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! :)

Benedict See your point exactly but isn't this a result of 'birth is a normal life event' no intervention activism?

Women are being 'educated' to 'challenge' health care professionals so that they can 'birth' naturally. Bad mummy if you permit interventions or need an epidural. Caesarean? you are an utter failure as a woman and a mother, you will never bond, your child will be born gasping for breath and suffer a lifetime of ill health......you didn't trust your body and your midwife....

Seriously though, I do think that is the message.

I think Ina May Gaskin should always be read alongside Amy Tuteur and then for people to make their own decision.

skepticalob.blogspot.co.uk/2012/06/no-homebirth-advocates-you-are-not.html

Sorry Ushy, I think I'm being terribly thick (have just finished night shift where I witnessed a lovely water birth where I did nothing bar intermittently auscultate and talk mum through delivery of the head oh and prompt her to pick baby up from the bottom of the pool!) but I'm not sure if you're agreeing or disagreeing with me

How about viewing birth as a natural event where no intervention is necessary under normal circumstances??!!

What's so wrong with saying c-section may be worse for baby? It's not ideal for women is it really, having someone slash you open, leaving you with injured muscles in the first few weeks of your newborn's life? I'm not saying people shouldn't do it, if that's their choice or for necessity, but let's not muddy the waters with elective medical intervention and necessary intervention. Especially if people keep going on about how bad mothers some women are because they choose home birth.

Why should birth be medicalised? It's not an illness. If you want pain relief in the form of an epidural, fair enough, but that's not happening in a home birth is it??!!

The whole point of the debate is about women having the choice of home birth within the normal protocols, if they are low risk & so on. That choice extends to hospital birth and elective c-section.

FWIW, I wasn't monitored once during my DDs birth, and that was at a hospital.

I am sure you are saying that women need to understand risks and benefits and make their own decision and so I guess I agree.

Unfortunately, the information out there is biased - so one solution is to read up on the perspectives of the proponents at the opposite ends of the spectrum.

Whatin - good post

Can I just add something though? There is no requirement for a woman to be able to acknowledge the risks of a procedure she is declining although there would be a duty of care for the HP to explain them.

It is enough for her to say 'don't do that' or 'I don't want that'. The unconsented touching of the body would be an assault and battery even if the intent was to help the woman.

Ushy
Women are being 'educated' to 'challenge' health care professionals so that they can 'birth' naturally. Bad mummy if you permit interventions or shock need an epidural. Caesarean? shock shock you are an utter failure as a woman and a mother, you will never bond, your child will be born gasping for breath and suffer a lifetime of ill health......you didn't trust your body and your midwife....

That may be your opinion, but it's certainly not been my reading of the thread. There is nothing wrong with having a Caesarean if it's necessary but I do think it's legitimate to question why mulliparous women in CLUs have significantly more CSs than those giving birth in the other locations.
The Place of Birth Study showed this to be a fact. The Study wasn't able to show that there were better outcomes for the baby in that situation.

If all of us/ even a third of us today decided to go down the home birth route to escape the problem of bad maternity wards in the NHS, there won't be enough midwives to look after all of us . It would be a disaster. So we are back to square one and back to the same problem we had in the first place which is shortage of trained midwives and therefore poor experience .

So the solution is fix the NHS . The NHS is short staffed and needs more trained midwives to give one to one care for labouring women .

The home birth is a poor side show .

Rhianna My understanding is there are enough midwives but there aren't enough jobs for midwives as there's no money.

Chunky" How about viewing birth as a natural event where no intervention is necessary under normal circumstances??!!"

The problem is death is a natural event and we intervene in that so the waters are muddied by people having different opinions.

Birth being a natural event where you don't need to intervene is a belief about birth which not everyone shares.

Other people have different beliefs e.g. babies are getting bigger, women are having them at a later age and there are more complications. We are a technological species so intervene to make birth better.

I don't think we can argue one way or the other - it is for the individual woman to decide what her world or 'birth' view is and have her views respected.

The problem with saying caesareans are worse for the baby is that a lot of women and obstetricians argue the opposite. You can say it, but some people may look at the evidence and decide not to agree.

Ditto homebirth, I don't think anyone in UK is arguing that homebirth is risky for low risk women after their first baby. But in the US they do argue that.

I think everyone can have their views of what's best for themselves but not impose their views on everyone else.

Flispaps : we are still facing the same problem which is lack of midwives because of lack of money .

We have to dish out some extra money for the ambulance fleet too.

With the same amount of money that we would spend on sending out midwives and ambulances we could have them all in one place and use them more efficiently .

"
This is not the proper comparison because this included the high risk group that were transfered to consultant care - so not fair to the obstetric group."

YOU CAN'T CHOOSE NOT TO BE IN THAT GROUP. the fact that group is part of the clu 'characteristics' - it may be caused by something done by CLU admissions (so definitely fair to include) - or a feature of the demographic (so corrected for later - still fair to include) or a feature of CLU antenatal screening (so still fair to include) - just as transfers are part of the HB stats.

so the statistics for decision making are as i have reported them, and as they are on the front page summary of the study.

"With the same amount of money that we would spend on sending out midwives and ambulances we could have them all in one place and use them more efficiently"

Our local maternity unit uses midwives very efficiently.

In the sense that they can spread them nice and thinly between as many mothers as possible.

And if it results in more women having hideous labours, PTSD, avoidable c-sections......

"I think everyone can have their views of what's best for themselves but not impose their views on everyone else."

Could not agree more.

And at the moment, at least going by the evidence I've seen, the view that's being 'imposed' on women is one which holds that births take place in hospital.

"Caesarean? shock shock you are an utter failure as a woman and a mother, you will never bond, your child will be born gasping for breath and suffer a lifetime of ill health.."

Ok - this is your summary of a range of concerns raised about the impact of surgical birth? Can we stop polarising this issue by distorting and exaggerating people's opinions and views?

I don't know ANYONE who holds the view that a woman who has a c/s is a 'failure' as a woman. Not one person. Nobody who says mums who have a c/section 'won't bond' and nobody who says c/section inevitably results in health problems in children.

Nobody is saying these things. So why do you feel the need to post comments like this?

no, there is no requirement for women to do that, but I am a midwife and I find that women, bar a very very few exceptions, want to work with us to make the whole process better and to help them have the experience they want. I have never, in 10 years, met a woman who didn't care a hell of a lot more about her baby than those looking after her, so I think we do a disservice by assuming that some women don't care enough about their babies to make sensible choices, or indeed that they are not capable of making such decisions. I just really believe in collaboration, not dictation. I certainly wouldn't feel comfortable going along with a plan which went against protocol/evidence and which hadn't been clearly and honestly discussed. I would be quite happy telling a woman that I felt her decision was not the safest, but that it was hers to make, and indeed i have done so and happily looked after her while her plan was seen through. It's all about good and timely communication. I still see and hear far too much 'you are not allowed to XYZ'.

I don't understand why the debate about homebirth is so polarised tbh, when the evidence is clear.

Shagmundfreud
Read my last 2 posts then reply .

The point is that home birth is unsustainable if everyone wants to do it . The most efficient way is fixing the NHS.

so..the argument goes like this...

i have my opinion (HB is fine)
others have theirs (it isn't)

that doesn't get us very far.
so you get statistics ..

which present a complex picture ..neither yes nor no but under these circumstances x, y, z....

which require proper interpretation.

hopefully HCPs do this in good heart without bringing too much of their own initial prejudice (either way)

but that doesn't say anything about individuals - like thunksheadontable - one of the most interesting posts and an illustration of a good care plan being found - individuals are not statistics. we make decisions as a population of 1, not as a cohort.

individuals should have the right to make their own choices, with proper information - not anecdote, not scaremongering and certainly not OBEM! where home birth services and ML units are closed women don't get those choices...or it is made stupidly hard for them.

Benedict,

I'm my recent homebirth, the midwife said nothing during delivery of the head (8lb 9oz) and my breathing changed to panting instinctively and the head came out REALLy slowly and controlled. Having said that, I was totally unafraid and not even had any gas and air which might have interfered with my instincts. But, my body really did know what to do and how to breath. No stitches required.

rhuianna as that isn't going to happen, not worth worrying about. you might see a gradual uplift in HB if they act on that study...

which could be planned out properly.

Edgar :
That's not the point. Whether honebirth rate is going to increase or not is not relevant . Having 2 midwives for one lady in labour at home is drain on the resources . I have lost count of how many women on here complain that they didn't have one to one care in labour and were neglected . So the solution according to you is to drain the hospital even more from midwives ?!!

So when you are sitting there with 2 midwives at home , there is some ward out there short on staff and screaming for midwives . Do you feel good about it ?

It is a RESOURCE issue at the end of the day .

Ushy, I agree wholeheartedly that we shoukd make birth better, and that intervention in current birth practices are required for this. Except I believe the intervention into current birthing practices is to move away from the unnatural. I believe too that many homebirths have a long way to go before they are ideal.

MY DAD passed away recently from a very aggressive cancer. They didn't catch it in time. If they has, and they intervened, he coukd have had two years of slow decline and suffering instead of the two weeks. My whole family is relieved that he only had the two weeks.

What,

You say you would be happy telling a woman her plan is not the safest. But when would you do that?

I tried to inform every one of the 6 mws from the first of all 6 that I was planning some things a bit less than usual but the clinic sessions were too short for discussion, and transition when they turned up for the hb, was far too late for any discussion.

It is safer surely, for midwives to be clear about any deviation from the norm BEFORE the birth rather than have a Junior midwife turn up to find a very wilful woman dictate to her exactly how she was going to birth which went against her training and hospital protocols!?

Ushy a few posts on here did argue that homebirth is risky for ALL women & babies and argued it should not be permitted/supported.

You state the argument for c-sections may be supported by evidence, yet real research used here to justify the statement that home births are not unsafe is overlooked/ignored. Personally, having had a baby vaginally and had a couple of operations, I know which I'd rather do, but that's my choice based on my experience - I wouldn't impose that on other women, & I wouldn't use that to support my decision-making process if I held a medical position, I would use the latest research-based evidence & relevant protocols.

If you use "death is natural and yet we intervene" stance as an argument for medicalised birth when no medical intervention is required where do DNR orders or suicide fit in? And how is that argument relevant to homebirths? Nobody is talking about doing it without medical care just unnecessary intervention.

Rhinana, hb is cheaper for the NHS overall. No auxiliary staff. Less need for consultants, surgery, anaesthetists, linen washing, and labours are shorter.

It is 1 midwife, from when they are called which given no need to travel is usually much later in labour. The second mw just comes at the end or for a second opinion.

Rhianna - So when you are sitting there with 2 midwives at home , there is some ward out there short on staff and screaming for midwives . Do you feel good about it ?

The midwives attending homebirths are community midwives though. They're not hospital midwives. They work out in the community anyway. Homebirths don't take midwives away from hospitals.

And yes, I felt very good knowing I had two midwives watching out for me and DS who I hadn't taken away from 'some ward out there short on staff' rather than being on an understaffed ward with two community midwives 'on call' sitting at home.

Rihanna in my health authority, home births and pg appt are run by community MEd and hospital/MLU births are dealt with hospital/MLU midwives. They are not the same pool of resources at all.

I had a complete stranger at the birth of my DD, & as much as she was lovely, she didn't have a clue about my pg or my birth plan, & didn't ask! My community MW was also lovely & provided support before & after birth. This time, I hope to have my community MW with me during labour too. So yes, I feel quite happy with that.

The resource argument is poor when we are talking about the continuity of care, or lack thereof, and the detrimental effect that has on the health & well-being, both physical & psychological, of mother, & therefore child.

Amy whatsherface on the blogspot is actually mental.

Don't read it, it doesn't give anyone a good view of why not have a homebirth. Her thoughts on birth and breast feeding are so so high BP inducing and biased, it's not worth it.

Carries views on previous pages are mild in comparison.