almost convinced by homebirth article in the Guardian this weekend...

[elportodelgato]

I don't know if anyone else saw this article by Sali Hughes about homebirth on Saturday in the Guardian Family section? probably there is a whole thread about it somewhere but I can't find it...

I've never considered homebirth before but this article has really made me think again. I had a straightforward pregnancy with my DD but she was induced at 41+3 so I was in hospital so they could monitor the induction. Besides, it was my first baby and I would not have wanted to be anywhere except hospital. The whole labour was 7 hours in total and I did without any pain relief (not out of choice btw, would have loved something to take the edge off) until G&A for the pushing stage - I tore and had stitches but otherwise all was normal. It's entirely possible that I will be induced this time around too but if I'm not then I am really considering homebirth - can someone come and tell me if I am being silly and it's my hormones?

I almost cried when I read the bit about her being tucked up in her own bed in nice clean pyjamas with her new baby. It has made me really realise that my hospital experience last time was 'OK' but not amazing - busy London hospital, laboured for the most part behind a curtain in a ward which was not at all private or pleasant and I remember being hugely embarrassed when my waters broke on the floor. In the night following the birth the call button in my cubicle didn't work and no one came to help me. Because of my stitches I needed help to get to the loo etc but no one did this. I'd like to avoid all these downsides if possible and suddenly homebirth looks attractive. Can anyone offer a view?

I wonder how many more people would opt for a HB if we had to pay for childbirth?

£800 for a HB

£1500 for hospital birth with epidural

£2000+ for a c-section

£200 per extra night in hospital

The rate of hospital births went up because people stopped having to shell out for it out of their own pockets.

A HB costs the NHS much less (on average) - think about it.

and uses less staff time (a major part of the above cost).

selfish use of resource = a completely fallacious argument.

thebody it sounds like you had quite a scarey time with two of your births...glad to hear the children are fine.

Howver, regarding your last sentence...it might be worth having a quick read of the thread or the people on here that support HB might think that you are referring to us when you talk about 'obsessing', and that you think that we don't think our children's lives are important - and that could come across as really unpleasant and offensive.

Ah now foreverastudent don't forget about people in the US. They do pay for things out of their own pockets and it doesn't stop them from going to hospital, quite the reverse!

There is also a woeful lack of support for HB in the USA, and most people probably feel they have already paid for the birth via their existing contributions. having said that, there might well be similar attitudes over in the US as their are here towards HBs, so that is not such a surprise.

I assumed that the point forever was making, was that birthing in hospital is a costly thing compared to many HBs.

I'm a US expat and still would opt for hospital even if I werent a resident here and had to pay through the nose like my mom did for me. Hubby's mum and her 2 sibs were all home birth but she also said hospital for both him and his sister.

I feel it's a matter of choice, what you're comfortable with will let you have a better delivery. So as long as there's no complications you know about go with what you want to.

For me there's a lot of reasons against, I hate to think about the mess which could be big or small, sounds fairly random. Gushing waters to dribbles is what I read on the other threads here. If I gushed gunge out on my carpet I'm pretty sure they wouldnt want me down on all fours mopping it up just then. I also dont like the idea of being away from a hospital if something happened suddenly. A lady in my yoga class said her first turned after hours of labor and she needed a sudden c-sect. Earlier this year my cousin's son was born with an undiagnosed heart condition and no one noticed until his o2 levels dropped past 60%. If he'd been home, he'd have died. So, no homebirth for me, not after baby's here and I know he's fine. I'm too much of a worrier

Ooh, I'll have a read of that article as I'm planning on having a HB.

MWs have been very supportive about our choice and all say it's as safe, if not safer, than a hospitable birth when I asked them about it.

They did say that I should keep an open mind though, as if anything happens before or during labour (eg, placental position, high blood pressure, waters braking too early, etc) I may have to go in to the hospital's birthing unit, or maternity ward.

DH was a bit concerned at first but, having read a HB book, the HB website and talked to the MWs he's come round and is as keen as I am.

If we didn't live so close to the hospital (10 mins without the use of a siren!) then I might not have been so relaxed at the idea but I'm really looking forward to the birth now (well as much as anyone can!).

Good luck on whatever you choose and remember that less than 100 years ago women had their babies at home!

Tittybangbang, great article, I've emailed it to DH.

Had the MW over this morning and we are now both settled on a HB. The MW was lovely and very positive and reassured DH that all being equal and with a low risk pregnancy (though for some reason my thyroid disorder gives my the blanket label of high risk, even though it has no bearing on my labour ) you are safer at home. He liked hearing that directly from a 'professional' as is his way, and I think he felt reassured by her positivity. I can have a complete water birth if I chose. She said the only PITA for me will be that I will need to go into hospital if I need anti-d afterwards, as I did with DD, but that is 24-72 hours later so not a real problem.

We both feel more relaxed and positive about it now. I did tell her that for me it wasn't about 'having a natural hb' but about having a relaxed and safe labour so if for any reason they thought something might go wrong I would transfer straight away, I wouldn't protest (this seemed to relax DH a bit too). She was pleased at this and said it is the best way, just to be flexible and keep all options open.

That's great news Bumper

Great news Bumper. Although with DS I needed anti-D and they brought it out with the community midwife as they would have done whether I laboured at home or in hospital.

I also had anti-d administered at home after the birth. After our homebirth, my dh contributed to a homebirth book by Leah Hazard which recounts numerous experiences from the Dad's point of view. It might be interesting reading too.

I'm glad that you have made your decision and feel more comfortable about it.

"I feel it's a matter of choice, what you're comfortable with will let you have a better delivery"

Sadly the research doesn't suggest that women birthing in hospital actually do have 'better' deliveries, even if they (rather irrationally you could say, given the facts in this case) feel safer.

By the way, I am interpreting your use of the word 'better' to mean 'healthier', in the sense of less intervention, less need for analgesia, fewer maternal birth injuries, higher levels of satisfaction with the birth, and baby born with good apgar scores.

Good luck Bumper by the way - hope it goes well!

"For me there's a lot of reasons against, I hate to think about the mess which could be big or small, sounds fairly random"

Maybe I'm just a total slob, but I felt that the trade off of a messy duvet cover for a much reduced likelihood of needing major abdominal surgery was a pretty good one!

You can put your duvet cover in the wash/bin and clean your carpets in an hour. You have a c-section scar for the rest of your life!

FWIW I just bought a duvet and pillow set in Primark for a tenner, so if Have to chuck them it's not a problem (but I am cheap and will probably just wash them if not too bad! I even kept my 'sacrificial' knickers from last time and still wear them!). I have a shower curtain and some old towels and will get some decorating sheets (the thin ones) I think that will do for the mess.

Haven't read the whole thread, too sleep deprived! But just thought I'd mention that I really relate to those cats in Tittybangbang's post!

During my preciptious birth (13 mths ago) it all happened when I was left alone. My dh had taken dd out for a walk, the doula we had hired (this wasn't a planned hb, we intended to go to hospital, we hired her because the 1st birth had been so lenghty, too many staff changes etc)went into town (dh couldn't believe she left me alone, I wasn't thinking as I was distracted in labour or I wouldn't have let her go)anyway soon as she left my waters broke and ds was born within the hr, luckily all safe and sound and with a fantastic ambulance team which dh called, I never felt unsafe although I should have as we are an hour from the nearest hospital, whereas during my 1st birth in hospital I never felt safe I was only just getting the hang of it at home, once in the hospital it all changed for the worse.

comix- they dont have many hbs in usa because they are banned in many states.

Also they dont have many midwives- even low-risk birth are attended by obs, assisted by ob nurses, as oposed to midwives. Therefore even if they didn want a hb there would be no midwife to attend it.

foreverastudent, is it really all about the cost though? Surely, one of the reasons why there are so many less stillbirths / women dying during labour nowadays, is because when in hospital a midwife / obstetrician can see when things are going wrong and act accordingly.

I can completely understand why women want HB - it is horrible being in hospital and having people poke at you unnecessarily and having unnecessary interventions (I know I was in that position myself).

On balance I think there are other things to think about other than what I want personally. The things I consider important are the risks to my unborn child and also what my DH is comfortable with. Taking all this into account I would not take the risk with a HB.

Not wanting "unneccessary interventions" was far from a selfish motivating factor in my case. Unnecessay interventions present real risks to baby aswell as mother.

The (very experienced) HB midwife said that if I had been in hospital they would have almost certainly wanted to start intervening (it took about 2 hours to push DD2 out). In the end I had a wee and a jaffa cake and she shot out into the world .

Because midwives at HB's can't intervene, they have to be more patient and creative. I am sure this, and the constant monitoring are the reasons HB's are as safe as hospita,l births and it's why I chose one and why I would do so again.

Who knows though which interventions are necessary and which aren't. The last thing the medical profession will want is a law suit against them if a baby dies during childbirth. Of course some will be unnecessary and I believe the figure for unnecessary c's is about 10%. But how would I know whether I was in that 10% or not? (IYSWIM)

At home by virtue of the fact it is a HB there is more risk associated with it (unless you live within 5 minutes of a hospital).

In the days before c-sections there were definitely more stillbirths and more women died during childbirth - I really don't think anyone can argue with that. Obviously, HB midwives
are trained to a higher level (although I understand that most of them can't deliver breach births) but if something goes wrong it is a doctor who can do a c-section and can do it quickly that I would want.

TBH I would rather be safe than sorry.

So, one question.

Those in favour of HB, in the event of a rare, sudden, unforeseen emergency requiring fast treatment by surgeons or doctors in a theatre, during your labour, at that point would you rather be at home or in a hospital?

I'd rather be in a hospital.

I can't definitively say "A serious and sudden emergency during labour will never happen to me" and neither can anyone else.

It does happen, however rarely.

That rare chance is the chance I can't and won't take. I know 2 women who required an EMCS involving a general anaesthetic. That's the super emergency, flashing lights, staff running to theatre one, not the sort that gives you half an hour's notice and time for your DP to put on his scrubs.

If a HB suddenly needed that type of EMCS, no matter how close you are with or without traffic and flashing blue lights etc, there will be a delay for travel.

Rare, rare, rare situation I know but... it has happened to someone out there! Why wouldn't, couldn't or shouldn't that ever be me?

Like I said, if I could guarantee a safe, straightforward HB I'd do it. But like Violethill said, there are no guarantees. There I am then.

"remember that less than 100 years ago women had their babies at home!" Yes they did. Probably because there wasn't any other option. I don't think maternity wards had been invented then, or medically trained MWs. It's incomparable, really.

Have you not read Tittybangbang's (admittedly long) post above. You are stating "facts" based on your intuition and presumptions. You are not actually stating facts at all.

If I had been in hospital I would have had forceps/ ventouse, if that had failed then no doubt I would have had major abdominal surgery to remove my baby. Would this necessarily resulted in a positive outcome - who knows. I therefore certainly don't consiuder HB to be more risky and the research backs me up.

PS. I am not trying to do down HB. I like the idea of being at home. I think it would be lovely to move around in my own environment during labour. I didn't enjoy the lights/noise etc in the postnatal wards. But I did feel safe. I was in a major hospital with an excellent reputation. There's another, smaller, hospital not too far away that I would really dislike to give birth in (although I still would).

I just wish the hospital unit could move into my garden during my HB, y'know, just in case

The time it takes to prep theatre and page surgeons is about 10 minutes or as I like to think of it: about the same as the journey from delivery suit to theatre. Or in my case from home to theatre.

And if I was going to have a life threatening bleed I'd rather do it with a mw there to notice at home then on my own in a hospital bed.

You can spin it any way you like can't you? Bottom line is homebirth is not any more dangerous than a hospital birth if you're low risk. Fact.

Bellepink- most of the time people require a crash c-section under GA it is because of hospital interventions.

Most complications of childbirth are predictable before labour. Good antenatal care and health has been the main reason for the reduction on mortality not hospital intervention.

And as I have previously said, even if you are in an emergency situation in hospital there is no guarantee that there will be a consultant in the hospital to perform a c-section.

Ahem, being historically pedantic here.

Yes, 100 years ago (i.e. in 1910) there certainly were maternity wards, and medically-trained midwives.

The interesting thing is that it was the incredibly high rates of post-natal deaths in doctor-led maternity wards compared to midwife-led maternity wards when they were introduced in the mid 19th century that led to Semmelweis's theory of germ transfer (which was then ignored by everyone else)

Apparently, women in Vienna in the mid 19th century begged not to go to one particular doctor-led maternity ward as it was well-known that you had a very high chance of dying as a result, and some preferred to give birth in the street outside.

Not that that has any bearing on modern experiences of birth, but I can't let historical inaccuracies slide.