Where should I give birth?

[PrincessJenga]

When my midwife asked me at my booking appointment where i wanted to give birth I immediately said '[local] hospital'. I've had various gynae problems, several surgeries and a miscarriage in the past so I wanted to be near the doctors 'in case anything goes wrong'.

Fast forward to now (32 weeks pg) and the pregnancy has gone smoothly: I'm officially 'low risk' and under midwife led care (started under consultant care but signed back over to midwives at about 16 weeks)

The only delivery suite in our town is the consultant led unit at the hospital I'm booked in at. I like the hospital and they looked after me well when I was ill in the past. It's also only a 15 minute drive from our house. However, it has high intervention rates and DP really doesn't like the 'hospitally' feel of the place. There's also only one room with a pool so they can't guarantee a water birth (which I'd really like) and friends have said it's very much an 'on your back' kind of a place. After the birth you're usually put into four-bed pods on a bigger ward.

The nearest big city (about a 40 minute drive) has a midwife led unit that focuses on natural births. There's aromatherapy wafting the halls, each room has a pool and a ball and there's not a hospital bed in sight (after the birth they pull down a double bed from the wall and leave you, baby and DP to relax together) The consultant led unit is just down the hall, so help is nearby if you need it.

WWYD? Local hospital or longer drive to the MLU? Having never given birth before I have no idea how uncomfortable that drive will be. I'd really appreciate your ideas.

a planned homebirth is SAFER than a hospital (or other place eg midwife unit)

If a LOW RISK person chooses a home birth both themselves and baby have a significantly higher chance of being alive at the end, than if they had gone to hospital
they are much less likely to tear or need intervention.
Babies born at home on average have higher apgar scores than babies born in medical units, and are significantly more likely to have an apgar score higher than 8.

(all comparing like with like, low risk at home VS low risk in hospital)

personally i only know of one person (mum / baby) who has DIED during birth. sadly it was the baby, and died in a hospital. Had the mum chosen a home birth (where she would have had not 1 INEXPERIANCED midwife, but 2 midwifes with much more experience, it is highly unlikely that her baby would have died..... an experianced midwife wouldnt have let her push for over 12 hours, the stress of which killed her baby... ) If baby was alive she would be 4 years old now.

"i was grateful to have Drs on hand (who have had many years training in birth management\resuscitation plus acess all the necessary equipment) and took advantage of this expertise. rather than 'some woman off the internet who's read a homebirth site"

Sorry - what do you think I was suggesting? Delivering the OP's baby at home myself?

"the idea of needing to transfer in (should it arise) would've felt like i had 'failed' iyswim"

It's true that many women have high expectations of how they feel their birth 'ought' to go, that would result in a feeling of failure if it didn't turn out that way. Wouldn't have put you into that category from what you've said on other threads on this board though.

In my own experience as a homebirth support contact - I've spoken to loads and loads of mothers about their experience of homebirth, the good and the bad, and have also experienced a transfer from a homebirth myself, the usual response isn't 'oh no, I've failed', but tends to be 'thank goodness I opted for a homebirth and spent so much of my labour out of hospital. It would have been MUCH worse if I'd gone in at the beginning. And they often feel that in opting for a homebirth they'd done EVERYTHING they could to achieve a healthy birth for themselves and their baby and don't have to walk around thinking 'what if?' - which some women do after a hospital birth which has gone wrong, knowing that homebirths tend to result in a halving on the c/s rate. Most transfers are done for reasons of failure to progress, so tend to be fairly leisurely affairs. I remember feeling very positive when I went in for this reason - very much 'come on then, let's get this baby out and get home again'. Lots of people feel like this - when it happens they're ready to go!

It doesnt sound like the OP is up for a HB though.

You have to be confident in your choice or you will spend the whole pg fretting.

I wouldnt have hosptial birth unless I absolutly had no choice. The thought of going into hospital to have a baby (or do anything else) repulses me. But HB s are not for everyone. I wouldnt have dreamed of having one with DC1. It was suggested to me and I thought it was mad!

I think its a shame that people assume they are dangerous though. There is no evidence to say they are but its seems to be what people automatically believe.

You had reason to belive that a HB wouldnt be safe for you and your babies. You used this information to make an decision.

Nothing wrong with that. Again - you have to want and feel comfortable with your choice. There is no benefit to having a homebirth if the mother is anxious and doesnt feel its the right thing. Whats the point?

Hospital births were really not for me. As I had no risk factors and lived very close to the hospital HB was the right thing.

I got a bit fed up of having to defend my choice though. I wouldnt dream of telling another woman (usually a total stranger) where she should give birth. Any attempt at explaining why I didnt feel i was at any increased risk was met with glazed expressions.

Just wanted to pop on and say a big THANK YOU to the women who have taken the time to post on this thread.

It's really reassured me that going for the MLU rather than labour ward is definitely the right thing for me. I'm lucky that my local hospital has a brand new shiny MLU right next door to the labour ward so it seems a no-brainer.

Phew, you can't turn your back on threads for a second can you? Sorry people, I didn't mean to start a hospital vs home birth scrap!

I do appreciate everyone's thoughts though. It's really interesting to see what people are saying about home/hospital births and it has made me realise even more that the MLU 40 mins away feels like the best option for me. I'm going to discuss it with DP and my parents and explain that my preferred option would be to go straight to my parents' place as soon as anything starts happening, then transfer to the MLU from there when I'm in active labour. Not sure how dad will react; he doesn't cope well with seeing other people in pain!

MrsDeVere is right; much as I can see the benefits of a home birth, I'm not feeling 'up for' one (yet! Maybe I'll change my mind over the coming few weeks when it becomes clearer where we'll be living) but I do appreciate your thoughts on it.

PS - Spud, I'm sure you're lovely, but no, I'm not adding 'Spud delivers my baby at home' as Option 3 on my list

lol

ultimately the best birth for ANY mum is something she is happy with if you are worried / stressed about where you are, it automatically releases stress hormones which hinder birth.
Being in a place that YOU are happy to be, is going to be best for baby and you long term.

Good luck with your chosen birth

stats for first timers are good though - you are likely to be in the 60% that delivers at home, the majority of the 40% that transfer in do so for pain relief.

as already mentioned there is no increased mortality associated with home birth. And it does reduce your chances of c/s, forceps, episiotomy...etc. comparing low risk Hbs with low-risk hospital births...

if you decide otherwise on the day, you can transfer in.

erm, and the person attending a home birth would be a qualified and experienced Community midwife.

ah..missed update. sound slike you fancy the MLU.

Might be worth remembering that no decision has to be made regarding delivery until you are actually in labour. You can register anywhere but turn up somewhere completely different, or not at all in the case of a homebirth.

I registered for a hb with my ds2, had to be cancelled due to hypertension, guess where he was born, yup, at home, not through choice I might add, we lived 45 mins from hosp and he came in an 3 hrs start to finish, thought I had longer than I did! All was well and after an overnight stay to get my bp sorted we were packed off home, much to my delight.
DD in Dec last yr I registered for hb again at 37 weeks to make sure bp was ok, this was done with a view to seeing how far I got a home, but if transfer was necessary then so be it, as it was bp went wrong again, this time at 38 wks and they also found a heart problem so had to go in as soon as waters broke.

What I'm trying to say, in a very long winded way, is that you have loads of time to make a decision, don't let any mw force you to decide before you're ready. Take your time and make the right decision for you.