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.

tittybangbang, good to point out that statement. We did discuss how lots of the data is American and therefore needs to be discounted because of lay midwives, midwives who aren't part of the integrated health system etc.

I am always a bit at these "My baby and I would have died if I hadn't been in hospital" comments. I mean, how do people know that?? There seems to be a lot of ignorance about the extensive training that midwives have, as well as misinformation about what actually constitues an obstetric emergency. I have actually heard, "My baby's cord was wrapped around its neck and it would have died had we not been in hospital with a doctor!"

Just to add, I think care varies HUGELY even within different areas of the UK. My midwife and the other midwives in my area have all expressed a lot of support for homebirths (I am planning to have one in somewhere around 3 weeks), and I think this is largely because they are very experienced midwives. According to my MW, to attend a homebirth the MW must be much more qualified/experienced than MWs in hospital (MW who delivered DC1 told me as she was putting on her gloves and I was pushing that she wasn't qualifying for another 3 days!!). If my midwife was nervous about HB because of her own inexperience I probably wouldn't want one, but then again, why would any midwife choose to attend HBs if she isn't confident in her experience and abilities? My own MW who will hopefully be on duty when I go into labour has attended a lot of homebirths and her experience is that they are relaxed and enjoyable, and rarely end in emergency transfer (usually a transfer occurs because the mother decides she needs more pain relief). I don't feel even the tiniest bit of guilt for wanting/having a homebirth with two experienced midwives, instead of having to send my husband frantically running down the hospital corridor in search of a midwife because baby is COMING OUT RIGHT NOW. I was made to feel like a nuisance going into hospital because I had to demand a bed (for the second time) since they didn't believe I was in full labour since I was too calm but yet gave birth 20 minutes later after. Given how busy the hospitals are I figure I'm doing them a favour by staying out of their wards (my MW is a community midwife and doesn't work on the hospital wards at all, she just does HBs and home visits).

thanks for your support Tangle,

I continue to ask every time I see a (different) consultant - and will continue to ask until DS arrives no doubt! I've been made to feel that I'm being 'difficult' for wanting them to justify themselves and have been told that 'they' will decide what's best for me! I will continue to gently but firmly make my views known - I just find it frustrating that they aren't even prepared to enter into the debate with me - and as a 39 year old chief exec of a big charity I do like a good debate - but they just see me as difficult.

Protocol, statistics, and the 'just in case' seems to be all that matters to them. Interestingly of the 1600 or so births at my local hospital last year, only 490 were categorised as natural labour, 60 home births, 400 (or so) were csections, and about 660 'assisted' - or thereabouts.

I am persistent and want them to demonstrate to me why their 'recommended' approach is best. They seem increasingly willing to talk the further the pregnancy progresses so I'll try to remain hopeful

Sorry I have not read every post carefully, but it seems to me that most people confuse HB with and unatended birth, and they are in no way the same. MWs attending a hb carry what's needed to resucitate baby, stop bleeding from mum, etc. They clean up afterwards and more importantly, there should be no hurry! In my mind the dangers of unnecesary intervetion are greater than those of a HB in a normal, low risk pregnancy.

It all boils down to how individuals assess risk. Yes you could have a low risk pregnancy and be an ideal candidate for HB but we all know within a second a normal birth can become a problem birth. The questions are: are midwives alone able to manage the majority of these problems? Does transfer to hospital take the same time it would take to get consultant/obstetrician into a room if you were already in hospital? If not what would that delay really mean.

If at the end of those you think, well the risks are so small i can take it then fine. I personally know little enough about medicine that i'd rather be surrounded by experts and in a hospital with a top neonatal unit than my house, in case something does go wrong. I can suspend my own comfort for a few days if it means i am safe and so is my baby...we have a lifetime together at home to look forward to, i am sure i can cope without my labour being spent there.

They stop homebirths round here by refusing pain relief.

They say that homebirths are for people who want to do it naturally, so if you want drugs you have to go into hospital. This includes gas and air.

Unsurprisingly, we have one of the lowest stats for homebirths.

the answer is yes. midwives can handle the majority of issues.

home is as safe if not safer.

"I personally know little enough about medicine that i'd rather be surrounded by experts and in a hospital with a top neonatal unit than my house, in case something does go wrong."

No - it's great to have doctors on hand if you have all the interventions you are likely to have in hospital. God knows if you had as much intervention at a homebirth as are involved in the majority of hospital births these days (ie, syntocinon, continuous monitoring, induction, ARM, supine birth, epidurals, opioids, episiotomy etc) the neonatal (and probably the maternal) mortality rate would be sky high. You need technology to solve the problems that being in hospital generally causes.

"I can suspend my own comfort for a few days if it means i am safe and so is my baby...we have a lifetime together at home to look forward to"

Yes - incredible isn't it that women have their babies at home simply for the sake of their own comfort, and selfishly put their babies' lives at risk.

For me, the safety of baby and mother must always come first.

For me, unless there are complications, that will always mean a homebirth.

I would do without pain relief to ensure this safe outcome.

I am planning a home birth because of the 1:1 care (or 2:1 really!) and because I dont see why birth needs to be medicalised unless there is an actual medical problem. The moment anything seems skewiff with the birth, or if i come to the decision that i just can't hack it i will be off to the hospital quick sharp (and yes im going to take an ambulance because the maternity ward is a bugger to find). I am though in the lucky position of being 10 min from the hospital (poss less in an ambulance).

Whilst plenty of people on here can claim their baby would have died had they not been in hospital, my friends experiences so far are that being in hospital nearly killed their baby, got ripped to bits, traumatised them for life etc etc

DancingCat, It sounds to me like you ought to get in contact with AIMS. Or at least read up on some of the stuff on their website to empower yourself.

good luck on the journey you are traveling. They have no business treating you like this.

"No I haven't. And I would do everything possible to scare a woman out of home birth because if DC1 were born at home, that's where he would have died"

My mother's friend's daughter lost her baby in hospital. They were too busy to monitor her properly, the baby started losing oxygen and by the time anyone did anything about it it was too late. He died 3 days after he was born, entirely down to medical mismanagement.
Hospitals are not the be-all and end-all of safety

oh, and that was only 2 years ago

I planned 2 homebirths. I desided on homebirth after a lot of research and evaluating the risks of homebirth and the risks of hospital birth. I felt the risks of homebirth were less than in hopsital.

Both my children were born by EMCS. The first was born by crash section with GA. With DD I went to hospital willingly because I knew thngs weren't right. I had been in the hospital for many hours before the crash section happened, and the trigger was her heartbeat crashing as a result of the epidural I was having in order to be induced ( I had asked for CS over induction because I knew she wasn't coming out.

But I was refused the CS then, and they insisted on inducing. I would have needed CS regardless because she was a brow presentation but we didn't know this till they got her out. (Brow can almost never be delivered vaginally unless they shift a bit to a face presentation AKAIK)

On paper, that looks like - oooh, a HB and the baby would have died at home. When actually, it was an unneccessary, very traumatic crash section because they didn't listen.

I still planned HB for second time. When I failed to progress, again due to wonky positioning of the baby, I willingly transferred to hospital and this time insisted on a CS which I got.

Both of my CS were down to awkward babies for me - not related to homebirth at all. I am a HCP myself, and my DH is too. I am still happy that HB is lower risk than hospital for most women, as long as all is normal.

One tiny example, as a VBAC having a homebirth I had 1:1 care. As soon as I got to hospital (baby well, just not progressing in labour) I was left on my own with a monitor belt on. That proved to me exactly why I hadn't planned a hospital birth.

IMHO if care in hospital was better, a lot of women wouldn't feel they had to choose HB to be looked after properly

Lots of things in hospital contribute to less the good and sometimes catastrophic outcomes in hospital.

Fibilou and ghost have highlighted two common ones. Not listening to women and leaving women strapped on with a monitor. Then when things progress from worrying to critical, it is easy to conclude that 'if I wasn't in hospital I/my baby would have died.' Thereby perpetuating the myth.

So sorry for your mother's friend's dd Fib.

My scenario was similar. Taken to hospital in an ambulance but then ignored there till things became critical and DD and I ended up in the high dependency unit. Utterly unnecessary if they had simply listened to me and done something earlier, leaving me with PTSD years later, breaking my trust in NHS midwives and becoming of petrified of hospital birthing.

She is pregnant again, FT. She must be dreading the birth

I also find it unbelievably patronising that women are expected to put up with inferior care because "there's not enough to go round". Birth is a dangerous event yet is routinely expected that a woman in labour share her attendant with several other women in the same situation. For many women it might be the only time they ever use a hospital, yet despite paying thousands in taxes we are expected to put up and shut up.

I wonder if a man having a heart bypass would "put up and shut up" if his surgeon was doing 3 procedures at the same time ?

Also frustrating the level of "my baby would have died without the doctors" - yet without considering that the problems the doctors had to solve might well have been brought on by those doctors.
I had to fight not to be induced at policy 10+, baby arrived at 13 days overdue. I have no doubt that I would have ended up with a EMCS as my cervix was still pretty firmly closed 8 hours before DD was born. Yet she was born with no pain relief in a 6 hour labour (almost entirely at home, she was born 10 minutes after getting to hospital). Policies, timescales and staffing levels seem to be the biggest risk factor in the modern birth

Fibilou- I know someone who went 14 days over with her 2nd. She was absolutely fine, and luckily, her MW was supportive of it - she said that she's have to go in for monitoring if it looked dodgy, but she didn't and had a good HB.
with her first, her waters broke loads before the labour started - I think it was over 48 hours. had she been in hospital, they would have induced her - I'm sure she said she didn't tell them because she was scared f that happening (her mum is an HCP, and she told her, who wasn't worried, so...)

i think there is more room for study into what really causes stillbirth, and what the risk factors are - blanket rulings like induction at 40+ 10 when the uplift in risk is marked at 40+14 and very slight anyway mean many many women have inductions which are slightly bad for the majority, in order to safeguard a tiny minority. If the risk factors could be properly isolated (eg, is it smaller women going over 42 weeks who are most at risk? smokers? higher/lower body mass? older/ younger? first timers/second timers?) then that could be avoided without any increase in risk, and in fact a decrease of risk for the majority who wouldn't be advised into inductions any more.

When i heard a friend who is 6'2 tall had been told she must be induced at 40+10 i was very - as it seems likely that length of gestation could be just her normal gestation and not a sign of anything wrong at all. But these things aren't taken into account - stats are used as a blunt instrument which i am sure is not a good way to operate evidence based medical practice.

My last two were both 40+10 and i'm not even that tall!

I had excellent care in hospital, so please don't assume that all hospitals births are bad.

If I had had DD at home she would have been formula fed from day one because she wouldn't latch on. With the help and support of the midwives who were on hand every time I needed to feed DD we managed to successfully establish breastfeeding. I wouldn't have expected a midwife to be on hand for 4 days and nights after the birth to help if I had been at home.

its great that you got such excellent support bunbaker - though exactly that is absent from many womens accounts of post-natal wards.

stats wise, homebirthers are more likely to make it work though - i expect because it is easier to go naked and have lots of skin to skin time in the comfort of your own home. Or possibly because it is easier to get on the web for advice!

worth a read I can't find it but she wrote another article on how she went from a 'If I wasn't in hospital my baby aould have dies' to a 'becasue I was in hopsital birth was difficult' person.

interesting article WOT - a great story of what a good midwife can do - it made her believe she could do it!