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! :)

The three times i had hb i didnt tell the midwives in advance,in fact,maybe it was luck but they seemed really supportive.With my first and 2nd they did examine me and listen to the baby when they first came,but once i got in the pool they just let me get on with it unless i needed them.With number 3 however i felt a real rappor with my midwife and actually ended up chatting to her about all sorts inbetween conractions and really enjoyed her company so she stayed with me.

I would like to have an independant mw but the nearest one is 35 miles away and i tend to give birth quite quickly,on a busy day she might not make it in time,plus idid actually interview one once but she went to the wrong house and then sent me a really angry email about how she had waited for me for ages!So i didnt bother with her,luckily the nhs has provided well for me,but that could have something to do with the fact that ive not had any complications or anything.

Can i just say aswell that i am almost as hippy as they come,but i do think its important to remember that some modern things have made life better,like antenatal care,scans to detect abnormalities and low lying placentas,and also the option to go into hospital should i need to.

Empty "Amy whatsherface on the blogspot is actually mental.

Don't read it,"

But that is exactly why it is a good idea to read it. If what she is saying is untrue or ridiculous then it will stand scrutiny. She argues just as strongly that the Ina May Gaskin theories are wrong.

I would say read them both and make your own mind up.

Amy whatsherface on the blogspot is actually mental..... Don't read it

Read it by all means, and Ina May Gaskin, but don't listen to her in preference to considering good UK based research, if you are having a baby in the UK.

Amy Tuteur is just too extreme. Sorry Ushy. She really isn't a good example. There are other people out there saying things without being bonkers.

I read it. It seemed like defensive raving rant. Rather than promoting anything good about intervention and hospital care it is simply laying into people who want homebirths and making some rather odd statements about how you can't learn anything from the Internet.

I agree Starlight - a rant - if she could put up some stats of her own about how her births are safer for the baby and the mother, she might be worth giving some consideration to. At best, how far do her rants transfer to the UK? We have qualified midwives, not the mish-mash that occurs in the USA.

Contrast it with this country where we have the RCOG saying that a homebirth is a safe option for low risk multiparous women. Why do people want to ignore this? They are hardly a radical out-there group of people.

Also, isn't Amy Tuteur American? (I know Ian May Gaskin is).

I think home birth is one area where it's really important to have a UK-specific debate. Obstetrics and midwifery are totally different in the UK and USA - different training & skills, professional roles, cultures, care provision models etc. That's why you can't take research findings for one country and apply it to the other.

When you ignore the context, then you end up falling back on arguments driven by dogma and hypothesis. A Tuteur vs Gaskin celebrity death match special might be entertaining but not especially enlightening

x-posted with LaVolcan !

starlight if it was one of my own women (and i maintain very good antenatal continuity of care give or take the odd holiday) either whenever the woman mentioned it first, and if not then towards the end of the pregnancy when birth wishes/plans are discussed. I do really encourage women to go to parent ed to help with those plans, and also towards AIMS who are often really helpful if women want something out of the ordinary, in terms of explaining their rights etc. Similarly early discussion gives time for me to ensure that I am professionally protected by talking to my supervisor of midwives, who can also visit the woman antentally, if necessary.

In your case, it's not good enough that there wasn't enough time. those midwives should have made time, if not in that appointment then they should have asked you to book a longer appointment another day to enable time to discuss it. Yes, we're all busy, but this is bread and butter midwifery and if we can't get this stuff right then we're in the wrong job.

sorry, just to clarify, I do alse explain their rights, obviously. AIMS are a useful support.

sorry for caps locked bit -

to put it in an example - a woman i met on monday had been in labour on the same night.

she was stalled all day from coming in, they even considered transfer to another hospital 1 hours drive away (minimum) - that hospital was also too full.

when she was finally admitted to hospital - she was already 7cm dilated and no doubt very stressed - if she had presented at that point with

high blood pressure
waters gone longer than 18 hours
or if the baby had also become stressed resulting in meconium in waters -

just for example

then she'd have been in that 20% -

she went on to labour another 16 hours on a rammed ward.

just in what way would it be statistically valid to disinclude her from CLU stats?

no-one is arguing for no intervention.

minimal intervention is a different matter.

It all turned out okay in the event because I went overdue by my scan dates and there's nothing like refusing induction to get you some attention.

I was elevated to a senior mw who wanted to make sure her staff were covered and she even swapped her shift on the day to attend as otherwise I woukd have had the mentioned Jnr mw who had never met me and with no prior knowledge of my birth plan. Absolutely can't fault the care or respect for me and my birth plan, but also know that it may well not have been as smooth as it was.

The homebirth rate in this country is so low it cannot possible be the cause of anything in the NHS.

Factoring the huge cost of even stepping foot inside a hospital I cannot see how homebirths cost more.

Two midwives are in attendance but for a relatively short time compared to the average shift of a MW in a hospital.

There are no additional costs to the NHS bar the delivery pack and a newborn check by the local GP.

Unlike in hosptial where everything costs money and a lot more than it would 'per unit' in the community.

It is utter nonsense to suggest that HBs are a drain on resources and the poor women labouring alone in hosptial do so because of the selfish homebirthers.

I wish people would make up their minds. Are we selfish because we want to be left alone to have our babies or are we selfish because we want lots of attention?

Edgar The 20% group that were rightly excluded were women who had complications right at the very outset. Obviously women booked for MLU care who phoned in with say bleeding would - rightly - have been diverted to the consultant unit.

So you couldn't include these in the 'low risk' group which is why they were excluded.

'at outset' = at admission. the example i gave stands. the study authors left those in for a reason....

there were some included for MLU and Hb at rates of 7% and 3%. as you can't know in advance (whatever the cause of this is) ....still should be included.

3% and 7% ..the other way round..

wow !!!

Did any one see thread from a midwife forum that all Mns are mad about medicallised births and it was sad we didnt belive more in homebirthing!
I hope they read this thread!

You do hear some right classics about MN from health professionals ... some (probably older generation to be fair) seem shocked and appalled that we ordinary folk are actually allowed to share information and discuss issues with each other without a HCP present

LaVolcan

I agree with you on one point as well- a healthy baby is not the only thing that matters, the mother's health is equally important.

Why then do you so harshly judge women(like me) who choose c sections by repeatedly bringing up respiratory disorders for babies caused as a result of c sections? Do you doubt that we are aware of the impact c sections may have on our babies and ourselves? Why do you so passionately support one choice and so harshly judge another?

shagmund
I've never understood what your problem is.

You claim so desperately not to be biased, but you are in reality so biased that it makes me want to bang my head on a wall. You love homebirth and drug free labours and you hate all interventions, possibly even when women themselves have no objection to them.You are clearly a fan of homebirth(nothing wrong with that) and you clearly mistrust all doctors- you seem to think they are all out to perform "unnecessary" interventions on women and those sweet, innocent midwives are just trying to protect us(if only). I think it is pathetic how you are arguing with a healthcare professional and that too an obstetric aneasthesiologist over the safety of interventions. She has a medical degree- you don't. She has seen all kinds of births- you've only seen your own, and maybe those of a few close relatives or friends.

I think most people wouldn't much care about your opinion on what's safer- anyone sensible would trust an obstetric HCP over you, who are clearly a layman.
Research has it's place but so does the years of experience of an HCP and what he/she has noticed in all those years of practice. Research may have claimed that homebirths are safe enough for certain women, but that doesn't eliminate the possibility of some serious risks associated with homebirths and the fact that many women will not be comfortable with those risks.
To assume they don't understand research and that they are uneducated in some way is sickeningly patronising.

You are against anything that costs the NHS even a penny extra (eg; elective sections and epidurals) and you think it's perfectly acceptable to deny women those choices because they are expensive and to simultaneously promote other options simply because they are cheaper.So if the government is short on funds, it's OK for them to direct their cuts at an area that impacts women so deeply? Why, because women are always at the bottom of the barrel? What is disgusting is that being a woman, this is still acceptable to you.

LaVolcan

Dr. Amy actually does offer very well explained and logical research on why she feels homebirth in America is not safe the way it is currently. I don't know if you are aware that in the USA, the midwives who attend homebirths are not CNMs with proper training and degrees(like we have in the UK), but CPMs, some of whom haven't even graduated high school or attended more than 10 births.

She also offers very valid explanations on why sometimes interventions are mandatory and why the natural childbirth movement often hands out misinformation.

If you read her blog with a little less bias and more of an open mind, you may actually learn something valuable.
You don't like her because she challenges the assumption made by the NCB advocates that vaginal birth=best in every case and that breastfeeding is always easy. You don't like her because she talks about the risks associated with vaginal birth, the reality of the rising c section rates and the truth that breastfeeding is sometimes very hard and not always the best. You call her opinions a rant because she challenges your belief system.

Can I add my viewpoint please?

I am someone who was very, very pro-homebirth, and given my experience with my last birth I have now decided that a minimal intervention hospital birth is the best option.

I was due to have a home water birth with DS. I was very, very set on this, no-one could change my mind. I read Ina May Gaskin, was regularly reading Angela Horn's very informative homebirth webpage. When it looked like I wasn't going to be granted a HB I really kicked up a stink.

However, my waters went and I didn't go into labour. As someone who was very paranoid about Group B strep infection, I was keen to be admitted into hospital for an induction. As I was already booked in for a HB the hospital were very accommodating, and let us light candles, play music etc and the midwives were very hands off.

I had a wonderful labour in hospital, up until DS's shoulders got stuck. It was an emergency situation, and it seemed like 20 people ran into the room when the button was pressed. Luckily, DS was birthed after a few attempts at McRoberts, but had to spend what seemed like a fair amount of time on the resus table after.

I must admit, when planning my HB, something like shoulder dystocia is something that I just didn't really consider would happen to me. I was a low risk patient. I do worry about what might have happened had I been in my birth pool at home and the shoulder dystocia occurred... I dread to think how they would have got me out.

Next baby will be born in hospital, but will make sure that I get the lovely experience I got first time around.

WhatTheHell

Why then do you so harshly judge women(like me) who choose c sections by repeatedly bringing up respiratory disorders for babies caused as a result of c sections? Do you doubt that we are aware of the impact c sections may have on our babies and ourselves? Why do you so passionately support one choice and so harshly judge another?

Are you addressing this bit specifically to me, or are you mixing me up with someone else? As far as I am aware I have never brought up respiratory disorders for babies however caused, and certainly not repeatedly.

I do think it is legitimate to question why different places have different intervention rates without there necessarily being any greater benefit for the baby. I am not just talking about comparisons between home/MLU/CLU - I think comparisons between CLUs are just as important.

I read the Amy Tutuer article. I found it odd. Very little fact, lots of rhetoric. The 'immunization' tactic she discusses seemed like every debate I'be ever seen from American politicians, and frankly I don't rate most of them. I am very concerned that the most rich and powerful nation in the world is so anti-woman, given the recent anti-abortion issues. I digress...

I felt that none of her arguments were supported by research or statistics in the articles I read, and that I have to question the motivation of any medical professional where money can be seen to be such a big motivating factor (although I appreciate that in the UK, lack of money is often a motivating factor) and where the culture is so law-suit fearing that a HCP might feel its better to intervene before any signs suggest it was necessary...

It was interesting reading, if only to see an alternate argument that was poorly argued. I feel it bears little relevance in the UK situation, where MWs are trained & qualified well.