Want home birth but there "might not be staff"

[Kopparbergkate]

I'm expecting DC2 and am nearly 38 weeks now. Ever since my booking in, I've said that I wanted a home water birth with this baby. I didn't have a pleasant time (putting it mildly) having DD1, albeit in a different hospital, and I am really really keen to stay at home; though I have also said throughout that if anything changed and I became high risk, then I would go in.

Anyway, the community midwife I have had for all my appointments has seemed keen and assured me that there is no reason I can not stay at home.... That is, right up until my 37 week "home birth check" at home last week, when she said that, of course, there's only one home birth team in this area (its a big rural area) and if they're attending another woman, then when you phone for a midwife, you'll have to go in to hospital. I asked how often that happens and she said it happened at least every month.

I've never had an issue with the thought that I might need to transfer in labour or indeed that I might develop a complication in pregnancy that means home birth isn't an option but that's not the case. I'm in tears at the thought I might phone up expecting to ask for a midwife and get told to come in instead and it's really worrying me (i guess partly cus of what happened last time). I have a doula and she's given me a letter template from an AIMS book to send to the supervisor of midwives basically demanding a midwife be guaranteed.

Thing is, I feel really torn; I do really want them to guarantee me a midwife and they have had months of notice but I also don't want to come across as an entitled arse making a huge fuss when NHS resources are limited etc etc.

Wwyd?

Home birth, properly managed is good for the NHS. Don't fret about making a fuss. Their staffing issues are not your problem.

If you politely maintain that you're staying at home unless medical circumstances dictate then they will find a midwife from somewhere. There's a good chance you'll be told they can't/won't but they will. I think if you look at the home birth website there's a script for you/partner/doula to use. Will look in a minute. Don't feel guilty though. You're the patient, you're not a 'problem'.

Make a fuss.

And have a look at the Birthrights fact sheet up there at the top of active convos.

here under staffing shortages.

I bet your doula knows how to do this - get her to deal with it whilst dh concentrates on you.

This is linke don the home birth site but here is a seperate link for ease - the AIMS site.

You CAN do this

YY to sending the letter Northern has linked to from the AIMS site.

I'm sorry but to me you are being unreasonable. You can't say they have had months of notice. Your expected due date is just that, expected. You can't guarantee you'll give birth on that date, so how can they guarantee you your home birth?

The NHS has limited resources and you have to respect that they can't always meet everyone's needs to that person's specific requirements as their resources don't allow it.

Ok, that AIMS letter is the same as the template my Doula gave me... It just seems so confrontational and arsey and I worry if I send something like that then I'll be marked as a "difficult patient" or something... Despite being an ex-solicitor, I'm really rubbish at sticking up for myself and I get really concerned about what people will think of me :(

Do you reckon I could add a more personalised paragraph about how much this is stressing me out?

My doula's already said she's more than happy to handle the phone call on the day if they say no...but I was keen to not have the uncertainty hanging over me...

I'd have felt exactly the same - hospital for medical reasons fine, hospital just because there's not enough staff not fine.

Totally agree with sending the letter. If hbs continue to be cancelled because of lack of mws, they will continue to argue that the existing resources are adequate when clearly they are not if it's happening once a month.

Good luck OP - really hope you get the birth you want .

Patches - the NHS is supposed to support home birth! Home birth and hospital birth - bith are unpredictable. Hospitals are staffed accordingly. Home birth teams should be too. The OP has a right to this resource. It's not her problem how the staffing rota works.

Sorry x-post. Think personalising the letter would be a good idea so it fully represents your views and the impact this is having on you.

And OP - yes do add a personal note if you want. No reason why not. Just don't apologise for asking for something you're entitled to receive.

Definitely not being unreasonable - until women start making a fuss the NHS won't begin to do anything about its staffing issues. And that applies just as much to understaffed hospital births as home births.

This happened to me. Had a HB planned (bought pool and everything), then when my waters broke I rang the community MW team to be told "we're busy - you'll have to go to hospital". MW seemed v disinterested and I was gutted as a few of the MWs had said they were hoping to be on duty when I went into labour so they could attend (MW on the phone wasn't one I had dealt with before).

In the end, I didn't give birth til 36 hours later, in a hospital with forceps, episiostomy etc etc. Although my waters had broken, I was slow to progress, they suspected meconium and I was so worn down by the pain that I surrendered to hospital and high intervention!

In a way, I'm glad this was the reason I didn't get a HB, rather than there being no one available when I was in established labour. I always knew the chances of having the baby at home were not terribly high, but I would have been bloody gutted if the birth was totally straightforward and the only reason HB didn't happen was because of staffing.

Good luck and really hope you get your HB

Northern I appreciate what you are saying but unfortunately with limited resources what are they supposed to do?

Are you prepared to pay more taxes so that they can accommodate everyone's wishes? There are loads of people who don't get the treatment they require due to lack of resources and the NHS need to prioritise the money they have.

I'm not saying it's right, but that's the way it is.

Why should one person give up her right to a homebirth over this? Patches, i see where you're coming from but I'd happily pay more taxes, or have less of my taxes spent on giving tax breaks to rich people. The NHS isnt a charity handout given by a kindly government, its part of our society. Without it, private employers would have to offer healthcare as part of compensation packages and its about time we stopped being grateful and starting demanding what we've paid for. If we all put up with shoddy treatment, we'll all get it. I would say kicking up a fuss is the only way to ensure that good care is the norm, and appropriate resources are allocated to women's health. Midwives benefit from increased resources too, even more than patients, so insisting in our rights is important. Rosa Parks, after all, didn't say 'I can see this bus is busy and there's a seat shortage'

Lion unfortunately I think you'll be in the minority of people who'd pay more taxes to enable the NHS to have more money. Most people wouldn't - they complain enough already about the amount they pay.

You're right the government aren't being charitable in giving us the NHS, we do pay for it, but in my opinion we don't pay enough to start demanding particular types of treatment (for want of a better word) when there is a perfectly suitable alternative available.

Koppa I hope you get your home birth. From the way I read your OP it sounds as though you'd have to be rather unfortunate not to get it.

Homebirths cost the NHS less than hospital births. If anything, MORE women should be supported in their choice to have one, in order to save the NHS money (and pay for more midwives and different treatments in other departments)

I have had 4 hbs so obviously I am pro BUT where do they get the midwife from then??? All our community midwives do hbs, but if there is a team then there is a team! So demanding your rights is one thing but who are they actually going to send? Do you want a reluctant or inexperienced person attending you? Seriously the chances are that this will be fine but you do need to think it through to a natural conclusion.

I planned a homebirth in a pool, never once warned there might be staffing shortages, I live in the a huge city close to the hospital.

When I went into labour my partner rang the team and was swiftly told there weren't any midwives available and I would have to come in, he refused, they insisted, I got on the phone and flatly refused (I now realise I couldn't have been that far gone if I was up for an argument!) and miraculously they managed to find a midwife to send out.

When she arrived she did explain that in my immediate area 3 women, excluding me, had already rung in for the homebirth team which put me 4th on the list, I was only 3cm and she left. luckily it took a good few more hours till I really needed them and they were available and I got a lovely () homebirth.

Sorry to ramble, but I agree - demand what you want, they have to find the resources, it will also help future staffing levels too if they are aware of the need.

You are entitled to a home birth on the NHS

stand your ground and be get your OH / Birth partner / doula whoever to be a parrot and say "kopperbergkate" is in labour and looks forward to seeing a midwife at home very soon....

No discussion, no debate, repeat and repeat and someone will come.

Even if there is another homebirth in the same area.

You have a right to one on the NHS and when they realise you know that life should be easier

(both me and my friend are due to the same day... and yes our midwife teams have had our home births on the system since our 8 weeks booking..... and i know that in the unlikely event we have our babies at the same time, neither of us will be consenting to the risks of a hospital birth, which we choose not to take)

How do hbs cost less? I'd gave thought economy of scale etc?

oh and last time when i was asked to sign about going in if staff levels required i quite simply refused to sign (but acknowledged that i had read it, but didnt agree to it )

munchkin it was one of the things looked at in the Birthplace Study in 2011. Home births are cheaper for the NHS.

But why? I'm genuinely wondering?

Fewer interventions (so fewer drug costs etc) fewer post natal stays, even things like fewer meals/less laundry in a hospital setting. All adds up.