Home birth, am I mad?

[rogersmellyonthetelly]

I know home birth is safe in low risk cases, which I'm technically not, but I'm finding myself thinking about it more and more.
This is my third baby, I'm 37, so getting on a bit, a bit on the chubby side (Bmi 29 ish at the moment) and I have a borderline hyperthyroid which is being monitored.
In my favour, I've had 2 previous vb, first ventouse due to an odd presentation, the second very easy. I'm tall at 5ft 10 and large framed, and I tend to have small babies (ds was just shy of 8lb and dd 6lb12, I'm expecting around 7/7.5 lb this time)
Would I be mad to even consider it?

I wish there was a 'like' button for the last two posts - they sum up the situation so well.

(Yep - bed blocking - speeding up - forceps - I know about that.)

Absolutely agree with the continuous monitoring, it only actually works if someone qualified is actually watching the bloody monitor!
I remember with dd after my epidural, I was on the monitor for about 6 hours before she was born, I saw a mw 3 times in that interval, all 3 times I was watching the monitor myself, when lying on my right side, babies heart rate was too fast, but had good variability, so the midwife swapped me onto my left side and then it slowed to a much better rate, but had very little variability, again not good. So they moved me again. Finally, I rang again when I felt something odd down there, she was actually crowning, and was born about 30 seconds later with the cord wrapped around her neck 3 times and the placenta already detached and at her feet following her out. If I hadnt rung for the midwife, I dread to think what would have happened, as I was immobile and couldnt have helped her be born myself, although if I hadn't had the epi I would have been much more aware of things happening!

Pregnant with DC2. Planning home birth after straight forward birth with DC1. MIL appalled. Keeps saying that she would have died and DH too if she hasn't been in hospital. There is no doubt DH was in an awkward position but I can't help thinking that if she wasn't in stirrups, flat on her back with an epidural that maybe the poor bugger might of have had a chance to move in to a better position and she would have been saved hours of stitches and discomfort. Never said it though

rogersmellyonthetelly I think you sound pretty clued up.

Your post shows how appauling hospital care can be. I hope you get the home birth you want.

The problem with statistics is that they rarely compare identical groups, so a high CS rate in hospitals is often inflated by higher risk cases that were more likely to end in CS anyway.

That said if you feel you want a HB, you are aware of the risks to you personally and you midwifery team would support you then you're not crazy.

Yes I suppose I just want to be sure that I'm getting an unbiased genuine medical assessment of the risks based on my own personal circumstances. I know obv no one on here can comment medically, it's the thyroid problem that is the big unknown for me.

no, you're not crazy but you do need to be aware (as I'm sure you are) of the increased risk specific to you in regards to your hyperthyroidism, which is much riskier than the hypothyroidism talked about by another poster above. Known complications do include eclampsia, cardiac arrest and stillbirth, although they are of course rare, and, importantly, you haven't actually been diagnosed as having a hyperthyroid yet, have you? If you haven't got it, it's all moot.

The BMI and age are a non-issue. IMO the hyperthyroidism isn't. But the most important point is that it's up to you. If you look at it all and decide you want a homebirth then you should be supported to have one.

I have been diagnosed with hyperthyroid, my tsh has been

Personally I wouldn't be 20 mins from the hospital, 25 mins until a surgeon can clamp a gas-mask over my face and make an incision.

From an older horse-riding woman who planned a home birth and has had one emcs + 1 elcs (which would've been emcs). I can see the hospital from my front door, but knowing what I know now - no, I wouldn't.

You don't sound massive at all to me, but if a 7 stone mw turns up it could be an issue for her.

The problem with statistics is that they rarely compare identical groups, so a high CS rate in hospitals is often inflated by higher risk cases that were more likely to end in CS anyway.

No, no no. I for one am sick and tired of this lazy excuse for a poor standard of care. Last year's Place of Birth study matched low risk cases in home/MLU/CLUs and excluded high risk cases. They found for women on their second and subsequent births the outcomes for the baby was the same but that the women herself was significantly more likely to have an instrumental delivery/CS/ perineal trauma in a CLU. Until hospitals are prepared to admit that this is the case, they are not going to bother to improve and women are going to continue with a shit service.

LaVolcan hence I said rarely. Some people bandy figures around without looking at them critically. Others don't of course but IMO it's always worth making the point to encourage examination of the statistical assertions. And you can never factor in the psychological effect of access to pain relief - epidurals increase the likelihood of intervention, they are categorically not available at home but are on a CLU, what's to say that them being available in itself doesn't have an effect.

Id highly recommend it but with yr concerns wd takensdvice from mws.

I had 2 lovely home births for all the reasons mentioned here ... avoid cascade of interventions, privacy, comfort etc. But I also made that choice on the basis of research showing HB is safe for low risk pregnancies, which is what I had.

There are many women giving birth in hospital who don't need to be there ... but there are also some women who really should be in hospital.

I would always opt for safety - far more important.

I've had all three dcs at home, I had gestational diabetes with no. 3 and after a long meeting with the Supervisor of Midwives and much discussion of the pros and cons opted to try for a homebirth. I think if you are making an informed choice then go for it :)

Well around here, midwives are in short supply, but that mainly means hospital ones not the ones who do home birth.
If your community midwife is generally in favour of home births then I would talk to her.
I also found this blog, if you read the comments at the bottom they may help. The other thing to do is to talk to the NCT.

I would always assess the risks and choose which risks I was happy to take. The risk of ending up with no midwife in hospital (I barely saw her during labour except to attach monitor and then break waters - she had to leave the room after the head was delivered to get another midwife) but after ds was delivered they were great, let water out of pool for natural 3rd stage which was hospital waterbirth policy. This was 20 years aago and staffing levels have decreased I think. In contrast to 2 midwives turning up for an hour or so to watch dd1 being born - wish they hadn't bothered, we were fine, they only got in the way and spoiled the moment by cutting the cord immediately. Dd2 was also a hb, 2 midwives and 2students I think. blood loss and transfer in which was a waste of time, noone actually monitored me there, just left on my own overnight. People have strong opinions both ways.
what really tired said
There is no evidence for the immediate cord clamping intervention and lots of evidence for delaying cord clamping and continuing placental circulation until baby has started breathing.resus can be done with cord attached if required.

I would always opt for safety - far more important.

Who doesn't?

People will always have very polarised views on this topic. I had an amazing HB with my DC1 and am hoping I'll be lucky enough to have the same with DC2 next year. I got comfortable with the 'risks' because I'm low risk and by talking to the MW and a doula friend about all the things that could possibly go wrong (not for the faint hearted!!) and how the management would be different at home vs in hospital. I was surprised to learn that there's v few things that being in hospital would mean it was treated differently and for me, the benefit of problems being picked up early by an experienced MW giving me 1 to 1 care were far outweighed by the drawbacks.

I wouldn't bother with laboraide. I think it would be a waste of money

Unless there is something seriously wrong labour isn't that bad. I found that labour at home is far less painful than in a hospital where you are under more stress.

I found TENS excellent and some people like a waterbirth. Its a really pity that this not possible to combine tens and waterbirth. I used nothing but tens for my homebirth. Self hypnosis is benefical to many women.

I would always opt for safety - far more important.

If you want 100% safety then don't get pregnant. The risks of a homebirth are different to a hospital birth. I believe that in some circumstances a home birth is far safer. Each woman in combination with health professionals needs to weigh up the risks to determine the best birthing option for her.

clearly many people who have posted on this thread have no idea about the fact that for most people who are low risk giving birth at home is the safest place for both mother and baby.

You are less likely to die / have an infection / need intervention / breastfeed successfully so baby then gets the additional benefits of BM

OP is there a homebirth group locally you can join?

There will be lots of people who know what they are talking about and can help you make your choice to give birth where ever you like

Bear in mind that giving birth on a roadside / in a car is much much much riskier than giving birth at home / in hospital, so everyone who makes the decision to travel while in labour is risking that situation.

Obviously not being low risk you do not fit in the criteria of the many many studies who compare homebirth to hospital, but it doesnt mean you cant evaluate the risks.

being in a hospital itself increased the chances of intervention, so all these people who needed to be there because they needed this or that; well had they have been relaxed in a familiar calm environment may not have needed it at all.

Choosing a homebirth gives you 2 experianced midwives, with 100% attention in you. You do not get this in a hospital (unless you are lucky)... you may be sharing someone who qualified last week..... They are extra cautios and will suggest a transfer at first sign of things not going well..... so long as you are prepared to follow this advice then whats the problem?
You then get the beneift of traveling to hospital in an ambulance (more comfortable than car) WITH a midwife, so dont take the risk of giving birth alone on the road side.
With ragars to PPH (which is one of the bigger risks for HB) there is a procedure midwifes can / will do that will keep you alive until you reach hospital..... when reading all the stuff i seem to recall that most midwives dont so this more than once in their career. It exisits.

There is lots to weigh up but the choice is yours

(DD born at home, with just the 1 midwife, 20 mins before i wasnt sure if i was in labour, hospital = 45mins journey away.... chord round neck etc, only 1 midwife had arrived, but she was fine.... had i have chosen to travel to hospital it could have been very very different. planning HB for #2)

but then all situations are different

rogersmelly I think homebirth is as safe for women who choose it but not for the first birth where the risks are several times higher.

But since rogersmelly is on her third birth, that isn't something she needs to consider.

You sound like me ! First birth was a ventouse , second nice and easy , so decided to have third at home , was 38 , had a BMI of 30 . The midwives were very supportive and i made it clear that if at any time they were not happy , i would transfer to hospital . Laboured at home until 9cms when i heamorhged (sp) and was blue lighted to hospital where i had an emergency c - section. One of the main problems was my cervix wouldn't dilate any further due to scar tissue from previous treatment following abnormal cells , that and my placenta abrupting or whatever its called.
I would still reccomend a home birth though , what happended to me didn't happen because i was at home , even if i had chosen a hospital birth i would still have laboured at home until the last minute , probably about 8 cms . On the plus side if i had had a hospital birth , in that i had gone into hospital instead of starting as a homebirth , i am fairly sure knowing what i know about what was happening in the unit that night that the outcome may not have been as positive.
I would not reccomend one if you live along way from your nearest hospital though.