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! :)

shagmundfreud
"Although I would agree that consultant led care for low risk mothers not planning a c/s is - categorically - a waste of resources in a medical system where there are not enough obstetricians to provide adequate care for the many women in this country with complicated and fragile pregnancies.

Are you really going to try to make a case that low risk women should have a right to see a doctor throughout their pregnancy? Even if they have no medical need? And aren't requesting a c/s?

Why?"

Why not? This is what I mean when I say that the likes of you only support choices you feel are appropriate. If a low risk woman prefers the care of an obstetrician and has more faith in the competency of an obstetrician as opposed to a midwife, why shouldn't she have the right to choose who provides her ante natal care for her? How can you support a school of thought where women don't have the right to choose their ante-natal care provider? If resources are limited, why should it always be women who are sacrificed at the altar of austerity measures? Because we are always the bottom of the barrel? And you (as a woman) support that? I know you have more faith in midwives and prefer the care they provide. How would you feel if you were forced to go to an obstetrician and were given no choice in the matter? Advising low risk women to choose midwife led care based on evidence is perfectly reasonable. Leaving them with no other choice is not.

UK is not the only country with universal healthcare and limited resources to deal with. Yet, it is one of the only countries where women are forced to see a midwife whether they like it or not. Canada has universal healthcare as well, and I doubt that the Canadian government has a bottomless pool of resources to pump into healthcare. Yet, women are free to choose who provides their ante natal care- be it an obstetrician or a midwife. And that is exactly how it should be.

I am not making up points to argue with you. I have observed your skewed arguments in many threads and you consistently exhibit biased opinions even though you desperately claim to be fair.

WhatTheHell, that's a bit like saying that you should eat all your meals in A&E just in case you choke or have an allergic reaction!

Actually, all women in the UK, including those who are low risk, DO have the right to choose consultant-led care. Probably most women are not aware of this, but even if they were, I can't see the uptake being particularly high.

shagmundfreud

"Exactly what would you like to see WhattheHell? A further lowering of the normal birth rate? More women giving birth in hospital? To what purpose?

There is on the whole not a great deal of discrimination against mothers wanting medicalised births. In fact they're quite likely to get one whether they like it or not. I have sympathy for women who want a planned c/s and would like all women to realise their choices for birth. However - there is a separate debate to be had about the best use of finite resources within NHS maternity care

The real problem is the very large group of women who don't want to have interventions in their birth if they can possibly be avoided without risk to mother and baby. It's these women who are really struggling to have access to the type of care - namely one to one midwifery care - which would enable them to have an optimal chance of achieving the birth they want."

Exactly where have I said I want to see a lowering in the rate of normal births? What exactly would I achieve if that happens?

Maybe you should finally explain what you want to see? More women giving birth at home? Women being denied epidurals and c sections because they are too expensive? Women being denied all choices that you disagree with and choosing the options you champion?

The difference between you and me is that I want to keep my nose out of how other women give birth. The national VBAC or c section rate is of little significance to me so as long as every woman is getting the choices she wants and the maternal and perinatal mortality rates are not adversely affected.

While people like you often enjoy whining about the high c section rates, the little fact you ignore is that it hasn't adversely affected the maternal or perinatal mortality rate. If anything, the latest WHO statistics ironically reveal that countries with the highest c section rates also have the lowest maternal and perinatal mortality rates.

To be very clear, I do not support unnecessary c sections or any needless other intervention for that matter. BUT I don't think you or I have a crystal ball to be able to determine with certainty which intervention was necessary and which wasn't. I also don't think that the way to bring down the c section rate is to deny women the right to choose c sections. The way to do it is to educate women prior to the big day so that they are armed with sufficient information to deny any procedure they are uncomfortable with.

And yes, women want medicalised births are judged. In fact you've been judging them all through this thread, even though you will vehemently deny that.
I don't think it is all that much of a struggle to access midwifery in the UK- the last time I checked it was available to everyone whether they liked it or not. So I don't know what the hell you're talking about there. Home birth is also safe and legal in this country- in fact you've had three haven't you? So what exactly are you trying to say?

StarlightWithAsteriod

I fail to see the analogy. It is illogical and ridiculous.

In several countries across the world, women routinely go to obstetricians for ante natal care- Canada, Singapore, Qatar, Korea, Belgium, Australia, UAE, USA, to name a few. The concept may seem incredible to you, but it is working rather well for many countries across the world. In fact, even in several European countries women mostly choose to go to obstetricians for ante natal care. Even countries like India and China which aren't fully developed yet, have mainly obstetrician led ante natal care.

Bue

I don't think that is true. You cannot choose consultant led care on the NHS. You can only be referred for it if the midwife or GP think it is necessary.

The point isn't whether the uptake will be high- the point is that everyone deserves to be given a choice.
The uptake for home birth isn't particularly high either, even though it is safe and legal here in the UK. So shall we stop offering it, because only 2% of women desire it?

StarlightWithAsteroid

"WhatTheHell, that's a bit like saying that you should eat all your meals in A&E just in case you choke or have an allergic reaction!"

Is it ? I read that simply that women should have the choice?

Isnt that what we should all be aiming for?

Choice to have HB, ELC or CLu or whatever, because we need a choice and we are all very different? A choice without anyone judging us?

Re costs, I totally agree that BEFORE looking at trimming maternity costs to the NHS - first of all - tighten up on all the other money heomoraging problems,

costs to nhs of drunks fighting...missed appointments - systems that simply dont work and are in effective - hospital tourism?

Does anyone have stats on how much money is owed to trusts by people that have come here to use NHS then buggered off without paying?

But What - obstetric care for low risk mothers in the UK is not linked to better clinical or psychological outcomes than midwife led care - so why on earth would we want to squander scarce NHS resources on making it available to low risk mums?

What would be the point of it?

I dont think many people are aware but you have complete choice,you can have a midwife,you have the right to and can request a consultant,you can even legally go without either and do it yourself.

I agree everyone should have the choice,but i also think there needs to be more education,and not just from your standard mainstream experts,from all different points of view.

"And yes, women want medicalised births are judged. In fact you've been judging them all through this thread, even though you will vehemently deny that. "

I got that impression too - I have been granted a maternal request ELC but now that I have I feel much more relaxed and open into looking into other options....including a HB which I would absoluty LOVE.

So I have slogged through all 17 pages of this and I am amazed at the way in which some people who have come on to say they personally wouldnt do it - have been shut down, critised and and abused and when they have fought back - everyone has jumped on them - ie carrie.

I found her opionion to be very interesting, I think its great when proffesionals working in the field come on, we all know that thier view point may be skewed as much as the ...well i had this birth experience...BUT that is thier experience, and I am very glad proffs come on here....its up to ME how I use thier info, but to have a debate, you do need oposing views!

But What - obstetric care for low risk mothers in the UK is not linked to better clinical or psychological outcomes than midwife led care - so why on earth would we want to squander scarce NHS resources on making it available to low risk mums?

What would be the point of it?

Because who is to firstly judge a LOW RISK MUM.

how do you judge low risk?

personally I would rather tackle other areas of NHS sqaundering money - managers - hospital tourists - a&E drunks BEFORE worrying about cutting back costs of woman and children at the most fragile time of thier lives - probably....

Because we should all have CHOICE.

If a woman feels SAFER by chosing that - why not let her have it?

From NHS Patients' Rights: "Generally, an obstetrician will only get involved if there are complications. However, you can request to see an obstetrician, even if the midwife or GP is providing all the care."

OK so it's not actually "consultant led", but you can at least request to see one.

"Exactly where have I said I want to see a lowering in the rate of normal births?"

Nowhere. It's just that you seem to feel there is an unfair focus on normal birth in the way maternity care in the UK is delivered and in term of social attitudes towards birth, to the detriment of women who want a medicalised birth.

I simply don't see what you see - the figures support my view that there has been a huge increase in the epidural rate/hospital birth rate/c-section and intervention rates generally in the last 40 years. In a cultural and medical sense we are moving more and more towards medicalised birth. Not away from it.

"Maybe you should finally explain what you want to see? More women giving birth at home?"

If there is evidence that more women want this (there is) then yes - more home birth.

More one to one care.

More caseloading care.

Because these things are linked to the very best health outcomes for women and babies.

"Women being denied epidurals and c sections because they are too expensive?"

Where did this come from? But what happens if maternity funding isn't increased and the money has to be shared out fairly across maternity services and across all sectors of the population? What should be prioritised?

• increasing access to obstetric services for low risk mothers?
• improving access to obstetric services for high risk mothers (who at present are suffering from a lack of consultant cover and one to one midwifery care in hospitals)?
• improving postnatal care?
• increasing midwife numbers?

Seriously - there is rationing going on all the time. How do hospitals decide what their priorities are if there isn't enough money to go around. And there isn't?

"I also don't think that the way to bring down the c section rate is to deny women the right to choose c sections."

Going on current evidence the quickest and easiest way to bring down the rate of emergency c/s would be to significantly increase midwife numbers, open more birth centres, improve access to homebirth, and encourage many more low risk women to stay the hell away from the labour ward when they give birth. Oh, and improve consultant cover in CLU's so that women with complicated pregnancies have access to expert obstetric input day and night.

"And yes, women want medicalised births are judged. In fact you've been judging them all through this thread, even though you will vehemently deny that"

How? Do you want to give examples?

"I don't think it is all that much of a struggle to access midwifery in the UK"

One in four women didn't get one to one care in labour from a midwife.

Midwifery is in a state of crisis in the UK - there are not enough midwives. Many midwives feel the service is at breaking point. Obviously this is not true across the UK, but where I am in London there is a real problem in many hospitals.

Shag

"Midwifery is in a state of crisis in the UK - there are not enough midwives. Many midwives feel the service is at breaking point. Obviously this is not true across the UK, but where I am in London there is a real problem in many hospitals."

Really, well until we get a handle on immigration - this is going to be alot worse for ALL of us.

Oh yeah! Let's all vote for UKIP, they'll sort maternity services out for sure!

I will hide this thread because I really can't be bothered with it anymore: I entered into the debate originally as someone interested in a HB & it has descended into a massive debate about all aspects of MW care, the NHS & a discussion of the general indoctrination or otherwise of women. It is no longer worth my time reading it, as I have got what I came for; HB is a good option for me & my baby.

But before I go...

1. I was flat on my back during my CLU birth despite planning not to be, & I feel that it led to a slowing down of a natural swiftly progressing labour, a harder, longer pushing stage & a 2nd degree tear (although I appreciate there is no way of knowing this for certain)

2. I didn't have any MW support/care during the vast majority of my labour because they wouldn't admit me at 1cm. However, I believe that, if the hospital was not under such pressure, I may have been admitted and I may have experienced a calmer transition stage & felt more cared for generally. Obviously the MW that checked me first time didn't know I'd go from 1 to 9cm in a couple of hours, but if she wasn't worried about workload, it might not have been such a big issue. I actively wanted to be in the MLU/CLU and didn't necessarily feel labouring at home was beneficial to me.

3. my local hospital isn't suffering because of immigration; its struggling because other health authorities are closing their hospitals/shutting their maternity units & the MLU/CLU now deliver twice as many babies annually with the same resources. What makes it worse is the other authorities often fail to pay for treatment provided to their patients and my health authority is going broke, quite literally. These facts cannot help but influence my decision to HB.

4. I think educating women about other non-medicalised options, and informing them of the risks of the options they choose, is vital if every woman is to get a safe and healthy delivery of their baby. I didn't want or need an epidural with my DD and don't intend to have one this time. I don't blame other women for having them, its not for me to judge BUT perhaps better information about other options might help women birth more 'naturally' and avoid complications. There are drawbacks to everything afterall, and being educated on the pros and cons doesn't mean you're going to change your mind, it just means you've made an informed decision.

So thank you to those of you on this thread who have provided so much information about HB and MW practice in this country. I have learnt so much (too much) and have certainly developed confidence in my decision.

OP - I hope you make a decision you are happy with and things go well.

Given that birth is unpredictable even for low risk women (with their second pregnancy ) , why would anyone put their life and life of their baby at risk and mercy of a fast ambulance to the hospital ? Unless they are being selfish .

I want to pile in and agree to earlier poster too .Yes I'm pro choice as well and according to your argument I should be able to demand a consultant led birth which in reality will never get unless I have complications. Let each of us have their preferred birthing style . You want to have your baby in the kitchen , and I want the most experienced consultant on offer . Isn't NHS all about choices according to you ?

WTF wants to have a baby in a kitchen.
Why are you not able to discuss this issue without making ridiculous comments?
I wonder.

What's wrong with the kitchen ? it's part of the home .

1. It is convenient to snack there while labouring
2. Has all the necessary equipment needed for birth eg spatula , kitchen paper , episiotomy knife , blender for placenta, mop for the blood and poo
3. Need the double doors to make it easier for the paramedics to come in when my legs are spread out

1. None carpeted , therefore more hygienic

Im going to have number 4 in the dining room!

shagmundfreud

It terrifies me that there are women who think like you.

"But What - obstetric care for low risk mothers in the UK is not linked to better clinical or psychological outcomes than midwife led care - so why on earth would we want to squander scarce NHS resources on making it available to low risk mums?

What would be the point of it?"

What would be the point of it?! What would be the point of any choice for that matter? What is the point of epidurals? Or waterbirths? The point is that for some women these are choices that give them satisfaction and peace of mind, even if they don't have solid medical benefits.

It disgusts me that you think a woman exercising her right to choose is "squandering" NHS resources.
A lot of options that are available as choices are not really associated with better clinical outcomes. That doesn't mean women should be denied those choices.
More importantly, if other countries can give women the right to choose who provides their ante-natal care, then why exactly is this such a scandal in the UK?
I think it's a very simple choice. A woman gets to decide who will provide her ante-natal care and who will support her during delivery. I can't imagine why this bothers you so much.

If you are so worried about "scarce NHS resources", maybe you need to direct your cost cutting suggestions to areas other than women's healthcare. As I have tried to get through to you a billion times- women are not the bottom of the barrel. Childbirth can impact a woman's mental and physical health in unimaginable ways- this is not the area to direct cost cutting measures. There are plenty of other areas where the NHS can save their precious resources. Women don't have to make sacrifices in yet another area for the benefit of society at large. This may sound strange to you, but it is OK to make us the priority sometimes, especially when we are bringing the next generation into the world.

Are you sure you are a actually a woman?

I genuinely have no idea what a consultant could do with a low risk woman, who has absolutely no risk factors at all

If a woman has deviations for the norm, she is referred. Then it is shared care. I have women who are high risk that see consultants for plans of care but still like to come to me for the normal stuff, even if it's just a chat about how things are going, a listen in, and a matb1 needs to be signed (examples) In any case it would be very unusual for a consultant to see a woman at every AN appt she needed.

Eg - booking, 16,21,25,28,31,34,36,38,40. Usually they see women at beginning, then plan for subsequent visits to suit. I can't imagine a time when it's only cons that see women. Unless your paying for it.

Anyway I'm going off tangent and after a long day at work I'm probably not making any sense.

I also think there are a few of you here who are really passionate about women's choices and give really good strong arguments, and can look at evidence, understand it and pick it apart.

You ought to think about midwifery as a career. Seriously.

elizaregina So I have slogged through all 17 pages of this and I am amazed at the way in which some people who have come on to say they personally wouldnt do it - have been shut down, critised and and abused and when they have fought back - everyone has jumped on them - ie carrie.

Carrie didn't come on and say that in her personal opinion she wouldn't do it though. What she actually said was I am 100% anti home births. I am both a mother, and an anaesthetist,... .....I would go as far as to say that anyone contemplating home birth needs a reality check. We are in the 21st century now - why would anyone deliberately jeopardise the well-being of their baby, even if the chances of adverse events are small?

When she was told that the lastest extensive piece of research, The Place of Birth study didn't back up that opinion, she didn't say that it surprised her because it was contrary to her experience. No, we were told that it was statistics, which is OK until you are the one for whom it goes wrong - then a nice piece of shroud waving - tell that to the woman who was brought in from a home birth with a dead baby.

When asked whether she had not seen a baby die after a hospital birth, no answer ( unless it was in tiny letters and I missed it). When asked how many normal deliveries she had seen, no answer except a grudging admission that her experience was skewed. When asked whether she had read the Place of Birth study, we didn't get a yay or nay, but we were told that she didn't need million pound studies.

We finally did get something of an admission that planning a home birth if you had experience of rapid deliveries was better than giving birth in a car by the roadside. If she could have come on and said something like "the piece of research you quote says ... but this alternative research says... " and quote a reference,that would be fine.

Plus a few choice insults en route when people disagreed with her. That's why she got jumped on, but having dished it out to others, she didn't like it and took herself off.

OK what - we have a situation in the NHS where there is not enough obstetric cover in hospitals to provide safe care for women whose labours have become complicated or for women who have serious health complications.

We also don't have the money to pay for one to one care from midwives or adequate postnatal care.

And the difference with the UK is that we have fully socialised medicine here. Pay for it and you can still have a doctor in charge of your care as a low risk mum. If you're not willing to pay you still get to choose a hospital birth and generally you're going to have access to epidural analgesia. Theoretically you may also be able to elect for a c/s - women on this board have done just that, though admittedly tight hospital budgets mean that they may come up against resistance to any of their care choices which cost more money and aren't associated with better clinical outcomes. This is true for treatment choices across the NHS.

And if we did get more money for maternity services you would spend it on.... consultant care for healthy women.

Why? Because some women like it.

Are you insane?

Women and babies are dying unnecessarily in UK hospitals because of a lack of emergency consultant cover and you want these doctors sat in an antenatal clinic discussing piles and birth plans with healthy (but spoiled) women who have no need of the skills which are doctors' sole reason for being paid twice shedloads more as much as midwives?

Seriously - I'd have like to have had a full course of one to one hypno birthing classes in pregnancy, but I don't expect the NHS to pay for it. Though by your reasoning this would be a reasonable demand (and by my reasoning more justifiable than obstetric care for low risk mothers in the sense that it is cheaper and would probably have some clinical benefit).

Oh by the way, yes I am a woman. And an adult. Are you?