Would I be allowed a homebirth or ELCS due to my previous history?

[nomoreheels]

Thoughts welcomed...

I had DD1 6 weeks ago. It was a quick & brutal labour for me (5.75 hours) & I was quite frightened - I also developed pre eclampsia & was on BP tablets during labour. Baby was fine though so they continued with natural birth with g&a & pethidene only. In connection to that, had a PPH (lost a litre of blood) & very nearly had to go to theatre to have my placenta removed, though it finally came away at 31 minutes. I also had quite a few 2nd degree tears & lots of suturing. The whole thing left me feeling hugely upset afterwards, even though the midwife who delivered DD was utterly lovely & kind, & described the birth as "beautiful"!

Anyhow. If I were to become pregnant again, would my medical history make me automatically a high risk pregnancy? I did not enjoy labouring at the hospital, so if I did try for natural birth again I'd rather be at home, ideally with a pool. However I am worried the same thing would happen & I'd just have to go through all of that again.

Or are they likely to suggest an ELCS?

Thanks for any thoughts...

Congratulations on your birth :), and sorry to hear that it was not the experience that you wanted :(

I am not sure of the specifics with the health problems that you had, but I was high risk in both pregnancies - and pph with both too. Having had a hideous first hospital labour, I had a quick and easy home birth with DC2.

I dont think that they can refuse you a homebirth - but you obviously need to weigh up the risks and seek advice. FWIW the cons was utterly anti a home birth and wanted me to have a managed labour, the CMWs were willing to allow a homebirth as long as I signed my life away. Ultimately, rightly or wrongly, I didnt decide anyway, and had a quick unplanned homebirth 10 days early. Fortunately a CMW arrived soon after delivery and gave me the sinto to stop the bleed- thats the only bit that could have got a bit hairy!

I think that if you have a history of PPH, then you will be told (very firmly) that this is excessively risky for home birth (sorry to spell it out in these terms, you can die before even the speediest transfer can happen). It really is one you don't want to take chances with.

Pre- eclampsia and 2nd degree tears would not in themselves indicate any particular means of future delivery. But if you have pre-eclampsia again, you may need to be induced again (will depend on you individual situation).

Have you thought about going back for a thorough post-birth debrief with the mid-wife? It may help you understand what happened, and why, and this might be useful when you come to think about any future deliveries.

Congrats on DD!

Hello & thanks for replies. I forgot to say that I wasn't induced - waters broke spontaneously at 38 + 4. I'd had slightly raised bp in the last few weeks of PG but had otherwise been considered low risk throughout, apart from a late growth scan as I was carrying fairly small.

I will ask for a debrief, that's a great idea. I could ask for more info on second pregnancy then & see what the midwife says.

The more I think about it though, the more I'm feeling that I would hope for an ELCS as I'm guessing I would be high risk. I wouldn't want to go through the pre e & how ill I felt afterwards (very faint & dizzy, ears ringing constantly) or the tears again either. :(

Sorry you had a bit of a rough ride after the birth of your DD :(.

I'd also suggest a debrief.

Re. PPH, how dramatic was the PPH that you had? A catastrophic PPH is indeed an obstetric emergency that could have dire consequences in a home environment - but many women have a PPH without being at any risk at all of bleeding out. I had one (at home) - from a tear. As it was from a tear it should not increase my risk of a uterine PPH (more likely to be catastrophic) in any way shape or form. You might find this page interesting and informative.

As a mentally competent adult your HCP's may advise you that they would recommend a hospital birth, but they do not have the authority to allow you a HB - that is up to you. It might be harder to achieve a CS, although if you decide that is the best option for you then do some groundwork and find a consultant at your trust who is sympathetic to CS due to maternal request.

I hope you're enjoying your DD, and that you can find some peace with what happened after her birth.

The risk of pre-eclampsia is much reduced in subsequent pregnancies, so hpefully you wont have that to deal with next time.

Also, given that you managed an unassisted vaginal delivery, your chance of having a successful 'normal' delivery next time is good.

No-one can forbid you from having a home birth, it is up to you if you want to choose that. When you speak with the miwife she will be able to xplain the risks that apply in your situation.

Thanks for the further replies, all of this info is great. DD is fab despite the difficulties of her birth - we love her very much.

I can't say for sure but I think my PPH was related to my placenta not delivering (despite injection) - memory is hazy but I think they said the bp meds interfered somehow. They didn't tell me it was happening at the time - maybe so as not to alarm me?

I will book a debrief, it may help me come to terms with this birth first & then i'll take it from there...