advice for getting the homebirth i want when "decision" wont be made until 36+5

[nannyl]

At the moment in 28+5.
Im having an uncomplicated (first) pregnancy, and I always see my (lovely wonderful) community midwife on a Friday so Im always X+5.

Anyway i have known since before i was pregnant that I intend to have a home birth. Now im pregnant and have researched it even further i know the decision is right for me.
Its what i want, what i have a right to have, and MY choice.

I also know that midwifes / NHS like to think its their choice, but the reality is its mine.

I have been talking about having a home-birth since my 9 week booking appt. My midwife has always maintained that they dont make the decision until my 36week apt (which i will have at 36+5)
(I have not yet bothered to have the "its MY choice" discussion cause i dont see the point... at 9 weeks anything could have happened and even now i could have a premature baby and have to go to hospital)

The midwife has always said they dont decide until 36 weeks as there is lots of paper work, and no point doing it, if there are last minute complications, which i understand.

However if my baby is breech (today she was head down but of course can move) I will STILL be wanting and insisting on a home birth. (Im sure that wont go down well!)
Also in the event that my BMI is slightly above the limit of 35 (I doubt it will be, im only a size 12) I will still be choosing a home birth.
Or if there are any other minor risk factors which matter to NHS (but not to me) I will still be choosing a home birth against their advice.

It strikes me that on the Friday, less than 48 hours before i become term on the Sunday, i could have to start my battle for my right to a homebirth. (and this doesnt give me much time to fight my corner if necessary)
Also when Im so close, i want it to be all sorted and not wondering at 36+4 if i will be allowed to give birth at home!

Does anyone have any ideas?

Also if baby is breech, and NHS really have a strop id happily go for an IM, but it doesnt give me much time to find one, if i only call them, when i could go into labour at any moment, and they will have bookings / plans etc.

Id rather use the NHS (and have met 2 lovely community midwives out of the 5 that might attend already) though, and on the positive side, because i live so far from the hospital home births are very much supported in this area, much more so than in many other areas.

I have already been admitted to my hospital (I have no choice regards to hospitals, there are no others close enough) with HG, and (unless in an ambulence for an emergancy) i do not plan to go their willingly, at all, ever. It was awful (another thread lol)

Of course if there are complications during the birth i'll have no choice, but to go in, which is fine, and if baby is transverse (or if placenta was in wrong place; its not) I accept that a homebirth is positively stupid, and id be admitted for a CS, but otherwise i intend to at least try to give birth at home, as is my right.

Has anyone else had the decision made SO late in pregnancy?
I am normally super organised with everything (i have my birth pool, towels, waterproof sheets etc all ready ) and I find it stressful that its my decision and im not allowed to make it until just a matter of hours before becoming "term".

Also i know the midwives here like to deliver home birth stuff so its ready. Well if i dont get 'booked for a home birth' until Friday at 36+5 will they really get the stuff here before Monday? 37+1?

(and yes i know as its my 1st im highly likely to go overdue anyway, but i still want to be all ready!)

Any advice welcome!

[ScroobiousPip]

Good for you nannyl. I wasn't going to comment because you have had some great advice upthread.

But, in response to totally unhelpful comments from a couple of posters, I just want to add that I had a first baby at home with a very easy straightforward labour, less than 6 hours end to end. Always had the option to transfer if there were complications, but being at home avoided so many of the risks of a hospital birth, including infections and interventions.

At the end of the day, every woman makes their own choice. But i do find it scary that some women seem to be brainwashed into thinking hospitals are safer for low risk pregnancies, when the evidence is less than clear on the point (IIRC the dutch evidence in particular points to home birth being safer), and then promulgate those comments without any thought for the impact on others.

[EggyAllenPoe]

fotheringhay more anecdote?

on the basis of anecdote i would recommend against our local CLU because half the people i know that gave birth there did so unattended and the other half had EMCS after lengthy intervention-laden labours (having been low risk) ... - however as a rational human being i have to recognise that their stats are actually pretty good (though not as good as a hb in the same area)

where is the rationality people?

[fotheringhay]

To be honest, I'd also like to be in hospital where an epidural might be available.

I was strongly influenced by the "it only hurts if you're scared" genre of birth books. Mainly written by men.

[fotheringhay]

The point of my anecdote was "be prepared for having to go in anyway".

That's pretty rational, I think.

[babyonbord]

Well there would have been the medical resources available in the hosiptal to save the baby, resources that were not available in my friends home simple as. I just don't understand why you would want to take such a huge risk with something that is so important just so you can give birth at home. If you think you know better than the doctors then why even bother going to see them, why bother seeing a midwife if you aren't going to listen to them. It's selfish i had a hospital birth with my first and a long labour, without any complications, i had a very fast 2nd stage and baby was born healthy, being in hospital didn't impact on my ability to bond, or my relationship i actually giving birth at home would have cause far more emotional problems as i would have been in a hell of a lot more pain and i would have been a lot more scared, labour can be traumatic at least in hospital you know you have instant accsess to medical intervention should something go wrong, nothing is more important to me than that peace of mind. Mind you the only thing i care about is that me and my baby survive labour and are healthy i'm not stupid enough to put what i want before what my baby needs.

[babyonbord]

What we are talking about though is having a homebirth against medical advice not having a homebirth persay.

[nannyl]

I KNOW I "may" have to go in.

The point is i am not CHOOSING to go in unless it is medically necessary

And for the record a personal friend of mine lost her first baby in a HOSPITAL birth.... She was low risk and could have chosen a home birth and been fully supported by NHS but didnt.

After 12 hours of pushing, under the "watchful eye" of a newly qualified midwife who she was sharing with another lady in labour in the next room her baby died . It was stuck and no one noticed or did anything.
Had she have chosen to give birth at home, it is highly unlikely that 2 highly experienced midwives would have let it go on for so long, she would have had 200% attention, and they would have realised something was or might be wrong.... she would almost certainly have been transfered to hospital and her baby would now be a 6 year old.

[fotheringhay]

I'm very sorry to hear about your friend, op.

My main reason for wanting hospital next time is for (hopefully not, but maybe) wanting an epidural.

I agree it's not necessarily safer, in fact brings its own risks as you say.

[umf]

OP, I also felt my MWs were being a bit dithery towards the end when I wanted everyone to be in agreement that a homebirth was the plan. But I was firm and it all worked out fine - I think they really do just wait and see so as not to cause themselves extra work. And as others have said, waiting and seeing is a wise approach to birth, since what happens can vary so much.

Good luck - I hope you have a straightforward and well-supported birth, wherever you end up.

[umf]

X-post: sorry to hear about your friend.

I also chose a hb for my second because I knew I would get better care from more experienced midwives at home.

[HandDivedScallopsrgreat]

To counterbalance babyonboard I know 2 women who had homebirths for their first baby and they had better experiences than any of my other friends and me. In Holland the default choice is homebirth and you have to "fight" to have your baby in hospital as they are against medical intervention (which of course is the antithesis of here but no less dictatorial and dismissive of a mother's requests or wants!)

I am wanting a homebirth too nannyl (2nd child - 23 wks at the mo) but I have far more complications than you. The midwives haven't ruled it out (nor the consultant) they have just advised that as the pregnancy progresses we will know more and to be aware that some complications i.e. gestational diabetes will probably rule it out (and tbh if I do have gestational diabetes I would probably opt for a hospital birth).

I was ready for the "let" and "allowed" arguments but thankfully they haven't transpired. In fact everyone has been quite receptive. I really dislike the attitude that the mother's wishes are unimportant/uninformed/can be overruled for relatively little evidence. And I fail to understand why some people feel the need to come on a thread like this to purely denigrate someone else's well-informed and researched choice.

It sounds to me like your pregnancy is going fine though so try not to worry. I can understand your frustration and worry that this can't be sorted out sooner and you can be left to plan the birth you want. More than likely you will not have to fight for the birth you want and I hope you get it. I am sure you are well aware of the risks (most of which exist because you are giving birth fullstop - not your surroundings) as you have researched it.

[babyonbord]

Ithe origional post it seemed as though nanny was making a point that she would have a homebirth even if she had complications and experienced medical staff recommended against it, which is silly, i have nothing against home births in general, i personally would never have one because in my personal experience a hbospital is the safest place to be and the care i have always recieved in hospital has been second to none. What i am saying is just because you have read a few articles and spoken to a few other mums who were lucky enough to have an uncomplicated homebirth does not mean that you are better informed than the hospital staff who are simply trying to look out for your saftey and your babies saftey, and to write off their advice thinking that you know better is selfish and stupid. You can't ignore their advice when it suits you and then expect them to come to the rescue in the form of an ambulance crew when things go tits up. if and it's a big if they advise you to have a hospital birth then i think you would be incredibly stupid to ignore them.

[brettgirl2]

I am not anti homebirth but to have a home birth when advised not to (in the case of breech for example) would be mad. Homebirth is safe for low risk births.

[HandDivedScallopsrgreat]

That's not what you said babyonboard. Your first sentence said that you thought that the OP was crazy to even consider a home birth for a first birth. You were dismissing her wishes and feelings and stated that she clearly didn't know what she was talking about - despite her saying that she had researched it. That is just scaremongering and being a bit nasty.

I don't know what research the OP has done, obviously, but given that she feels this strongly about the birth there is no evidence to suggest that she knows any less than the midwives advising her. There is plenty of information out there about home births and the benefits/risks and it is doubtful that the midwives know all there is to know about home births either.

Her pregnancy is progressing normally and again there is no evidence to suggest that a home birth wouldn't be possible. No-one has said to her she can't have a home birth. They have just been dictatorial in saying that they decide. As the OP quite rightly said (whether you agree with it or not) the choice is hers.

[lukewarmmama]

Chill! You sound like me with my 1st!

If it's all fine, then you'll get your homebirth.

If there are complications, then you can go in.

There are so many different possible complications that you cannot plan for them all, nor expect the midwives to at this early stage (yes, it's still early!). There's no reason to think it won't be fine, and positive thinking is a large part of the battle, so calm down.

You can't plan labour like a military campaign, you have no control over how it'll go or what might happen, and you need to accept that. Women whose labours didn't go according 'to plan' are usually much unhappier with them than women who didn't really have a specific plan (believe me, I've been one of them!), so I think it's really worth trying to change your mindset a little. I had an IM second time around, and she really helped me with that. You have to work with the HCP, not set yourself up against them unless you have to. Bad for the blood pressure!

And if you want an IM who is happy to attend a home breach, you might have to get Mary Cronk out of retirement! There aren't many others left these days. But your baby isn't breach, so why worry?

[babyonbord]

you can research labour and childbirth as much as you want but until you have actually experienced it you are taking a blind stab in the dark. The fact the op thinks that labour can be planned to the last tee shows that niavety, i dont know a single person who had labours that went to "plan", To say you want a homebirth with no experience of what labour is like is like jumping into a pool without testing the depth very very silly

[nannyl]

baby on board you do NOT need to know what labour is like to choose a homebirth.

i know several people who have had their first (and subsequent) babies at home. Even our NHS dont consider 1st baby to be a reason to advise against a homebirth (and they do have lots of criteria and boxes that they like ticked, and even 1st prengancy is NOT one of them)

Sorry but IMO my 1st baby is not a practise for giving birth the second time, to see what i think.
Im quite positive about it..... my mother has done all hers with only gas and air and homeopathy, and i see no reason why i cant too. except ill be adding water and tens to mine, and have pethidine already prescribed and waiting incase i want it.

to me, sitting strapped into a car for 45mins while in labour is madness... and will only make intervention far more likely....... and then my grandmother went from "heavily pregnant with no signs at all, to holding my dad in her arms in 45 mins" my journey could be longer than that..... giving birth in the car is far more dangerous than at home.... and travelling WILL stress me, and stress WILL NOT help me in labour. Yes id be very unlikely to have 45mins with my first..... ( though my uncle was 15mins start to finish, and even my grandmothers 1st baby nothing to born in under 2 hours).

Id much sooner be at home for the birth and immediately after, so its what i am choosing to do.... and clearly i may end up in hospital regardless... and as its my 1st birth im even more likely to end up in hospital than those who choose to home birth second and subsequent babies.

OR baby may be early... or i may be hit by a bus and be dead, who knows, but just cause it might not happen (for 101 reasons) doesnt mean i cant plan the scenario I would like..... cause if i dont plan it the why i want, i can be 100% certain it wont be as i would like.

[Secondtimelucky]

I can't say enough that the plural of anecdote is not data

but

If I had my time again I would choose a homebirth for my first. Not because it was an easy labour. It was a hellish three days with syntocinon, epidural ARM and forceps. But I had dis interested and overstretched medical staff who gave no attention to the malpositioning issues I was experiencing and were dismissive of my pain. Both of those contributed to a spiral of intervention I still believe may have been avoided at home.

By the reckoning that the first time is a 'test' for the second, I should have ruled out a homebirth for my second after all that intervention. In fact, my midwives were very supportive (none of those things are counter indicators for homebirth) and I had a wonderful homebirth with DD2.

[HandDivedScallopsrgreat]

Oh don't be ridiculous babyonbord. Again you are denigrating, unnecessarily, her choices. There are thousands of women that give birth at home as their first birth every year. As I mentioned up thread in Holland it is the norm. There is no evidence for a normal pregnancy that hospitals are safer.

It isn't your choice - we get that. There is just no need for the disparaging language when clearly the OP has thought about and researched this for a substantial period of time - probably more than most women going into childbirth. She has also said that if she needs to be transferred to hospital then she will so she understands the risks.

"To say you want a homebirth with no experience of what labour is like jumping into a pool without testing the depth" - the same could be said for those women having babies in hospitals.

[VivaLeBeaver]

Haven't read the whole thread but I think maybe you ought to look at it from a different angle?

They haven't said you can't have a homebirth and as you're low risk there isn't any reason why they should. They've said about it been a protocol reason for not doing the paperwork until 36 weeks, this is standard for everyone. So hopefully tehre won't be any battle.

So look at it as you have made the decision. The midwife isn't coming till 36/40 to do the paperwork which is normal. No point doing it before as it really wouldn't be sensible to have a homebirth before 37 weeks. And yes they can get the stuff to you very quickly. You've got everything you need such as towels, sheet, pool. I should imagine they have everything they need in their car (for unplanned emergency home births this is normal to have everything in the car).

[Bramshott]

FWIW (and I know this wasn't the point in the OP, but the discussion seems to have moved on somewhat!) - I had DD2 in the car, and wish I'd been encouraged to have a homebirth. Travelling in established labour was probably one of the most foolish things I have done, although luckily it worked out okay in the end.

[mumwithdice]

OP, I know how you feel, but ime, it's just being careful. And I say this as someone who had very supportive midwives and a lovely, calm homebirth with my first baby. Funny thing was, she was born at 37 weeks and 4 days just a few days after we signed the paperwork.

With regard to home birth and hospital birth, could we please all accept that women and babies are all individuals? Some women feel safer in hospital, some feel safer at home. Surely, a calm, safe-feeling woman's labour is best for baby?

[nannyl]

thats what Id like to plan to avoid bramshott!

One of my best friends had her baby just 3 weeks ago (and lives much much closer to her hospital than me) the head started to come in the car park and she only just waddled to the birthing unit... they had no rooms available so suggested she waited in a little side room while they found somewhere... and she took off her trousers and had baby there are then, just minutes after being in the car.

Viva a like your way of thinking,

[susiesheep2]

Hi Nannyl, I had a home birth with my first, dont worry they are just singing the party line, it will be fine, they say they wont decide even when your on no2 and you had your first at home - so I wouldnt read too much in to it.

Anyway, they dont decide - YOU DO, and they have a duty of care to attend to you even if they disagree. And the time frames they give you arent as set in stone as they try to make out, I was 2 weeks over with my first, even though they said at first the cut off limit was 10 days. She was perfectly healthy btw :)

Im sure you wont have any trouble though, I read loads about NHS midwives & consltants being resistant to homebirths, but as long as your sure in your mind, which you are, then I can not see how they would try to talk you out of it. Any if they do, just say, im having my baby at home, I am low risk and you have a duty of care to provide a midwife. I doubt you will even need to though :)

I think the only thing midwives worry about is to them as a first timer you are an "unknown" in terms of pain, thats what they told me anyway. So just be sure of yourself, the NHS midwives who attended me at home for my first where amazing.