In two minds about having a home birth

[ViolaCrayola]

I had a horrible hospital induction 1st time around (have posted about this before), now 31 weeks with DC2.

Have been seriously considering a home water birth - have terrible SPD and water really helps. Plus all the other pros about home comforts, privacy, 1-1 care etc.

But I am very unsure that I actually want to have a baby at home! People seem to often be either very definite about home births one way or another, but I just feel undecided. Has anyone else felt like this? How did you decide eventually? Time is running out! :)

Interesting historical point LaVolcan!

Rhianna I think it might be useful for you to actually read up on what a home birth entails. It's certainly nothing like giving birth with no qualified attendant in a mud hut in the slums of Africa.

After a homebirth that went a bit tits up, I won't be having one again. I support them though and was witness to my friend giving birth to her son which was amazing. But I have learnt from my personal experience, and I know this isn't for everyone, that birth is upredictable and at the end of the day it's not about you having your special experience and all that, it's about getting that baby out safely.
I'm studying to become a mw this summer and know I will always fully support and encourage homebirths because I think they really make a difference to the mum. That said, they're not for everyone and not myself after what I went through with dd (gave birth in the back of the ambulance whilst trying io transfer to hospital. Not nice trying to push a baby out on a thin stretcher with paramedic staring at fanjo)

having read carries posts, I agree with a small percentage of what she said, but I'd like to remind her, just because she's a doctor doesn't mean anyone here will take kindly to being spoken to in a patronising and fucking rude manner.

it's not about you having your special experience and all that, it's about getting that baby out safely.

My impression is that most of us were discussing what was/is, in our own circumstances, the safest option, rather than a special experience. I don't think there is one person on this thread who isn't concerned about the safety of the baby.

"it's not about you having your special experience and all that, it's about getting that baby out safely."

Say this at your interview and you'll guarantee your application for midwifery will be binned the minute you leave the room.

Agreed, the implication that women who choose home births do so for their own gratification at the expense of the safety of their baby is one that pisses me off immensely. Home birthers care about their babies just as much as the woman who goes into hospital at the first contraction, they have just made a different risk assessment based on what they are comfortable with.

It's absolutely vile.

I have had one hospital birth and three planned home births.

I think in statistics, being a researcher. Therefore distance from the hospital was the primary concern for me. With a qualified, experienced midwife, there's practically nothing that can go wrong that wouldn't happen in hospital anyway. Things that do go wrong take around 60 minutes to happen (unlike what you see on Hollywood and the TV, which are made to look a lot more dramatic). So there is plenty of warning. If you are within 60 minutes of a hospital, it's straightforward to transfer you by ambulance, and you won't be disadvantaged medically. If it's more than an hour from the nearest hospital, then you need to look into it more carefully, as the risk increases in proportion to transfer time.

It is also risky to drive to hospital to deliver if you are prone to rapid labours, and one thing consultants and midwives hate is car park deliveries. So that's another example of where a home birth is likely to be lower risk and more appropriate. I am only 15 minutes from a hospital, but my record is 10 minutes for second stage, without much warning that second stage was imminent, so I was advised by the obstetrician to stay at home for the fourth delivery and to ring for a midwife as early as possible, on safety grounds. In the event she was right - I probably wouldn't have made it in time.

Home births also ensure the full attention of one if not two midwives, which reduces risk. There is also reduced risk of post natal infection.

People should stop flapping and look at the data on risk before leaping to conclusions about whether home or hospital births are safer. Headline statistics are not enough. You need to consider where your case fits within that. Are you healthy? Singleton delivery? Hospital close by? Home birth may be safer. Scottish island? You would need your head examining. See the logic?

Well said Benedict, Shagmund, LaV et al.

Anyone saying that HB's steal MWs & resources from other mums is deluded. For both my HBs, they happened so quickly that I only managed one MW - the first turned up about 8pm and left shortly after DS was born at 11pm, after running me a bath. She had been anticipating birth at about 5am and was really surprised how quickly it progressed, so hadn't called for another MW.

The second, the MW was passing on her way to a night out with friends when she got a call, she walked in the door and checked me over, told me to push whenever I felt like it, and 5 mins later DD was born, MW checked all was ok, and still made it in time for her meal!

Of course its not about having 'a lovely special experience', its about keeping it as stress free and calm as possible for the benefit of mum & baby, which for me meant knowing that my other DCs were safely tucked up in their beds, having the comfort of my own surroundings, having H around afterwards (not being sent home like he was in hospital!) and not having a bunch of doctors being patronising and presuming they know what's best for me (I have very little respect for most of the ones I've met, with good reason).

I'm sure they were both so quick because I was relaxed and had spent the previous couple of hours having natural contractions which did the job they were supposed to do i.e. helped push the baby out (they were DC2 &3 so DS1 had paved the way!)

I don't think 'lovely special experience' enters into the equation for a lot of people. It's just a very practical way of doing things. HBs are a lot cheaper for the NHS as well - the full cost of occupying a delivery suite is eye watering, and in my heart of hearts I think these ought to be reserved for the women in difficulty, not wasted on those of us who just pop babies out in the ad breaks.

I've read through this thread and I have to say I'm utterly appalled by the level of arrogance being displayed by Carrie. Its one of my biggest bugs, that they are so opinionated, they fail to listen when they should because they think they already know it and have already made a decision about what is best for you, either without any discussion or with a massively biased opinion that puts undue pressure on someone.

Thats one of the big things with medicine, you never can and you should always listen as you might learn something if you let your own opinions control your thinking you are close minded and shut down people who might not feel able to express something or reveal a piece of information that has clinical importance.

In short, if you are close minded like this on an internet forum, you are a bad doctor.

Anyone who says: Shagmund, I think you have been listening to too many 'knit-your-own yogurt' NCT zealots when you make the statement about problems being caused by being in hospital.

Is not only rude but deeply unprofessional. Whether or not there is merit in the comment, is totally lost in the attitude and arrogance. Judging others and using derogatory name calling as a put down has no place in the debate. Especially if you are a doctor.

Not to mention I have to say, there also too much focus on physical issues and ideas of safety and a neglect psychological considerations both long term and whilst actually in labour...

I think your views may be skewed a bit stmoritz. You need to be really careful those views don't rub off onto women in your care if you get a place at uni.

I think you'll also find once you've done 3 years of a degree, and numerous hours in placement, that actually getting a baby out safely can be achieved at home easily, and more so if the mum is relaxed. That statement you've made actually saddens me because that's your view of childbirth already, and you've not stepped into midwifery yet.

Also wrt having "a lovely special experience" surely as a pregnant woman planning her birth aiming for this is going to be beneficial for everyone. Happy mother = happy everyone I would have thought. It's OK to make this day all about you, because it is all about you! So, doesn't make sense to me really all this making out that mother's should think of others (eg baby) at this time. Don't you think we all want a happy baby too !!

Too true - 'tis doctors like Carrie that give obstetricians a bad name and, ironically, create the backlash against hospital birth that they constantly moan about.

Any other doctors lurking on this thread? It would be sooooo nice to hear from some non-loony medics who are capable of understanding evidence.

You simply cannot separate a mothers determination for the safety of her baby from her desire to have a homebirth. IME, the decision STARTS with the baby and the benefits of as physiological and less interfered with birth FOR said baby.

One comment I heard was "I'm sure a home birth is a more spiritual experience, but it's not safe".

WTF! Like those of us who have HBs would rather listen to whale music and burn incense than have a healthy baby!!!

Carrie370 Fri 29-Jun-12 21:06:46
Oh, give me strength! Starlight your obstetrician needs to explain a few things to you!

Will all the good little children people shut up and listen to those who know better.

Hadn't seen that one. Un-fucking-believable.

I dunno. Being insulted by an idiot isn't a big deal is it?

What IS a big deal however, is that said idiot is in a rl position of power over women's hospital treatment. Biggest advert to avoid I'd say.

My NHS obstetrician was reasonably pro home birth, actually. Because presumably she had read the literature and knew what did and didn't work for the women she was working with, in this particular local area. Bookings for HBs are higher round here than for other areas, and our mortality rates aren't any worse, as far as I know.

In fact I have a vague memory of the hospital giving me an official leaflet saying "Have you considered home birth as an option?" at booking in. No lentil weaving there.

Home birth is one of the three options routinely given to pregnant women in the PCT where I live.

It's supported, as a safe and mainstream birth option, for low-risk women by national NHS guidelines, the Royal College of Gynaecologists & Obstetricians, and the Royal College of Midwives.

And yet the media and assorted nutcases like Carrie continue to push this scare-mongering bullshit, depriving women of the choices they are entitled to. It makes me so

What do women fear most about childbirth?
Going by what gets put on MN?
Not being listened to, being treated with contempt and a lack of respect or patronised and treated as if a child by HCPs is pretty close to the top of the list, after the baby dying or being injured. It seems to come up, as much, if not more than concerns over pain.

Saying stuff like Carrie has just done, intensifies that fear and actually arguably takes her onto thin ice as to whether she could be opening herself up to a 'disrupt' charge, as it could have a very negative impact on any member of the public reading this.

It could put a woman off seeking medical attention she needs and drive her down the HB route when it is inappropriate in her circumstances.

You can argue about the safety of homebirths by much better means that don't scaremonger but also don't damage doctor/patient relationships.

Selected bits from the RCOG statement no2

Bold is my emphasis.

Summary
The Royal College of Midwives (RCM) and the Royal College of Obstetricians and Gynaecologists (RCOG) support home birth for women with uncomplicated pregnancies. There is no reason why home birth should not be offered to women at low risk of complications and it may confer considerable benefits for them and their families. There is ample evidence showing that labouring at home increases a woman's likelihood of a birth that is both satisfying and safe, with implications for her health and that of her baby.

1. Review of the evidence: benefits and harms

2.1 The review of the diverse evidence available on home birth practice and service provision demonstrates that home birth is a safe option for many women. However, this is not to define safety in its narrow interpretation as physical safety only but also to acknowledge and encompass issues surrounding emotional and psychological wellbeing. Birth for a woman is a rite of passage and a family life event, as well as being the start of a lifelong relationship with her baby. Home births will not be the choice for every woman.

2.2 Randomised controlled trials to assess the safety of home births are not currently feasible. The observational data available show lower intervention rates and higher maternal satisfaction with planned home birth compared with hospital birth. Overall, the literature shows that women have less pain at home and use less pharmacological pain relief, have lower levels of intervention, more autonomy and increased satisfaction. The studied interventions included induction, augmentation, perineal trauma and episiotomy, instrumental delivery and caesarean section. These are not insignificant interventions and may have considerable impact on a woman's long-term health and emergent relationship with her baby, as well as her satisfaction with her birth experience.

Note the last sentence above says AS WELL AS, not that it was the most important thing.

Last time I checked the RCOG wasn't a bunch of yogurt weaving zealots.

I don't know though, there is truth to the idea that many women seem to book homebirth for continuity of care, is this good enough? I don't believe home can categorically be said to be as safe or safer than hospital as homes are very different to one another and not all women will feel more relaxed and in control by virtue of being in their own environment as I discovered. I would like to see equal mw care in all environments vs adequate care offered as a carrot for choosing a cheaper birth...

Yes. I find it disturbing that many MLUs are offering partners the opportunity to stay the night/visit all hours, support the woman in all stages of labour but if the woman is a higher risk case, and thereby likely to need MORE support, her partner is chuck out to minimum visiting levels.