More about HB - sorry! DH not keen, how do you get past the 'what if something goes wrong?' factor

[MassiveBumperlicious]

Just been to see the MW and hoped that would help me come to a decision. I'm feeling more and more like I would like a home birth, though I am not 100% decided. I don't know how to get past the 'what if something goes wrong?' fear factor. DH even less so. He thinks hospital is the best place to be. He is not vetoing, but obviously I want him to be on board if we are going to have a HB. DH isn't really the natural type and puts a lot of faith in doctors and nurses and less about instinct and gut feeling.

Not sure what to do. I really don't want to go into hospital, but am not 100% sold on HB, especially since we have recently moved house.

What I really want to do is not have to think about it and hope for the best . But that is not realistic. I hated giving birth last time, and had flash backs for an awfully long time, despite a pretty straightforward labour. It was very quick though, 5 hours, presumably this one is likely to be even quicker!

I don't know what to do, but I am in panic/stress mode, not just about labour, but all round really, am leaving work next week and it's a stressful process.

Right. Let's see if I can help. Had HB for DC1 planning one for DC2.

1. Proximity to hospital. Are you near? From my understanding, it is a bit of a myth that if something goes wrong in hospital, say it is decided that you need a crash C-section say, that it happens within seconds. Instead, as in my example, there will be (admittedly a veryt short) delay while staff are beeping, rooms prepared etc. Apparently 15mins is the aim.

1. At a HB you had 2 MW all to yourself. For me this was the clincher. They stay (unless you are v unlucky with shift change (which is 24hours not 8 like a hospital)) with you in the room with nothing else to do except watch you and the baby and monitor what is going on. They can;t wander off for a break, get distracted with a more critical birth next door, strap you to a monitor and pretend that it is the same thing.

1. Related to 2, precisely because they are watching so intently I had full confidence that if something were to begin to go wrong they would get it dealt with earlier, whether that meant transferring in or otherwise. It seems to me that often things have gone wrong in hospital because a woman is not checked on until too late.

3B. Again, because I am so clearly their responsibility, I suspected that had something begun to go wrong they would want me in asap rather than face the consequences. [although this assumes that they don't get territorial about the birth I suppose]

1. I feel that my DH had an easier time than the hospital dads, again because he wasn;t resposible for trying to work out if I needed extra help, monitoring, something going wrong, that would be down to Patience and Enoma sitting over there on the other sofa!

1. If you are possibly going to be a quick delivery, then even better than you are prepared with all the relevant kit (which includes oxygen for you and baby and resus kits and all manner of other stuff) at your house rather than relying on what an ambulance or a passing community MW might have.

1. A home birth does not mean a birth without medical assistance. On the contrary, you get v well monitored.

Sorry - a lot of those points actually relate to one thing - namely the presence of the 2 MWs. My DH was also a bit sceptical at first, but came round because a) we are super near the hospital and b) 2 MWs. He's happy we're going for another HB, although truthfully I don't know whether he'd recommend it to another dad, although he loved not being kicked out because of visiting hours.

I wonder if because you had a tough response to labour (although luckily not a tough labour in itself) he is just anxious about it generally. SOunds like you are too, so maybe he's feeding off that a little. Plus you've just moved house etc etc. All a bit much for both of you and you suggseting something "crazy" like HB is just adding to it in his mind.

Perhaps it will be easier once you have finished work and will be a little calmer yourself.

Good luck in what you decide.

Thanks for the response table, I will show him this thread.

We are 3 miles from the nearest hospital, though that is not the hospital I am booked into (obviously they would go to the nearest in an emergency).

I got him to look at the HB website and he said that it just gave him more things to worry about than he knew about before!

I've had 2 babies, both born at home. Before our first baby DH was really not keen, and he is naturally a worrier. I dragged him along to a homebirth group where there was an indie mw who talked through the whole thing and answered questions, there were also women who told their homebirth stories.

He was also sold on the fact of having 2 mws with us during the birth, having heard horror stories from work colleagues (other dads) about one mw between 6 labouring women etc. He was there for my 37 week AN appt where the community mw went through birth plan - she ended up delivering DS.

I don't think you can get past the "what if something goes wrong" argument. If you decide to have a homebirth, you are deciding to run the additional risks (admittedly unlikely to arise) of not being in a hospital when you and your baby need one. Obviously, everything will almost certainly be fine, as it was for the people who have posted above, but if its not, you are undoubtedly better off in the hospital. Really good friends of ours booked for a homebirth for DC2 having had a really easy birth in hospital for DC1. On the night she went into labour, there were not enough midwives to cover all the labouring home births and so they had to go to hospital. Immediately after the baby was born she had a catastrophic PPH, and was told that she undoubtedly would have bled to death at home or in the ambulance on the way to hospital if she had had her home birth. I don't mean to scare monger - Obviously that is very unlikely to happen to you, but it could. In a big and well equipped hospital they will do a crash c section in much less than 15 minutes. Your baby can sustain a hypoxic brain injury in minutes - so every second counts, and if you add a minimum 10 mins for the ambulance to be called, come, pick you up and get you into hospital, that could easily make all the difference. Again, probably won't happen - but what if it did?
You would no doubt have a nicer time at home than you will in hospital - I would much rather be at home myself than in an anonymous hospital ward, so I quite understand why you would want to, but I personally can't get past the "what if something goes wrong" argument, and you shouldn't let people whose babies have arrived safely at home without anything going wrong persuade you that your experience will definitely be the same as theirs - it might well be, but it might not.

The best thing you can do is read up and show him the facts (I assume you have looked at homebirth.org.uk - I would get him to read that through too). HB is statistically safer than hospital for a normal pregnancy.

As far as "going wrong" goes, it depends what you mean. A community midwife at home can resuscitate a baby, and maintain them on the way to hospital. I have read some interesting case studies where a home born baby did better as the midwife didn't cut the cord (as they do in hospital to resuscitate) so the placenta continued to support the baby through resuscitation.

The target for crash sections in the NHS is 30 minutes from decision to delivery. Only 60% of hospital births meet that target, 90% are delivered within 50 minutes. 3 miles from hospital with the ambulance on standby is no difference at all, the midwife would call ahead to get people bleeped in to be ready for your arrival (although you are close enough you would probably still be waiting for them when you got there.

In most other cases of complications, the midwives at home will do exactly the same as they would in hospital, and if they need hospital facilities, they will arrange transfer, and it is unlikely that the equipment/personnel would get to you any faster if you had started out in hospital.

Home birth is safer - Netherlands is the safest place to give birth in Europe and has 50% HBs

as already stated, they don't leave you to labour alone - labour is on avergae faster, and women report lower feelings of pain.

i know two women who gave birth unattended by any HCP at our local hospital. that wouldn't happen at home.

One of these women was told 'not to be so stupid' when she said she was about to give birth, then they left her. Her baby wasn't breathing, and it was 2 mins before MW returned (the mother grabbed the emergency cord fortunately) - had she been at home the MW would have been in the same room (and very definitely would not have been rude to her!). then they transferred her by ambulance (45 min ride)to a different hospital entirely where there was a SCBU. Gain from being in hospital = zero.

This particular story makes me vey angry on that womans behalf, simply because of the way she was treated - things go wrong in labour, but people do not need to abuse you whilst you are in pain.

I dislike horror stories on childbirth threads, but this illustrates the statistics - labour wards are busy and the service isn't always great. the safety net argument is not a valid one for low-riskbirths.

the main reason people transfer in is to get pain relief. (40% first timers, 10% second or more timers) which you won't know that you need or not until the day....

Interesting points porcelain, thanks, and everyone else.

DH has read homebirth.org but he said that made him worse and gave him more things to worry about!

I've just started reading Childbirth Without Fear and it is really interesting. But the toss up is am I going to be more scared being at home and something going wrong, or more scared with being in hospital and all the baggage that surrounds that?

I asked the MW if she though I needed to be committed to the decision of a HB and she said she thought I did. I was hoping I could just 'go with the flow'!

I've had two HBs and am now expecting DC3 so hope to have another one - fingers crossed. DH was initially sceptical for all the reasons outlined but afterwards was the biggest advocate for HB you could find LOL! The MWs bring a HUGE amount of kit with them which covered a dining room table and half of the lounge floor. Covered all manner of stuff from resus equipment, injections for Synto/Ergometrine in the event of the bleed (I lost a pint after my first birth and they dealt with it swiftly) and oxygen and suturing kits etc.

I felt safe with them as I had two MWs with me watching me, was never left alone and I was told that they tend to ere on the side of caution and transfer you at the first hint of something untoward.

Very positive experiences and I'll be gutted if I have to have a hospital birth for No. 3 :(

EnglandAllenPoe That story reminds me of my mother's situation, which was probably the main motivation for me looking into HB in the first place - she went straight into established labour, no warnings, 2 mins apart from the start, both of us were born in under 4 hours. My brother was born on the toxaemia ward as they wouldn't believe he was imminent, I was born 15 minutes after they gave her pethidine she didn't want and told her to have a sleep (the drug inhibited my breathing and feeding, I was sleepy for a couple of days). This was 38 and 30 years ago so things have undoubtedly changed (although I met a woman with a 3 year old who had the same pethidine issue, so maybe not.

Interestingly when I told her I was having a HB she didn't like the idea, because with my brother she had torn badly (would a midwife acknowledging he was coming too fast and trying to slow things down have helped perhaps?) and needed surgery, but I pointed out to her that in that position, I could still transfer to hospital.

i've had 3 wonderful hb's and live within 25 minutes of the nearest hospital.

My mw said sth that stuck in mind which was that things don't often happen quickly and with good monitoring they can forsee any problems and transfer you if necessary.

Iirc, women who birth at home are likely to have fewer interventions, because of the very fact that they are at home and are relaxed.

Like you, all mine were very quick, in fact in all of them the second mw was too late.

I don't see why you need to make a firm decision yet, and even if you do decide to have a hb, there's nothing to say you can't ask to be transferred if you aren't comfortable with it.

I look back on my births with really fond memories- I had the labour I wanted, at my own pace and lovely midwives who even ran me a bath afterwards and cleared up the mess.

Porcelain, it still happens, unfortunately.
I was induced with DS (first child), told nothing would happen until the morning, given pethadine (despite me saying very clearly to the ward MWs I didn't want it) because 'nothing would happen until the morning' (and therefore my worries that it would affect the baby were unfounded).

No one would believe I was in labour, DH had been sent home. Finally I was examined and rushed to the delivery suite. DS was here 4 hours later!

For this reason, I'm going for a HB this time. I don't want to be left alone without DH. I don't want to be given things I don't want.

FWIW, DS was ventouse in the end, as his heart rate began to decrease and I couldn't push him out. And even in the throes of labour, I realised it took ages to phone and discuss with the consultant, get him to come and see me, and finally do anything.

God forbid I'm one of the ones that comes back here in a month's time with a scare story! But I'm going to go for it, all being well.

porcelain i think having torn once during childbirth and not the second time, that there is no force on this planet that could have slowed the contraction that made me tear (very fast birth) as it was utterly beyond my control.

second birth was slower, and i could control the final contraction better, and DS (a full Lb larger than first baby!) came out without damaging me (stopped and went easy to plop him out once crowned).

this is not really something in the control of the person attending, the best they can do is coach and advise you through it - something you will hopefully get from any attending MW in hospital or your home.

unfortunately i think reading Childbirth stories of any kind can make you nervous about it!

in my pre-Mumsnet days i never doubted childbirth would go well...

I booked a home birth, never imagining for a moment that I would actually give birth at home. If anything for me, it was a way of staying at home for longer with a midwife support and a guaranteed birth pool (we hired one).

So I went into labour, breathed through the contractions, had a bit of gas and air, and ended up delivering my son on our bed a few hours later.

My midwife was really supportive of my "I might want a home birth" attitude, saying it was far easier to book one then go to hospital before or during, than it was to go to hospital and realise I was coping well and could have been at home.

My husband had been worried about how he would cope with me giving birth, but I think being at home really helped him because he could potter about, choose the music, make cups of tea, rather than us feeling confined to the one room.

Having a home birth itself isn't the be all and end all of childbirth, having a healthy mother and baby is, so perhaps this let's-see-how-it-goes is a compromise your husband might be happier with.

the statistic that homebirth is safer is very misleading. Over the course of a large number of births, overall, homebirth rates might be as good as or better than hospital birth rates - however, the point that is being missed is that if something goes wrong, and you have no guarantee it won't, you are much much safer in hospital, and so is your baby.

Prosecco has a point which is the "what if it went wrong" thing. However, that swings both ways as there are plenty of women who deliver in hospital only for there to be big problems either with them or the baby and are left wondering what might have happened had they a) gone to another hospital b) insisted on something happening or not happening c) going in later etc etc

Child birth has risks. No getting round that, sorry. However, there are many ways to minimise those risks and having the mother feeling that she is in a secure, supportive environment in one of those. For some women that will mean being in a hospital, for others that will be at home for while, if not the whole time.

As MrsG says, you can always book a HB even if you think that you will ultimately transfer.

Good luck with whatever you decide.

I loved the idea of a home birth, but I couldn't get past the 'what if'. End of story.

I had a lovely intervention free birth in a hospital :)

The actual process of giving birth was, for be, the most instinctive, physical this I had ever done in my life, and absolutly awesome. I was also completly oblivious to my surroundings.

I did a hypnobirthing course which I'm sure really helped.

To me I had the best of both worlds. I went into hospital with a natural, hypnobirthing philosophy, knowing that the best of first world medical care was available if I needed it.

A friend of mine had 4 home births.

she was features in a book called Home Births by Abigail Cairns isbn 9781905179022
it's print on demand: you can usually get it within a week.

here's the blurb:
A moving collection of real life stories celebrating the joy and wonder of birth at home. This collection of first-hand recollections by mothers and their partners gives an insight into the modern experience of home birth, from the first decision to the final push. "Oliver was born in our bedroom on the second floor of our house in Uxbridge. It was a gloriously sunny Monday in March." "The pushing stage involved me on all fours grunting and sipping cups of tea between pushes. One of the midwives joked that it was the most sedate second stage she had ever seen. Fred was born in the corner of our bedroom." "Ameet passed him through my legs and my life changed as I saw him for the first time. I sat against the sofa and held my baby. He nuzzled at my nipple and we took each other in, softly, skin to skin." "Two hours after the birth we were were left alone at home: the three of us, a bottle of bubbly and the cat."

massivebumper: I really don't think you need to be totally "committed" to the idea of an HB. Just book it, plan for it in a hazy way and see how things go (and how you feel) on the day. I would say that is a perfectly acceptable way to go.

It could also be the safest option if you think your labour might be really short - the equipment would be there ready for the midwife to use in your homebirth pack and there would be less danger of giving birth on the way. If you decide to transfer to hospital you hopefully would have a trained midwife to accompany you rather than just a scared husband or not-so-well-trained-in-birth paramedics.

Of course, just because your 1st birth was fast and nasty doesn't mean your 2nd will be faster and nasty. It might be a lot slower and nicer. It might take the same time and be nicer. It might be quicker but somehow feel more under control. The fact that you have experienced it before will make a huge difference to how you react this time.

Are you doing hypnobirthing? I would seriously recommend it.

When I am in labour I am the most inconvenienced person in the room hence my decisions takes precedence over every one else's opinions. Therefore his opinions on where would be the safest place for birthing didn't matter so much. But that is just me.

Dh kept his reservations to himself about a home birth. I knew he had them so I made him watch 'the Business of Being Born'. I had an awful hospital experience the first time and it was only after watching this documentary that he said it was 'horrendous' too so we may be coming from a different place from your dh.

The documentary made a lot of sense to him and taught him all he really needed to know really. He ended up being the only person present at dd2's birth and he feels empowered by it and that the birth was very special to him too.

My labour was under 2 hours and I can't imagine how more inconveniencing it would have been for him with me giving birth in the car at 4 am on the side of a motorway instead. (nine miles from the nearest hospital)

With DD I was desperate for a homebirth but DH was frightened and pushed heavily for hospital. Labour was very straightforward but because the labour ward was busy when we arrived I saw a midwife only once an hour for the five hours we were there. DD was born back to back and the labour pains which I had managed easily at home (I was 8cm on arrival at hospital) got more andmore painful at hospital as I was encouraged onto my backand left in ignorance and fear. I had to wait an hour in pain before someone showed up to show me how to use the gas and air. I ended up with a phobia of hospitals and doctors, plus it took me almost four years to contemplate birth again

DS was a homebirth at DH's suggestion. I had a midwife with me for the last four hours and two for the last hour. The birth was absolutely astonishingly good, virtually painfree and I never felt out of control. I had my music on, my pillows, my tv, I pottered around the house and garden and got through two canisters of gas and air.

I can recommend the Michel Odent book Birth reborn. Very inspiring and encouraging. Good luck, hope you get the birth you want.

My homebirth was on the verge of going wrong when my waters broke, and a lot of meconium in them. MW stated clearly and firmly that the added risk meant a homebirth was no longer an option and I would need to transfer to hospital.

An ambulance arrived 4 minutes later, at which point I thought I needed to go to the toilet. This was actually the urge to push (DC 1&2 were forceps deliveries with epidural so I did not know what that felt like . The MW sent DH to her car to retrieve all the equipment and she and ambulance crew delivered blue DC3. MW resuscitated with oxygen, while lovely paramedic talked me through what was happening. DC1 was also blue when he arrived in hospital but was whisked away and I didnt know he was okay for about 5 minutes. Similarly DC1 was cleaned and dressed and held by DH before I was allowed to hold him.

So, what I am saying is that things can go wrong anywhere, but at home the MW is only concerned with you and your baby not the other labouring women in the next door rooms. If you are a reasonable distance from a hospital (amulance crew informed me they do a mile in maximum 90 seconds with blue lights on) then I genuinely dont think the risks are greater.

The more I think about it and read published studies and analyses of home and hospital birth outcomes, the more I think that focusing on birth location in itself is not the right approach.

The key factors for positive birth outcomes seem to be:

• Adequate level of antenatal care and monitoring
• Qualifications and experience of birthing attendant
• Provision of 1:1 care during labour
• Clear communication channels between birth attendants and medical backup
• Time required to move from birth location to fully-staffed operating theatre in case of emergency

If you have these things sorted out then I think home vs hospital is probably irrelevant beyond personal preference.

When I had DD, I decided that I was only guaranteed to get all of these through a homebirth with an independent midwife who had good relations with the local hospital.

If I'd gone to the local hospital, I couldn't be sure of getting the second and third of these. Given some recent local cases in the news, I was pretty dubious about number 4 too. As it was, I had round the clock 1:1 care from a midwife with more than 20 years experience, backed up by two others with nearly 30 years each. We were a 10 minute drive from the local hospital where I'd had my scans and bloodtests done, and my midwife phoned in twice to let them know how labour was progressing in case we needed to transfer at a later stage. My midwife carried drugs to deal with pph, as well as gas and air, oxygen and pethidine in case they were needed. (Luckily, they weren't.)

I suggest that you both do some research into practices and staffing at your local hospital and compare this to what you would get for a homebirth.

Good luck!

Chris

There will always be arguments in our own heads both ways.

I would book in for a HB and if you reach a point in labour when you fancy going in - just do so.

If not stay xxx

MassiveBumperlicious -- Have a look at this article from the BBC stating the latest research on the safety of homebirths:

www.bbc.co.uk/news/10465473

I would certainly look at both sides of the coin and then make an informed decision.

I strongly disagree with EnglandAllenPoe's statement that homebirths are safer than hospital births....research has shown that they can be AS SAFE as hospital births in low risk pregnancies -- not safer.

Best of luck in your decision.