Ever wonder why so many women are scared off by the thought of a home birth?

[foxytocin]

These questions [[
store.aqa.org.uk/qual/gcse/qp-ms/AQA-3561-H-W-QP-JUN09.PDF from AQA]] give an insight into our mindset.

3 (a) Suggest four advantages of having a hospital birth.
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3 (b) Name three types of pain relief usually available in a hospital.

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Where was the mention of home births here - or the disadvantages of hospital births.

Really disagree that home births are a luxury. They can actually save the NHS money!

I know from data in other countries that a homebirth generally costs the health service quite a bit less than a hospital birth - you've got fewer women taking up beds in hospital, having to be fed, far fewer costly interventions etc. Even though more midwives are needed to cover home births, overall the savings outweigh the additional salary costs.

I too disagree they are a luxury.Strongly disagree. For the reasons Bue has already said.

I could sugest Epidurals are a luxary,for which women should have to contribute towards paying for, but wouldn't dare. I don't want things thrown at me!

(Actually I would have paid a hell of a lot of money for an Epidural with DC1)

But what about when after half way through a home birth its decided that the mother needs to go to hospital, then the expense of an ambulance + crew is added into the equation, and it becomes an emergency which costs money that could have been saved if she'd just gone to hospital?

I can't help myself
the thred below goes into detail about MRSA in hospitals and how dirty they.

I'll be having a home birth. the thought of going to hosptial scares me silly!

I don't see home births as a luxury-to me shutting the door, going off to hospital and concentrating on yourself and the baby is the luxury.

I disagree with Pickledbabe, if DH is your birth partner then it is very important he is calm and happy with your plans as well, his feelings do need to be taken into consideration. Also just because you go to hospital you do not automatically lose the word "NO" from your vocab, if you want to move around or moo like a cow then do it and stuff the midwives they will work round you. The key, as always, is to be informed whether you are in hospital or at home.

But Lizzzombie, sometimes pregnant women who have planned hospital births have to be taken in by ambulance, too. That exact situation happened to my cousin in December - she began bleeding heavily in the early stages of labour when she was still at home so paramedics had to come and get her. Emergency scenarios are not restricted to home birthers.

And many (most?) transfers are not emergencies and do not involve ambulance - you get in your car and go.

Homebirth as a luxury which takes MW resource away from labouring women in hospitals? An interesting but badly thought-out idea.

Bue has already touched on the key objections to this argument. Yes, they apply to the UK too. Yes, homebirths cost the NHS less than hospital births.

The savings continue in the weeks after the birth too since HB mothers are less likely to need further medical treatment after birth (e.g. for PND, episiotomy care, breastfeeding support).

If there aren't enough midwives to go around in the UK (and there aren't) you could logically blame unhelpful health funding structures and priorities, poor political and managerial decision making, poor planning and incentivisation in midwifery education and training etc..

It's absurd to blame the tiny minority of women who choose to give birth at home.

i am incredibly grateful for the care i had in hospital, without which my baby would probably have been brain damaged/dead.

she had shoulder dystocia, meaning her head was out but body stuck (and cannot breathe) and needed VERY quick intervention to get her out. in the hospital i had a whole team rush in within seconds and help deliver her. if i was at home i hate to think what would have happened.

We are very far from a hospital with consultants out here.

If I'd have had DS at home, he and I would have died.

Hb is a luxury? Perhaps you could provide some data on the comparative costs, or did you just assume that?

It makes me laugh how people suggest that having an acceptable ratio of qualified staff attend your birth is somehow selfish....if there is any time in my life when I put myself first - it will be the few hours in my life when I am bringing my child into the world, and I don't think many people favouring hospital births do so to keep NHS costs down, especially as we all claim we would do anything we had to to protect our babies!

Those who see homebirth as a risky or reckless thing to do are more than welcome to go into hospital and share a midwife between 4 labouring women (which might well include emergencies), if you have judged that to be a safer option, but it is the level of care for me and my baby that is one of the driving motives for my desire for homebirth, and I can't stand it when people imply that people choosing homebirth are somehow not doing the best for their babies -I think all opinions about pros and cons are welcome, but it stinks when people suggest that those of us who might opt for homebirth are toying with our baby's lives...disgusting.

I'm really surprised that this is such a contentious subject (and am a little nervous about commenting for fear of being shot down in flames! )
I was born at home 39 years ago and arrived before the midwife did - my dad did a great job of delivering me, my 20 month old brother was there, I'm sure that's one of the reasons why I was so close to my dad when he was alive and why I'm still so close to my brother.
I'd love to be able to have a home birth even though this is my first and I'm absolutely terrified - I simply haven't got the option due to pre-existing medical conditions and the 'just in case' approach means an overly medicalised consultant-led planned delivery (which terrifies me all the more). I just want to have a healthy baby boy, and to be healthy myself. I'm dreading the whole thing and trying to keep an open mind. Home birth seems more natural and less scary - but maybe that's just because its not an option for me.
Just wanted to share my view

I wouldn't be scared of a home birth, but of the women I know who wouldn't entertain the idea, it was due to wanting the option of heavy duty pain relief which isn't available at home. It's that simple. statistically home birth is as safe as hospital comparing like with like.

Crap exam paper btw

costs

HB - £800

hospital £1400(with epidural)
C-section £2200+

homebirth saves the NHS money.

and a planned Homebirth In The UK (so not including poverty-stricken Americans who have no medical cover LIKE THAT lancet-published article) is every bit as safe for the baby, and has advantages for the mother (halved risk of c/s, reduced risk of tears)

"hospital £1400(with epidural)" how much without epidural if you are actually going to compare like with like......

"and has advantages for the mother (halved risk of c/s, reduced risk of tears)"

but again is that because of 1-1 continous care....

splashy - all MWs are required to keep their training on SD up to date, and there is extremely little that can be done in hospital that can't be accomplished by 2 competent MWs in any location.

DancingCat - I'm sorry you're having such a stressful time of it. How much have you asked your HCP's to explain why they feel their "just in case" approach is necessary and what research they are basing their recommendations upon? I don't know the ins and outs of your case, but in many instances "just in case" and "hospital policy" aren't supported by any sound research (CFM for VBAC's and CS for breech being two prime examples). I know all too well how hard it is to go against medical advice, but if you've reached the point of dreading the birth of your DS, is it worth seeing if there are aspects of the plan where you and your HCP's can work on a compromise to make it a less daunting prospect? I found these phrases by Mary Cronk to be really useful to keep in mind - even if I didn't use them, they helped me to remember that they could recommend what they liked but what would happen was ultimately my decision and that gave me the confidence to keep asking questions until I felt I understood why they were making their recommendations. Wishing you a calm and straightforward birth :)

the MWs that attended mine also said that women who had HBs progressed faster and coped better with the pain. Don't write off the positive effects of active birth in a relaxed setting.

lizzombie you live in East Sussex - that was incredibly ill-thought out move of the PCT to deny women a proper choice in birth. nd not backed up by fact - HBs are cheaper. Not maintaing the right amount of the right kind of staff is the problem - community Mws as opposed to surgeons, aneastheists, consultants.

That PCT has alot to answer for - more women will have had C/S and birth trauma as a consequence of that decision.

for those wondering why high-risk rths sometimes are planned at hme - my Mum had a high risk delivery at home - she'd been bleeding throughout the pregnancy, and it was feared PPH and/or stillbirth was likely.

her previous labour took only 45 minutes at home. She had 3 other children and a husband in full time work (so, think about it, she starts labour, even if she wants to go to hospital, she has to get childcare first, then get herself to hospital (she then had no driving licence)...) she came to the conclusion that she might have been at risk at home, but she was safer there attended by a skilled MW, than delivering in a moving car, or whilst still waiting for childcare alone. As it happened, it was fine (and another 45 minuter) - had it not been, she at least had a very skilled MW there who could have provided care until an ambulance arrived to get them to hospital.

It was a shame the consultant that saw her claimed she was 'trying to kill her baby' by having a HB, he obviously hadn't considered the practicalities involved in very short labours.

i really need a new keyboard.

Another reason why high risk births are sometimes planned at home is that the mother suffered such bad care the first time round she suffered from PTSD and won't go back in a hospital :(

...and also I wouldn't dream of 'scaring' anyone into having any type of birth. I would expect them to have done their research and taken the best advice they could get.

What if I was 'scared' into a birth option by one of the earlier posters, and something terrible happened to my baby as a direct result of where I had my baby...how would they feel?

I think with these things it's best to gather as much information as possible, and keep your own counsel...I couldn't bear to think that my emotive comments in a chat room had devastating real life consequences for someone , and I don't think people realise how powerful those emotive comments can be, even in the face of good background research. I sometimes have a real wobble about HB for this reason, and sadly see the end result of me being terrified of giving birth wherever I am.

splashy - so glad your DD was OK.

I was warned of a possible risk with DS of shoulder dystocia because of his size (in fact, the research shows that size is irrelevant to the risk). The research showed, I think, that repositioning of mum was likely to be the most effective means to get baby out - and that that could be achieved as well by a MW at home as in a hospital. Personally, I suspect the odds are even better if you have an experienced MW at home v a junior registrar in a hospital (which, lets face it, is what you actually get most of the time).

There is so much misinformation and fear spouted about giving birth. Sadly, IME, a lot of that comes from doctors who lack experience in 'normal' birthing techniques (how much time do gynaecologists spend observing MWs on low risk births??) and who, as a result, and opt to use medical intervention without consideration of whether that is actually in the best interest of both mum and baby in the long term.

yes, Edgar, I agree with all your mum's reasons - If I still lived in the middle of nowhere like I used to, I would say that HB would be easier and far less stressful than waiting to see if the ambulance could get to me on time (there's no way I would risk driving all that way if I were in labour!!)
At least at home, then you can sit and read, or you can get i nthe bath, or go for a walk, and not worry about how you're going to get to your birth place in time.
(especially in winter, when you don't really want to give birth on the road!)

Haven't read all the posts, apologies, but did anyone else note this comment in the NHS choices article Tangle linked to which showed higher rates of mortality for babies born at home?:

"It is also important to highlight that when the analysis only looked at homebirths that had been attended by a certified midwife, there was no difference in risk of neonatal mortality compared to hospital births".

"she had shoulder dystocia, meaning her head was out but body stuck (and cannot breathe) and needed VERY quick intervention to get her out. in the hospital i had a whole team rush in within seconds and help deliver her. if i was at home i hate to think what would have happened."

Well - probably what happened with me and everyone else I know who had a s/d at a home birth: it was dealt with quickly and efficiently by the midwives. And mine was a pretty difficult s/d because it involved an 11lbs baby, who also needed resuscitating.

In my case I was saying 'thank god that didn't happen to me in hospital' after my shoulder dystocia. All the women I know who had this happen to them in hospital who had teams of medics rushing into the room, adrenaline surging, felt pretty traumatised afterwards. My birth left me absolutely euphoric.