Home birth

[Sheepoverthemoon]

Has asking for a hb been a challenge with the midwife and drs? I'm really keen to have a home water birth (and thought I did my research well) and was really positive for asking, but my friends have been trying to put me off and say that it's a battle to get a hb for your first baby and it's very risky for the first one...
Any advice would be great

Yes, horrid outcomes can happen at home..The stats show similar frequency in hospital. One is only 'safer' if you assume that the home issues were preventable by being in hospital and the hospital ones were inevitable.

But home birth are not these idyllic things- with nearlly 50% of women trying for a home birth transferred to hospital during labour that doesn't sound a very positive scenario. Who wants to be transported in advanced labour?

Of the 45% transfers to hospital, these are not all in advanced labour. Some are early labour and some are after labour

Notwithout- still not ideal if planning a home birth. If the home is such a safe place to give birth then why are half of the women transferred? Surely they would be safer staying at home.

Of women didn't take mw away from hospitals to have hb it would be better for all.
My last thing on the topic.

atastroke - it sounds as though you were lucky with your hospital.

Not one who was left labouring to then give birth on her own in a corridor. Not one turned away because it was decreed she wasn't in established labour and the hospital was heaving and closed to new admissions, forced to drive up the motor way to the next hospital, to be turned away again, despite being desperate for some pain relief, because the baby was presenting in an awkward position, but getting no support until 48 hours had passed.

That is one of the problems - the ideal hospital is compared with the worst case scenario for home birth, instead of there being a realistic appraisal of the pros and cons for that woman's circumstances.

BTW half aren't transferred in, it's much less for multiparous women, and of those who are transferred quite often it's for more pain relief.

They don't usually take midwives away from the hospital, home births are usually done by community midwives. If anything, it's the other way round, the community service is raided to cover the hospital.

But with a massive one in two chance being transferred to hospital that's a massive chance of being transferred in an emergency situation or because pain has become too much to bear. Who wants that?

Atthestroke, that figure would be much lower if it didn't include the women who changed their mind during the home birth and asked to be transferred for an epidural. Presenting the full 45% as women who got rushed to hospital with the sirens on is very misleading. And, importantly, you haven't addressed the fact that, as PP have said, a similar amount of deaths occur in hospital. Why is this the case if the care you get in hospital is so much better? And you haven't replied either to the women saying that the less dedicated level of care they received in hospital meant that important problems were missed, or that they were stressed out by the hospital or left waiting in corridors on overcrowded wards for a long time.

Jokers you are making things up. In our area, community midwives each spend a day on call for home births, so they would not be in the hospital otherwise at all. In other areas, I know some places have specialist home birth teams employed specifically to deal with the very small minority of women who chose home births, so they would not be in the hospital otherwise either.

I am a hospital doctor so I see stuff at the "cutting edge" too: nonetheless anecdotes do not trump data. But I understand people feel emotional about this stuff, and obviously if you are very scared of not being in a hospital: give birth in a hospital!

Thankfully both home and hospital are very safe places to give birth in this country, both have small and different risks. Nothing is risk free.

atastroke - everyone who gives birth in a hospital has to transfer in labour (unless you're induced). A women who gives birth at home is the only one who DOESN'T transfer in labour.

I agree, but it is being suggested that some women are being transferred because they need an epidural or other pain relief. I would rather transfer before it gets to that stage.

Jesus Christ mark! What about all the home births you don't get called to? Of course you will only see the shitty end of the stick, that's your job to be there in an emergency. Not when every thing is hunky dory.

But what does your personal choice about when to be in hospital have to do with other women's choices? No one is suggesting mandatory homebirth.

atastroke: Is it a problem if some women decide that they need more pain relief, which in practice will mean an epidural, because the others are available at home? What's wrong with saying that you will start at home and see how you go?

You also assume that you will get your epidural just like that in hospital - see a good few threads on MN to see that this is by no means so.

yes, I think it is worth weighing up carefully for those those reasons.

Equally someone might prefer to try not to transfer at all (or leave the decision to the day? That's how I felt - I'd go in if I had to but not before -in the end I didn't have to and my midwives were amazing throughout all 30 hours of it - who knows what might have happened in hospital - likely the labour would have been slower, augmented and then…? But who knows)

I feel emotional statements about what might have happened if someone had been elsewhere are not really supported by the data. but it's ok to have preferences and it's great we can choose and both options are safe.

I would definitely have had (or asked for) an epidural in hospital. I was struggling. The outcome was so good for both me and baby (I had the best 48 hours post birth that you could ever imagine including rest showers food and champagne, the best start to pain free breastfeeding of anyone I have ever met with a baby who was back at her birthweight at 3 days) I guess I have made my peace with that.

It's not always that straightforward to choose; there are definitely pros and cons to both. But scaremongering is simply that.

I had a wonderful 48 hours too- I was home from hospital two hours after my second birth, had a chinese takeway and a bottle of champagne. Established breastfeeding in comfort- although it would have been fine in hospital too. My babies didn't lose any birth weight and piled on the weight in the first week.

Midwives supported me to avoid an epidural, giving me the confidence to know I could manage without. And I did, labouring in a bath and on a birthing ball- giving birth on all fours while experienced midwives coaxed and massaged me. In hospital.

And I had a shitty time in hospital.

It isn't really that relevant though is it? The question is about safety and what each individual mother prefers, not anyone assuming that either form of birth is right for everyone?

That's great atthestroke. If only all experiences were like yours and mine.

Both options are safe; either preference is fine.

I am actually dithering more over whether to have the second baby at home; not for questions of safety and having had one straightforward labour the odds are really on my side I'll have another, and my care at home was so excellent… it's just because the first one took so bloody long and hurt so much and some of my friends who had epidurals are so blasé about labour. I think I was more rose tinted about things in the first pregnancy! Blah.

I'm due June with my 4th and hoping for another home birth, my midwife is quite happy to let me if things continue how they are and no issues crop up, they really are lovely and so much more relaxed x

atthestroke I will try for a home birth (first timer) if I stay healthy through this pregnancy. However, I have a completely open mind about transferring in if I need or want to. I am planning it this way because it doesn't work the other way around! I can't plan for a hospital birth and then at the at minute decide to stay at home as there would be no kit in the house and no midwives allocated to me. You seem to think that a transfer in labour would be a bad thing, but as someone else has pointed out, that is what all non-induced women do for a hospital birth. So if i transfer in, I would be one of the 50% of "failed" first timer home births, but I don't see it that way - I'm trying it and if it works for me, that's great. If not, I have the hospital option available at any point. I doubt I am the only one who approaches home birth in this way.

Mark I have a paediatrician friend who has similar views. She only ever attends the "bad births", where things go wrong. She herself had a quick and easy labour with her first, and so would have been fine at home, but is anti because of her professional experience, which is very skewed.

But I don't think transfer for a planned hospital birth is the same thing at all. Going into labour at home and transferring when you think the time is right rather than being forced to by the situation. With both my transfers I had time to have breakfast, hang out some laundry, have OH take a toddler to gran's house while I had a bath. we even waited until the rush hour traffic had died down so the traffic would be lighter.
Once there I was booked in, shown my room, had a cuppa, chatted to the midwives, offered another bath etc.
Of course not all transfers are like that, but if during a home birth for a medical or pain problem I think would be a lot more traumatic. Not to mention the disappointment of those hoping for a home birth. And that is 50% of women!