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?

The thing is, no-one is saying 'more babies die/have problems during births in hospitals so I think it is folly/naive/stupid/irresponsible give birth in a hospital' so why is it ok to say that about HB, especially when the facts don't bear it out.

Just pumped up the birth pool in a box btw! Now I've made my decision I've gone from fretting to feeling reasonably calm about the whole thing.

My biggest worry now is not being given much warning, DD was a 5.5 hour labour, every time I leave the house I start fretting that I am going to go into a very quick labour!

I couldnt get the thought of anything happening to my baby when having a HB out of my head, so though HB is said to be as safe as hospital I plumped for being in the hospital as I knew if anything did go wrong at least I was there and not at home having to call an ambulance out. I felt much more at ease being in the hospital. It is whatever feels right for you really.

Absolutely Juicy

I don't feel at all at ease in hospitals and I felt very fearful, panicky and out of control during DC1's birth in hospital. I wasn't even there that long- turned up just in time to start pushing, for which I am grateful as the hospital in question has a bit of a reputation for wanting to get women lying down and being monitored etc when they are in labour. They weren't able to do that with me. I strode into the delivery suite, stripping all my clothes off; climbed onto the bed on all fours and my waters promptly burst all over the midwife

DC2's birth at home was a totally different experience- calm, controlled and blissful.

Nonetheless, many of my friends would not have felt at ease at home so a HB wouldn't have worked for them. Wherever a woman feels most in control gives her a greater chance of having a straightforward labour, IMO.

I've had both. Home was so beautiful and fabulous. My main reason for wanting one was that I didn't want to get in the car while in labour - my husband's a bit of a crap driver and I'm SO bossy when I'm labour.

The midwives arrived just after DS2 was born - luckily I had a doula on hand as I knew I would be quick - 90mins in the end.

Had a shower and hopped into my own bed in my own pyjamas before DS1 ran through to inspect his new brother.

That's true juicylips, I wasn't sure if I could get past that fear and knew that if I was anxious about being at home then it would be pointless to do it at home as the whole point is about being more relaxed.

Somehow though, between speaking to the MW and reading on here the fear does seem to have dissipated, I didn't think it would. Still, if at any point I don't feel comfortable I know I can go into hospital, but unfortunately you can do it the other way round.

not in a million years! i want to be in a hopsital environment every time i give birth.

i had a private room and it was fab; hubby was allowed to stay over, baby was nice and close, nurses came within seconds of my buzzing for help.

also i had an elective c-section, best decision of my life; perfectly healthy baby followed by a perfect recovery.

I'd much rather a doctor than a midwife deliver me; not very fashionable i know, but it's my body my choice :)

I'd rather have a doctor too for an elective cs !

That told her not to try to get you to lie down or be monitored, hey Olifin . How varry dare they think of doing such a thing, in a hospital too! Monitoring indeed!

Makes me glad I'm not a midwife. Not because of the gunge - that's the nice bit compared to the sheer attitude given off by some women...

Sadly Hankypanky,it is all too common in hospitals for women in labour to end up flat on their back in bed - this certainly happened to me with dd - and was one of the factors influencing my decision to look into having a hb.

Unfortunately most maternity wards are not set up, designed or run to enable women to labour in a more natural and relaxed manner. Some monitoring is often necessary, however in a labour that is progressing normally, constant monitoring is not.

I was told to move around in my hospital, I walked around and round the maternity ward which was great, and only monitored as necessary, so it probably depends on where you are in the country and who you get midwife wise to what they tell you to do (or whether they just let you get on with it in your way, as the case may be)Mine was pretty good.

Awww hankypanky, why did that annoy you so much?!

'Sheer attitude'. Ha ha ha haaaaaa. I was too busy entering the 2nd stage of labour to give off any sort of attitude.

Yes, I'm glad I wasn't made to lie down and be monitored. There would have been no need to monitor me. Why is that so irritating to you?

I had a homebirth purely because I wanted to get in my own bath and my own bed after, and 2 years on, I still remember that wonderful feeling.

It was my third baby, I had the first 2 in hospital, but after a completely straightforward bith with No.2, who was born 45 mins after I got to the hospital, with no complications, feeding well and they still made me stay in overnight - I decided that the only way I would ever see my own bed within a few hours of birth was to stay at home.

I am not in the least bit hippyish and didn't use a pool. Just wanted my own bed. But only after 2 straightforward pregnancies and births, and only 5 mins bluelight ride from the hospital

I dunno, Olifin. I think it was the "strode" that gave me the impression of attitude also the "they weren't able to do that with me" as if they would tie you to a bed immediately on arrival, based on some sort of pre-conceived reputation. If I was a midwife who believed in treating labouring women as individuals yet was constantly working against a pre-conceived reputation I would find it very depressing.

Each to their own regarding monitoring, but AFAIK it's meant to be for the baby's benefit... not to annoy the mothers. This also relates to the general attitude I am referring to. Many a complication has been diagnosed from monitoring so it's hardly useless. Unless you have x-ray eyes and a built-in heart rate monitor for the baby, how do you know a baby (that's the baby, not you) won't/doesn't need it?

No need to answer. I don't need an answer. I just wanted to pose the question.

Well, I can only say I think I came across wrongly in that post then! I wasn't trying to suggest I was being bolshy and cocksure at the time, I really wasn't; rather, I was out of my head on pain and feeling a very strong urge to push, hence the striding! And I really just meant 'they didn't have the chance to do that' as in, they didn't have time. I have no truck with the midwives there, they were very nice to me but I do know that a lot of friends had some crap experiences there in terms of possibly unnecessary interventions. They also have a very high C-section rate. I didn't know about any of this before I actually went there to give birth, it's all stuff I've heard/read about since.

I understand that monitoring is intended to be for the baby's benefit. The one I don't really understand is the monitoring of contractions, which seems to be fairly routine in some places. Why the need for it when an experienced midwife can surely tell from observing a woman how strong her contractions are?

Obviously I didn't have any monitoring during that hospital birth and I also didn't have any during my HB. Certainly no monitoring of contractions- the midwife knew when I was coping/having a wobble and when I was transitional.

I remember her monitoring the baby's heartbeat once or twice (just before/during 2nd stage), with a small hand-held doppler so I was barely aware she was doing it- somewhat different to being wired up to a machine from which one can't move. It's possible she measured the heart rate more than twice but I don't remember. There certainly wasn't constant monitoring and using the small doppler meant it was very unintrusive.

No, never. I'm always so scared something will go wrong. I feel more comfortable at the thought that everything necessary is closer to me at a hospital than at home, in case of an emergency.

My daughter had both her babies at home, never went near a doctor. Looked at hospital option , not impressed. No guarantee that one would have same midwife throughout. We hired a private midwife who worked jointly with my daughter , her DH and me.
It worked wonderfully on both births....
Hospitals too much drama and trauma is what the stats say.
Not sure why or when women were instilled with so much fear about childbirth but it has created an entire generation of womon who believe that 'hospital is where a baby should be born' and that home is a risky place.
It is incredible that home births are regarded as odd or quirky by most women to-day.
I agree that womon should be given a 'real' choice about where to labour their baby, however there does seem to be some level of control exerted over womon by the medical profession, with massive assumptions that hospital is the most suitable venue to birth a baby..
I think womon need to demand greater choice and greater resources that enable them to consider all the options.
I also think women should receive vouchers to the value of birthing their baby so that they could at least make a choice about where they go and who they pay. Such a voucher would allow womon to hire their own,properly insured midwives if they wanted or book a bed at an establishment that was totally womon and baby centred rather than set up for illness and diseases.
I do feel strongly that maternity services in the UK are a post code lottery and that is a disgrace in the 21st century.

I forgot to add that there should also be serious concerns about the huge increase in CS in the UK...that is a major operation...and unless for medical reasons should be a careful decision taken by the womon with support from her maternity team......

I agree with your point about the fear of childbirth. And. talking of how depressing pre-conceived notions can be, I would say one of the biggest pre-conceived notions is that having a baby is so awful that it needs to be medicalised and can only happen in hospital pumped full of drugs. Sure, some women consider the options genuinely and still decide that's what they want. But an awful lot seem to make that assumption- I have known several who say they want as many drugs as possible- and that's when their pregnancy is normal and they have every chance of a normal delivery! Things have swung way too far in that direction.

Absolutely violethill. I think a lot of women go into it with an open mind re. drugs and decide they will see how it goes before asking for them. However, I also know a lot of women who have already decided they're going to have all the drugs available, before they've even experienced labour for themselves. I think this speaks volumes about how we talk about birth in our culture and its effect on people's expectations.

Actually hanky you're not correct. Continuous foetal monitoring is for the hospital's benefit, not the baby or mum. MWs who stay with the woman throughout and check on the baby's heartrate every 15 minutes in a non-intrusive way pick up just the same things as a CFM. CFM reduces the woman's ability to freely move and therefore inhibits free labour, increasing the chances of complications and interventions.

It is a fact (ask your MW) that CFM has in no way decreased foetal morbidity or mortality (recent studies prove this) and in fact increase the level of interventions.

Unfortunately, hospitals cannot afford to have a MW there all the time with a labouring woman. Of course with a HB you have your MW there all the time, which solves that problem.

I agree that there's no right or wrong, but the best place to be is where you're most comfortable. I've had two planned HBs, neither followed through. The first was a transfer following meconium in the water and I was put onto a CFM which slipped, dropped the baby's heart and I was going to be taken in for an emergency CS until my mother realised what had happened!!! (healthy and fine baby born naturally). Second HB couldn't go ahead as I had PROM and chose to take the suggested option of IV antis in labour followed a week of PROM before going into natural labour at 37 weeks. Had a pool birth in the hospital for DS2 though, which was wonderful and better than any drugs IMO. If I had another child I'd def try again for a HWB as I feel safer and more relaxed there, but if you feel safer in hospital then that's where to go as being comfortable is essential for a good labour.

Don't forget you can always refuse CFM, laying on your back, vaginal examinations etc. Makes them work harder of course but it is not something that they have to do if you don't want to. Some people (like me) detest VE. Others want to know how they're progressing. Either choice is fine but it is a choice.

"Each to their own regarding monitoring, but AFAIK it's meant to be for the baby's benefit... not to annoy the mothers. This also relates to the general attitude I am referring to. Many a complication has been diagnosed from monitoring so it's hardly useless."

Yes - but CONTINUOUS monitoring of low risk mothers having a normal labour isn't associated with lower rates of neonatal death and injury and IS associated with higher rates of c/s and assisted birth, which is why it's no longer routinely used for low risk mothers in the UK.

NICE guidelines are that the babies' heart beat should be listened to every 15 minutes in active labour, and after every contraction in second stage. Unfortunately some low risk mums are being left on the CTG machine because there isn't always the staffing to allow for proper intermittent monitoring which conforms to these guidelines. In other words, a woman will be wired up to the monitor, told to stay still on the bed, and then left on her own while the midwife goes to check on her other mothers.

In my local hospital they were still often doing entrance traces on low risk mums 2 years after the hospital protocols had changed to discourage this practice in the CLU.

oops - cross posted carrot!

I couldn't imagine anything WORSE than having my baby at home. I have had three hospital deliveries; the first and last were fairly straightforward, but the middle one was emergency cs. I had a private room with en-suite bathroom each time, the mw was around when I needed her (throughout the actual delivery, of course), and all the mess was on someone else's floor (I have a cream bedroom carpet ffs!). Do you NEED a mw there all the time during labour?

I also found myself tucked up in clean sheets with a piece of toast and a cup of tea shortly after the birth, and the nursing auxiliary did a far better job of looking after me than dh would have done!

I also loved the camaraderie of the post-natal ward, particularly after the first birth. I was able to selfishly concentrate on myself and my new babe instead of worrying about the housework/dealing with other kids etc. which would have happened had I been home.

BUT I think the key to my enjoyable experiences is that I was very well-informed, so was able to resist any pressure to over-medicalise things (despite DD2 being a VBAC). Also, I realise from the above comments that my local maternity unit (East Surrey) was really rather good.

Good luck to you home-birthers, but I won't be joining you!

I also don't understand this obsession with having the same mw throughout. I didn't give a toss who was down at the business end; I was too focussed on what I was doing to care much. The one who delivered dd2 was absolutely lovely but I only met her for the first time at the delivery stage.

I think some women can feel vulnerable and inhibited in labour so, for them, it helps to have a mw who they can get to know a little during the process (even better if it's a mw they've met during antenatal care- sadly rare though).