Homebirth, is it my right to have one?

[Manicmummyhavinabiccy]

Im 31 weeks pregnant and my MW has told me due to my anemia i'm not allowed a homebirth! found out they knew i was anemic 11 weks ago, but I only got told a few weeks ago in the hospital as I was addmited for blacking out.Tha MW says I wont be able to get my levels up by 36 weeks and thats when she will organise the homebirth, she is also telling me my Hb needs to be 11, but have been told it needs to be over 10, when I told her this , she got quite defencive, and told me there is quote 'no way i'm allowed a home birth'! I'm having nightmares about going into hospital, following a very tumatic birth and treatment with DC2! :(
I was anemic with both other DC's at the end of the pregnancys and in labour with DD1, has hb levels the same as now (8.8) but didnt have any problems, I live 5 min walk from the hospital so if there was problems I could get there fast. A few people have said i'm selfish, because is something happened to me, I would leave the kids motherless, but I would like, after 2 horrid labours, to have a nice experience! but this has also got to me, and I'm starting to feel maybe I AM selfish for wanting this :( It's also causing problems with DP, as I told him, if I cant get a homebirth, I will go tho hospital by myself untill my mum (who lives miles away!) can get here to look after dc ( they do not want anyone but nanny or dad) and he thinks im trying to take away the experience from him!but if I'm stuck in hospital, I dont want the thought of 2 crying scared kids to worry about as well I have read on other threads that you don't NEED permistion, but i'm not very assertive, and with the hormones on top, any confrontation, i just cry!
Should I just forget about my dream Homebirth????

you do have the right - they can't refuse to attend.

you are very definitely not being selfish.

from what you say the negative impact of being in hospital is real - have you had post-birth counselling to help you come to terms with this?

even if you went for a HB there is a chance of transfer in so it is best to try and overcome your fear.

given the situation - you need to talk to your DP and explain this to him.

given the practicalities - try and get an assessment of what the risks really are to you and your baby, taking into account the fact you may have to wait for childcare to turn up. Then make a decision.

I agree it is very hard to go against medical advice, butadvice is exactly what it is - they can't tell you what to do.

Well I dont know a lot about anemia, per se, but no-one can force you into hospital for birth.

If you phone for help in labour are they really prepared to not send anyone out?

If you are only 31 weeks now is there more you could do to increase your Hb? I refused to have blood tests in pg and then had a homebirth. I made sure i took iron tablets with oj everyday and had medium-rare steak and green veg for dinner as often as I could stomach it.

As I understand, the biggest risk in these circs is pph. If you've had 2 easy births before with no

You can have iron tablets, when you're pregnant, on prescription. (i have no official reference to this, but I had a friend who was given iron on prescription when she was pregnant)

You should eat as much food that contains iron as possible - meat, nuts, broccoli, that kind of thing.
Make sure you have fruit juice when you eat your meal, as that helps absorb iron, and make sure you don't have any tea (i'm not sure if you're allowed to drink that when you're pregnant anyway)

And, no, they can't refuse you a homebirth - it sounds like having a hospital birth will cause you more trauma and complications than any risk of a home birth.
Only you can make the decision, and don't let yourself be bullied, because that's just going to make you more stressed.

good luck :)

ask for a cosmofer.

it's a transfusion of iron through a drip, it would involve being in hospital for a day.

my iron levels were 6.1 on 25/11/2010 and had the cosmofer on 29/11/2010 my levels are now 10.9. thats without taking anu additional iron tablets for last few weeks. ask for it asap though as it takes about 3 weeks to work properly.

no advise on the homebirth thing, but i'm not allowed to go to the midwife led unit for the same reason, even though it is on the floor below the cons led unit

friends of mine recommend spatone. It's a natural source of iron so is absorbed by the body much more easily than iron tablets. Drinking it diluted in orange juice optimises absorbtion (vit c in juice). you can get it from lloyds the chemist, i think, or online.

hope you get the birth you want!

I would ask your mw to explain what the complications could be so you can make an informed choice. I was fine with my 1st 2 but needed iron tablets for this pregnancy. HB wasn't that low though (10 something) and I didn't loose much blood with last 2 so mw is happy for me to have another homebirth (will be my 3rd). She retested my iron levels a couple of weeks ago but didn't have the results back and has still booked me in for a homebirth. If the only issue is potential pph and you had no major blood loss with your last pregnancy then I can't see what the problem is. My mw reassured me with my 1st if I had a pph they could get a line in for fluids and i would be fine untill i could get to hospital - mine is also 5min walk away.

Take a look here: www.homebirth.org.uk/youcant.htm#9

I would second spatone and Floradix. Spatone has a leaflet in it which tells you which foods to take it with (and avoid) to aid absorption.

You have weeks to up your levels, start glugging

It is your right to give birth wherever you want, but I understand how hard it is to go up against professional advice - I'm in the middle of doing the same thing myself!

I also feel cross on your behalf that they didn't tell you about your low hb sooner when you had longer to do something about it - such a shame.

I had a huge pph bleed - about 1500ml - with DS1 (7yo) at hospital after a long and eventually instrumental delivery.

Then with DS2 (2yo) I had an unplanned homebirth since he was too impatient to wait for me to go to hospital! I only bled about 500ml-ish and it was easily conrolled by the midwives. I was also slightly anaemic by the end of pregnancy but still over 10.

This time I want a planned homebirth. The experience was SO much better than hospital, but the midwife has told me it's a high risk birth because of previous pph's. (Although the birth itself should be fine). She made a consultant appointment for me (without telling me she was doing so - nice compliance with informed consent policy there ) who she also told me that she wouldn't recommend a homebirth. Both tried to put the fear ofd God into me about bleeding to death and leaving 3 kids with no mummy.

I have discussed my wish for a homebirth with my midwife, and despite her advice she has quite clearly stated I can plan for a birth wherever I want. She will be getting her manager to meet with me (she is experienced in high-risk homebirths) and says I can still plan for it if that's what I want. I am relieved about this, since it seems that the consultant completely missed my point - that since I had already had one fast delivery it was likely to be another and I would prefer to plan for a homebirth than have the added stress of an unplanned one like last time. Even the midwife said this was quite likely!! (Although I know it might take longer this time round).

I am prepared for a managed 3rd stage and will transfer to hospital if I need to but for me, I need to know I have planned for what I think is the most likely outcome. Surely this is what a plan is for??

I have also used spatone and at the moment am taking Floradix tonic - tastes yucky but midwife recommended it. I have 13 weeks to go yet and blood tests are next Thursday - so I will be eating steak and cabbage on Wednesday night and snacking on lots of dried apricots during the day, just to boost me up!

I think you need to try and get your iron up as much as possible, but if you are really clear that you want a homebirth then stick to your guns. If your midwife won't discuss it then maybe it's worth asking if there is a midwife who is more experienced in higher risk homebirths in the practice?

Good luck

Hi again, I wrote on your other thread, just wanted to say, I know how difficult it is, I'm not very assertive either and find it hard to have "everyone" against me.

I don't know anyting about anemia, my issue is gestational diabetes, but I also have 2 normal pregnancies behind me.

KirstyJC, same here, my second birth was so quick that we had an unplanned homebirth just 4 minutes after the ambulance arrived, so am quite nervous about how quick it might be this time around. Although knowing the MW and OB they will use that as yet another reason for an induction...

It's so hard when the people who are meant to be there for your support are doing the opposite to supporting you...

x

Another thing would be to ask how a PPH - if that's what the concern is - would be handled differently at home vs at hospital.

Good luck OP and I hope you get the birth you want. However can I confess that I got an uneasy feeling at the use of the words 'my right' in your thread topic in terms of having a home birth. I don't think any of us have a right to demand our births go in a particular fashion, not without admitting we have some responsibilities too. Nature tends to ignore such self declared rights anyway. I declared i was having a largely drug free water birth and while I managed the drug free bit, other than gas and air right up to the end, ended up in a high dependency ward after a huge PPH following an emcs. Porkchopster I think they handle PPHs pretty differently at home to hospital, I'm not sure but I don't think midwives come with blood and serum to hbs, and few houses have operating theatres and high dependency units. OP I hope these tips on raising your iron levels work so your risk levels are reduced because I found my PPH utterly terrifying and both me and my DH thought I was on my way out.
I hope this post hasn't scared you or offended anyone. I'd always hoped to have a HB the second time round if my first had been okay so I'm totally not against it. I just have a newfound respect for some of the risks. Good luck.

Hi there,

Just thought I'd give you these contact details for MIDIRS, who have a very informative booklet on the subject, supported by the Royal College of Midwives and the NCT.

freephone Informed Choice 0800581009

Also homebirth.org.uk, as mentioned by previous poster, has some good info as well.

Good luck. A homebirth is absolutely your right, if it is what you decide is best for you! I hope you find all the info you need to make an informed decision. The NHS will have to attend you, whatever you decide.

All the very best.

Thanks everyone for your help and links, spent most of last night writing up notes and getting prepared for my appointment with consultant, turns out I didn't need them! As In less than a month, my hb has gone up from 8.8 to 10.4! :) still have a little way to go as my mw says have to be over 11 but in the 3 weeks till I see her, I think I can get there :) just hope she doesn't come up with any other obsticals :/
hope all the other mums to be who are having problems getting the birth they want ( it seems there are quite a few! ) it all works out for you guys too x

Actually you do not 'need' to be up to 11 you could be 8 and still have a homebirth but that aside the usual guidelines for being considered anaemic is haemglobin at term below 10.5 not 11, ask her for written proof that this is their guideline as most hospital in the UK it is 11. This is also stated in the NICE antenatal care guidelines.