Your thoughts on home birth after a bleed at 36 weeks...

[victoriasmith]

Hello

Would just like to know what people think about my situation and whether any of you have had similar experiences. I really would rather not hear negative comments please from people who are against home birth any way though, thank you.

This is my first child and from the beginning of my pregnancy I have been planning for a water birth at home. However at 36 weeks (this monday) I woke to find I was bleeding and was admitted to hospital over night. After being scared to death by one consultant in particular who immediately began talking about us having the baby in the next 48 hours as they would need to induce me and the possibility of a c-section as well, we saw another consultant who reassured us, did an ultrasound scan to check the placenta which was fine, monitored the baby who was fine, and admitted me over night until the bleeding stopped. Overnight the bleeding stopped and by the morning the consultant was happy to discharge me, but not before telling me that a home birth should not be an option any more which was also plastered all over my notes, the usual "advised against home birth". I am having another scan at 38 weeks to check everything is fine and then going to full term but having my sweep a little earlier at 39 weeks dead on to try and get me going into labout a bit before 40 + weeks. The consultant also said they would want to induce me should I get to 40 weeks but to be honest I have instantly discounted this as it seems ridiculous.

In all my boyfriend and I were left slightly traumatised after this experience and it has taken me a long time to calm down. I am not wanting to take unnecessary risks with the health of my child but am also not willing to give up on my dream of a home birth as I feel the stress that I would be under should I go into hospital would affect my labour.

I am seeing my midwife to discuss our options with her next week but would like to hear if anyone else has experienced anything similar.

Apparently if I had had the bleed earlier in my pregnancy then by this point I would still be considered low risk and "allowed" a home birth. I know the decision is ultimately mine and that the NHS have to provide care at home if this is what I choose, I also know that the instant anything happens hospital staff almost have to suggest against a homebirth which is making it very difficult for us to trust anything the midwives and consultants are saying to us.

for a PPH, a midwife at a homebirth will firstly try and 'rub up' a contraction - give your abdomin a good rub and try and make your uterus contract.
An atonic uterus is the main cause for bleeding.

Blood pumps through the placenta at around 500ml/minute, once the placenta is out, the uterus must contract down to stop this bleeding - as you can imagine - thats alot of blood you can lose very quickly. The uterus generally contracts down no problem. If it doesnt, you can bleed like a tap on full force!

Secondly they would give you ergometrine - an injection to aid your uterus to contract.
They may also carry misoprostol tablets - these are given via rectum, again to aid contraction.

Followiing that if it hasnt stopped they would have to call an ambulance (they would have phoned one before that anyway, just in case)
you would need some cannulas in your hand ready for IV fluid and further drugs at the hospital.

They would also be checking that the placenta is complete and nothing is left insdie you and that the bleeding isnt coming from a tear.

Again - generally you dont bleed and your uterus contracts down lovely with no problems and you get to cuddle your lovely new born

thanks that's really helpful to know. So they would have ways of dealing with this at home.

I have also just been reading ladies stories of PPH on homebirth.org and have been reassured that even with heavy blood loss of 750ml there was still ample time to transfer to hospital. Thoughts ladies? I know some of you who posted before who have experienced PPH said you felt that being in hospital was the only thing that saved your life, would you mind if I asked for a few more details from those of you who dont mind sharing, such as how much blood you lost etc?

victoria - I lost 800ml and had no ill effects afterwards but I'm sure I would have been transferred to be sure I was going to be ok had I been at home. As it was they were very keen to hang on to me for a while and I'm sure I would have felt less tired had I not lost that much.
There are things midwives can do to help manage the crisis at home but a serious pph - which is more than the amount I lost - needs specialist attention, blood transfusion and potentially life support. The midwife at home is managing the situation as best they can, NOT dealing with it. It's not easy either to work out how much has been lost. It's always an estimate at least until they weigh everything they've mopped up with and even then it's not exact.

I think I lost about 1.5 litres - although the medical staff have always been very vague about it.

I assume it is very difficult for the drs to quantify so rather than accurately assess how much blood is lost I think they look at the effects and say "if this was the outcome then the amount must have been x". I may of course be completely wrong

More than the actual risk was the pure fear I felt. And that which my DH experienced. I know he would describe it as the most terrifying experience of his life and TBH he has had a few. If we'd been at home that would have been amplified 100 fold and honestly I don't know how we would have coped. It has had a big effect on him.

I don't want to turn this into a fright thread. I am being induced myself this week so have no wish to scare anyone but something else relevant to my story was that a few weeks before my PPH a woman died of a PPH at the same hospital. I didn't know this at the time (much later I met a friend of hers ) but I was told her death meant there had been a lot of full on "this is what we do in these circumstances" training in the weeks prior to my admission. So not only was I at hospital but at a hospital with experienced staff who knew exactly what to do.

Sorry just to confirm, I have no problems with transfering into hospital post delivery if necessary or even before hand if the midwife believes that things are not going as they should be or there may be a problem with the baby, I just want to try and decide whether to even go for a home birth at all after being advised against it by the hospital due to the bleed at 36 weeks.

I had a PPH of 750ml (in hospital) and it was only this week that I realised that it only classified as a minor PPH.

It was due to uterine atony (too tired to contract any more basically) which I put down to 17 hours of syntocin-forced contractions.

I don't know if being in hospital saved my life, I was given syntometrine, kept on the syntocin drip and afterwards I looked grey and had 9 weeks of iron tablets to take, but that was all.

thanks FLisspaps it stories like that which make me feel a bit better about still going for a home birth as the midwife would be able to administer the syntometrine at home before transfering me in.

Victoria one thing I have learnt about hospital births is that if everything goes well, there is nothing to stop you having a quick bath and going home straight away. So you would get all of the benefits of a home birth (being tucked up in your own bed with DP with you etc), but with the knowledge that the skills of a consultant are somewhere along the corridor in the hospital should you need them.

I'm fairly positive about homebirths, but I think pro-homebirthers might want to use the language "I'm hoping to have a homebirth" rather than "I am having a homebirth" as there are too many variables and, as other posters have said, once that baby is in your arms, you won't mind how s/he was delivered.

To second Nonno with my second DC I laboured at home for about 15 hours, went to the hospital started pushing, DC born about an hour after arrival and went home exactly 6 hours later and was tucked up in my own bed that night.

I got the reassurance of a hospital birth but the comfort of a homebirth.