Homebirths: Why / Why Not..?

[ICindigo]

HI Everyone
I wonder if anyone can help me. I am a student (waiting to hear if i have been accepted for a midwifery degree) and am in the process of writing an assignment.
The topic is why more women don't have home births. Anyone who hasn't had a home birth or wouldn't in the future - can you tell me why..? You dont have to go into detail i just need to know the main reasons..

i would be very grateful for your thoughts!!
Thanks, kelly x

[Jasnem]

First birth I didn't consider it, as I was quite nervous and no one suggested it.

Second was planned as homebirth, but ended up having crash c section in hosp.

This time will be hospital. I know baby no 2 would not have survived her homebirth (only went to hospital due to staff shortage, not because of any obvious problem), and am no prepared to risk it again.

Also DP is (and always was) against.

[geekgrrl]

I wanted a home birth with baby no.1 but went off the idea when I became increasingly unhappy with my community midwife - she insisted that I must get pethidine and said that 'all women have it'. I tried to find an independent midwife but there wasn't one nearby.
Babies 2 and 3 were born at home, thank goodness (we'd moved house by then so had a different midwife).
Check out www.homebirth.org.uk/ for lots and lots of info - and the ways the medical professions like to put women off home births.

[ICindigo]

Thanks for your help- it will be really useful.

most of the women i have spoken to and most of the research i have done leads to either - not being given a choice, or being scared of giving birth at home (mainly caused by health prof.s!!).

I think it is diabolical the way many health authorities try to persuade women to give birth in hospital against their wishes- It is becoming like conveyor belt care in hospitals due to lack of available staff.

Admittedly, there are a shortage of midwives- but it isn't made any easier to become a midwife with the limited number of uni places... i had an interview at Leeds last week- they said they had received 850 applications for midwifery (so there is obvious interest in the course)but they were only interviewing 120 of those- and there were only 30 places.. So no wonder there is a shortage of midwives.. I know that Liverpool uni only have 10 places!!

Its a nightmare trying to become a midwife these days - and its a pity because its such an amazing job..! I was at my nephew's birth and it was unbelievable, the only problem was that the midwives seemed to have no time for us as the labour ward was busy!! I know its probably not their fault but the situation needs to be sorted out, its a catch-22- shortage of midwives but not enough provision of uni places..!

Sorry to rant but it's something i am very passionate about!!

Again, thanks for your help,
Kelly x

[TuttiFrutti]

2 good reasons for not having a home birth are:

1. You can't get an epidural. This is the only pain relief which IME actually works, ie stops the pain rather than merely distracting you or making you so spaced out you stop thinking about it. After my sister's first birth, her biggest fear with births 2 and 3 was that she might be denied an epidural.
   
2. If it's your first birth, you are dealing with the unknown and would be taking a risk in choosing to do it far away from drugs/consultants/operating theatres. You just don't know what might go wrong, and sometimes you need fast surgical intervention. I had my first baby last year and would have died if I hadn't been in hospital. I had undiagnosed fibroids in my womb, one of them under the baby's head the size of a tennis ball. By the time the doctors realised what was going on, the baby was in distress, but they got the baby out by emergency C-section within minutes. I know some home births can go brilliantly, but I would advise anyone having their first baby not to risk it.

[Rhian101]

I did have a homebirth second time around but 1st time I didn't even consider it.
Because:-

1. None of my health professionals ever suggested it as an option, it was simply assumed that hospital was the best choice.
   
2. Not knowing what to expect from the whole birth process (pain levels etc.) and also not knowing whether or not my body could actually do it meant that I wanted to be somewhere that intervention was available asap
   
3. In hospital you feel you can rely more upon medical practitioners, i.e. they are responsible for getting you through this, whereas at home there would be fewer people to lean on.
   
4. Drugs and monitoring appeared more effective and available in hospital and since the alternative of a home birth was never discussed then I was sure that if at home I would have to do it without drugs.
   
   I hope that's of some help! I know you didn't ask for reasons to have a home birth but I'm now so passionate about them that I can't help but give you my opinions! My 2nd birth in which I had a home water birth was so much more relaxed and enjoyable. I did it all without drugs but knew that they were available if I wanted them. I felt completely in control of the whole situation and didn't have the pressure of needing to go into hospital when labour progressed. Everyone who can (and wants to) should do it and I think there should be more education on the positives of home births. It makes me so angry when they are portrayed as bad by the use of misleading statistics (when any births occuring outside of hospital are included as homebirths - such births as teenagers going it alone and those on their way to hospital). We need a balanced view giving both risks and benefits from the NHS!
   Ok, rant over.

[ICindigo]

I completely agree and don't worry about the rant- i almost started one myself then!!! haha

[conni]

Other reasons not to have a homebirth:

• many midwives are inexperienced in dealing with homebirths in the UK, hence the transferral rate can be very high i.e. in excess of 50% (i.e. more than 1 in 2 women, given that you go through all the palava re organisation/maybe renting a pool, then it seems not very appealing to still be faced with such a high transferral rate due to inexperienced midwives - big big difference with for example the Netherlands!)
  
• here, you are likely not to know who your midwives for the homebirth will be, i.e. two total strangers will end up on your doorstep (at least if using NHS), so if you don't get on, you really have a problem
  
• risk assessment before a homebirth is crucial (at least in the Netherlands) but here most midwives/hospitals don't seem to bother. Especially for a homebirth you expect to get a scan at say 37/38 weeks so you are sure about position of the baby (mad how often you hear that baby turns out to be undiagnosed breech, that really shouldn't happen in this day and age IMO) and whether there might be any complications

[Blondeinlondon]

I didn't have one because my family (except for DH) were strongly against it and the head of my community midwife team told me I would get a tired m/w etc etc

I would consider a home birth next time just because the hospital was bloody awful with hardly any care!

[poppiesinaline]

Have had 3 babies and would never consider a homebirth. I personally wouldn't want to take the risk. A friend of mine - 2nd baby, birth fine, but she haemorrhaged afterwards and needed a blood transfusion. Fortunately she was in hospital but the midwife said to her afterwards that if she had been at home she would not have survived. On the other side of the coin, two other friends of mine had homebirths and were fine.

personally though i would not want to risk me or the baby.

[Cristina7]

I wouldn't have considered it for my first. Given how it went (big baby, needed resuscitation, I needed blood transfusion) good thing too. Had it gone well and knowing what to expect I might have considered it for subsequent ones. For various reasons, I didn't have a HB.

[Cristina7]

Friend of mine had planned a HB for her first. She completely trusted the MW. She needed induction and hospital birth in the end. Just as well because the baby was breech (MW advised against US as she was absolutely sure the baby was head down) and she needed a C/S.

[coppertop]

First time around it was never even mentioned to me. In the end I needed an induction anyway so would still have ended up in hospital.

Second time around I had a fantastic midwife who was very much in favour of helping women who wanted a home birth. Sadly he eventually lost his job because of it. In any case I knew that I was at risk of shoulder dystocia (sp?) and wanted the security of a hospital birth. I also ended up having an induction again anyway.

I'm all in favour of home-births for those who want them. It just wasn't something that I wanted.

[ICindigo]

Thanks everyone.. all fab inputs- just what i need. When we decided on the topic for this assignment i was quite excited as its something im really interested in

x

[Rhian101]

Why is Britain so damn rubbish about HBs?

[Frizbetheexpansionset]

Didn't have a homebirth with dd1 as was never even mentioned to me as an option. However due with no2 at the mo, and since I went for booking in, MW has been very keen for me to have a HB (area now midwife led very pro active) and thus I am having one sometime in the next few weeks! (she says hopefully!)

[Rhian101]

Hooray!

[melrose]

Did not even consider it for fist birth, DS got stuck and was delivered by forceps but do wonder if this would have all been avoided if I ahd a home birth, hated the hospital experiencea nd would go gfor home next time butnot sure theyw ould let me. Only 1 mile from hospitl so feel i could easily go in if needed

[ICindigo]

i think its becoming more common now, like it was before we had and NHS and it wasnt really possible- people who went to hospital in the 1940's were rich people who wanted the pain relief!! haha the rest fo us would have to suffer!

[MrsDoolittle]

I must be odd. My dh and my midwife, who also happens to be my friend want me to have a homebirth. I want to go into hospital!!
Why?

1. I don't want to worry about keeping the house clean.
   
2. I would like the security of being in hospital.
   
   FWIW I am a health professional.
   
   Funny, isn't it?

[ICindigo]

i 'spose its more relaxing not having to worry about the housework..!! haha
FWIW i dont have any kids and not sure whether i would have a HB ...? maybe cause have never been in that situation...

[Rhian101]

Not at all! It's all about choice isn't it? If you need the reassurance being at hospital gives you then definately go to hospital, if not then stay at home. I just think we should all be given all the info so we can make up our own minds and not be pressured to have a home or hospital birth.

[ICindigo]

My thoughts exactly Rhian. So many people have told me they weren't allowed a HB... I read somewhere than 98& of births are in hosps and 72% were offered no alternatives!

[Rhian101]

Sounds about right, and I hear so many tales of overworked hospital staff and people being pushed into medical procedures that aren't always necessary. I have nothing against hospital births at all but I know that when i'm in labour i want to relax at home in my own environment and not have to worry about when to go into hospital. I didn't know the midwife who attended me at home, but then I didn't know the ones in the hospital either.

[ICindigo]

I know its difficult because some people don't know they have a right to say no or decide what happens to them..things are made to sound worse than they are so a woman will go along with it- they can't make informed choices! most women aren't even told they can choose which hospital they go to. Its a good job people do their research

[LeahE]

I initially wanted a homebirth with DS but was in the position that my preferred hospital didn't cover my area for HB, so I either registered with my less-preferred hospital (would be OK if I did have a HB but would mean giving birth somewhere I didn't particularly want to if come D-day I needed a hospital birth) or stayed with my preferred hospital and gave up the HB idea. I thought about it a lot and eventually opted to stay with my first choice of hospital - thereby meaning I wouldn't get my most-preferred choice (HB) but wouldn't get my least-preferred one (hospital birth at the other hospital).

In the end DS was a big baby and never engaged (waters broke at 39+4 when he was still happily bobbing around free and easy) which made me a fairly high risk for cord prolapse. Even after a couple of hours of pushing he hadn't got further than 0 station, and I had an emergency c-section (they were planning to try ventouse, but after getting into theatre and re-examining me the doctor felt it was too risky). I know plenty of people have vaginal births of big babies with no problem, but I genuinely think that DS was not coming out by the conventional route and that whatever I had done I would have needed a c-section. So in the long run I think giving up my attempt at a home birth in order to have the hospital I preferred was the right decision (mind you, if it had would up being a really easy and uncomplicated vaginal delivery that I could easily have done at home I'd probably be kicking myself).