Home birth with fibroids. Any experiences or opinions?

[Ihopeyoudance]

I'm 33 weeks pregnant and have had a trouble-free pregnancy so far. They discovered 2 fibroids on my dating scan but I've had no adverse effects from them so far and did not have particularly heavy periods previous to pregnancy.
As everything seems to be going well, I mentioned to the consultant today that I would like to have a home birth. Her response was, 'Have you ever seen anyone give birth? I'm sure you'd change your mind if you had.' Not terribly positive! She decided to do a scan to work out where the fibroids were to see if they would be in the way of the exit route or could affect the baby's position. The baby was head down and the fibroids were well out of the way. One was the same size as at 12 weeks and the other had grown slightly, though it was at the very top of the uterus.
Now, to me, that scan was reassuring in that the fibroids don't seem to affecting the pregnancy at all and seemed to be the best situation possible, given that they weren't going to have disappeared completely! The consultant however said that she hoped I'd put my 'romantic dreams' of a home birth out of my head and that it was a silly idea as I may have a postpartum hemorrage due to the fibroids so I needed to be in hospital. She tried to scare me with talk of losing pints of blood and needing transfusions etc.
Is there anyone who has experience of giving birth at home with fibroids? I can't decide whether it is her attitude which has got my back up and made me not trust her opinion, or whether I actually just disagree with her. Obviously I understand there is a slight increased risk, but I'm happy to wait and see what the situation is at 36 weeks when I have another scan booked.
Are there any midwives out there who can offer an opinion on how they would feel about attending a home birth where a woman has fibroids? Consultant said no midwife would touch me with a barge pole I thought most women had them at some point tbh and they didn't have to be a big deal.
So tell me: am I deluded and being selfish? Or could this consultant just be against home birth in general and erring on the extreme side of caution?

I haven't had a home birth, but had a hospital birth which ended in emergency c-section because of my fibroids. One of them (not visible on the scans because it was on the back wall of the uterus) prevented the baby's head descending, and by the time the doctors realised this it was an emergency situation and people were running down corridors. They had 5 minutes to get the baby out alive (which they did) but then the fibroids caused me to have a big haemorrhage on the operating table and I lost a lot of blood. If we'd been at home I don't think either of us would have survived.

Sorry, I don't want to scare you, but this is what can happen with fibroids, which may explain your consultant's caution. To put it in perspective, about one third of women have fibroids, so they are very common, and most of them are small and benign and won't cause problems in childbirth. But you can't know for sure until you're in the middle of it.

Personally I wouldn't risk a homebirth in your situation.

The scans carried out in pregnancy don't show everything, because they can only be done from the front and the baby blocks out part of the uterus from view. I asked the sonographer if they could scan me from the back when I was pregnant the second time, but apparently this isn't possible.

Don't necessarily be put off so easily. I have had a home birth when I knew that I had/have two fibroids.

Both were discovered after my first pregnancy. I have two as I said one is like a pom-pom on a bobble hat and is currently about 15cm diameter, the second is in the uterine wall and I've forgotten its exact dimensions but it is about 10cm x 4cm or something. I always paid more attention to the pom-pom as it gave me a bit of discomfort as my babies grew as it occasionally got stuck under my rib cage (or that's what it felt like).

I had a healthy pregnancy and my midwife was fine until it became apparent that nothing was going to go wrong to allow her to get out of delivering me at home. In the end she sent me for a scan as I was told my baby was "too big". I was scanned and told that DD3 was on the 97th centile. I knew the consultant as he'd found my fibroids after my first pregnancy, he has a reputation for hospital managed deliveries (I don't think it was by chance that she organised my scan with him). Luckily he knows me and my attitude to birth (which incidently is, happy to be in hospital, have the drugs and interventions, but only if I need it, otherwise, my body is designed for this so I'll get on with it myself) and so he said 'Yes, your baby is big but that's still on the normal spectrum, go home, have your baby'. A statement containing no concerns about my fibroids you notice!!!

Sure you could bleed out, but that happens to a tiny percentage of births whether at home or not. That's shite if it happens to you but there is no reasn that it should.

In the end my midwife (who'd been with me for the entire pregnancy) wouldn't deliver me at home. I wrote letters to the Head of Midwifery and the CEO for my hospital informing him that I would expect him to send me two midwives when I called in to say I was in labour (as is yours and every womans right!). It was a judgement call I had to make, but the most experienced midwife who did homebirths in our area, had said that were she not on leave she would deliver me.

Later that day I went into labour in front of the most senior midwife in our area who was there to discuss my care plan for me to have my child at home. (I had no idea I was having contractions but she said I kept grimacing slightly!)

She left and after labour was established DP called the midvives as normal and I went on to have DD3 (in water) and was in my own bed with a cup of Earl Grey made just how I like it, in my favourite cup with my beautiful baby. No problems.

Don't be scared, see if there is a local homebirth group to support you. (They are not loonies who want to free birth or whatever it's called when you do it with no-one else there). They know who to contact and have templates for letters you need to write and most importantly they support you whilst the most senior health care professionals scare the wits out of you with horror stories.

It's your decision (and things can go wrong) but they'll help you get the headspace you need to make your decision.

HTH

Anyway, later that day

I suggest you check out www.homebirth.org.uk she has collated a whole load of research on homebirth and should be a good resource. I haven't yet seen anything on there on fibroids but almost every niggle i've had about homebirth has been on there.
The other place to have a look is NCT you can also phone and ask for advice.

Can I also say I am totally appalled with both the midwife and the consultant. they should discuss the risks with you to allow you to make an informed decision. there are risks in any choice you make about birth but it really up to you to make those decision.

Oh and can i just say the midwifes comments are ridiculous. Having seen three woman give birth I'm so so so keen to have mine at home because I know it can be a positve wonderful experience.

I really hope that you get the birth that you want. good luck

As a midwife I'd be a bit nervous about a home birth with fibroids. But its your choice at the end of the day, if I was your m/w I'd advise against it but support you if you still chose to go ahead. I'd certainly recommend that you have the syntometrine injection.

Viva do you usually deliver ladies at home or in hospital?

I agreed to syntometrine, I agree with Viva on this point, I think it's a sensible point to compromise on.

Thanks for your replies everyone. It's really helpful to hear both sides.
I had a look at the homebirth website you suggested hazchem and couldn't find anything on there about fibroids either.
Just wanted to clarify that it was the consultant who made the comments as I didn't see the midwife today. I plan to discuss it with her once I've got my head round what was said today.
I think it's the way I was made to feel like a silly hippy for wanting to give birth at home that's narked me most. I don't have any ideas about it being spiritual particularly and I'm perfectly willing to accept that things may not go to plan and I may need a plan B. BUT, the damn things aren't in the way and it's going to hurt wherever I am so I'd rather be comfortable at home until something happens which dictates otherwise.
MarniesMummy thanks for your positive story, it's made me feel at least I'm not completely mental!
Does anyone else have any experiences to add?

Hospital, so I guess you could argue that I'm not as confident in home births. However I am a big supporter of them.

I've delivered a couple of women with known fibroids. One of them was fine, no more bleeding that usual. The other bled like mad and we struggled to stop the bleeding, synto IV infusion, heamabate, rushed to theatre to have uterus packed and also emergency blood transfusion. None of which would be possible at home. Yes it could have happened to someone without fibroids but its more likely to happen if you have them

You need to ask your midwife what she would be able to do in the event of a PPH at home. I'm guessing apart from cannulate and rubbing up contractions/bi-manual pressure there isn't a lot else they can do till you get to hospital. Of course you might not bleed, or if you did then rubbing up a contraction could be enough to stop it. No crystal ball though so no way of knowing.

I'd talk to your midwife and see what she says. Also see if you can find out any figures for how likely it is to have a PPH when you have fibroids. If its a small percentage risk and you're happy with that then go for it.

What's syntometrine?

Syntometrine is the injection to help deliver your placenta, it encourages your uterus to contract. The danger of fibroids is that the uterus can't contract enough for the walls to press against each other and stop the bleeding from the placental site. So anything that may help the uterus to contract is good.

I'm interested to read this thread.

I found out I had small submucosal fibroid at the fertility clinic one month before I fell pregnant. I did have symptoms (heavy periods, mid-cycle bleeding, long cycles). At the 12wk scan it still showed small (2cm). I saw the obstetrician a few weeks ago and was so relieved when she said 'it's small, it isn't obstructing the baby or cervix, we'll confirm on the 20wk scan but if it looks the same you can transfer to community midwife care and I won't see you again'. I had the 16wk check today and raised the subject of a homebirth and my midwife seemed positive. She advised I have a syntometrine injection to deliver the placenta, fine by me. I know it's early days and things could easily change but it's my 1st baby and I'm enjoying the reading and preparing...

Ihopeyoudance what size are your fibroids? Your consultant sounds horrific, can you ask to see another?

I signed up to a homebirth yahoo group which I've found interesting - you could post your question on there? health.groups.yahoo.com/group/homebirthUK/

It's good to know that such a thing exists Viva, thanks. See, this is the kind of information I need to make an informed choice (take note nasty consultant! )

newyearsday my fibroids are about 5cm long but only stick out about 30mm apparently, and they are well out of the way of the cervix and baby. I was expecting a reaction more like the one you had to be honest, as I thought consultants had enough to do.

Do you think it is common for doctors to try and bully people when they're a bit vulnerable? I would have thought a more measured approach, stating risks and benefits, so people can make their own decision with the risks they are happy with, would be more appropriate. I hope that's more common but I'm starting to doubt it is.

I hope you get the birth you want newyearsday.

Ihopeyoudance

You said it, your obstetrician is a 'bully'.

Have you discussed it with your midwife?

If she's not supportive an alternative might be to pay for an independent midwife, if you can afford it. www.independentmidwives.org.uk/.

Thanks lots, I hope you do too!

Your obstetrician is a big bully and you should report their negative response!!! Go see you midwife, she'll be much more reasonable and take time to talk through with you. I'm a midwife - NOONE can deny you a homebirth, and any midwives that do come to you are contractually obliged to support you. Fibroaids are not necessarily a problem - I would recommend having a managed third stage to reduce risk of bleeding. Home births are amazing and just because you may have "risk factors" does not mean that you are "high risk!"

Hi,
I supported a woman in the summer who had received a similar response to you. She gave birth without any problems, bleeding was minimal.

the important info is:
fibroids away from cervix?
fibroids clear of placenta?

If you can answer yes to both of these questions you have just as good a chance of having a successful homebirth as anyone else.

don't give up, if this is what you want to do.

greetings,
Anja

Just wondering what you decided in the end? I’m in the same position as you were in.