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?

So what is the answer? Do we all just settle for being told what we can and cant have for a service that we pay for ( when I lived in the states our private gealth insurance was aroubd the same amount my oh pays out in NI). If we do that demand fir services except for the piss poor maternity services that are on offer isnt goibg to increase - perfect opportunity for the powers that be to simpky throw their hands up and say - look, only 2% of births at home...there isnt demand for it!!! I wonder if they lumped all births that were supposed to be home births into the statistics if on fact there would be a higher demand than just 2%?

Aditionally...what about rights? It is our right to not be forced, bullied, coerced into giving birth in a manner that is against our wishes. If the NHS turned around and said - sorry folks, we can still provide smear tests but youre going to have to forgo a nice private room in a Drs office for it being done down the local church hall because we cant afford it / I wonder how many more women would not go get tgeir smear tests done? In the case of pregnancy the system has in a way got us by the short and curlies - we're much more likely to just alliw whatever because we're in such a vulnerable position

And why cant you hire bank staff for a 5 week period - say on an on call basis? You dont see the local fire service saying - oh sorry, someone else is havibg a house fire right now....they have a retainer service on call....

North West the middle of nowhere maisiejoe with few people? Manchester, Liverpool, Leeds, Bradford, Sheffield?? (OK last three not north-west but Yorkshire, but not a million miles away.)

Mayhew - do you think more could be done to promote homebirth, in your area, or nationally? Some of it, I imagine, becomes self fulfilling: if you live in one of those areas in Cornwall which has a relatively high number of home births you might well know someone who had one, so you know they can and do happen, and not just by accident. If you are in Northumberland where they almost never do home births, you probably won't think to even ask, unless you are very, very determined.

Lavolcan - if there was a demand for private maternity care in other areas why hasnt it being spotted. Honestly, would you pay £5k for each baby. I dont think there is a queue of people asking for private maternity care in the North.

Sorry, but if there was demand it would be fulfilled. LaVolcan. Could I ask. If you werent happy with the NHS option would you go privately and pay?

The bank of people available on the off chance is not viable. No company will work like this. You only need one person to go down and the whole system collapses.

Some are saying that we should all pay more taxes. Well, if you really feel strongly about this write your cheque out to the IR today! But of course we dont do that, we make sweeping generalisations about being happy to pay more tax but dont actually follow it through unless it is forced.

The one time many years ago when I did call for a ambulance the first response was that they didnt have any ambulances in the area and because it was an emergency could I drive urgently to the hospital.

I did in the end because I couldnt wait but what if I didnt have a car, what if I had been drinking...

maisiejoe - it does surprise me that there is no private maternity provision in the north-west - there are some very wealthy parts of south Manchester.

Would I (have) paid? Yes, I would. I was able to arrange a home birth with NHS midwives, but I would have moved heaven and earth to find the money for an independent midwife if not. I was very glad I didn't have to, because we weren't very well off at the time.

How is it available with the fire service then masiejoe? I already do pay for the service of maternity care which is supposed to include home birth provision- in my taxes.

I appreciate I said I wouldn't post again and I've been sitting on my hands but I just wanted to point out that the low home birth rate in areas could be down to numerous reasons and have absolutely nothing to do with lack of promotion of HBs. It could be for example due to the fact that there are good hospital facilities available, that people would actually prefer to err on the side of caution and have medical facilities at their fingertips in case something should go wrong or that people don't want to give birth with another child in the house. I don't think you can assume that it is necessarily down to lack of promotion in certain areas.

I actually live in Northumberland and I can assure you that I've been asked both times at my booking in appointment would I like a HB and had the various options for birth discussed with me. The midwives seem pro HB here, and having talked to them they all seem to enjoy doing them so I don't think it isn't being promoted.

I'll go back to sitting on my hands again

But it seems to be the frequent case that women are offered HB's and then at the last minute, after veing lulled into a false sense if security, are toled they cant gave one...how many of thise women subsequwntly relent? Thise births are marked down as hospital births and dont go into the correct column of - would have been home birth but we sprung one on her - column? When thise in their ivory towers review the figures for demand they actually get a skewed statistic....

I was offered a home birth for my first child depsite being in my mid 30's. I rejoice that there was a choice. It wasnt my choice and I felt more comfortable with my epedurial which I got at a hospital.

I agree we arent all gagging for a home birth and being refused.

The fire service is an emergency service. Maternity services are not. Midwives are not (which is why even going to homebirths they still stick to speed limits). There are no other options to the fire service. There are other options to a homebirth. Although, I would imagine in times of high demand, the fire service can be stretched to the limit, and have to get help from other areas. But actually, not the same thing. At all.

What if the back up fire service is also being used.... We can never know when fires occur. When I called an ambulance many many years ago they said there wasnt one and the operator told me to get in my car immediately and get to the hospital as that she felt would be quicker.

What makes you so sure there are all these women out there that want HBs? From the people I know who have given birth (v scientific I accept) not one of them has wanted a HB.

May be we should do a poll on Mumsnet and ask if people want(ed) a HB or a hospital birth and if so their reason why in each case?

Ok, so maternity services arent emergency services....and what does one do when one turns up to the hospiral and the services are shut because they dont have enough staff. And here in Leucester that happens at an alarming frequency..at what point di we say enough is enough? The NHS is even failing to provide the service that most service users request...are we still saying oh well, the NHS just diesnt have the resources and keep hudfling round our nice bowl of apathy?

I'm going to ignore the argy-bargy on this thread and just address the op (only because I have nothing civil to add and Northern and co are doing a marvellous job):

When I was planning my second homebirth "staffing levels" were mentioned at the 36 week home visit due to "restructuring and cut backs" so to let the mw team know ASAP when I went into labour. Reading between the lines I said to the mw the following: I know that there can be issues, but if i give plenty of notice and refuse to come in a mw will be found? And am I right in thinking that unless there is demand for the service there will be little or no incentive for management to provide the service? [mw nodded sadly] So, it is actually in my interest, the midwifery team's interest and other women's interests to make a hell of a fuss?" Mw replied with a knowing look "We all really enjoy doing home births and we really don't want to stop" she said.

In the event there was no problem either time and I'd do it again.

Katie, you are the sort of woman that mws like me need?..

My midwife the first time was really keen to support me on a home birth.

In fact a few months later she left the NHS and became an independant midwife so I do know how keen the MW's are on HB's. I think if I was a MW I would love a HB, where I could support a women knowing that I was wanted without a doctor looming over me.

Problem is - its not for everyone. I didnt want one....

Thanks mayhew :)

For the record I have 3 other friends that have had home births. Two on NHS like me and one with indy mw. Two were second births and one a first timer like me. I also know lots and lots of people who have had other types of birth. It means very little and means nothing in terms of data or evidence further than to say women have various preferences and choices including home birth.

Where I live the community team do hb. This does mean that postnatal checks and home visits can be rearranged if a hb is on but tbh you never really know when a mw might turn up post birth any way. I would rather my community mw rescheduled a postnatal check or there were two mw at clinic instead of 3 to enable a home birth in the extremely unlikely event there are three home births on at once.

When we start using our own preference to deny other women maternity services we put the whole maternity service and women's rights in birth in jeopardy. I would go so far as to say it is dangerous to erode maternity rights because once you start it becomes very easy to reduce the service to a one size fits all service. Which of course it doesn't.

Our right to home birth needs to be protected not just for those wanting a home birth but for anyone who wants to choose how and where she gives birth; take away our right to home birth today and tomorrow you take away our right to demand epidurals, elective sections, pethedine, water birth or any other birth choice.

Op, best of luck and I hope you get the birth you want.

TBH its hijacking this thread, but the answer to your question about why hasn't it happened in the NW is purely political and massively down to planning and the idea that allowing such a hospital means the end of the NHS...

..but yeah carry on about how there is no demand. There is.

We are civilized up here too by the way. Just in case you are wondering and whilst you are struggling with your geography and knowledge of how many people live outside the Great Wall of the M25.

I'm sorry I haven't read the whole thread.

I had a homebirth on a Sunday and they tried to make me go into the hospital over and over when we rang to check if they were coming yet.
eventually, we got a friend of ours to get permission from her hospital to be one of the mws. as soon as she got permission we were inundated with mws.
I don't know if it wss coincidence.

if you want a hb, then.you have to keep on at them to provide mws.
if you end up going into hospital and "there isn't staff" then you will end up going into the proper maternity unit (at our hospital.there's an amazjng birth centre but if staff is low, you have to go in the normal labour suite)

my labour/birth is legendary on here

here's the tgread where the birth happens
I assume the mw saga is on this one...

Actually I think the bit before labour is legendary U&A. Wasn't it 4 threads before a contraction?

Congrats U+A!!

With regards to the suggestion that women who want home births should just pay for a private midwife...this article may interest you....

birthgeekuk.wordpress.com/2013/03/08/independent-midwifery-the-end-of-choice/

What happens then? Of course, "demand" will likely fall further and independent midwives drop off the map and the NHS keeps on throwing it's hands up (at the increase in women booking in for home birth who would have had an independent midwife) and saying "You'll have to come in, sorry!" and again, births go down as hospital births instead of the home births that were wanted and requested and denied at the very last minute...

And this, well put by KM, is the real crux of the issue...

When we start using our own preference to deny other women maternity services we put the whole maternity service and women's rights in birth in jeopardy. I would go so far as to say it is dangerous to erode maternity rights because once you start it becomes very easy to reduce the service to a one size fits all service. Which of course it doesn't.

Our right to home birth needs to be protected not just for those wanting a home birth but for anyone who wants to choose how and where she gives birth; take away our right to home birth today and tomorrow you take away our right to demand epidurals, elective sections, pethedine, water birth or any other birth choice.