Thoughts on a homebirth with an IM for first baby

[PinkFondantFancy]

Hi all,

I was hoping to get people's thoughts on having a homebirth for my first baby. I know this thread has probably been done 1000 times before but I'm finding it hard to find a balance of opinions. This might be a bit rambling, sorry....

I had originally planned a hospital birth. However, now that I've started thinking about my birth plan and from reading www.freewebs.com/birthresearch/homebirth.htm and www.homebirth.org.uk/, I think that a planned homebirth could be the ideal way to have a positive birthing experience and avoid intervention where possible. It would also allow me to attempt a water birth, whereas this is very unlikely to possible at my local hospital, as they only have one pool which is currently out of action in any case. I have an independent midwife whose original brief was to be my and DH's advocate in hospital. However, she is very positive about the prospect of a homebirth.

The facts are - I'm considered a low risk pregnancy with normal BMI, blood pressure, iron levels etc. and live about a half hour drive from the closest hospital. I'm currently 36 weeks pregnant, and the baby is head-down and partially engaged.

From talking to my IM, it seems that there are very few situations in which the level of treatment I would receive from her (and the accompanying midwife) is lower than in the hospital. Her view is that I would be monitored at least as closely, if not closer, than I would be in hospital, and most dangerous situations would be picked up early enough before they become an emergency.

I was feeling pretty confident about the idea of a homebirth, until I read this thread. I also heard a friend's birth story today where she required a crash c-section under GA due to baby being in distress when she was ready to push. This is pretty frightening as clearly under these circumstances, a half hour is just too far away from the hospital.

I would really appreciate people's thoughts on this, both positive and negative as I'm feeling so confused.

i booked homebirth for my first child with a view that I am very close to the hospital and from here it is almost faster to get into an emergency room as from your normal birthing suite that is actually inside the hospital. it did not go to plan as my baby was delivered early by emergency due to an infection but this is another story.

when i met my im for the fist time we discussed the options and one of them was that she will go with me to the hospital to act as a birthing partner. this way one is still in the hospital environment with all the facilities nearby, but never left alone and whos wishes are closely observed/followed. Husbands are really bad at this role as doctors can push any bs at them and get the response they need, whilst they would be much more aware of an independent professional nearby. my midwife was happy with this role. some were not (and I did not book them). you need to find one that you trust and agree with.

OP, it really is one of those things that you can only decide for yourself.

I have 2 DDs, both were born at home, and DC3 is due in March and will also be born at home. Magical experiences and I'm so glad I had them all at home instead of in a hospital. But I knew it was the right decision for me, based on risk assessment (the stats say that homebirths are as safe as a hospital birth for a low risk pregnancy, which was good enough for me. Add all the other pros of a home birth and it was a no brainer). But in the end, it doesn't matter about the amount of amazing stories or horror stories (both hospital and / or home birth) that I was told, all that mattered was that I knew having my babies at home would be the best place for me, and if I needed to transfer in (I was 25 mins away from hospital) that this would be fine too.

Good luck in your decision.

OP I totally agree with boobz, formbydoula and speculation. These threads inevitably attract people saying how brilliant their homebirths were, how grateful they were to have been in hospital because their babies would have definately died if they'd been at home and all the experiences inbetween.

I would seriously recommend you do your research NOT based on individual stories because at the end of the day it is your choice and you have to do what is most comfortable for you, where you feel safest. It's often good to find out why people initially chose home or hospital but I'd avoid reading any labour and post labour stories simply because you have no idea what the outcome would have been if those women had made the opposite choice, and they didn't have a crystal ball at the time either.

FWIW I had my first at home and am 29weeks with DC2 who I also plan to have at home. My community midwives are based at a hospital a good half hour away (in London traffic) but in dire emergency (massively rare, the good thing about that close 1 to 1 care is they are prepped and ready to spot anything not remotely going to plan well before a counterpart in hospital exactly because they need to factor in getting you to hospital if the need arises) I live 10mins from another hospital. I had similar fears about hospitals and after my research, the vast majority of which was talking to the midwives who's care I was under, was convinced I would feel safer (NOT the same as "happier") at home and felt I giving my baby and myself the best opportunity for a good labour and birth by planning a homebirth but accepting I might need to transfer.

Don't listen to the scaremongering, every labour experience is utterly different. Good luck and congrats!

I wouldnt personally have a home birth,only because my daughter gave birth 8 months ago,the midwife was at the house,said she was a prime candidate for a home birth,as her blood pressure was spot on,she was 4cm and coping really well,with no pain relief up to then, luckily she went to hospital for the deliveryshe ended up from start to finish 33 hours and then hemorrhaged really bad,it took seconds for the room to be filled with medical staff,who saved her life,and i know if she was at home,she wouldnt have made it to the hospital on time.. I know its just one of those things,my mum had two at home with no trouble and it was wonderful,its just being with my daughter troughout it really really scared me,and made me realsie just how quickly things can change,good luck with whatever you decide .

lilmamma there are plenty of people who do have nasty PPH after homebirth, and who DO make it to the hospital on time and who do not die!

Midwives are trained to deal with it, hence why there are 2 present at all NHS planned homebirths.... one to save mum after birth and one for the baby.

pleased your daughter was ok though, but nasty PPH + homebirth does certainly NOT equal death!

..and most of the 2% of home birthers that have a pph do so in hospital because, like your daughter..they already transferred in. the rate in hospital births is 4%....

I planned a home birth for DD 13 months ago. Managed to stay at home for 18 hours before exhaustion and pain got the better of me (despite pool, TENS, hypnobirthing techniques etc..) Transferred to hospital by ambulance (was happy to go in DH car, but once you're "in the system" the midwives have responsibility for you).

Ended up having Syntocinon, pethedine, gas & air and an epidural. After a further 7 hours DD's heart rate was dropping with every contraction - it turned out the cord was compressing with the contractions and cutting off her blood/oxygen supply. I had CFM, but despite the epidural I could still move my legs and actually managed to get some sleep which was a blessed relief. She was eventually born after an episiotomy and forceps delivery - 25 hours after my first contraction.

Absolutely not the birth I had planned, but I still would consider it to be a positive experience. I would just say, whatever birth you've got planned in your head, prepare to be flexible. Every labour is different.

Of course babies die in hospital during births just as some will die during home births, but you can guarantee, that if something happens to you/the baby during a home birth it will be to be perceived to be your fault for choosing a home birth, when you could have had a hospital birth (however untrue that may be). I believe this will be the attitude of most people until such time as home births become as "normal" as hospital births in this country.

I don't want to end on a doom and gloom note, because you are about to enter the most terrifying, exciting, rewarding and tiring time of your life, so congratulations on your forthcoming arrival and good luck!

I am having a homebirth with an IM. My first was born in hospital where I had an episiotomy and 3rd degree tear so I can't comment on what homebirth with an IM is actually like yet.

My antenatal care has been lovely though and I would recommend having an IM even just for that. She accompanied me to my hospital appointment with my consultant yesterday who wanted to warn me of the high risk of a repeat tear (but couldn't actually give me the %). I accept that my risk will be higher than the general population and I have done my own research and it seems to be upto 7%. I know, however, that even if she'd said 50:50 I would still birth at home. That risk is acceptable to me but I know, from posting on the birth injuries thread, that any risk of another tear after 3rd/4th degree isn't acceptable to most women. The decision is so individual.

One thing I did when I met my IM was put all my concerns to her - what will you do if X happens? What's your transfer rate? How often do women suffer 3rd degree+ tears in your care. This all helped me to build up a picture of how things would be at home.

I also asked about PPH. I am not high risk but it is something to consider. She explained the technique that midwives use whilst transferring you to hospital. I won't go into the details here but I was satisified that I wasn't likely to bleed to death because I wasn't in hospital. Plus the ambulance team also work on you on the way in.

OP, I would suggest meeting your community mws - though I know there is no guarantee that they will be at the birth you'll get an idea of the culture they work in. Also meet with an IM. The first one I met didn't make me feel comfortable at all. I guess we just didn't click and I didn't feel comfortable having her take over my care.

I think probably you'll just know which way you want to go with this. It's hard to make a fact based decision on such an emotional issue.

Good luck though and wishing you a lovely birth - wherever it happens

Hello all I just wanted to update you all that I had a wonderful home waterbirth on Friday night. The experience was amazing and DD is just perfect. Thank you all for your advice and input, it's really appreciated.

Oh how lovely! Thanks for updating, Pink, that sounds utterly beautiful.

I think most people who have the birth they feel is right for them have a better outcome. The only thing I would be uncomfortable with is using an IM - they do not have insurance so in the event something goes horribly wrong, the child or you may have no comeback.

Have you thought of going the NHS route but having the IM there as well or may be a doula as support because there are lots of good NHS midwives? Definitely have a good think about the insurance situation though. Good luck!

OOh - congratualtions Pinkfondantfancy - glad it all went well and you didn't need the insurance. Sorry x post - hadn't got to the last page before posting!