wouldn't dream of nagging a friend about the risks of hospital birthing although I believe they are very significant (particularly where I am).

It's quite simply not your business.

There could be undiagnosed problems with the baby though.

My DS was undiagnosed footling breech. My planned water birth, turned into an emergency CS. Not emergency as in "unplanned", enmergency as in "you are going to theatre now, don't for goodness sake push". Also half an hour from hospital. I stayed at home as long as I could because I didn't want any pain relief - which was down to positive mental attitude. Thank goodness DH had the nouse to take me to hospital when he did.

I dont think I wouldve wanted a home birth with my DC1.

But I had hb with DC4 & 5 when i was 40 and 42.

Age isnt a risk factor as far as i know.

They were wonderful. They bloody hurt but I didnt feel in any danger at any time.

I am 15mins away from the hospital. I have been in hosptial with DD and had to call for emergeny attention. That took a great deal longer than 15 mins.

Horrible things happen at homebirths but they also happen at hosptial births. Unless there are known risk factors you cannot tell what is likely to happen until it happens.