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! :)

You obviously know more about the practice of medicine than I do, Shagmund, so I'll just let you rant right on :o

Love
But the facts remain that your DD suffered a complication that can happen at home or in hospital and she was treated sucessfully.

You can add in all the 'what ifs' in the world but your DD's homebirth was not either a cause of problems nor did it end in disaster.

What if a HB advocate wanted to scare women off hosptial births? She could just as acurately say 'what if the person coming to help fell over in the hallway and the lift broke down and the communications system had a break down....' etc etc.
All these things could happen, technically.

It seem there is no hope for HBers to be anything but selfish or lucky.
Selfish and to blame if their child dies, lucky if it doesnt.

I had a HB with my first DD, it was a great experience (well f'ing painful but great :) ).

I am now currently preg with 2nd DC and have decided to go to hospital. I stress that this is not because I am against HB but because I don't want to disrupt my DD and can't be arsed with the preparation this time round. Also I am more confident in me being able to cope with birth and post birth with a new born baby.

What really, really, REALLY frustrates me whenever there is a bun fight about HB is the lack of debate or comment on why are women are choosing to go for HB over hospital birth.

My reasons were because I found the hospital environment scary, I wanted to have a MW with me constantly through my labour and NOT leaving to check on other women (in the end I had 2 MWs and 1 student who was qualifying in 2 weeks time through all of my labour and 1 for 4 hours afterwards), because I was shit scarred to having to go to the ward after birth and my DH would have to leave soon after the birth if it was night time, because I was nervous about having pressure put on me to have interventions I did not want, etc, etc, etc.

If Dr's are so against HB why, why, why are they not LISTENING to what women are saying for why they are choosing not to go to CLU and doing something about it? It is all very well saying 'we know best because we have seen what can go wrong'. I accept your higher medical knowledge but such scare tactics does not help with reducing women's anxieties, especially if they have had a previous traumatic birth. Surely the NHS need to be looking at making CLUs friendlier/relaxing, increasing MW support, making postnatal wards nicer experience, etc, etc, etc. If these things are done I can imagine that less women would be interested in HB.

But then again I work in the public sector where EVERYTHING is being cut so I guess there is no money to do these things :(

MrsDeVere or we are being selfish because we have one to one midwifery, (two for the actual birth, if it doesn't happen too quickly). We are stealing them from other women.

I thought the Place of Birth study was pretty good. The big story which the press chose to miss, and some medical staff would prefer to ignore, was that home birth/MLU birth was as safe for the baby for multiparous women, and much less safe for the women herself. Which begs the question why are our CLUs failing women? And the stock arguments - "we get all the high risk cases so that's why we have more problems", or "it's for the greater safety of the baby", just don't wash.

Offs I do wish people who are (pretending?) To be doctors wouldn't keep saying things like they don't 'believe' in evidence based medicine. If I wanted a shaman, I'd get one ta. Much better to base medicine on, what, exactly? How you feel today?
Maybe our shitty neonatal death rates have something to do with this rather cavalier approach to science. Don't know why anyone bothers doing any research or studies at all when we could just use our GP's 'gut instinct' fabulous
Luckily I still can't quite believe you are for real or I'd be even more concerned about the NHS

I'll raise a similar point again as most anti-HB posts have ignored it.

If I did happen to have a serious complication during my 2nd child's birth (& following my late admittance with #1) would I be better off if
a) I gave birth in the car because neither the CLU/MLU (which is based in my local & only maternity serviced hospital) hadn't admitted me earlier,
b) I give birth in triage in the same hospital because the delivery suite or MLU were full/near capacity
c) I barely make it to the next nearest hospital because my own is full, or
d) I give birth at a planned home birth, as a low-risk 2nd time pg, with 2 MW in attendance & being blue-lighted if need be?

The first 3 examples are not spurious or random, and whilst not based specifically on my own experiences, are based on my friends & acquaintances' stories and go some way to supporting the decision I have made. I want a MW at the birth of my child, as they are trained experts & I am not, nor is my DH. Home is one place I can be fairly sure I will get that. I don't think that's selfish, or ignorant, or short-sighted, or yogurt-knitting or any of the other insults thrown towards those women considering/choosing HB.

"There is a truism that the length of a woman's birth plan is in direct proportion to the likelihood of her needing intervention"

This utter contempt for patients, their contribution to their own care and responsibility is exactly why my first birth went tits up, and why my subsequent birth plans stated clearly that I was going nowhere near any doctor of any kind.

"You obviously know more about the practice of medicine than I do, Shagmund, so I'll just let you rant right on"

Carrie - that is so lame.

You've been caught out behaving like a know-it-all arse, and you don't like it.

Your doctor badge won't make people genuflect to you on mumsnet.

You'll find that people tend to have massively more time and respect for the opinions of the midwives who post on these boards, who unlike you, see the full range of births - from the most complicated to the most straightforward. If they are of the opinion that homebirth is a safe and reasonable choice for a mother, then that's good enough for me.

I don't know how I've missed this thread.
I'm not particularly good at articulating myself but I'd like to add my thoughts.
I've worked on CLU's and MLU's as a MW for 14 years.
I chose to homebirth my DC's.
The biggest factor in my choice was because i wanted a midwife to myself.
I see this as the biggest factor in how a birth can go. I see that how your birth will go very much depends on how busy a unit is when you give birth and pot luck as to the MW you get on the day.
People have often commented that I was 'brave' for having a homebirth(s). In my head I'm thinking 'You're the brave one, have you seen what can happen to you in a hospital?'

Shagmund has it all spot on. This woman knows the truth about maternity services.

Reading this debate with interest.

I always find Doctors comments on home birth interesting . It's obvious they are going to have a skewed view of children, and in Carries shoes even more so due to her personal experiences.

It's really interesting that most doctors ive ever had this converstion with would opt for hospital birth - they've only ever been called to emergencies. Same with paediatric doctors they are much more nervous in my opinion about childbirth in general, let alone at home.

However most midwives I know, would opt for a home birth over hospital birth. I have probably not been a midwife for as long as carrie has been an anaesthetist but I havent even some of the things shes mentioned in her opening post. I think this shows how rare some of them are, and also that midwives see more normal birth than high risk stuff. This is why we tend to be more open minded and neutral regarding birth choices, and where to have your baby.

I 100% believe if I had have been a midwife when my first baby was born I'd have not had the outcome we did, I was pretty clueless and allowed myself to fall into a cascade of interventions. I would 100% have booked a HB. But that's anotheR story .

There is no evidence or statistics behind my observations by the way, just my personal experience. Would be interesting to have a survey or something on this.

OP good luck with your choices and I hope you get the birth you want wherever that may be.

My GP insisted that I have a hospital birth for no. 3. His reason?

That I wouldn't be able to cope with the pain and hospitals have analgesia!!!!

Turns out his wife had an OP baby and needed an epidural. Fine, but not a good enough reason to pass judgement on others.

To answer the OP question, absolute NO to homebirths.
I want the very best 21 C medical help handy just in case something goes wrong and my baby needs immediate medical help to stay alive.

I have to agree Empty. The majority of mw's I know have had homebirths. I even know a few dr's who have, including consultant obstetricians!

Has anyone mentioned physiological cord management? Left the cord intact after my son was born he was blue having had cord wrapped tightly around his neck. If it had been clamped immediately, I don't think he would have come round so quickly. Am still annoyed cord was clamped immediately when dd 2 was born at home as it interrupted the process but no harm done and it was a magical Waterbirth. Much nicer to be at home afterwards, too.

Unnecessarily harsh, Shagmund. I am entitled to my opinions, and to express them in this forum, in exactly the same way that you are. I don't pretend to be a know-it-all, I don't expect anyone to genuflect to me :o , and I certainly don't feel caught out.

I never expected people on this thread to agree with me, or like my views (the pro HBs are disproportionately represented here) but I would have expected adult debate, rather than playground-style petty insults.

Disappointing, but I hope I've swayed a few people. I'll bow out now as I've nothing more to say on the subject.

It's less about liking or not your views, it is about being horrified that you are attempting to qualify your 'views' with declaring a professional status.

And despite being medically trained have not once provided any evidence to support your 'views'.

Please ignore my typos. Fat fingers & iPhones.

Also have to say that things like cord prolapse, abruptions, amniotic fluid embolisms etc etc that are obstetric emergencies happen when there are other risk factors present, ie - unstable lie, polyhydramnios etc. Id like to think women with these associated risk factors are counselled about the risks present before deciding upon a HB. I'm not saying they NEVER happen without a risk factor being present, but it's quite unusual.

A baby changing from cephalic to breech during labour isn't something I've experienced, unless the baby was unstable lie and increased liquor volume was present. Im not saying it doesn't happen, or hasnt in Carries case, I'm just saying I've never seen it without associated risk factors present.

I'd throughly recommend a home birth. I've had 3 children:

1. Started as home birth, ended in emergency c-section
2. Home birth (VBAC) with independets midwives
3. Water homebirth with independent midwives

The fantastic thing about a home birth is you can relax from the moment your labour starts, knowing you don't have to transfer somewhere else. Because you're in your own home, you feel more in control and comfortable, especially afterwards, when you can just have a bath, get into your own bed, watch tv (and, in my case, eat fish and chips).

But my main advice is choose to have your baby where you know you'll feel most relaxed, safe, comfortable and in control. If this is hospital, then a home birth may not be for you. And an even more important thing is having 1 on 1 care from a midwife, throughout your whole pregnancy, labour and birth. If you can't get this on the NHS, an independent may be worth consideration.

Good luck with everything - remember that giving birth is a normal bodily function rather than something to be dreaded or afraid of.

I've supported women at homebirths and hospital births. Personally I prefer the homebirths because Mum tends to be more relaxed and she has at least one midwife who is more concerned with her than machinery. The best bit for me is leaving mum, dad and baby tucked up together.

I have supported women at hospital births where they have had lovely births and also far too many where they have been pushed into things that they didn't want. I could recount horror stories (of treatment) both at home and in hospital. It all comes down to your midwife/doctors.

Viola... what does your instinct tell you? The hospital vs homebirth question brings out people who are diametrically opposed to the other and as such, I don't think that will help your decision making. You know where you would like to be. You can always opt for the homebirth and change your mind at any stage during labour.

Whichever you choose, I hope you have a lovely birth.

It's funny how 3rd world countries are begging for charities for money and more doctors and clean and well equipped hospitals while we here in uk want to reject all the millions of pounds worth of equipment and research that is available in favour of having a baby in the kitchen.

It's insulting and offensive for all the women and babies who died in birth without access to proper medical equipment in the past.

A lot of the pro home birth argument here is primarily because their NHS hospital is not providing a very good service and has failed them. But instead of ignoring the problem by making it even riskier (home birth route) we should write to our MPs ,( get the midwives on it too), to get the gov to improve and spend more money on the maternity services. We should all be demanding a proper treatment . It's not acceptable for the NHS to promote home birth to save money !

Rhianna - nobody is 'rejecting' research and equipment.

Women who want a homebirth want

antenatal care
a qualified and properly equipped midwife at the birth
access to a hospital and medical care should the birth become complicated.

So not rejecting modern medical care at all.

And in countries where the maternal death rate is high, simply providing good antenatal care for women and a trained midwife to attend the birth results in massive improvements.

"But instead of ignoring the problem by making it even riskier"

It's SAFER for mothers to have their babies at home.

It's no less safe for babies to be born at home, except for the babies of first time mothers, and even these babies do just as well born in an environment where the mother has no immediate access to doctors and operating theatres - as long as it is a birth centre. (free standing birth centres - not attached to hospitals - do just as well for neonatal outcomes as CLU's)

I didn't want to go to hospital for various reasons, one because of substandard care, but primarily also because I believe that it's disruptive to the optimal hormonal physiological process of birth to move a woman in active labour into a large, unfamiliar and busy institution where she will be cared for by strangers and subjected to unhelpful hospital protocols.

Read here and it will help you understand: [http://www.pregnancy.com.au/birth-choices/homebirth/out-of-the-laboratory-back-to-the-darkened-room.shtml here]]

So while I definitely would like to see improvements in the care provided in hospital, there will always be some women who simply feel they cannot labour safely and efficiently in a hospital environment. Those women need a good homebirth service.

I also think that if twice as many low risk women are having emergency c/s in hospital as they might have done had they laboured at home, this is putting the lives of women with complicated pregnancies on the line.

"It's not acceptable for the NHS to promote home birth to save money !

I think that if a 'treatment' or pattern of care

a) has as good or better clinical outcomes as the more expensive option

b) is preferred by the people who use it

c) is cheaper

then it's absolutely acceptable for the NHS to promote it!

rhianna1980 countries with high maternal death rates don't want hospitals actually. All the campaigns focus on antenatal care and midwives to attend women in their local area.

Antenatal care saves lives, not hospitals. Most risk factors that kill are identified in antenatal care.

I would bet quite a lot pd money that women in those countries would opt for a home birth if they had the same resources as us.
What a stupid argument
Force women in the uk to go to hospital by talkiing about starving Africans

Births in this country moved to hospitals because conditions in the home were often poor
I live in the east end but not in a slum and I certainly don't live in a one room shack.
I have also had the benefit of adequate antenatal care and nutrition.
Two things that would do more for positive outcomes in developing countries than shiny hospitals

Carrie may have bowed out but I feel I need to comment on some of the things she said. She says to shagmund I would have expected adult debate, rather than playground-style petty insults. and yet when I said that she was talking outside her area of expertese yesterday, I got a petulant 'I know more than you do' . Shagmund was accused of being an 'knit-your-own yogurt' NCT zealot'. I presented an extract from a good report about the Place of Birth. The stats from this didn't support Carrie's view, so she chose to ignore it and I got a cheap jibe from her about whether I liked stats or not. I told my husband then that she sounded like kid in the playground.

Homebirth views over-represented. What does anyone expect when the original question is about Home birth?

'Rhianna80' I would just add to shagmunds post: non-one is rejecting modern medicine. You haven't seen one voice on here talking about unassisted birth except where they occurred by accident. Another point which is conveniently overlooked when trying to compare us with third world countries is that we have an infrastructure of telephones and good roads. So if you have a problem, your midwife can pick up the phone to the nearest hospital; an ambulance comes, you can be whisked there. You are not giving birth in a hut on a dirt floor with the nearest clinic 100 miles away and if it goes wrong being bumped there on an ox-cart over dirt-track roads for three days. (OK wilds of Scotland and some islands, this distance may be the case.)

You also say It's insulting and offensive for all the women and babies who died in birth without access to proper medical equipment in the past. As has been said before many, women especially, and babies did die in the past because of the problems caused by Doctors - the example of them spreading puerperal fever in hospital because of their refusal to wash their hands after being with cadavers is infamous!

About the costs of the NHS - back in the 1950s when the country was nearly bankrupt after a long war, homebirths were encouraged, and women were entitled to a midwife - courtesy of the Local Authority. Come 1960 when the birth rate dropped and the country got on its feet financially there was a push towards hospital birth, based on what has now been proved to be an erroneous assumption that it was safer. What's the situation now? The birthrate is rising, the country is bankrupt. Instead of leaving women unattended in hospital, or unattended because they can't get over the threshold of the hospital, how about about revisiting the 1950s model to see what we can learn from it?

This was something of an essay and it wasn't meant to be a hijacking of OPs thread. I hope she can decide what's best for her.