Those of you who had or planned homebirths- how far from the hospital were you if you needed to be transferred?

[bubbleymummy]

Hi,

Not expecting but planning DC3 for this year. I like the idea of a homebirth but we are now living 45 mins away from the nearest maternity hospital and I would worry that would be too far in case of an emergency. Although, I also think I'll worry about driving for 45 mins in labour so I could be a bit stuck either way! What are your experiences/thoughts?

TIA

I have had 2 hospital and 1 homebirth (my third child)

With my first I lived 5 mins from the hospital planned homebirth, but labour was very long and back-to-back labour, so in the end I requested transfer to hospital. Ambulance took less than 3 mins to get me there.

With my second I lived an hour away from the hospital, had on/off pre-labour for 5 days and they would not discharge me from the hospital, but probrably was a good idea as when it kicked off it was only 2.5hour labour and dh just made it in time to see the head crowning!!!!!

With my third, as was still living an hour from the nearest hospital I requested homebirth, I found a wonderful independant midwife and was all set to go. Then found I had group strep B so was no longer allowed to have a homebirth. When the labour started I was very quickly progressing so knew it would be safer to travel with medics. Called an ambulance and the independant midwife. Considering the first half an hour I did not know I was in labour, and the whole thing took 1.5 hours, if I had got in the car, the baby would have been born on the side of the road or the hospital carpark......!!!!! I am very grateful to the independant midwife who came and confirmed it was too late to transfer me, I was giving birth then and there at home.

I have to say my homebirth was the best experience ever, despite no pain relief (not even gas and air) it was fantastic. Fast and furious, but magical afterwards to get into my own bed.

If you have a history of fast labours, then I would definitely have a homebirth plan in place. If your labours are not fast, then you have all options still to consider

I fully agree with your first paragraph Ushy- with my home birth everyone was just that much more alert starting from ante-natal appointments right through to delivery. In my case though I am comparing it with being a low risk person in a consultant unit - where they seemed very a bit complacent.

Overall, homebirth is probably a teeny tiny bit less safe for a low risk woman and baby than having the baby in a consultant unit but the evidence is flaky. (Planned homebirth women having about the same risk as ALL women including the high risk ones in a consultant unit).

I haven't read the article, - but just reading MN and seeing how many women are left unattended in hospital I wonder how can it be safer?

Margles - because obstetricians have a bigger role than midwives in preventing death and brain damage when things go wrong. (Google the Dr Rachel Joyce/Elizabeth Peacock study on obstetricians and perinatal mortality) Midwives alert doctors to problems and it seems to be something to do with the time lag between the decision to do something and getting the baby out that makes the difference. Even an absent midwife is going to hang around the mother in hospital if the baby's heart is giving cause for concern.

The problem with homebirth is that the MW may recognise a problem, then she has to phone, transfer the woman into an ambulance and out the other end THEN she is assessed by a doctor. Basically it takes longer and in the unusual case where the baby's heart suddenly starts to deteriorate rapidly it can take too long.

That said, it is incredibly rare - (off the top of my head only 1 death in a 1000) and in many other ways home birth has lots of advantages for women who really want it.

People just have to decide for themselves - the tiny risks of homebirth are comparable to lots of other risks we take like riding bikes or crossing the road.

Hmm, but if the midwife is absent how is she going to know that the baby's heart rate is deteriorating rapidly?

To me, the big, big advantage of a home birth was the one to one midwifery. The risks when slammed onto the CLU production line were in my opinion much greater. As you say though - we need to decide for ourselves.

Why does your dh prefer the mlu? What does he think that offers that hb doesn't? One thing that sold my dh on hb was the lack of visiting restrictions, he hated the idea of having to leave us to go home to an empty bed.

Perhaps you need to have a heart to heart with the info in front of you, or both at a mw appointment. Perhaps there is a local hb group you can attend. You need to find an arrangement that both of you are happiest with. That might mean educating him, or it might mean mlu.

The recent stats are suggesting hb is safer (mw crisis and. all) but stats and logic don't necessarily control your more primative feelings of safety. Personally I feel much safer and more relaxed at home, others are more comfortable in a clinical environment.

Margles, you raised a good point about midwives shortages in hospitals. About 1 in five get left alone in labour and that doesn't happen at home. However four out of five are not left alone for long enough for decelerations/meconium not to be picked up and dealt with quicker than HB so statistically hosptals remains marginally safer based on the flaky evidence we have.

There is a lot of RAW data showing home birth is safer but the problem is that hospital populations are not the same as homebirth populations. Nearly all the multiple births, the gestational diabetes cases, severe obesity etc will go to the consultant unit. It will always always have higher mortality but that does not make them less safe.

Also some studies look at ACTUAL successful home births and compare them with actual births in hospitals. This makes home birth look much safer than consultant unit because most babies that die following homebirth actually die in hospital after transfer. That said again, it is incredibly rare if the mother is low risk.

My personal view is that within the normal meaning of safe, homebirth is safe. It shouldn't be foisted on women who DON'T want it - midwives pushing hb is bad practice - but equally there are HUGE advantages for women who feel safer in their own home.

I would recommend people do their own research but do not assume that doctors try to twist the information to make homebirth look riskier - some do but equally some home birth protangonists twist the info their way. There all as bad as one another :)

Meant 'they're all as bad as one another:)'
Illiteracy was my best subject at school:)

You need to get your DH some information on home births. DH wasn't keen on an hb for DS2 but I got him some info and the mw talked him through it and he felt much happier about it.

We are now planning hb two from July.

I have had 2 hb's, am planning a third, due July. I live about 5 mins from the hospital, but know others who have had home births who live much further out in rural areas. They have been fine. If they need to get you to hospital, they will. Also, midwives are trained to spot any difficulties so will be able to make a decision probably before you are aware of any issues.

HB's are not for everyone, but mine were fantastic. Hubby not keen for the first one - just automatically assumed all babies should be born in hospital - but didn't murmur for pg2 and now pg3.

when I gave birth in hospital in scotland last april I had 3 midwives (including one senior) all of the time, and 2 MWs the rest of the time. (was a normal water birth). So not all hospitals have shortages...

I realise I didn't answer your original question about time to hospital.

I was 35 minutes from hospital for my HB. The reason for having an HB was distance from hospital for me. I have short labours and didn't want to travel that far in hard labour. I always figured and ambulance would get me there quicker than DH if there was an issue.

I booked for a homebirth to ensure I received one to one care. I'm a midwife. Nuf said.

Thanks everyone!

DH was very pro my planned homebirth with ds1 but we only lived 5 mins from the hospital. The mwl unit option that he prefers is actually in the hospital so no distance to transfer!

I'm a bit of a worrier too so I know I need to feel really confident in my decision. I was 100% sure about my Hb decision for ds1. If we lived closer to a hospital I know I would have no qualms now either. I just like having backup nearby! Clearly I'm a bit pathetic :(

You're not pathetic, you are trying to do what's best for your baby!
Much better you find your truth now, than go for hb as the "noble" thing to do and end up transferring because in the reality of labour you realise you wanted to be in the unit.

I have had one hospital and two home births. I wasn't left alone at all during any of them. I had a midwife with me for more time with each baby (unusually) as my labours got longer. With the first homebirth I lived one mile from the hospital, with the second I lived 4 miles from the hospital. The second homebirth was in January last year when there was a lot of snow. I had decided to go in in case an ambulance would have trouble getting to me but in the event it happened on the first day that the snow had gone enough to drive normally. As far as I know there is no research that suggests that distance from hospital makes a difference to the safety of homebirth. As a midwife myself I have been to many midwife led and home births 10 - 15 miles from hospitals without any problems.

Also as an aside, I rarely leave women in established labour, if I do it is usually to get something that I need for them, or a for myself, which I would drink in the room if she were needing my support. I work in a very busy unit, but am surprised at the amount of women on mn who have been left alone as I don't think it happens too much where I am. If I do have to leave someone I always make sure they know how to call me, maybe I am just lucky where I work.

I have had one hospital birth and a planned HB 9 weeks ago. I was 15-20 mins from hospital, probably much less with blue lights. It was a fantastic experience, but I was quite nervous and not sure if I would go through with it whilst pg. I decided to book the HB anyway and get all equipment in as if I changed my mind I could easily go to hospital.

Once I got to about 37 weeks I realised I desperately wanted to birth at home. The midwife went through everything in terms of scenarios where I would transfer in and I felt confident and happy at home in a way I didn't in hospital. It was an amazing experience, just fantastic. Still hurt like hell :) but I coped so much better at home (I am quite scared of hospitals).

I was left alone in my first labour and didn't want that to happen again, so hired a doula which I can't recommend highly enough, whether you give birth at home or hospital.

10 mins away in car max. Having said that it took the ambulance an hour to arrive (in London). Lucky brilliant mws had managed to stop me haemorrhaging by then to be honest.. Having said that I still got my homebirth and the whole experience, even with the transfer and a blood transfusion after, was still much much better than hospital birth I had with number one. HTH

Hi Bubbly - I read your post with interest. I had a great HB with my 1st LO, we lived 10 mins from the hospital (so I guessed 5 with blue lights).

However we have since moved and are now 24 mins away (according to Google).

Thou I am no where near ready to have no. 2 my DH ans I were discussing this. He is very prow HB and can not see how the distance changes things but I have this small niggle that those extra minutes COULD make a difference.

I so would want a HB but at the same time I am not 100% sure, which is not good i think.

Sorry for bad typing, baby on boob:)