First baby at home - ok?

[amidaiwish]

my sister is having her first baby at home. please tell me she will be ok. i am worried about it. (had both mine in hospital and though both were straightforward i have heard so many birth stories where the baby really wouldn't have been ok, crash team called etc..)

Here's what I posted one a thread for someone thinking about a homebirth for their first:

"you aren't being silly - I had a lovely home waterbirth with my first and as a doula have supported plenty of first-timers who have had their babies at home in water. I've just put up a nice birth story from a first timer who I supported who had a water birth at home hackneydoula.co.uk/?page_id=239 .

Can you go along to a local homebirth support group? There's details here [www.homebirth.org.uk - that site is also brilliant for information.

I would also suggest thinking about a doula. I think you need a third pair of hands at a home birth (one to have the baby, one to look after you, one to open the door, fill the pool etc) and there are stacks of other reasons which I won't bore you with but you could look at www.doula.org.uk and have a poke around my blog.

If you think you'll feel more relaxed at home you probably will so go for it!

but...
what about if the baby gets stuck, shoulder dystocia or similar
what if the baby comes out not breathing?

both these things have happened to 4 people i know... if they hadn't been in hospital it could have gone seriously wrong.

i haven't tried to put her off by the way as she has made up her mind and has researched it, she's done a hypno breathing course etc... but she talks about all the benefits, which yes i can see, but they all sound like benefits to her. what about the baby if it needs urgent medical attention at the delivery/immediately after?

I would say it is worth a go as long as she is not too far from a hospital with a consultant unit, as you have said, anything could happen (shoulder dystocia with my first so I know exact where you are coming from, but am well aware that it is uncommon).

well how far is not far?
10 mins in a siren on ambulance i suppose...

NCT has a good leaflet on homebirth and explains the evidence that as long as the pregnancy has been problem free then it is probably the safest option for mother and baby. I recall they say 70% of first timers aiming for a home birth deliver at home and 30% have to transfer to hospital at some point but even then still have a lower rate of intervention when they get there.
I am planning it for my first.

no-one can tell you she will be ok. they can't tell you that if she goes to hospital either.
I only know of 2 babies who have died during/straight after birth. Both were hospital births.

I know you are worried, but it is her choice and she clearly has the backing of her midwives etc.
homebirth is no more dangerous than hospital birth.

a friend had a baby at home with a shoulder dystocia. what happened? the same as would happen in hospital! mcroberts manouvre. healthy baby delivered.
if the baby isn't breathing an ambulance will be called and the midwives will do exactly what they would do in hospital

I had my first at home in a birthing pool. It all went really well and quite quickly - active labour for only about 6 hours. If I have anymore I would definitely want them at home if I can.

I put the quickness of my labour down to being relaxed and not having to go anywhere - the midwives came to me. And as it turned out if I had gone to hospital it would've been at rush hour and I might not have even got there!

In making the decision I did attend a homebirth support group which was really useful. One point that was made there is that (especially with the first) if there are any complications they are very unlikely to arise quickly and the midwives would have plenty of time to arrange a transfer to hospital.

Lots of studies have shown home births to be just as safe as hospital birth and the chance of intervention is obviously much lower.

I can understand your concerns about the baby but the midwives are experienced and able to deal with a baby not breathing - they have oxygen and suction with them.

In fact I was transfered to hospital after the birth due to tearing and blood loss. It wasn't an emergency but was handled really smoothly. And by then I had my baby and couldn't have cared less!!

The most important thing is that your sister is happy and relaxed about her choices as she's then most likely to have a good birth experience.

I had my first at home (and second and hopefully third soon). It was all fine - wonderful in fact. The one thing that made me feel a lot better about having a homebirth was talking to someone who had planned a homebirth and had to transfer to hospital. Knowing what would happen in the event of something going wrong made me feel a lot more confident about at least trying to have a homebirth.

The great thing about a homebirth, for me, was that I had 2 very experienced midwives with me for most of my labour and birth. They could pick up problems much more quickly than at a hospital where you have midwives looking after multiple women, shift changes, and just the general hubbub of a hospital. I fully believe that if I had laboured with DD in hospital it would have ended in c-section. She was back to back and stuck on an anterior lip. Having 2 experienced midwives meant they could talk me through it and everything turned out fine. Left to my own devices in hospital it would have been a very different story.

Problems do happen with homebirths, but they also happen in hospital. If you sister has really done her research then she is thinking about the baby just as much as she is thinking about herself.

ok thanks everyone for the reassurance.
i really do support her choice and haven't said a word against it.

Benefits are - you are so much more likely to get one to one midwifery, and two for the actual delivery itself. A good midwife will anticipate problems and seek ways to prevent them.

Midwives are trained to resuscitate new babies and deal with shoulder distocia. Shoulder distocia will be dealt with the same way at home as in hospital.

She would be advised to transfer if the midwife thought that problems were likely to occur, or if she wanted more pain relief.

Much less likely to have routine interventions which may be the cause of some/many of the problems.

More beneficial for the baby - the woman is much less likely to need pain relief, more likely to establish breastfeeding.

I had my first at home - no problem at all and we were actually significantly closer to the hospital here than we would have bene in the MLU if anything had gone wrong. If we ever have #2 it will definitely be at home if possible!

I planned a home birth with my first but had to transfer in with suspected meconium in the waters. I was about seven cm at the time. Ds never showed any signs of distress and when he was delivered they decided there hadn't been mec. The waters had been a slightly odd colour and they weren't quite sure, and had transfered just to be safe.

I am pg again and will definatly be going for a homebirth again. I know that midwives hold both patients safety as paramount and will not take risks. Incidentally perhaps it is this same drive, a bit overgrown thanks to all the equipment to hand, that leads to unnecessary interventions (which carry risk) in hospital.

thanks, very reassuring.

Im planning my 1st baby to be a home birth. (still only 17 weeks)

It is one of the safest places to give birth to a baby (that has now huge complications)

I see no reason to be in hospital, because my body is doing something that its designed to do, and that all my ancestors have done for centuries.
Can always be blue lighted to hospital if necessary, but i really hope its not!

across the globe nannyl do you know how many women die in childbirth?
a scary amount.

not saying that is going to happen, it doesn't in the UK due to our midwife care, just had to respond to your comment "I see no reason to be in hospital, because my body is doing something that its designed to do, and that all my ancestors have done for centuries."

don't mean to be inflammatory, sorry if i offend, but giving birth is not without risk.

Oh i agree... of course there is risk

I meant that in the sense that i have researched my family tree and am fortunate enough to go back for many many generations on almost every branch.... and none of my ancestors appeaered to die during child birth, based on all the records i have found, and the ages they were when they (my great... grandmothers) died.

I imagine that quite probably many of their friends / sisters etc might not have been so lucky.

I still see no reason to go to a hospital, when a midwife will come to me, (yes lucky to live in England and have the NHS) and care for me in my own home, where i am even less likely to need intervention than if i were anywhere else

no idea what happened to italics... only the words my were supposed to be in italics!

Sorry amidaiwish - I don't think anyone is saying that childbirth is without risks but we are not presumably talking about a woman who is poorly nourished, without access to clean water and sanitation, with no access to health care professionals, no antibiotics, possibly suffered genital mutilation, started bearing children in her early teens and is now on her fifth child at the age of 20.

But if you are going to bring up the issue of women dying in childbirth - you might like to ponder why the US - the home of medicalised childbirth has one of the poorest records in the developed world.

agree with margles, intervention does not remove risk, just brings different risk.

And there is lots of (at least anicdotal) evidence that nannyl's attitude can be very helpfull. (there may be more rigourous evidence too but i wouldn't want to say).

Fear and nerves (ie of dying) increase adrenaline, which is the enemy of oxytocin, the hormone that drives good steady contractions (and therefore a smooth labour).

I'd really recommend that you read Ina May Gaskin's guide to child birth op. It will reassure you about the normalcy of what your sister is doing. Ina may is an independent midwife in the states with an increadable track record (in a land that has a terrible one as margles points out.)

I had my first at home, and it was great - for me and DD. I could find no reason not to have my first at home. The more research you do into HB, the more you realise how safe it is. I had one to one MW care (and 2-1 at the point of delivery), felt truly accompanied through the process and utterly safe and supported. I don't know many friends (sadly) who have felt the same giving birth in hospital.

I find comments such as, "but she talks about all the benefits, which yes i can see, but they all sound like benefits to her" really hard to read, as it is very hard to separate out where a mother feeling safe and well supported during labour, and receiving uninterrupted qualified care, being able to have unlimited skin-to-skin, establish feeding, wash in her own environment and rest in her own bed, eating her own food, and control noise, light & visitors, does/does not impact on the baby.

I am not knocking hospital births for others, and indeed would agree to an assisted/medicalised delivery if advised, but where all things are equal, I would go for HB every time.

Hi OP, I was a first-time home-birther and it was really fantastic. Three other mums I know also had HBs for their firsts - lovely stories all round. I know quite a few mums through mum and baby groups, NCT etc, and without exception the home-birthers had better birth experiences than the ones who chose hospital births. My own relatives were concerned at first but now aren't batting an eyelid that my second is about to be born at home too, they know what an easy time I had first time round!

I understand why you are concerned for the safety of a loved one but rest assured it's very likely that everything will go to plan. Enjoy being an auntie!

Hi OP, this is an old thread, but really helped me to make my mind up: www.mumsnet.com/Talk/childbirth/573041-the-thread-for-first-time-home-birthers-or-thinking-about?pg=40

I'm 21wks and I'm definitely having a home birth. My 3 best friends who all have 2 yr olds think I'm mental, but their circumstances were different (2 were induced) and I have the benefit of their experiences to point me to what I don't want. Plus I detest hospitals and my DH does too. I can't think of anything better than being relaxed, active, and DH making me a cup of tea and a sandwich while I relax in bed with the bairn. The one to one care from the mw seems to me to make a huge amount of sense as well- why would you share?! :) am v aware tho that I'm lucky to have the NHS though too. I'm no fascist about any of it and will transfer if it's recommended, but see no reason why that would happen. I'm no earth mother either, but your sister might want to look into visualisation techniques- seemingly they can be v powerful in helping with a relaxed (as it can be!) birth.
Hope all goes well for your sister, and you!

thanks everyone, you have really reassured me.

i suppose i had such a good experience in hospital - single room (kingston), midwife with me from start to finish, support to establish bf, no complications etc... that i didn't experience the downsides.

It was partly because my hospital would have been Kingston that I went for home birth so it does show how much is perception!

That said, the local midwife was very anti home birth and I ended up going with independent midwives who were absolutely fantastic. Could not have asked for more. In fact, one of them delivered all 3 of my babies over 7 years and a move!

In terms of concerns, while I was having one of mine, a friend who is an obstetrician had hers, at home. Her reading of the statistics is that there simply aren't the figures to show that one is safer than the other in terms of deaths but in terms of other indicators such as infection, intervention etc home is safest for both mum and baby. Her colleagues were far from supportive but she's never worried about the opinion of others, though she was a bit surprised by how strongly they were expressed. (She did say that if she ever had another it would be hospital and an epidural, but that's another story!) Must say I was very impressed by an obstetrician who, by definition sees the things that go wrong, could see that her professional experience was not the be all and end all of birth.

I was also surprised by a midwife who did both home and hospital births who said that they tend to watch and wait more at home and intervene less as they don't have the back-up they would have in hospital. She didn't actually see one as better or worse than the other just the reality of each situation.