Good result OP - glad you've been listened to. Good luck with the birth!
(oh and sorry to hijack the thread)
"but I will say that anyone who chooses to have a VBAC (which carries a small but significant risk of uterine rupture that can be fatal for baby and mother) distant from obstetric and neonatal facilities is, in my opinion, taking an unnecessary risk with the life of their baby and choosing the experience over the outcome."r
TrainTrack - why don't you ASK women who've opted for a VBAC at home why they've done it? Maybe you don't know anyone who's done it.
The women I know who've done it have made the choice because they believe they are more likely to have problems in hospital. Problems like stalled or prolonged labour. Some feel that a uterine rupture is MORE LIKELY in hospital because of these things. Or they have been traumatised by their first birth and feel unable to go back.
Seriously - glibly repeating that women who have been labelled 'high risk' who opt for a homebirth are valuing 'the experience' over the life of their baby is cruel and to be honest, a bit thick. Birth isn't like a fucking spa treatment. Women are desperate to get through it in what they believe is the the healthiest way they can - for them and their baby. And for some women this means choosing a homebirth even when they've been advised not to. It's not unusual for women to reject the advice of health professionals they don't trust or those they feel are not treating them and their baby according to their individual needs and obstetric history. You see posts about it all the time on mumsnet.
"Shagmundfreud, it is all very well to say that it was not a problem to have a shoulder dystocia at home as it was easily managed. Sometimes they are very difficult to manage and the baby can require cardiac massage and intensive resuscitation"
Yes - I understand that Maxbear. It's obvious that a baby born after a severe shoulder dystocia will probably need paediatric input and is not going to get that quickly if they're born at home. But oddly, given that shoulder dystocia is often completely unpredictable, and not that uncommon, it doesn't seem to have impacted on neonatal morbidity and mortality as a whole for babies born at home.
Which leads me to conclude: that's because it's probably less likely to happen at home, and that when it does it's generally managed appropriately and safely by midwives. I appreciate your friend's experience (and the mother's she was caring for) was hideous, but the occasional scary birth (with a good outcome in this case) is not a rationale for a mother who is not at specific risk to be refused a homebirth. And that was the focus of my response to the OP - she was deemed to be a 'high risk' for a birth at home on the basis of a 'possible', mild, shoulder dystocia, which was easily resolved, during the birth of a massive first baby BY FORCEPS and following an epidural! Would you really say this mother was any more at risk of a repeat, severe shoulder dystocia? More at risk than a mum with a BMI of 30, known to be carrying a 9lb baby, who in most places would be ok'd for a homebirth?
The other point I made on this thread, and which I really can't get my head around, is why it's OK for those mothers who are considered at risk of a shoulder dystocia to be positively ENCOURAGED to have an epidural, when we know that forceps and supine birth put them at an additional risk of shoulder dystocia? Is the attitude, 'oh well, it doesn't matter if they have an SD in hospital - the increased risk is OK, because we've got pediatric intensive care services on standby?' I think that's shit.