Need a last minute gee-up/support for my homebirth choice please

[TeaAndANatter]

Hello all,

Number three due by home birth in about 3 weeks. Babies 1 and 2 in hospital and in a midwife led respectively, both relatively trouble free. Baby 1 needed a bit of help after due to being forced to lie on my back throughout, and not having the balls to tell the midwives that I wanted to be upright (12 years ago). I was happy and determined to birth at home for this one, and feel very women-led about it, but have had all the midwife visits to arrange it over the last two weeks, and feel really unsupported.

The midwives don't say outright that they don't support home birth, so I can't really debate it with them, but I just pick up (so does my DH) a kind of pervasive monologue about the risks of x, y or z to do with home birth. When I try and quote statistics, I'm told that 'they just have to tell me for the paperwork', but I know that they believe that home birth is risky from the way that they say it. I'm left feeling unsupported, and like I really don't want any of them present. I'm almost wondering whether to send the birth pool back and just suck it up and go to the unit instead.

I've been told that I'll need to go in straight away anyway if I need more than one or two stitches, that I might need to go in the next day for an anti-D jab, and that I'll have to book a separate appointment to have the baby checked over there too. I'm starting to feel that the point of a home birth is pretty moot if I've got to go for all these separate visits that apparently can't be combined into one trip to hospital!

Basically, I'm doubting myself a bit, and just need a kick in the butt, and reminded that I'm following the science, and my choice is right for me. Thanks all.

Awwww hugs. Sorry you don't feel supported in your birth choice. I also am hoping for a home birth but so far my experience from midwife has been positive.

Read homebirth.org birth stories, there are some great ones. Also have a look at aims website regarding your rights.

You do not have to go into hospital for stitches unless it's a third degree tear. Most tears will heal naturally without stitching (this is the up to date guidance). Your baby check is usually done by the GP who will come out after the birth, the next day if after a home birth (this is not the 6wk check, this is done in the clinic).

Speak to your midwife about your options and be firm, if you feel unsupported you can also contact the supervised of midwives (sop) and see what their policy is regarding the above mentioned.

Midwives are health professionals and do have to give you all the information even the stuff you may not like such as risks etc however from my own research I have come to the educated conclusion that a home birth for myself will be safer than a hospital birth. Only you can make your decision but remember you can change your mind too.

Good luck and hugs x

Put some wacky things in your birth plan. It will ensure the most senior and experienced midwife is assigned to your birth when you call.

'No internals' often works best, as does 'delivering baby myself' and 'delivering placenta IN pool before cord cut'.

What you chose to do on the day will be up to you of course and it is your right to change your mind......

No this doesn't happen to the above poster. You get who you get - that could be a newly qualified mw if she is the one on call.

I'm a midwife. I fully support homebirth however I do understand why you would think your midwife doesn't following explanation of the risks. They sound scary and ott but the me wouldn't be doing her job if she didn't make you aware. Obviously you know what the benefits are otherwise you wouldn't be going for a hb. It comes down to whether the benefits outweigh the risks for you and your family?

It happened to me twice. Most senior on call. Maybe it was refusing consent to McRoberts that did it then!?

No team Manager wanted to put their staff in difficult situation.

Rose - You are a midwife aren't you? Do they really send newly qualified midwives to home births in your area? I was told in my last area that they didn't do that. You had to have X years of experience in MLU/CLU before they would rota you as the primary midwife for a homebirth - precisely because there weren't a whole host of other midwives on hand to check questions with. I have my homebirth booking in my new area on Thursday, so that's definitely something I'll be checking!

I'm due my second in a couple of weeks, after a planned homebirth for the first ended with induction due to SROM, and we're planning a water homebirth again. I too have the collywobbles about it occasionally but even if we end up transferring in, the reasons for the homebirth still stand so try to remember you're doing it for good reasons :)
Sorry, that made sense in my head!

Good luck and do what's right for you and your family :)

I know how you feel about all the talk of risks etc and I do think some midwifes are more risk averse than others. I had my fourth home birth recently and it was pot luck which mw turned up.

In fact on the day, three came as one was a student ( even though I didn't want students). Anyway, they sat back on a different sofa, without talking and just let me get on with it until I needed to push so in the end it didn't really matter who was there.

Regarding the newborn check one of the mw's was qualified to do it so she did that at home a few days later, but in previous births the GP has come the house.

I hope you can regain some positivity - you'll need to be strong mentality for birth so if you want to go for it, then do and look forward to it. I loved my home births and really hope you get the experience you want.

Hi, no not in my trust but at another local one all the midwives work on a rotation between community and hospital. This includes newly qualified midwives.

Most areas will have two midwives attending you birth though. In theory it shouldn't matter which area you work in once qualified, you should be 'up to the job' on day one. However, anecdotally most midwives are more experienced in the community.

I'm sorry you're feeling like this.

I had a home birth for my first dc in October and it was a positive experience. Once I was in established labour and in the birthing pool I was in control and the mw was very calm and hands off, which is what I wanted. It was worse being alone with DH in early labour! I laboured in a pool overnight, and when ds was born I got to be the first to touch him and hold him. They left after I had a shower and ds was sleeping in his own crib. These days I could have been discharged from hospital in almost the same amount of time. I had a second degree tear and was stitched at home. The mw did the baby check the next day. Even if a GP has to come out because your mw doesn't do baby checks, that's not your problem. My mw gave me an anti d injection at home at the same time. His hearing check was done at the local health centre when he was two weeks old and tbh it was nice to get out of the house on that little outing.

It sounds like services in your area may be a bit different but honestly it's worth it. I found my mw was supportive of home birth but they still need to be really clear about the risks and the chances of hospital transfer. They don't want you to be disappointed afterwards if it doesn't go 100% to plan but you've done your research and I'm sure you're aware of things like that. I know a doula and when I was planning my home birth she told me how it's worth it, even if you get transferred in the end.

Good luck! I hope your birth goes to plan.

I think assuming the birth is straightforward then a home birth will be a fantastic experience and absolutely worth it. This isn't your first baby so you are not naive to the realities or potential for complications.

I planned a home birth with my first (entirely naively!) and I got the sense that the midwifes just thought 'yeah yeah whatever' thinking I'd definitely transfer into hospital as opposed to thinking it was risky as such...annoyingly I did have to - walked to local hospital (unknowingly at 10cm!) due to a bleed and effectively went to hospital just to lie on bed and push baby out - no drugs etc so it seemed pretty pointless and like you I had been active the whole labour at home only to have to lie on bed which was not comfortable.

Second baby planned hospital birth due to not wanting to disturb my daughter but blow me, he arrived at great haste as unplanned home birth with my husband to deliver - not exactly a zen experience, pretty terrifying for us all but he was fine (and my daughter slept through the commotion!) but frustratingly community midwife could not get to me in time so had to transfer to deliver placenta/have checks and stitches etc

So I think plan for what you would like but prepare for unexpected to potentially occur.

Rose - Gosh, thanks for that. I'll definitely be checking! I know that in theory you should get two midwives for the delivery, but my last planned homebirth I had a BBA (I appear to labour very erratically. Hours of very intense but irregular contractions. Waters went, called MW's, but DD was out in under 30 minutes from that point), so I'd be nervous about relying on the expertise of the second one to balance things. I'd have no problem with a newly qualified midwife at the MLU, but of course there she (or he) can stick their head round to ask questions of any number of more experienced colleagues.

I'm a lawyer and to me it would be a bit like leaving a newly qualified lawyer to deal with a complex case on their own. Yes, they should be up to the job from the day they qualify, but it doesn't mean that they don't need easily available back up if things get complicated!

I think that there is a dedicated community midwifery team who also attend homebirths, but I'm new to the area so I'll need to find out.

Where are you OP?

I've had 3 homebirths, the first with complete random MWs who were on call because my lovely community MW was off duty in the IOW so couldn't get to me in time. They were amazing, really unobtrusive. My second WAS with my lovely community MW who had supported me all through the pregnancy and was a bit of a HB guru, so I was very lucky to meet her and I now call her a great friend. When I was pregnant with my third, we happened to be living in Kenya, so I flew my MW out, and hired a local Kenyan MW, and the 2 of them delivered my son with my DH in the pool in my house in Kenya!

So 3 amazingly positive HB stories, all born within 3 years of each other, and all perfectly calm and lovely births. Homebirths rock. THINK POSITIVE! Even if you think the MWs are not supporting you, you've got to go into it thinking it will work and you can do it.

Good luck!

Thanks everyone, that helps a bit:

JollyMarie, yes, we both like homebirth.org. It's what I'm using to not entirely run down the street screaming!

RaRa Very cool idea - I'll add to the birth plan that I want recipe suggestions for the placenta. Although so far no-one wants to see my birth plan, so I'm not convinced they give a rat's ass in any case :-(

RoseandMabel - thanks. I know they need to outline the risks, and that's honestly not what made me feel unsupported, it's more the way that she does it, if that makes any sense? She kept telling me that midwives only have basic first aid skills, and that the paramedics would be the ones to help if the baby had any problems, and so on, and it just made me feel that I'd be attended by no-one who would actually be of any use (previously I've thought midwives are fab!).

Boobz - great +ve birth stories - thanks!

Findingmyfeet - you walked in at 10cm?! You are my new birth idol!

Woke up feeling anxious about the whole thing. I don't want to speak to the SoM as I'm not complaining, I just feel unsupported. It's not like the midwife said anything inaccurate (much), it's more that I can tell she doesn't support me. Might go and speak to GP. Not sure what she could do other than give me more piles cream, so everyone's a winner

Haha! The midwife had seen me shortly before we left and said i was early stages and had about 24hours to go!....she lied!!

Aww I'm so sorry you feel this way. I only keep posting because I'm so pro-homebirth, however I will also inform women about our limited skills in an emergency. It's not that we can't resuscitate - we can. But we are limited in an emergency to a bag of equipment (rather than a full resus trolly) and not having a full team at the press of a buzzer in an emergency at the hospital. Unfortunately this is the reality of an emergency situation at home. If you didn't know this you would feel very disappointed with lack the information did the worst happen. But then do we all spend our lives in hospital on the off chance we have a heart attack that day?!!!

I think you just have to accept that the check list of risks put a downer on things. Hopefully now you have got that bit out if the way you can focus on the positives again.

Home birth can be so wonderful but only you know what is best for your family. It sounds like this is what you want. The other issues like anti d etc are better to know in advance than be a surprise on the day.

Why not arrange another appointment to discuss what you need and how you can prepare to focus on the exciting and positive aspect of it? Best of luck op :)

Thanks Rose, I got the birth pool today, and feel surprisingly more ready for it. Inflated it, sat in it for an hour with a book, and decided that I will just cocoon my way through it all, and not spend too much time over thinking all the home birth risks :-)

Perhaps it would be helpful to think of it as spending most of your labour at home. Then if you feel supported and comfortable with the midwives who actually attend carry on, and if not transfer.

I had two home water births, one attended by my lovely community MW, the other by some random MWs I'd never met (much like you get in hospital! ;)), but given they only arrived 15 mins before DD did, they could have been the most negative MWs in the world and I'm not sure I'd have noticed. Stick with it, home births are great and birth pools too. Good luck, you will be fine. :)

I had a home birth three weeks ago, it was actually suggested by my midwife at book it. She took one look at us and said "so you'll be having a home birth then? " like it was a completely normal thing to do. I think she must have thought we looked like hippies which was a bit odd as we'd just come from work.

Anyway, as our was my first baby I decide to view it was a "how long can I labour at home" exercise rather than put too much pressure on myself to actually give birth at home as the risks/likelihood of transferring to hospital had been well explained to me.

Ended up with my community midwife delivering baby on the bathroom floor. She wasn't even on call, I'd rung her in the afternoon and as she'd just finished her clinic round the corner she popped round and ended up staying for 7 hours after her shift finished! Second mw who was actually on call came out too.

It was a wonderful experience and I'd recommend it to anyone who had the info to make an informed decision about it.

Best of luck to you.

'm another midwife who is supportive of home birth. I'm also a som and I suggest you phone one for a chat, it will probably help, soms are meant to be supportive of physiological birth. Where I work home births are just normal, a NQ midwife would not go to one on her own but might go to one with a more experienced mw. Most of us are supportive. Maybe you just got someone having a bad day? Did you question her attitude?

That's a great attitude Peace. I also planned to 'start at home' and see what happened.

It's a bit tricky to work that one through the systems though. Usually you have to 'book' a homebirth which suggests commitment to one.

Wouldn't it be great if everyone just started at home with access to a midwife AT HOME when they needed it, choosing to transfer in either before or after they had requested a midwife's attendance?

Surely that would be cost effective in the long run?

I had my homebirth booking apt this week and it was all really positive. I got talked through the situations where they would advise transferring, but no 'scare stories'. Was also told that all the community midwives who attend homebirths as first midwife are experienced and have actively chosen to work in that field - she actually said "if they weren't happy to attend homebirths they should stick to the ward" and that she knew all team members were very positive. Second midwife might be more junior, but they obviously always have back -up.

Sounds more positive, Penguins. My midwife made it sound like she thought midwives can barely work out which end of a baby goes 'up', which I don't believe!

Have you managed to speak to anyone else in the team about it? Maybe she is just an odd doom monger! I had one of those last pregnancy at an antenatal appointment. She sucked her teeth when she heard I was planning a homebirth and started on the 'problems' Including that if my iron was any lower they wouldn't 'let me' home birth. Despite the fact that my iron levels were fine and no one (including her) was even suggesting any more blood tests, so would have no way of knowing anyway.

My 'risk' chat was a lot more "If something is going wrong, we want that to happen in hospital where we have all the back up. It is rare, but sometimes there are things like bleeding (more than we'd expect) during the labour that might well be nothing, but could indicate something serious like a placental abruption. So even though the symptom might not seem a big deal, we'd advise you on transfer to be safe rather than sorry" Which obviously made total sense. I understand that there is less cope for a wait-and-see approach at home.

Another example was stitches - they will happily stitch anything up to and including second degree at home. But if it's going "a bit far back or a bit far forward" or is more serious then we'd like "proper lights, a medical bed and possibly extra pain relief for you". So again she was quite low key about it all.