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! :)

I transferred in during the second stage with DS after 4 hours of pushing and no sign of him appearing.

Blue lights, 25 minute ambulance ride. It was surprisingly OK, wasn't strapped down and had G&A.

I'd worked hard for a home birth as I was high risk due to problems in the third stage with DD. Yet there was no stress, I didn't feel unhappy about it - it was fine. It was the right thing to do and I was over the moon that I'd given homebirth a go.

Wow thanks very much for all the replies. So much helpful info and experiences. I am still feeling somewhat undecided, but edging towards booking a home birth, in the knowledge I can change my mind. I do also have the option (if I don't have any problems between now and then) of a midwife led unit within a hospital, in which I may have access to a pool, or may not. DH is fine with either option.

Something is playing on my mind - much is said about the psychological/comfort advantages of home birth, and the greater safety of hospital (however wrongly) but not much about the comfort/psychological advantages of hospital/MLU birth. Is this because there aren't many?! Does anyone have any views/experience of this? I had a rubbish time in hospital (arguing with the pushy MW/consultant, refused pain relief at points, epidural went wrong...) but I'm sure it can be different?

I have had a couple of friends say that they liked having some time in hospital just them and the baby after the birth, and liked the fact that their other child(ren) could stay in their home environment (I know this can happen for HB too if preferred). There is also the knowledge that there (probably) won't be a late stage transfer as mentioned above.

There is also still a small part of me that kind of wants to go off to hospital and come back with it all done and dusted, and have home separate from the birth... But mostly now I am thinking a home birth (especially a water birth) would probably be the best option for me.
Anyway, huge thanks again for all the helpful input. :)

Sorry just wanted to say I did read the posts by those who did have a positive hospital experience! It was interesting thunksheadontable what you said about being left alone more in hospital - as a positive thing. Also your birth room sounds amazing.

Sometimes it feels like it is a bit of a lottery - which room will be available in hospital and which MW will be on duty (at either hospital or home). Only guarantee would be hiring a private MW - no chance of that for me!

You're right on the lottery thing! I had a HB and was quite anxious about who the MW would be (obviously would have had that at either location!) but as it was, the MW was amazing and filled me with instant confidence in her. Plus being in the pool meant that I had my little area and I didn't feel any kind of intrusiveness.

In fact, I had three MWs including a student who came along because it was a rare chance to see a waterbirth and a HB!

The pool was a godsend for muscle pain, really helped the instant I got in. I can't get a pool at our local hospital and the nearest birth centre with a pool is a hell of a lot further from any obstetricians than my house, so all in all, home was the safest place to be!

Viola I would highly recommend a water birth - I had one with DS1 and it was a really great experience don't get me wrong, hideously painful but definitely improved for being in a birthing pool! Didn't have one with DS2, not enough time, and it was the worse for it.

I'm pretty scared of homebirths - and has proved sensible in my case to have babies in hospital because I haemorrhaged badly with no.2 but you can have a good birthing pool experience in hospital!

"but I cannot imagine the stress of having to transfer midway through labour, or the sense of panic if something went wrong an ambulance ride away from help."

I transferred in from home with third baby. Was fine. Most transfers are in no way traumatic or horrible. Actually you tend to go in with a light heart because you know you've done all you can yourself, and now you're going to get some help to finish and get your baby.

If you want to know about something going seriously wrong at a homebirth see the shoulder dystocia thread. Mine happened at home. Personally if the same event had happened in hospital with doctors running into the room and people yanking on emergency cords I think I would have found the whole thing even more frightening.

Well, I am certain I would never even consider it. It's not on my list of options and never will be.

It depends on how you view birth. I view it as inherently risky and I believe that modern medicine makes it safer. I don't belong to the "trust birth" gang of mothers because I don't see what there is to trust.

In any case, I cannot imagine giving birth without pain relief. As it is, I am having an ELCS. Had I opted to go vaginal, I wouldn't have done so without an epidural which cannot be administered during a homebirth.

Furthermore, obstetricians don't attend home births and I would be very, very, very uncomfortable giving birth in an environment where there is no consultant obstetrician or paediatrician on call for an emergency. I don't generally think midwives are equipped to handle every kind of emergency.

Also keep in mind that I am going private so I don't have the possibility of being turned away while in established labour or not getting one-to-one care.
A lot of women opt for homebirths just for a guarantee of one-to-one care. It's sad that this cannot be provided in NHS hospitals.

I planned a home birth and naievely didn't consider anything would go wrong. It was an amazing experience right up until almost the end. The midwife was brilliant and I needed no pain relief. And then my son got stuck - head crowning with the cord round his neck 3 times. I was bluelighted to the hospital (I managed to walk downstairs myself) and on a couple of occasions they lost his heatbeat. In the end he was ventoused out and I had a spinal block....which was a huge relief, as although I said I didn't need pain relief...I was lying. I nearly kissed the doctor when I couldn't feel anything from the waist down anymore. I am extremely lucky that my son was born a healthy 8lb4oz, but I think that was a miracle, rather than the norm. He was stuck for nearly an hour before he was born. I would hate to put anyone off having a home birth, as I have friend's who have done is successfully and it was a far nicer place to be than hospital. But I would never do it again. And I would also have a bag ready next time.....I had nothing with me at hospital. Those hospital gowns aren't very dignified.

In terms of your question about potential psychological benefits of being in hosp vs home, Viola - think it is very person-dependent. I had read a lot about the benefits of home birth and being in your own environment, but actually as soon as the midwives stepped into my front room it didn't feel like my environment. Everything I had heard about how in hospital you give away your sense of agency, you lose your voice etc.. that was actually paradoxically more true for me at home, somehow.

I am not a natural hostess. Our house is our private place, we only have family and very close friends visit, we are not those people who can have people drop by at a minute's notice and I am always worried about all the little things that need cleaning/revamping/renovating when new people come to our home. They were lovely when they came, but I didn't feel in charge. I didn't feel I could tell them where to sit or how to be, I felt a bit awkward as though I had the vicar round for tea when I knew soon I would be giving birth!

The noise was also a factor for me. Later on in labour, I was quite vocal. Very controlled, but vocal nonetheless. Dh said it was just standard mooing, but in my head it was very, very loud and I would have felt too inhibited to match my voice to the pain in my own home with my son asleep upstairs, knowing if he woke up he would have to leave the house.

I don't inherently "trust birth" either. I know the statistics are in favour of home birth for second timers with low risk pregnancies, but I am very risk averse as a person and I see no reason I might not be that one in a million person. One of my was also a low risk second timer, advised a homebirth as her first was nearly born before arrival (10 minutes in hospital!) but chose hospital, and it was good she did. She had an extremely rare issue with her placenta (the sort that shows up in journals, a tiny weeny risk, very very rare) and being in hospital actually did save her and her baby. It depends how you feel about that sort of risk. Lots of people can, very rationally, say "well the chances of that are small and the baby might die anyway in that circumstance in hospital"... but.. but... you can either do that, or you can't, I think?

I think it's a very personal decision. All the research in the world/statistics/studies etc can't make you feel comfortable with a homebirth if you don't, and vice versa. Good luck with your decision!

I think the thing that swayed it for me is that I saw hospital as the more dangerous option. From prolonged labour, neglect, less confident or experienced midwives, less chance of optimal positioning, risk of infection. Risk during transfer. Increasing chances of c/s and instrumentals with the associated risks and increased chances of needing pain relief, with THOSE associated risks.

I would absolutely not not not ever have had a home birth. Because I felt I'd be safer in hospital. Nothing logical it was just the way I felt. It is difficult if you are not sure. You can only talk to others and find out their experiences. However, if I had been tempted to have a home birth I think I would have gone for one. Realise this makes absolutely no sense!!

Fascinating and lovely thread.

Can I ask a question?

When Maternity units are "full" that tends to mean "not enough staff" more than not enough actual beds, although "not enough beds" tends to be the phrase used, because for every bed or patient they need x number of staff. Is that right?

How does it come to pass that a maternity unit can be so lacking in beds/staff that women who want hospital births end up giving birth at home, yet a planned home birth with two midwives gets to go ahead?

Do the two things come out of different budgets or something?

I am not accusing anyone of pinching someone else's midwives, BTW, if I had my way everyone should have 2 midwives, and in any case, if you are allowed something you should get it. I am wondering why this paradox occurs.

"
Do the two things come out of different budgets or something?"

in a word, yes.

community midwives are a separate group to hospital / MLU

Women are supposed to have choice but they don't do they?

The three women I know who had a homebirth all seem to have done so because like the OP they had a crap previous experience in hospital. One of them, like Emilyscribe had a near miss - ok in the end but very traumatic.

So is this really 'choosing' homebirth? or is it rejecting the TERRIBLE experience that hospital birth is?

Sorry if I go on about this, but what about the choice of a nice homely birth with a nice midwife and doctors on hand but within the confines of a hospital?

What about improving hospital birth? I completely agree if you really want a homebirth go for it but not just because hospital birth is bad.

Otherwise hospitals will never improve!

Ushy, Whikst you have a point, I woukd not be risking my and my baby's safety to help hospitals improve.

I will admit my main worry about HB was transferring. I couldn't imagine having to move anywhere whilst contracting!
But it seems they won't let you stay at the hospital if you are not in advanced enough labour so I would imagine a hospital birth would still involve a lot of uncomfortable moving about.
I have had two hospital and two home births. I felt much safer, in control and relaxed at home.
I recovered quicker and didn't have the horrible feeling I had been treated like a child.

It's natural to have concerns about giving birth, wherever you do it.

So is this really 'choosing' homebirth? or is it rejecting the TERRIBLE experience that hospital birth is?

yy this puts my concern very well (better than I did!) - that I am not choosing home birth so much as rejecting hospital birth based on my horrible first experience.

I recovered quicker and didn't have the horrible feeling I had been treated like a child.

I felt just like this in hospital too :(

For any posters who asked about transferring - I had a prolonged second stage and had to transfer to hospital from home. I just walked to the car - no legs akimbo - with a couple of pauses for contractions. (We live close to the hospital so it was easier just to drive than wait for an ambulance). It was the least stressful part of the process.

viola I definately rejected a hospital birth with DC4. That was absolutely why I had a HB.
But when I had dc5 two years later I absolutely chose a HB.
I have real issues with medical environments so went for HB because I couldn't bear the idea of going to hospital but my experience was so positive that became my main reason for opting for a second one.

I think Ushy has a point - hospitals should be improved, and certainly with factors like comfort and calm, responsive care in mind. It's often forgotten that human women are mammals; typically as a species we seek out quiet, private places for labour and birth. Even a 'home-from-home' hospital birth centre may not feel safe and private enough for some - and, speaking personally, I didn't feel the hospital staff were particularly competent, or interested in meeting individual women's different needs, or even treating them with dignity (as MrsdeVere points out).

The main thing, OP, is that you do what feels right (always remembering hospitals are there anyway if circumstances change) but I wouldn't be posting (twice!) if I didn't feel very strongly about homebirth. I had PND after both my children were born, mostly due to problems with breastfeeding, and the memories of my happy birth experiences got me through some dark times. I am thankful I had a choice.

I wanted to reply because for DD2's birth because like you, I wasn't very firmly pro or anti homebirth (for me personally - I'm certainly pro it as a choice for women in general!).

I actually had a pretty positive experience of a hospital birth for DD1, so it wasn't even a case of rejecting the hospital option - I genuinely thought about the pros and cons of each, and decided there were more pros to homebirth. So you can definitely book a homebirth without being some kind of homebirth evangelical.

Actually my main reason in choosing a homebirth with DD2 was that I wouldn't have to go to hospital in advanced labour (since they only let you come in once labour is properly established), kneeling on the back seat of the car, having very painful contractions, then stagger out and into the labour ward. I didn't have to stay on the postnatal ward with DD1, but friends have had to, and generally it sounded pretty grim. So I wanted to avoid that too. All the other usual pros (mentioned on this thread) also appealed too.

You mentioned the psychological / comfort advantages of a hospital birth. For some women who would feel more comfortable / safe in a hospital environment (whatever the stats / studies show, some women just will feel safer in hospital), home is obviously not a good choice. For others, it is. You should give birth where ever you think you will feel most relaxed and safe, and no one can say where that is for you personally.

One caveat - in the end, I had to transfer to hospital (in advanced labour) because I was told no midwives were available to attend my birth at home. Despite being told there were no problems with midwife shortages in my area. So bear in mind that you may have to transfer for reasons other than your own personal choice...

I have to comment here - I know I will be very unpopular for doing so, but here goes ...

I am 100% anti home births. I am both a mother, and an anaesthetist, and I have both personal and professional experience of the horrors that can occur unexpectedly during labour. A home birth is only ever safe in hindsight.

I was labouring with my second DD (in hospital), all seemed to be well when she flipped breech, presented by the feet with a prolapsed cord, and lost her heartbeat. Thankfully because of the amazingly swift obstetric, anaesthetic and paediatric attention we received, she is now a normal, healthy nine year old. Had I been at home, the outcome would, I imagine, have been totally different, and I would now be caring for a severely brain damaged child (if she had survived the experience at all, of course).

I have seen placental abruptions, cord prolapses, amniotic fluid embolisms, major haemorrhages - all treatable when medical attention is at hand, but easily fatal for mother/baby in the living room of your house.

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?

'why would anyone deliberately jeopardise the well-being of their baby, even if the chances of adverse events are small?'

Exactly, except that in hospital the same low risk woman is more likely to be subjected to forceps, with the risks associated, c/s with the risks associated, drugs, with the risks associated, neglectful care with the risks associated, less experience midwives, shared midwives, poor positions for delivery etc etc.

Why risk it?

carrie

read some evidence.

or the thread.

either would do.

Carrie what would the outcome have been for your DD if your hospital had sent you home as you were not yet in established labour, you progressed quickly & you were in the car en route when she went breech? I think we both know that would have had a very poor outcome too...

If all women could be admitted to hospital early on, like they seem to be on OBEM, then perhaps fewer women would opt for a HB, as other posts have suggested? As it is, MW are not omniscient nor are NHS hospitals able to support all the women in the ideal manner, and often women get sent home or give birth in triage when they could have done with more help/medical care. In that context, are HB really as risky as you imply??!!