How does an unplanned home birth work?

[schroedingersdodo]

I have booked a hospital birth in UCH, if everything goes right I'm going to the birth centre to have my baby in a few weeks.

However, my doula is a bit concerned that I may birth too quickly, as first labour was 7 hours from the time I got to hospital (about 11 hours from first very weak contractions). I'm in London, so depending on the time of the day there will be traffic to the hospital.

Yesterday I was alone at home with DS (DH was at work, not answering his phone) and thought: if labour started now I wouldn't have anyone to leave DS with - what would I do? And then figured out I would just have stayed home.

I believe if you are giving birth at home you have to call an ambulance and the paramedics would come, is that right? And then?

In my first birth all the midwives did was break my waters without asking for permission and forcing me to push lying on my back. In other words, I would have been better without them at all. I want health professionals around just in case something unexpected happens, and it seems that paramedics would fill this role perfectly well (hopefully nothing will go wrong and they won't even need to come near me).

What I'm asking is: am I deluded or does my reasoning make sense?

PS: Just to make it clear. I'm NOT PLANNING not to go to hospital. It's just that if things go too fast, if I feel I can't go there in time, or if labour starts at 8am (a horrible time to go to Central London), I want to know what my options are.

PS2: Before you ask 'Why don't you book a homebirth and then decide on the day?' The answer: I'm not booking a home birth because I live outside the area of the hospital I'm booking in, and I don't want to book it with the local team of MWs of the local hospital.

[nextphase]

Another unplanned homebirth here also.

Paramedics did carry entanox, but it made it up the stairs after baby was out. The first paramedic made it just before baby.
They also carried the injection for an assisted thirs stage, but weren't comfortable using in unless an emergancy - tho i wanted a natural third stage anyway, and by the time they had discussed it, placenta was out (4 min natural third stage).

From part of the conversation I heard, I think we (well, DH) should have phoned the labour ward, and got them to call the ambulance, but then it would have been an unassisted birth. DH was juggling DS1, phone and me, while following instructions about towels etc. Ambulance control centre stayed on the phone til she could hear the sirens of the ambulance, helping DH to get stuff we might need.

Paramedics asked how long the midwife would be, and we looked blankly, and said we'd phoned them. Midwife turned up quite quickly after we'd contacted labour ward (they wanted to know how close the contractions were together - err, no contractions, baby born!), but it was all well and truely over. She did check the placenta for completness tho.

All three stayed for about an hour, and then cleared off. Midwife came back alter in the day with the paper work from the hospital.

Recommend getting to a washable floor, rather than the carpeted rooms if you can!

Think DH found it worse than me, as he was juggling lots of things, where as I was just concentrating on labouring! Think it would have been very hard if I'd been on my own with DS1 and that close to giving birth.

[plonko]

Schroedinger it's the way my mum tells it, though I'm sure the 26 intervening years might have warped her memory. I think a lot depends on your outlook!

[cbeebiesatemybrain]

Notso did the mw apologise?

A friend of mine was sent home and gave birth an hour later on her bathroom floor. Baby arrived before the ambulance but they took her in to be checked over. Poor girl must have been terrified, it was her first too

[schroedingersdodo]

Tunip, your story is amazing!

As amazing as notso's is appaling :(

Nextphase, my flat is tiny and entirely carpeted. Not the best place to bleed...

cbeebies, I think they are just horrible to first time mums. When I called the hospital with contractions every 3 minutes, lasting over a minute each, they told me to take a paracetamol! (I told them I wasn't. I was going to hospital.)

[cbeebiesatemybrain]

Shroedingersdodo I totally agree, I was told the same thing and consequently nearly had an unplanned hb myself with dc1. I think that would have been better than the appalling treatment I had when I got there

With dc2 I had a lovely hb (in a tiny carpeted flat ) as there was no way I was going back there for more of the same. It couldn't have been more different to dc1's birth!

[notso]

No apology cbeeies when I was wheeled in past the reception they were all standing round laughing saying "you didn't need us after all".

[cbeebiesatemybrain]

Notso you poor thing! I found it scary enough not being allowed in until I was fully dilated, I would have been terrified in your situation. I would make a complaint about the cheeky fuckers!

[mustbetimetochange]

I had youngest at home - DH managed to catch baby as it crowned - he almost missed whole thing.

Ambulance arrived 15 minutes later - we were lucky cord was twice round neck and it could have been disastrous but dh v level headed.

They wanted to take us in but having confirmed there was no medical need I refused so ambulance people stayed until midwives arrived when they t

[mustbetimetochange]

*took over.

Male ambulance man stayed out of way. I just went straight skin to skin contact and put towel over baby - all ambulance people did was supervise cuttIng cord as

[VivaLeBeaver]

Paramedics spend a week on labour ward as part of their training. Last one I met was there in a quiet week and on their last day hadn't seen a birth! Not sure if they had to come back or not.

From talking to paramedics I think a lot of them pray like mad a midwife gets there or that if the midwife doesn't get there then the birth is straight forward. I'd guess that they might be a tad anxious if there was a shoulder dystocia or a massive pph. Not to diminish the work they do as they're fab but as said earlier they're not the experts.

I stopped at a bad car crash once and bobbed my pants till the paramedics got there! And yes they do carry gas and air.

I met a paramedic who delivered an undiagnosed breech once. He said that there was a bum hanging out and he didn't know what to do so he just grabbed and pulled. Thankfully all was fine!

[VivaLeBeaver]

Yes, mind the carpets. A friend had a bba and her insurance wouldn't cover it as they said it wasn't an accident!

[TunipTheVegemal]

Mine worked quite well from the point of view of mess because I was in the ambulance for the messy bit!
I do recall at one point I made dh get out the polythene dustsheets that we use when we're painting but they were all covered in flecks of dried paint so I freaked and said 'I can't have the baby on that!'

[Willabywallaby]

My DH spent 3 days cleaning the bedroom carpet, while I was thinking what I could replace it with!

[cbeebiesatemybrain]

I put an old shower curtain down with some absorbant bed pads on top (pampers ones iirc) which the mw and doula threw away afterwards. The only mess I made was one tiny blood spot from where the placenta plopped out. A bit of vanish did the trick

[Indith]

I am at all the "turn the heating up" comments. With ds2's birth we had a proper moment right out of Call the Midwife in the wee small hours of the morning when the fire had gone out so there was no hot water or heating . Poor dh was attempting to light the bloody thing and get it going so we could have some heat while the MW was mithering because it was too cold but asking dh to come through to do this that and the other (bless her she was lovel but I don't think a HB was her most natural environment) and dh was trying very hard not to yell at her that if she wanted heat then no he couldn't bloody well come through and do other things for her!. Meanwhile I was mooing and doing a face because she was telling me not to give birth before the other MW got there.

It was a lovely birth though.

Mine were all planned HB though so not the same.

I know earlier you said you don't want a HB because of the MWs and having had a bad experience at your local hospital before. Do you mind my asking though, do you know all the community midwives that would cover HB in your area? It certainly won't be the ones from your hospital. If there are enough HBs in your area there may even be a dedicated HB team rather than the community midwives. You may already have fully investigate that option but jsut wanted to mention it.

[schroedingersdodo]

Indith, I know the community mws in the area because they did my antenatals for DS1. Must of them were fine, not fantastic but good (probably that's because I'm getting old, but I feel most of them are too young...). And one was older and quite experienced (the one I would be feel more confident with).

My doula mentioned it would be them - and not the hospital ones - who would deal with a home birth. The thing is: I wasn't completely comfortable with the idea of a home birth anyway, so the fact that any complication would lead me to the Royal Free Hospital again just made me sure about the UCH hospital birth.

I don't think I'm ready for a home birth yet. Maybe if one day I have a DC3, who knows?

[blooblies]

I've just had an unplanned homebirth, and for us the 999 call operator was our health professional in attendance. She guided DH expertly in delivering our baby, who arrived within 15 mins of waters breaking and beginning to push. DH tried phoning the MLU at the hospital first but they were engaged. The paramedics arrived 7 mins after birth and they checked over the baby, took obs from me, cut the cord (the placenta was already delivered) and took me into hospital to get stitched. If it hadn't been the middle of the night I wonder if they would have phoned the midwives to do it, but I think with unattended deliveries they are keen for the hopsital to check both mum and baby over. It was reassuring but irritating too because we got kept in for 36 hours because it was an unattended delivery to monitor baby's temp. With the same thermometer that I have at home. Grr.

Good luck schroedinger

[DinosaursOnASpaceship]

I worry about going into labour at home. I am pregnant with ds4 and my three previous births have been 2-3 hours from start to finish. I don't have a partner, ds1&2s dad works over an hours drive away, as does ds3s dad. Adding on time it would take to get jold of them etc I'm looking at an hour and a half wait. Then it's 25 minutes to the hospital. This is of course depending on it being a day time, if it's an evening then chances are ds3s father (and father to ds4) will be out and drinking so not able to drive or look after ds3. My mum has her own small children so couldn't come in the middle of the night, I would have to get them there if it was an emergency.

I'm sure it will all work out in the end

[schroedingersdodo]

Booblies, it sounds frustrating to have such a straightforward quick birth just to be held in hospital for over a day... But anyway, congratulations for the baby and for the amazing birth!

Dinosaurs, maybe a planned homebirth would be an option for you? Good luck!

[YoullLaughAboutItOneDay]

I had a planned homebirth which turned into a BBA. I know you've had lots of responses, but I thought I'd add my story.

We had called the midwife and she was en-route, but suddenly things went very fast. So we called an ambulance instead. We got a fast response people carrier first. Then two ambulances (they send two in case they get two patients in poor condition who need to transfer). DD was out before anyone arrived, so one set of paramedics didn't even come into the house and headed off as soon as it was clear she was fine.

The first paramedic was a bit panicky and clearly uncomfortable. He was very stressed that I didn't want him to immediately cut the cord and kept saying that he 'didn't know what risks' it caused if you did that.

The ambulance crew were much better. They stayed even after the midwife arrived, the placenta was a bit stubborn and they helped with various things. I am fairly sure that it was them who had the gas and air.

I think that they would have been keen to transfer me for stitches if it had been an unplanned homebirth, but by then the midwife had arrived and she dealt with that. She was lovely and I am quite sad she didn't get to be at the birth itself. They definitely would have ambulance transferred me if I wasn't delivered/imminently delivered - I think their order of preference pretty much goes: transfer to hospital, BBA, born as we arrive!

[DinosaursOnASpaceship]

I would be very nervous to have a home birth I think - I like the security of having medical staff around. I'm not sure why really as I've had 3 easy births in the past.

[YoullLaughAboutItOneDay]

You have medical staff for a homebirth Dinosaurs - two midwives. I know what you mean though. Interestingly, proximity to all those extra staff and surgical facilities, etc doesn't actually improve outcomes for babies (with a very slight difference for first timers) according to the recent birth place study. My personal theory is that it can make staff complacent

[schroedingersdodo]

Youlllaugh, what a story! In the end there were quite a handful of people involved with the birth :)

Dinosaurs, I agree with youlllaugh that probably its the very fact that all facilities are available in a hospital that make staff a bit complacent. Lots of people told me home birth midwives are the best of all, with the worst ones being placed in labour wards (precisely because there are doctors and lots of back up staff there).

Anyway, I'm planning in going to a birth centre, which I believe is a middle ground...

[magichamster]

Just thought I'd throw my story in too....

Ds2 arrived very quickly and was delivered by dh about 10 mins before the paramedics arrived. They called the midwife who came and delivered the placenta.

I too did not want to go to the local hospital, and was booked to another. However, I had to go to hospital anyway because of my blood pressure, so ended up in the local hospital because the paramedics wouldn't take me to the other one.

Good luck with whatever happens!