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Childbirth

Share experiences and get support around labour, birth and recovery.

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Original poster

I can't have a homebirth because...

64 replies

trufflesbum · 20/04/2011 12:58

I'm 36+5 with my first baby. Midwife has claimed all the way through that she is supportive of my plan for a homebirth, but is constantly throwing things in the way. So far, everything has been by the book, but she tells me I'm "not allowed" a homebirth if baby might be big (he's measuring perfect), if he's early, if he's late, if my BP is high (it hasn't been), if there's meconium... There's also a large list of resons why I "have to" transfer.

I also "have to" allow the heartbeat to be listened to every 15 minutes, and must allow an internal at least every 4 hours. I am not wholly happy for either of these, and she can provide no logical reason for this other than it is "policy".

The most recent was at my appt yesterday, where she noted that the baby is not yet engaged. He has been head down for some time now but is yet to engage, which I gather is not all that unusual. Midwife says that if he's not engaged I "will not be allowed" a homebirth.

My reading suggests that some babies don't engage until labour starts. I'm also aware of the risks of cord presentation/prolapse and still feel that I would like to continue my plan for a homebirth.

Any stories of babies that didn't enage until labour started? Or suggestions of what to say to the midwife? I feel like she's determined to get me into hospital!

OP posts:

Are your children’s vaccines up to date?

Set a reminder

crystalglasses · 20/04/2011 13:06

Sorry but my first dc didn't engage until labour started and I ended up with an EMCS. You did ask. I would never have wanted a home birth anyway.

iskra · 20/04/2011 13:11

It soudns like your midwife is determined to get you to hospital! Maybe post on the homebirth thread?

HotchpotchHoney · 20/04/2011 13:13

is that midwife going to be your home birth midwife?

she will have protocol to follow that she must show in her notes that she has followed. However, if you refuse to allow her to listen in, she can document this, same with the internals.
Is there another midwife that works in your commuinty? It could be that your midwife isn;t confident in her ability to carry out a homebirth (it is her registration at risk should something go wrong) and another midwife may be more appropriate for you.

LynetteScavo · 20/04/2011 13:15

Ask her what the Royal College of Midwifes recommends.
My baby didn't engage until very late. She was born at home 12 over due.

For her to say "you are not allowed" a home birth is ridiculous. She can advise against a home birth, but you are not five for heavens sake!

LynetteScavo · 20/04/2011 13:17

If she isn't confident about attending a home birth she shouldn't be a community midwife.

Original poster

trufflesbum · 20/04/2011 13:21

Thanks all. You're right, I did ask Crystal! I just want to be prepared (and realistic).

I won't know who the midwife that attends will be until the time. It could be this her, but may be someone else. I don't mind her listening in, but every 15 minutes seems a little intrusive to me...

Will have a hunt for the homebirth thread.

Thanks again

OP posts:

frakyouveryverymuch · 20/04/2011 13:22

TBH your MW has pretty good reasons for most of those although I'm a bit about baby being big as a reason not to have a HB. I think she honestly is being realistic with you.

Early they won't allow, late you might need induction which needs to be done in hospital and if you have high BP then you would need to be in so they can deal with it, meconium is a sign of fetal distress etc.

They should be able to assess the risk of cord prolapse with a scan (more likely with low lying placenta etc) and that's a risk whether you labour at home at the start intending to transfer in or not.

Some babies don't engage and are fine. Some don't and aren't. Unfortunately there's no way of knowing.

Can you ask to see said policies? You might also want to familiarise yourself with the NICE intrapartum care guidelines which she ideally would be following.

LynetteScavo · 20/04/2011 13:23

The RCM say this; "Birth planning is a continuous part of antenatal care. This requires a good discussion about place of birth, at which ?women should receive clear, unbiased advice and be able to choose where they would like their baby to be born? (DH 2004). There is no evidence to suggest that it is inadvisable for women without complications to book for delivery at home or in a GP or midwifery unit"

You need to determine what exactly are "complications".

bigbadbarry · 20/04/2011 13:23

I had something similar with DD2 (who was born at home :) ) which is why I used an independent midwife for my third - I just got sick of it all. If you haven't already found it, I refer you to homebirth UK

Original poster

trufflesbum · 20/04/2011 13:27

X-post Lynette - I type too slow! Good to hear it's possible. I'm happy to listen to advice and don't want to put me or the baby at risk, but also don't want to be railroaded into something that I isn't necessary.

I feel as though she's using this as a reson to pursuade me to go to hospital, but could never prove it. She's made me an appointment at the hospital for 40+6, which she states is the cut off for him to engage. If he's not engaged by the, a homebirth is off the cards.

Have told her I will consider this closer the time, but will not blindly agree.

OP posts:

camdancer · 20/04/2011 13:27

She doesn't sound very supportive. My very supportive midwife did have a list of "have to's" before my homebirths but the difference is the way she said it all. At about 36 weeks I had an appointment where she made sure I was aware of all the risks of a homebirth and I had to sign something saying I was aware of it. But throughout that meeting she was still positive about it.

My list of "have to's" was similar to yours. They only do homebirths between 37 and 42 weeks and only if labour starts spontaneously (i.e. no inductions). Any meconium is an automatic transfer to hospital. I don't know about high bp as that has never been an issue for me. During my labours they did check the heartbeat about every 15 mins or so but they did it in a way that wasn't intrusive at all and managed it in whatever position I wanted to be in. The only internal I had was at the very beginning when the midwife first arrived, so definitely not every 4 hours.

I do think sometimes midwives use the 36 week appointment to see how serious people are about a homebirth. Being negative might just be her way to screen people out. Or she might not want to do them, so hopefully she wont be the one attending.

Prunnhilda · 20/04/2011 13:31

Intermittent monitoring is fine (and valid afaik) and can be done unobtrusively with a handheld doppler. Internals can also be done without you needing to be flat on your back. I don't like being told what I must and mustn't do, but I wouldn't waste energy being uncomfortable with those tbh.

There is time for the head to engage - that homebirth site is really good and has a lot of reading about what you can do to maximise your chances of the baby settling into a good position.

Your midwife does sound like a twit but if she's not going to be the one delivering the baby, you can tune her out a bit. Good luck.

bigbadbarry · 20/04/2011 13:32

PS My firsts didn't engage until in desperation I took castor oil at 41 weeks - she was born 18 days past EDD. First babies commonly don't engage in women of African descent too so if this applies, something to consider. Here#s another site to look at.

Original poster

trufflesbum · 20/04/2011 13:37

My concern frakyou is that she uses the words "not allowed" or "won't let" me. and that she's going to have real problems stopping me if that's what I choose. She can tell me that she doesn't think a homebirth would be a good idea beacuse of XZY, but she can't tell me I'm not allowed.

It would be great if she was 'screening', camdancer, as that'll save disagreements further down the line!

OP posts:

camdancer · 20/04/2011 13:57

It does seem that her approach is quite strict and paternalistic, but what she is saying seems pretty standard. The trouble is that by taking that approach it seems she has got your hackles up and instead of where you give birth being a decision you take together, she has made it a battle. Which is a shame - a good midwife should give you the information you need to make the decisions rather than making the decision for you. Hopefully she wont be the one delivering your baby and you get a more sensible midwife to deal with when it really counts.

Twit · 20/04/2011 14:09

I agree it's how it's said, even though actually it all seems reasonable. I have had 2 HBs and I was with a MW (or 2) the whole time for my 1st (3rd DC) and none with my 2nd (4th LO). I'm pretty sure I wasn't monitored heartbeat wise or internally for my first one at all except once as I started to push.

PollyFilla · 20/04/2011 14:12

It sounds to me as if she's putting obstacles in the way

This might be helpful:

\link{http://www.mrandmrssmith.com/destinations/france/paris/hotels\AIMS on homebirth}

(I've had homebirths, all was well, including first baby)

PollyFilla · 20/04/2011 14:13

This is more recent:

\link{http://www.aims.org.uk/homebirthUpdated.htm\Here}

gillybean2 · 20/04/2011 14:14

I had a home birth with ds1. I never had any intentions of going anywhere near a hospital and wanted minimal interference.

Every time I 'had' to go to the hospital they said I had to have a blood test. I said no... I agreed to have one and asked them to pick whichever was the best week they felt they should do it for whatever tests they needed to do...

Because I was determined to have a home birth I had to see teh consultant. Who tried to persuade me to go to the midewife unit at the hospital 30 mins away. I said what was the point, if I was going to do that then surely i should just go to the hospital (an hour away). After that they stopped trying to persuade me as they could tell I was determined.

And it was all absolutely fine and I would never have got to the hospital in time anyhow! I had an uncomfortable night. Couldn't settle as baby was in an akward position (realised after was early labour). Had a show in teh morning but still didn't feel like I was in labour but rang the midwife to tell her that it might be today. She took her time calling me back as being a 1st time mum it would be ages yet....
An hour later I phoned again saying I think someone better come fairly soon. So she then set off and arrived half an hour later and immediately called the second midwife. Who arrived pretty much the same time as ds did!
I only used a tens machine, had the one internal at which she said I was 9cm... hehe

Go for it. If you are happy, everything is how you want it, and there are no reasons to be worried then don't be worried!

PorkChopSter · 20/04/2011 14:33

You need Mary Cronk and this page

It's your choice, you don't have to do or allow anything.

spongefingerssavedmylife · 20/04/2011 14:41

Maybe she thinks you'd be better off in hospital? She may have more experience in these matters!

OnEdge · 20/04/2011 14:49

To your Midwife, I would say, thank you for being professional and informing me of my options and attempting to ensure that I give birth as safely as possible !

OnEdge · 20/04/2011 14:50

If it goes its up, would you trust her advice then ? Or will you still know better ?

OnEdge · 20/04/2011 14:51

tits up

wolfhound · 20/04/2011 14:52

I didn't engage until labour started - both times. Both straightforward births. Planning a homebirth with no. 3.

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