I can't have a homebirth because...

[trufflesbum]

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!

Just a quick addition - the time to theatre, if it comes to that, starts once you have called your ambulance (they'll be ready for you on arrival) not once you get to hospital. So assuming your hospital is not 4 hours away or something, that needn't be an issue.
(Sorry, am not articulating very well - what I mean, i suppose, is that an emergency section even if you are in a hospital anyway is not instant but takes a bit of time to set up for and you don't necessarily need to be there in the hospital while they are doing that setting up.)

It's true Tangle that if midwife had been observing more closely that my CS wouldn't have such an emergency as they would have noticed DD's heart rate dropping earlier and attempted ventouse and forceps earlier when she wasn't so weak already. I was just lucky that a consultant who had been called in to attend a private birth was passing as midwife went out of room to call someone. I actually feel that the staffing level, quality and the very medicalised attitude of the hospital actually resulted in me needing a EMCS so am not for hospital births per se. In fact I would have been up for a HB for DD's birth, but was living in a hostel at the time so not exactly the right environment as bathroom and kitchen communal. I feel I actually would have been more comfortable at home, would have been able to labour in position that I wanted and would have had a quicker recovery and less traumatic start to motherhood. Left hospital after 2 days at earliest opportunity as other babies kept waking DD up every five minutes.

Mamatomany - you're right every birth is different MIL had 5 and SIL had 6, all completely different. If there are no clear risk factors i.e. placenta previa, pre-eclampsia etc... then you really can't tell.

Bigbadbarry is right in my case the theatre was being prepped from DD's heart rate started dropping, the MW would call ahead and arrange with the hospital that you were coming in if in the worst case scenario you did need EMCS.

Something else that occurs to me is that your midwife has seem too many women with their absolute heart set on a home birth that doesn't happen for many reasons, and the subsequent devastation, feelings of failure and PND that can follow.

I don't necessarily agree with how she's communicating things, but maybe she's also trying to avoid you focusing solely on a HB.

Do hope that it works out for you.

I wouldn't complain just yet. I would wait and see what happens. It may be the mw knows something about transfer in rates and she's trying to warn you or just give you the facts so you're prepared. So much of imparting that knowledge is subjective and often better assessed with hind-sight.

I doubt there will be that many first time home birthers between now and your delivery so you don't need to feel responsible for anyone else's potential experience for a bit. Just concentrate on getting through your labour and birth first because you and your baby are undoubtably your first priority and that's as it should be.

I do understand this all feels so important right now but you can make all the plans in the world and still have your body/baby do something completely unexpected and make all those plans obsolete.

I hope you get the birth you want and it all goes to plan but don't be too disappointed if it doesn't happen. Healthy baby and healthy mum are the only objectives in this birth business.

Best of luck

Thanks all. Some very interesting reading.

Just want to stress that I am aware that I may need to transfer. I'm less than 10 minutes blue lights to the hospital and am happy to transfer if needed. Hell, I might even change my mind on the day and decide I want to be there in the first place!

What I object to is being told what I can and can't do. I agree now that much of what she says makes sense (though still not convinced about him needing to be enagaged), but also that the way she says things has indeed got my back up! There's been so many "you can't", "you won't be allowed" and "you must" that I maybe its making me a little stubborn...

As for monitoring, maybe I'll see how it goes on the day. I'm not entirely convinced of the clinical need of this much monitoring, but appreciate the midwife has rules to follow.

Will have a think about how to approach her about her choice of words, as it really has made things an issue that didn't need to be. Had she of used phrases like "we'd prefer it if..." or "we would suggest..." I may have been more receptive.

I am sympathetic about the monitoring; that's useful information to help her do her job....Which should be more in the tone of advice rather than CAN/CAN'T do statements, but I suppose they have to keep the tone simple for many people.

I know several people who had successful and rewarding first-timer homebirth experiences, btw. You can do it.

Homebirth.org.uk website and email lists are your friends!

I think almost everything she says is sensible - and I wouldn't worry at all about the monitoring - I didn't even notice them monitoring the heartbeat in my 3 homebirths, but with ds1 in hospital he did have late decelerations, which can be a worry.

Agree the language is a bit off - with my 4th baby (and 3rd homebirth), my mw (who had broken the waters in the previous 2 homebirths) didn't break them, because he was very late and she suspected there might be mec in the waters, because of his lateness, and mec in the waters is automatic transfer to hospital, so she really wanted to leave it till it was too late to transfer, as she was happy that this wouldn't be a symptom of distress with him (on account of heartbeat being happy).

Maybe she does think she knows better (as the medical professional one would hope so) - but this is should be a discussion not a dictation. OP should be informed of the risks, and allowed to make her own decision - not told what to do with no reasons behind it.

I ended up overdue with an induction, but at every point, even when it became clear an EMCS was pretty much inevitable, I was spoken to, given choices (with strong advice sometimes), risks, and kept informed. That is how it should be.

Perhaps this midwife is just totally rubbish at talking to people (a big problem in a community midwife) as whilst these things need to be communicated, it should be done in a much better way.

My mw was bvery pro-hb (had two herself) and the only thing she said was that I mustn't go into labour before 37 weeks. Obv I knew about things like meconium etc.

The disclaimer she brought round on her 38 week appointment: I decined to sign, and wrote as much on the form itself - I didn't want to feel I was weakening my position should they try to fob me off with 'no mw available' when the time to ring medicom came.

However, in the end, I was induced 72 hours after waters broke...

Truffle , id be annoyed too at being told what you can and cant do , nurses and medical staff have no authority over you and i think this contributes towards some women feeling they have no choices and being railroaded into things they dont want .

I think you need to deal with this now in case its her that delivers you . Next time she mentions youll have to have an internal or something else because its policy , dont ask her for any explanation , just state clearly that No , that wont be happening because you dont want it . If she persists tell her that you find these statements offensive , its your body , your baby and youll decide .

I had a home birth planned , with a loveley midwife who agreed to deliver me regardless of when it happened , i mostly saw her only throughout my pregnancy . Nearer my due date i saw another one who made similar comments to yours which i found really really offensive . I snapplily asked if the police were going to come and take me away if i refused an internal or any such other thing and later complained . Having had a previous horrible midwife previously who bullied me i was really cross .

Have you asked if there is a particular midwife on the community team who is supportive of home births ? If she is being authoritive with you now , i really would not want her at the delivery and would make sure she wasnt . In fact i think id speak to the superviser and complain and decline any more contact with her .You dont have to see anyone you dont want , nor do you have to have someone you dont feel comfortable with in attendance at the delivery.

some of the stuff is routine (HB advised within 37-42 weeks, for low risk PG) some of this stuff..(baby is big? head not engaged - i mean how can they know at the point you commence labour whether it is engaged?) is more debatable and wasn't mentioned in any literature about HB or by any MW i have ever seen in the course of 3 HBs.

The tone adopted is rather shocking. You don't have to have anything. They do not 'allow' you to do anything, they can advise, you can take or reject their advice.

Although they might say that about monitoring/internals (and again it should be 'we advise' etc) i really don't think any attending MW has monitored as frequently as every 15 mins, and if it bothers you you can say no.

Hi

Hope all goes well for your homebirth OP.

I had a HB for my first baby in January and luckily the CMW was very supportive.

For what it's worth, I think I had just 3 internals whilst in labour and two of those were at my request because I wanted to know how dilated I was. I think my temperature and blood pressure were monitored every 3 hours perhaps and I think the baby's heartbeat was checked at a similar rate. At the most it was every two hours. The midwife was very observant and I'm sure she would have monitored more frequently if needed.

It sounds to me like this MW isn't very confident and just doesn't want the hassle of a home birth. I hope you find a more sympathetic midwife to take over your care. Perhaps a word with the head of midwifery might help? Rather than complaining at this point, maybe request a new MW as your assigned MW doesn't seem very confident.