Home or the hospital

[jessnoble]

I was just wondering, what are peoples opinion on giving birth at home or in a hospital e.g. advantages/ disadvantages

It would be a great help :)

In my second homebirth, I was made to feel very uneasy and the very unsupportive midwives made it clear that they were expecting things to go wrong unless I did thing exactly as they wanted - seriously, they walked in the door and their first words to me was checking that I was having the postbirth injection as soon as possible. I was left alone repeatedly while they chatted in the next room. There was no one I could complain to - those two were it - and in the end their way of doing things almost killed me - she yanked on the cord until a chunk came out while I was screaming in agony. I didn't even get to know my child was a girl until almost 15 minutes after she was born because one midwife took her out of the room with my husband while the other pushed down on my stomach. I bled horribly - obviously - while waiting to go into OR I got to hear about how it was all because me, my disabilities, and having them glee about how I would require an epidural (can't have one medically, which the doctor when it came in made quite clear). And these were homebirth community midwives who also did antenatal care (one had seen me a couple times during the pregnancy).

At the hospital birth that followed, they disagreed with my idea, tried to hug me into changing my mind and yet still followed through with my wishes. I went in and out of second stage for hours - it first started at about 6 and he was born shortly before midnight, my DS was malpositioned, and they took all my concerns seriously (my birth plan was essentially I'm scared out of my mind, here are my medical concerns, here are what I need here to feel safe), and gently pushed towards what I wanted even when I was panicking and wanted everything else - seriously, three time natural births with medical reasons not to do anything else trying to get everything in fear and they calmly spoke through it without making me feel a fool. Even when the emergency button went for his stuck shoulder, they spoke with me the entire time, and each and every one of those half a dozen women congratulated me when he was in my arms - something the homebirth pair never bothered with. When they had to come back in to help me with PPH half hour later - after they allowed me to have a natural third stage and gave me the injection after the placenta came out which they disagreed with, not one blamed it on me in my presence (and my bleeding was a lot less this way, which was recognised). I felt like they were there for me all the way through even when panicking in a very bad transition.

The whole 'homebirth means caring listening midwives' is a load of bollocks and fills me with rage - I desperately wanted to believe that after my first bad hospital birth and the system that allowed overworked midwives with unchecked biases to be alone with vulnerable women and almost killed me, I had to a manual removal, three blood transfusions, and so much more just to get me back. It isn't the location, it's staff that cares, are trained to care properly, and are supported by the system to do so regardless of location or their personal preferences.

Spork I so agree- community midwives are a very mixed bunch and it's a huge lottery as to the care with a home birth.

I did enquire about a home birth with my second child- my midwife said "Ok you have a legal righht to that, but don;t blame me if it all goes wrong"

I have already illustrated the account of my friend's baby dying during a home birth and the hysterical reaction of the midwife.
I had another friend who attempted a homebirth and the midwife was truly wicked, including heaving her whole body weight on the woman's fundus trying to accelerate labour. Eventually ending in the crash team scooping up the mess.

Many community midwives will only attend one or two home births in a 10 year period, their skills are often lacking and they are ill equipped.

It's a huge lottery as to the care with any birth! Unless maybe you're flagged early on as high risk?

But the statistics are hugely skewed anyway- women who elect a home birth are low risk anyway, usually affluent and educated- these demographics although poorly understood are implicated in birth outcomes.
Women who have multiples, breech, pre eclampsia, diabetes, obesity etc are not good candidates for home birth anyway so of course all those having a home birth will have a greater chance of a good outcome.
THe statistics don't even measure those women who are transferred during labour to hospital due to difficulties- these are then classed as hospital births- and unfortunately have statistically a worse outome of any situation.

Birth can be dangerous, I totally understand the ideas about escalation of intervention but hospitals midwives are aware of this too.

msmiggins thyas not true the statistics take into accoutn all those factors.

It's not possible to eradicate all the bias.

Women who give birth at home are low risk anyway.

but that's the whole point mrsm!
the statistics comparing homebirth to hospital birth compared like-for-like.
they compared low-risk pregnancies and they took into account all outcomes.

you cab have hysterical mws in hospital too.
one of our very own lovely mners has a child with erbs palzy because the hysterical person in charge of her birth pulled wrong.

of course it's down to the staff you end up with and that can't be changed.
my mws were lovely (apart from the one who had obviously had a fag before she came on shift and I hated that)
they were great and let me be in control while advising me and ensuring my safety (and the baby's)

Some high risk women also have home births, sometimes to avoid the risks they encountered in hospital. The stats don't take account of these, simply because there are relatively few, so valid home vs hospital comparisons can't be made.

THe statistics don't even measure those women who are transferred during labour to hospital due to difficulties- these are then classed as hospital births

Not so, msmiggins, not with recent UK studies, which is why e.g. you find stats will show that some home births ended in a CS.

The issue is that home births will always sound better because all the high risk ones take place in hospital, so you can't always compare like for like.

I was high risk and had fabulous care in hospital. DD wouldn't feed and I had loads of breastfeeding support. If I had had her at home DD would have been bottle fed right from the beginning. The hospital were great and wouldn't let us home until I had managed to successfully breastfeed. I wasn't in any hurry to go home because I felt safe in hospital and had any number of midwifes available whenever I wanted one.

but you don't know that bunbaker you could have had just as much bfing support at home - the mws attending the birth, bfing supporters also visit if you ask.

I got crap bfeeding advice in hospital. Much better support once at home from a bfeeding counsellor.

It all varies, I had good births in hospital, four of them anyway, crap post natal care,,so glad to be able to discharge after four hours.

"but you don't know that bunbaker you could have had just as much bfing support at home"

If you have a home birth does the midwife stay with you day and night for several days? DD just would not latch on and I needed someone straight away every time I tried to feed DD. When she was a couple of days old she went drowsy and her blood sugar plummeted because she wouldn't feed. I was jolly glad we were still in hospital. She finally learned how to latch on when she was 4 days old.

msmiggins Wed 25-Dec-13 10:24:22
It's not possible to eradicate all the bias.

I actually disagree with this. I think you can have an unbiased view if you start to listen to what a particular woman thinks is most important when it comes to her impeding birth.

There are women who are calm, low risk and generally want as natural birth as possible.

There are women who are more anxious, not necessarily high risk, but might be more at risk and are largely indifferent to the birth they want.

I think it is wrong to ignore this and to try and push women done one path or another without being a) honest about their chances of success or b) being over zealous about the absolute need for hospital care.

I don't think that stating X is 'best' is necessarily the best approach to have. The approach does not cater for the multitude of the enormous range of variables out there.

A woman who is listened to, respect and informed and has an intervention heavy birth, could have a 'better' birth than a woman who has a traumatic birth at home where she isn't in control and isn't consulted about decisions in her care.

The current stats reflect not only a potential risk, but also lack of skills within the profession and that certain groups of women might be actively choosing one service over another or are preventing certain services. I think it is possible to spot patterns where this is happening; even without full disclosure of certain information, if you are savy.

The point is more that there are groups that are actively choosing the bias rather than the fact it might be difficult to eliminate. And thats the real question we should be looking at. Why?

Bias can be eliminated, but the strength of character it requires to do so makes that exceptionally difficulty. Its always just easily to ignore information or to disassociate yourself from it in someway.

HOME

If you have a home birth does the midwife stay with you day and night for several days?

No, but in which hospital does a midwife stay with you day and night? Or even an hour? The postnatal wards are the worst staffed, so you could easily go 8 hours without seeing anyone.

"No, but in which hospital does a midwife stay with you day and night? Or even an hour? The postnatal wards are the worst staffed, so you could easily go 8 hours without seeing anyone."

When I had DD 13 years ago every time I wanted to feed her and she wouldn't latch on I pressed the buzzer and one came straight away to help get her latched on. I wouldn't have been able to do that at home.

No you get left in peace by the time the baby is three hours old.

That's the whole point if a home birth.

You get to establish BF with no one watching and no one judging, it's utter bliss.

"You get to establish BF with no one watching and no one judging, it's utter bliss."

I was able to establish breastfeeding with my first with a very relaxed supportive, unjudgemental, encouraging, knowledgable, midwife in hospital.

Second time around I was home from hospital before my DD had her first proper feed.

Establishing breastfeeding alone at home is not such a "natural" situation, in fact quite Westerized manufactured situation.
If you look at cultures where home birth ( and breastfeeding) is the norm a new mother will have several elder experienced women around her to give support and encoragement while she estabishes breastfeeding.
It's not normally a solo pursuit.

Thank you msmiggins. The fact is that without the support of the midwives at the hospital who were at my beck and call whenever I needed them I would not have been able to establish breastfeeding at all.

"You get to establish BF with no one watching and no one judging, it's utter bliss."

Well bully for you.You are lucky that you found it easy. My baby didn't want to feed and wouldn't latch on. She would have been bottle fed pretty much straight away without the ongoing help over several days I received at the hospital.

I found it awful trying to bf in hospital every me showed me a different way. Each one saying I was doing it wrongwhen ds was latched on correct with no pain (as I now know after bf 3 babies for a total of 7 years experience) I had the woman in the bed opposite bragging her baby was feeding for a hour when mine was only feeding for ten minutes. The way the mws showed me was causing me pain and they wouldn't let me home till I fed their way and being only 17 I didn't feel strong enough to just tell them to fuck off.

There was a constant stream of male visitors making me feel uncomfortable having my baps out. Mws were constantly man handling my breasts without consent making me sore. In the end I bf the way they wanted me to while holding back tears just to be discharged.

Then at home I was able to sit down quietly on my own and figure out what felt right.

At my homebirth the mws stayed till I showed them a good latch and said if I hadn't I'd have had the option to transfer in. When a breast pad got stuck to my nipple after a day or two I pulled it off and took a chunk of skin with it I was offered a nd counsellor within hours. It all depends on the person just because someone finds peace and quiet easier to learn to nd doesn't mean they had a easy time.

It all depends on the staff involved so it doesn't really factor in besides you can transfer or have the me stay for a bit if you find bf hard

Sorry my phone changed bf to nd a few times.

And mw to me.

"It all depends on the staff involved"

Exactly. But when you have a baby that simply isn't interested in feeding and then goes all floppy because the blood sugar drops I found hospital a better place for me.