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.

apologies blueshoes if you have explained in detail that your crash section further below. I haven't read the whole thread.

I must say I was trying to explain that most c/s can wait for a ride in the ambulance to get to the hospital to which you replied that your emc/s (different from a crash) took place in 11 mins.

don't feel sorry for me. it is condescending if not downright rude to say so, especially by mentioning that I may not have informed myself about my choices. but those are your issues.

I had an awesome home birth and it has healed a lot of the mental wounds which I suffered for lack of care in a hospital. I am not intending to have any more children but if I were, a hospital for me would not be a place I would choose to labour.

buzzing, it is a fact that there are cs that need to be done faster than it takes for an ambulance ride.

Are you saying they don't exist?

If you considered all the risks before you decided on HB, it makes no difference to you whether my experience proves the exception.

Unless you are denying that an exception exists ... In which case, you did NOT consider all the risks.

'they didn't realise she was in established labour until staff changeover'

That happenmd with ds1 too; induction started at 4pm but told would take days- or to quote 'i'm off shift for three days now but I expect I will be here to see birth' from senior MW; contrsactions started at 2am, enough to need to pace; I called DH in at 9 (some farce involving his new car having a sheared clutch so couldn;t get hold of him, was before mobiles so common, he turned up at ten in the cab of a rescue truck); Dh was refused entry but talked himself in anyway. At 1 they wenjt on to change shifts and DH went to eat and the pain was so bad that I was told to bite my pillow so as not to scare oyhert women in antenatal ward, given 2 paracetamol. 2pm someone came back, 4cm dilated, ds1 born in 2 hours.

in my first post on this thread I mentioned and my last post I said, adding the bold this time for you:

" must say I was trying to explain that most c/s can wait for a ride in the ambulance to get to the hospital to which you replied that your emc/s (different from a crash) took place in 11 mins."

buzzing (I can do bold as well), why on earth are you getting your knickers in a twist?

Whatever fine distinctions you are trying to draw between crash and em cs (do the circumstances that necessitate a crash cs never occur in a home birth?), if my emcs or crash cs, if you prefer, needed to be done in 11 minutes, dd and I were very fortunate to be able to have it done in that time.

That was because we were in hospital, not at home. Not so difficult to understand.

Blueshoes.. yes, you can say if you or your baby want to avoid dying because you can't get to a crash section in time, then go into the hospital. You're absolutely right.

However, you can also say if you want to prevent you or your baby dying of iatrogenic causes as I listed in my earlier post, then stay at home.

If you are the average woman, the chances of you or your baby dying are the same in either place.

But you are still more likely to have a better recovery and fewer complications at home.

So why feel sorry for her and her baby any more than you feel sorry for someone who rushes into a hospital birth uninformed?

Oh - and uterine rupture is more likely to happen in hospital btw. Look at the figures - most are caused by inappropriate medical intervention. Just lucky those clever doctors are able to patch it up... sometimes.

Cat, I'm with you.

I managed a normal if rather slow first labour in hospital and was wondering why I hadn't opted for home, when they lost my DS's heartbeat and all hell broke lose. There wasn't even time to get me to a theatre, never mind wait for an ambulance. They didn't even wait for the pain killers to take effect before they got him out. And he's fine, thank God.

In the end it's up to your SIL but I'd put up with all the clumsy, insensitive, impersonal care and noisy wards just so I know there's a crash trolley and a gynae specialist within a 60 second run.

Carmen, if you are referring to inappropriate interventions that lead to uterine rupture, my hospital would not artificially induce women who had previous cs. I would assume that most hospitals in the UK would have the same policy.

I reiterate my wish for a better hospital experience and sensible protocols that lead to fewer unnecessary interventions.

Kathy - very succintly put. Those are my feelings exactly. At the end of the day, the safety and health of my baby takes prority over my own experiences. I would rather have a c-section "just in case" if there was the tinyest risk to my baby. I'm sure the majority of mothers agree with me - hence the high c-section rate in this country. Why risk anything happening to your baby because of your own fears of physical or emotional trauma?

look, you asked if It wasn't a fact that there are cs that need to be done faster than it takes for an ambulance ride.

using the bold the word 'most' from my previous post was an exasperated way of saying that I already had.

my knickers are fine, thank you. old but comfy.

OP I am with you 100%. All the talk about how birth is natural blah blah so not a medical condition. Sorry but 100 + years ago wasn't childbirth a huge killer of both mothers and babies??? I think HB is a huge step backwards (and the cynical side of me thinks the reason is because it is less of an expense for the NHS).

If you need medical support where are you best placed for it? If I had had a HB with dd1 (all fine, healthy, going to plan right up till the last minute) she and I might not be here. Like kathyjelly, when an emergency happens it is just that, no time for ambulance/drive/admitting to hospital. You need help there and then and that is something you just can't get at home. Why take the risk??

Catinboots, please read my last post.

No-one is prioritising an 'experience' over safety.

You introduce a 'tiny risk' to your baby by going to hospital.

Your sister is as likely to die in the hospital as she is at home. There are risks in both places. Both of which carry the same chance of dying.

Blueshoes, not just induction actually and you may find some of those hospitals are ok with 'augmenting' labour with pitocin even if they won't induce. But forceps delivery is a big cause of uterine rupture too, even in women who aren't VBACing.

Haven't read the whole thread... I had a home birth with DC2 which was very straightforward, I researched in detail the risks involved as I'm very risk averse. While planning the birth, a good friend of mine had a bad birth experience with her first DC - cord prolapse, which is obv one of the scarier complications. Her 'decision to incision time' was less than 15 mins with good outcome, luckily she was having hosp birth. I think transfer time is critical. Where I live, when there is a home birth underway the local ambulance station is kept on standby and in communication with the MWs, we're prob 10 - 15 mins from hosp. I too have experienced ambulances taking ages to attend emergencies (non obstetric).

Also there was no mess left, I loved having my own space, own bed, own food, I guess I'm a control freak! Hospitals unsettle me.

yes carmen - but the baby is more likely to die at home than in hospital.

The study released this week was actually a study review looking a births over the past 30 years.

my last pg had a [[http://www.vasaprevia.org/vasaprevia/velamentous.htm velamentous cord insertion) it was very extensive, (if anyone wants to see the pictures, I'm happy to share ) and it was undetected.

as the link states, it could lead to fatal consequences for the baby (something like more than 90% die) if they rupture before the baby is delivered. And that amniotomy is the main reason for accidental rupture. Now they don't tell you about them risks when you sign up for ARM, do they.

What I am trying to say in a roundabout way is that no one can comprehensively consider all the risks in life so asking me if I considered all the risks of a home birth, I would have to say no. Just like how no one seems to be able to consider all the risks of having a hospital birth. ARM, being something that women regularly agree to as 'safe' in hospital births.

Had I known about the VCI during my pg (it went undetected over 3 scans) I would have happily signed up for a C/S.

here

Home birth is safer than hosp birth.

YABU and nosey.

consideration for a family member = nosey???

At least make the effort to back up your blanket statement ladyanonymous

Catinboots... I have already addressed that 'study.'

It has been widely misreported and is highly politically and financially motivated by ACOG. Read the link I posted. Unless you want to argue that information from 30 years ago about women having unexpected, unattended out of hospital births is relevant to planned home births.

Your baby is as likely to die in hospital as at home.

Look at infection rates in hospital births for a start.

Buzzingnoise points out a good example (sorry, buzzingnoise for something so traumatic happening to you.)

By MmeRedWhiteandBlueberry Sat 03-Jul-10 13:33:27

"Most labours that require medical intervention are apparent before they even start. It is very unusual for something to go wrong after labour has started unless you intervene."

Could you cite your source for that? Because based on both my professional and personal experience that statement is the biggest pile of crap I've read in a while.

(If there was an addendum to this please point it out to me because I've not had time to read the whole thread.)

Buzzing, if you get exasperated someone asks a question, that you had already obliquely answered in an earlier post, erm, don't post on mn.

It is not worth the aggro. Believe it or not, people don't actually scrutinise your (and my) posts.

Now that you have pointed it out, Jacksmama, yes, that statement is counterintuitive.

Would also be interested to hear what MmeRed's source is.

Did you know that embolic diseases are actually the leading cause of maternal mortality in developed countries?

Way above uterine rupture.

Embolic diseases are very, very frequently iatrogenic.

Why are people so convinced that hospital birth is safer? It's not. We all agree that you can't do a crash section at home and occasionally, this will mean death for mother or baby.

But we all know that hospitals screw up. That you could be improperly monitored or treated, that you could contract an infection, that you are more likely to need an intervention or caesarean which carries risks.

The risks are small and where death is concerned, they are the same in both cases. But somehow there is a perception that the hospital is safer. It isn't.

Carmen, you have to explain jargon like 'embolic' and 'iatrogenic' otherwise your points are in danger of going over our heads.

yy blueshoes