Ban Home Births!

[NHSsupporter]

This should be a topic that will get the "rights for women" brigade fired up!

I have listened for several years to a close friend of mine who is an NHS Community Midwife, and have decided that we should bite the bullet and BAN "NHS sponsored home births".

I make this suggestion based on, what I believe to be, several compelling arguments:

1. Child safety

2. NHS Budget

3. Parent welfare

4. In my friends experience between 33%-50% of all home births at 2 hospitals she has worked at in 2 very different areas, seem to end up in difficulties ultimately requiring the attendance of paramedics, an ambulance, and subsequent blue-light evacuation to hospital. Surely it would be better for the unborn child's safety and welfare for it to start being born in a controlled environment, where all of the necessary professionals are already at hand should the need arise, rather than having to be born in an emergency and potentially rushed situation. Surely the welfare of the unborn child should be placed ahead of a so-called "pleasant birthing experience" for the new mother.

5. The use of emergency ambulance resources in 33%-50% of cases and Community Midwives must have an additional financial implication, which is significantly greater than parents, in a controlled way, simply entering the hospital and giving birth in a building, which already exists and is already being paid for, with staff present whose salaries are also part of the fixed costs of running the hospital. In this time of austerity surely this would be a sensible cost-saving exercise.

6. Parent physical and mental welfare would be significantly improved if emergency procedures could be avoided. I would go as far as to say, that I bet that one or more of the annual maternal deaths could be avoided.

I repeat, surely the welfare of the unborn child should be placed ahead of a so-called "pleasant birthing experience" for the new mother.

Comments welcomed?!

One wonders then what the reticence is to promote widespread HB for low-risk women. Surely it can't simply be to do with Doctor's self interest and empire building?

Maybe GPs and MWs would rather the mother to be aproached them WRT HBs? Which is sad I think, if it's because they're not allowed to suggest it.
I had no mention of the possibility of a HB until I brought it up, then every MW I met was really keen - excited even and really supportive. The only negative voice(s) I've heard have been in a non professional capacity, but I think I've been very lucky in this regard.

I have had two hospital births as well, both were fine, although I was more uncomfortable and stressed as I only just got there, which made for a stressed baby which isn't great.

My opinion is that for a normal healthy woman with a normal healthy pregnancy HB should be offered as routinely and equally as a hospital birth in most cases (first timers and distance I'm more on the fence about)

The last government IIRC were very keen on growing (right word? mind is a blank) HBs. I think the barriers are culture and training related. It's a cyclical thing - we have so few homebirths, because we have so few homebirths.

Back in the 1950s - 60s there was a big push to get women into hospital for birth. Since then we have had decades of, for want of a better phrase, anti-home birth propaganda - the 'do you want your baby to die?' sort of stuff.

There is no reason now why there couldn't be a similar push to get women to consider home births BUT we would have to make sure that the Community Midwifery service was staffed for it.

It could be done if the will was there - just saving on the costs of hospital beds would go some way to funding it.

It used to be that you had to beg or pay to get a place in hospital to have a baby. I would not like to see women being forced into a position like that. However I do think sometimes there is too much hysterical scaremongering about HBs in the absence of hard data.

For women within an hour of hospital, who have attended all their ante natal appointments and who have no existing health problems, it is a perfectly reasonable option. If midwives and obstetricians were all required to attend a couple of HBs as part of their training (just as they have to attend water births before being in charge of one, for example), it would become more embedded in local provision, as it is in Holland and Japan, for example. Then we would be upskilling medical staff and making sure that HBs became even safer (I note that the only recent maternal death in a HB situation was because a mw was too lacking in confidence to give an injection for postpartum haemorrhage, even thought it was clearly indicated, which would suggest to me a lack of training and a degree of professional negligence rather than a problem with care at home - this sort of thing can and does happen in hospital as well, particularly when there are staff shortages).

Hospitals in the meantime could be freed up for complex cases, multiple births, deliveries for women who lived too far away from hospital to be comfortable having a HB, very young and very old first time mums, and mothers with little support at home or psychological issues surrounding birth. Then we could use the spare money to improve care in such cases and leave the normal births and postnatal care in the community, where they naturally belong.

But until people start examining the data closely, and collecting proper stats about risk rather than scaremongering, it is unlikely this will happen.

Absolutely agree with you BoffinMum.

Didn't the woman who died die after 6 hours in the hospital? What were they doing for all that time? Of course, it was the home birth midwife who got the blame.

I don't know much about it, but invariably when mothers and/or babies die, it is a chain reaction of multiple errors (one of my best friends lost a perfectly healthy baby that way once).

"For women within an hour of hospital, who have attended all their ante natal appointments and who have no existing health problems, it is a perfectly reasonable option".

Throwing you a curve ball - is it not 'reasonable' for those of us who don't comply with these conditions to also make an informed choice to have their baby at home? I had gestational diabetes and was carrying a large baby. Was rejected by the community team as a good candidate for a home birth. Went ahead and had baby at home with an independent midwife, after careful consideration of particular risks and benefits.

I have met other women who fall into the 'high risk' category who have also opted to have their baby at home (high BMI, VBAC, gestational diabetes, breech, twins).

It does happen - usually with very good outcomes. Problem is that home birth is so rare for women in the UK with health issues that no good research exists which helps those of us who fall into this category make a reasoned choice, and hospital is the 'default mode'.

Cleo, it's surely ultimately up to the mum, and independent mws are a lot more skilled in facilitating HBs with tricky situations anyway. the more we normalise HBs the more skilled teams will become and the better the outcomes for everyone.