Home assessment for Homebirth

[CADS]

Hi,

Just wondering if anyone has had to have a home assessment when planning a home birth. What criteria do you need to fulfil?

When I mentioned to my mw that I wanted a homebirth, she started babbling about having to do a home assessment and about lighting, parking, and other things. Having finally managed to get dh to agree to a homebirth, i will be gutted if they won't agree because of something like parking/lighting.

The mw was also concerned about what we will do with ds (who will be 21mnths) and implied that they don't allow children. Strange?

Finally, when i asked about Pethidine, she immediately said that you not allowed it. As she has lied to me in the past, I would like to find out what the policy is for my area. Does anyone have any suggestions?

Hope this makes sense, thoughts are a little muddled.

Thanks

I can't do links but try the Association for improvements in maternity Services, they are a great source of info on your rights, all sounds a bit fishy to me, particularly parking etc, think the info on pthidine may be right though. Good luck x BTW, by law every woman does have the right to give birth at home it is yor choice, not theirs and they would have to attend your birth if you requested in labour.

I didnt have a home assessment when i had a planned home birth for dd1 (my first) or for dd2 although i had an em cs in the end. I had pethidine with dd1 at home but that was 3 yrs ago... the rules might have changed i guess.
Is there another mw you can see? or a doula?

She's being obstructive!

Except that some NHS authorities don't use pethidine, i think. I live in one of those areas, and anyone who wnated pethidine had to get it prescribed separately or something

But in terms of where you live, my homebirth mw's said almost anywhere was fine.

just read the bit about your ds, my dd1 would have been there for dd2 birth. she would have been 26 months, wasnt any prob, its your home, your birth.

I don't think you have to fulfil any criteria - if you choose to give birth at home, then that should in theory be honoured by your Health Authority. Have you looked at the AIMS website - they are very good on tips for fighting your corner when going for a home birth.

If you think your midwife is lying to you generally, is there a possibility you can change to a different one? Your midwife really should be on your side after all and I think it's imperative that you trust her.

I think home assessments are quite routine, I certainly had one (6 1/2 years ago now) and we just really talked through how things would be set up, what I was expecting etc. It was more like a chat really. Re. the pethadine I was told that they only did gas and air at home births. Pethadine's not supposed to be very effective anyway - it's possible it may have side effects that might require medical intervention and that's why they don't give it? Although if mrspink had it at her home birth it may be an area thing I guess. I'm probably not very up to date! The parking thing may just be your midwife wanting to record all the practical details so that it's all sorted for when they come.

I had a home birth and did not have a home assessment. Midwife asked me to get some pethedine on precription from the doc just in case (didn't need it). The one thing i was told was that as my ds would also be at home they asked that as well as my dh there could also be another adult present to take care of ds. The explanation given was that in the case of an emergency transfer to hosp dh would be available to come with me and there would be someone to look after ds.

I had a home assessment but it didn't mean that much! My midwives were supportive which was lucky as flat small, on 2nd floorand double yellows outside!

I was told that they are not allowed to give any drugs except gas and air at home now so I didn't have any. But that may just be in my area.

I didn't have home assessment for either of my homebirths - they just wanted to know how to get here (which didn't help much as one m/w got lost on the way...but no harm done there).
Didn't ask about the pethedine, so don't know about that one. Perhaps it depends on where you are? I am in London.

I didn't have a home assessment for my first home birth although I was the 1% in my area that requested one. I am expecting my second child in October at home as well - my midwife says that all women have a right to a homebirth and they are trying to encourage it as much as possible. It sounds to me that your midwife is trying to discourage you which is certainly not right - as for pain relief, I think gas and air was the only thing offered.

I had a home birth booking in about 4 weeks ago. Basically, it was just to go over emergency protocols, storage of drugs (i.e. for managed third stage) and practical things like need for anglepoise lamp, matress protection and so on.

I have been prescribed pehthidine by GP as midwives no longer routinely carry it. Had long discussion about pros and cons, and was made aware that midwives might refuse to administer depending upon the progress of the labour - fair enough!!

Your midwife seems rather obsructive to me.

CADS,

If you experience any problems getting a homebirth then go to AIMS who have been mentioned elsewhere.

I used to be a midwife and in my experience children are absolutely no problem. If it's at night then your DS will be asleep anyway. If it's during the day then no doubt you'll already have made arrangements for someone who can be with him while you give birth.

AND of course you are allowed Pethidine at a homebirth - I've never heard such rubbish - as a midwife I used to carry a drug which counteracted the effects of Pethidine if the baby was born experiencing the effects of it. All hospitals have their procedures for getting Pethedine - some supply it and some ask you to get it from your GP (but will supply it if your GP won't).
BUT at a homebirth I found women much more relaxed and less likely to need Pethidine.

Your midwife does not sound like someone you can build a good relationship with. Are you going to be happy if it's her at your birth. It might be worth asking the hospital to provide you with another midwife who will support you.

Also check out Angela Horn's homebirth site which you'll findhere

Interesting thread I am wanting a homebirth with DBno2 DP is dead against the idea as it is. To complicate matters further we are moving to a completely new area in a few weeks so will know no one to begin with. DD will only be 18 months when this one is born. I am wondering what to do with her if I have a homebirth or indeed a hospital birth. Family will be at least an hour away to come and look after her.

Thanks everyone.

I'm hoping she was just having a bad day, after all there is alot to cover during a 10min appt.

I will see what happens during the assessment and take it further if she won't do it.

Just feel it would be a bit harsh to rule out a homebirth because of such trivial things (well, to me at least) especially as the chances of her being the mw on call when I'm in labour are very slim.

I've had 3 home births and the first two didn't have any home visits prior to labour. For the third one, they introduced a home visit 3 weeks before the EDD to deliver the birth pack and go over a few details. It was always assumed that the homebirth would take place, and questions about parking etc. where just so that they could identify a place to park, rather than it being a showstopper.

The things they will want to get across to you are the criteria for calling them out in the first place, and the situations that may lead to a hospital transfer.

Other than that, they will want to look at where you plan to labour and birth and may give you little suggestions about what to provide and how to arrange things - nothing unsurmountable. For example, if you want to use your bed, they may ask that you move it so that there is plenty of room on the right hand side for the midwife to do her stuff.

I have found that midwives are reluctant to have other children around because of the uncertainty, and if you do want your child present, they recommend another adult (not the birth partner) to be available in the house to take care of them. We kept quiet about this - we were basically covered in the normal daytime and felt that they would be asleep from 9pm onward, so the small window of awkwardness was from about 6 - 9pm, which we were willing to risk.

You are allowed pethidine, but each trust will ahve different ways of managing it. You may need to get it from your GP, or the midwife may bring it. The midwives don't generally carry it in their bags as they used to, so you have to give them notice. Most will say that you are unlikely to need it in a homebirth, but if you do, the second midwife (who generally arrives towards the end of labour) could be asked to pick it up on her way to you.

I got a brief home visit two years ago, mainly to deliver the pack at 37 weeks. We didn't actually look round the house. And when I went into labour the completely different (and utterly lovely) midwives who turned up just asked where I was planning to have the baby, and we got on with it from there.