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?

My local hospital is actually changing to a MLU next year, but even though it will be in a hospital I believe that emergencies would still have to be transferred to the next city. To be honest, I'm not sure much will change when it becomes an MLU, can't imagine it's going to become more home-like. More that they will just take away the epidural options , thanks for the tip anyway.

I have one hospital 6 miles away and one 3.5. That's pretty close right?

Bumper, my nearest hospital was 10 miles away. I still went for a home birth.

Bellepink - HBs are not statistically less safe. That's the whole point!

They may not be everyone's cup of tea - and that's fine.

But just stick to the facts. If your pregnancy is straightforward, and you are have it on the advice of the professionals that your baby is no more at risk being born at home, MLU or in hospital, then have the balls to be honest about your decision. If you choose hospital, it's because you want it, not because it's safer. You don't need to try to denigrate other people's choices simply to validate your own. No woman I know would deliberately put her baby at additional risk.

I had my first baby in a MLU because it was a straightforward pregnancy and I decided the best thing for me and my baby was to try to avoid interventions.

My dc2 was about as medicalised as you can get - she had to be born by CS and spent months in an incubator.

My dc3 was safest born in hospital, because it was a VBAC and therefore I was termed 'high risk'.

We all make decisions based on the facts, and also our own particular preferences (provided the baby is safe!)

It shows a rather unpleasant mindset to try to pretend that other women are deliberately putting their children's lives at risk simply because they choose to give birth outside a hospital.

Childbirth is not a disease, or an illness, and in most cases can be carried out without intervention. Not all, but most. If the mother chooses intervention, that's her right. But in most cases it isn't medically necessary.

If your choice is hospital - good for you. Enjoy! Just let the rest of us enjoy our choices without making unpleasant and inaccurate comments.

Both mine were hospital births but had I planned to be home I'dve ended up in hossy anyway. So this isn't my experience, but my mate had her second at home and she says the best thing about it was that her DD1 watched a lot of it and held her newborn sister before she even did. And her DD1 was totally fascinated by the whole thing. Every time she tells that story it brings a tear to my eye... I was totally happy with both my births and couldn't have been in a better place, given the complications, but I still enjoy other people's lovely home birth stories. Aah. Whatever makes you feel happy and relaxed.

"Bellepink - HBs are not statistically less safe"

Violethill - I never said they were

"have the balls to be honest about your decision". Er, I am, thanks! Read my post. That's my honest opinion.

"If you choose hospital, it's because you want it, not because it's safer". Wrong way round, Violethill. It's because I feel it's safer I want it. I hope you're not going to try and tell me how I feel now?

"You don't need to try to denigrate other people's choices simply to validate your own". Oh the irony!

"It shows a rather unpleasant mindset to try to pretend that other women are deliberately putting their children's lives at risk simply because they choose to give birth outside a hospital". I'm not pretending and I didn't realise I couldn't decide for myself what risks I personally want to take. I am expressing how I feel personally, as I made clear, about HB and hospital births. Others are expressing their personal opinions that HB are not risky. That's fine by me. We're all here to share an opinion.

I find your personal attack on me unpleasant, Violethill.

Good post spongecake.

I just wish people who don't want, or don't have, HBs could happily accept that some people do.

I don't expect everyone to want a HB - I can quite see that it's not everyone's cup of tea.

A good parallel is with fear of flying. Some people are absolutely petrified about flying, and wouldn't set foot in a plane. It doesn't matter that the statistics show that it's a perfectly safe form of travel. Their instinct takes over and tells them they don't want to do it. If your instinct tells you that you don't want a HB - fine. Deliver in hospital if that feels right for you. But just as someone with a phobia about flying shouldn't try to twist the facts and claim that it's 'unsafe', neither should people who aren't in favour of HBs twist the facts. Just accept that whatever the statistics say, you personally aren't going to feel comfortable with HB, and exercise your choice to deliver elsewhere. Meanwhile, lay off those of us who choose HBs or MLUs!!

Bellepink: "I personally can't risk my baby's safe entrance into the world, and life or quality of life thereafter, because I wanted to give birth at home and not in a hospital."

This rather implies that other people are risking their baby's 'safe entrance into the world' though doesn't it?

Lovely post spongecakelover

Heck. No.

What it boils down to Violethill, is that I feel safer giving birth in a hospital. I am not trying to imply anything about other people and their choices. If I felt that I would say it directly, instead of implying it! but I don't.

All I know is how I feel personally as in it's a personal opinion that I don't expect everyone to share, not a snidy "I personally could not, by which I mean I am amazed all you lot could".

I think you have taken the "personally", er, personally .

I have had a hospital birth and a homebirth. With the hospital birth it was a 'normal' problem free delivery and I laboured at home for most of it (entered hospital at 8cms). Once in the hospital the pain escalated as I was left alone in the hospital room for hours, I only got a dedicated midwife in the last hour. I was terrified, had no idea where anything was, constantly worried and unable to relax in the sterile, bright room. I had no idea DD was back to back and the midwife gave me pethidine ten minutes before she was born as she claimed it would be at least two more hours (without examining me and even though I had been ten centimetres for the last hour). I ended up with flashbacks, suspected PTSD and a huge white coat phobia. It took three years to contemplate birth again and I had repeated panic attacks when I had to attend the hospital for scans.

DH pushed for a hospital birth with #1 but with #2 it was him who was totally positive when my midwife suggested a homebirth and encouraged me throughout. We had a fantastic experience, totally healed the wounds of #1 as I was in control throughout. DH is embarrassingly chatty about it and speaks of it highly to anyone who is prepared to listen.

My MIL ended up being there (unplanned!), as well as several additional family members - wouldnt recommend it generally, but it turned out to be a turning point in our relationship and I am now the DIL who can do no wrong, ever .

I think for me the reassurance of my midwife who talked me through everything that could go wrong and what they would do about it beforehand was the clincher, the homebirth team in my area are evangelical and were obviously ecstatic to be there (and thanked me afterwards).

That's helpful to clarify.

You feel safer in hospital. There's a big difference between "I can't risk my baby's safety", and "I feel safer in hospital".

It may seem like a detail, but it's an important detail, because these are the kind of threads women will read (hopefully along with lots of other info) if they are considering a HB, and it's important to know the facts.

If a woman has a straightforward pregnancy and is low risk, she is as safe giving birth at home as she is in hospital. Whether she FEELS as safe is a different question, and that's where it comes down to each individual to know themself and make their choice.

I would if I ever had a third baby. I def wanted to be in hospital for the 1st - good job too as it turned out. I had a horrid time. Number two was much more straight forward and I remember thinking 'I could do this again', rather than 'NEVER AGAIN' which is what i thought after number 1.

If there was ever a number 3 (which there won't be - snipetty-snip), and it was a straight forward pregnancy with no risks, I would probably ask for a home birth for the same reason as someone else here. Hated being in hospital with bloody call buttons not working and lights on all night.

I stand by both statements for me personally actually, Violethill, but I still don't expect others to agree with it or like it. I do feel I would be risking my baby's safety giving birth at home. I can't change that for you. I wouldn't bungee jump either as it seems too risky for me but that doesn't mean I am saying nobody should bungee jump! Just that it's beyond my comfort zone. I am allowed to express my comfort zones just as you are allowed to express yours. We don't have to have the same.

Agree with your point "If a woman has a straightforward pregnancy and is low risk, she is as safe giving birth at home as she is in hospital" up til that point, but if there's an emergency then I would feel safer being in a hospital than at home.

Seeing as I can't predict if how and when an emergency situation might arise during my labour, I personally would want to be in a hospital in case it did. I'm not saying an emergency would happen. I'm not saying an emergency is more likely to happen at home than in hospital, or in hospital than at home. I'm saying that if an emergency situation arose I wouldn't want to be a 15 or even a 10 minute ride away in an ambulance, plus waiting time.

For me, birth is a relatively short event in mine and my baby's life, lasting a few days or less, and I want that event to go as safely as possible. I feel I will find the most safety in hospital. My comfort is second to safety. Ideally we would have both equally, but seeing as we can't turn our homes into hospitals, I have to turn the hospital into my home for a short while. (No biggie to me, as long as I have the best medical equipment at the end of a corridor). Hence my support of improving labour wards.

I'm not doing HB down. If I was guaranteed a safe HB I'd do it LIKE A SHOT. But nobody can give that guarantee because nobody can see into the future. Except my old neighbour

Sigh. I'm going to bed now.

There are no guarantees with birth. Full stop. But as long as a home birth is AS safe as hospital, which is true for many women, then some of those women will opt for it. And they are not risking their baby any more than a woman who feels safer in hospital.

I had a similar thing taramaya. My midwife told me after dd 1 was born that if I'd been in hospital , she was 99% sure they'd have been pushing me towards intervention because it was a long labour. In her eyes it was just that- a long hard first labour, ie totally normal! She wasn't fazed or fussed, she just supported me in giving birth naturally. On comparing notes afterwards, one of my NCT friends who gave birth in hospital had a first stage which lasted the same length as mine, and she felt pressurised into having interventions because the staff made her feel things were taking 'too long' , and she ended up with an epidural , things then slowed down even more, and she had a csection!!

to balance your story, lequeen, I know someone who was supposed to be having a hb and had to transfer. she ended up in hospital where she had a still birth because the staff were utterly inept and crap and unable to read their own machinery or find any consultants. it took them over 24 hours from arrival in hospital to delivery by so called emergency c section. as violethill says, 'there are no guarantees with birth'.

"I expect that most women in third world countries would dearly love the reassurance of the medical facilities we have available here."

Yes - and if they they were in the UK and had booked a homebirth they would have just that: proper antenatal care, fully qualified and equipped midwives at the birth, and an operating theatre and doctors within easy reach should they need emergency care.

"Also if you give birth at home you have to be attended by 2 midwives. That's 2 midwives who aren't therefore working in the delivery suite in a hospital. Which can mean that other women in labour aren't having the same level of attention".

Only one midwife is with the mother throughout most of the labour. The second midwife usually only attends for an hour or so.

NICE guidelines are that all women in active labour should have continuous one to one care from a midwife. This is optimal care and you should get it at home or in hospital. And if they can't provide it in hospital because of midwife shortages then they are putting women's and babies lives at risk. Why should we compromise our baby's safety by making understaffing and suboptimal care an easier option for health service managers than forking out for the required number of midwives?

Re: risk issues.... You are right that there are some situations in childbirth where outcomes might be worse because a mother doesn't have quick access to doctors and an operating theatre: such as cord prolapse, placental abruption or post-partum haemorrhage.

So why aren't there higher rates of neonatal and maternal deaths among the thousands and thousands of women in the UK who've had babies at home in the past 20 years? Because some babies WILL die at home who wouldn't have died had they been born in hospital.

I can only see one answer to that paradox, and that's that there are babies who will die in hospital who wouldn't have died had their mothers been at home. As far as I can see, despite (or maybe because of) all the medical care in hospital, labours are much more likely to become dysfunctional and complicated in that environment, and mothers are more likely to end up needing emergency treatment, which sadly doesn't always save the life of babies who have got into trouble during labour.

How else would YOU explain the parity of neonatal deaths between home and hospital? (remembering that the really big studies which have looked at this have only included comparisons between similar groups of LOW RISK mothers delivering at home and in hospital)

So - there is a balancing out of risk. Yes - you're more likely to end up with a healthy baby delivering in hospital should you experience a rare obstetric emergency like cord prolapse. However, you're more likely to have complications in labour and your baby is more likely to experience fetal distress if you give birth in that environment, so that in the end the risk balances out. Unless you factor in increased risk to mother and baby caused by placental problems in pregnancies following c/s, which of course are far more common among mothers labouring in hospital.

Haven't read the thread or the article but I've had a home birth and it was amazing. Particulary as I had the comparision of my sons unneccesarily brutal and traumatic birth. I could easily write a few thousands words on how the birth progressed well and I could manage the contractions by feeling safe and avoiding the mammilian "flight or flight" mechanism which can make hospital births so hard. But... in terms of actal safety, for births following normal pregnancies with no other 'issues', it is statistically safer to give birth at home. Midwives are very careful and vigilant of signs that could mean you would be safer in hospital. Those kind of problems have early signs. Also, if you live right near a hospital, you would be in there as fast as it would for them to get emergency rooms ready etc. I also had a birth doula and she was worth every single penny. There are so many advantages to staying at home.Read up on it. But feeling safe is your key. And the place that you feel the safest is the best place you can be. Good luck.

Oh yes, and my DD spent her first night in the world next to me in our co-sleeping cot with DP and DS (who had snuck into our bed). Compared to poor DS who's 1st night was spent in a car seat on the reception desk, unfed, unchanged because the mardy, over-worked midwife 'told' me to sleep and wouldn't bring him to me until the morning! This was particularly dangerous for him, I later learned, as well as insensetive as the poor thing had been born via a brutal and unecessary forceps delivery because and I quote, I was "blocking up the emergancy room". This is why safey is the key. If I had found myself in a hospital giving birth to DD, there is no way O would have coped. I would have been scared and everything would have slowed down. I wouldn't have been able to detach and find my mental coping place.