Homebirth for first baby? Anyone done this - good or bad?

[pippinleaf]

I met with our doula for the first time yesterday, I'm 23 weeks, and we chatted about what my feelings were around birth. I'd not considered a homebirth really but she got me thinking. We live less than a mile away from the hospital and I'm not keen on hospitals (who is?) she has her own water pool that she would bring round and set up etc for me which we could use regardless of whether I intended to deliver at home or go to hospital just for the later stages.

My thoughts on pain relief are that I'll go for gas and air and reserve the right to go for an epidural if I cant cope. I don't think any other drugs are for me as previous experience says I don't like anything which messes with your head. I know I would need to be at hospital to get an epidural but my understanding is that I can change my kind at any time and transfer to hospital so getting an epidural should be ok proving the anaesthetist is around.

My husband is happy to consider home birth but is anxious about anything going wrong and the need to be at hospital if it does. I'm 38 and there are no complications in the pregnancy but it is my first. We could be at hospital in less than five minutes if there was a problem but obviously if I'm bleeding to death or the baby isn't breathing then five minutes is a long time.

I'd be really interested in your experiences and thoughts?

These posts make for really interesting reading but have scared the bejesus out of me. I wish my doula could come with gas and air as I think without pain relief I will end up going to hospital sooner. I'd love to have a home birth but I'd hate to have a moment of doubt that if something went wrong that it was my fault. I guess il be at home as long as poss and then go to hospital.

Well done ladies, another home birther scared off. Hope you're proud of yourselves.

The BMJ study someone linked to earlier on the page didn't find that out of hospital births per se had worse outcomes for the babies of first time mums, only that homebirths had worse outcomes (while still being considered safe).

Birth centres not attached to hospitals have outcomes similar to consultant led units for the babies of first time mums - despite access to obstetric input requiring transfer by ambulance (in the study the average transfer distance was 7 miles).

My view is that if you are well, and have an experienced case-loading homebirth team, you are very, very safe at home, as is your baby, at least as safe as hospital, even for a first time mum.

"Yes but knowing who the right candidates are is the problem."

It's not.

There are very good protocols in place to screen women for home birth suitability.

They work very well - hence the excellent outcomes.

I had my first at home, it was an easy and quick experience, though we had to go to hospital as but I was already aware I'd have to go in for monitoring due to a long time between waters breaking and going into labour. Some babies will die in home births that may of been saved in hospital and some babies will die in hospital due to infections and intervention which may not of happened at home. I know a lot of people who have had home births and none of them had any problems, I also know a lot of women who have birth in hospital and had a horrendous time.

pippinleaf - if you have a home birth your midwife will bring gas and air so that is not something to worry about. Having said that, I believe it's the case that women at home tend to need less pain relief.

Cheesilycheerful - how do you know you would both have died if you had been at home?

A great problem with childbirth is fear, and scaring people without evidence to back it up is only perpetuating the idea that labour is dangerous and an experience to be dreaded. Please stop.

I don't know if OP is still here, but for a first time mum the safest option is a stand-alone midwifery unit - as safe for the baby, and safer than a CLU in terms of avoiding unecessary interventions, EMCS etc. I am firmly of the belief that the mother's health matters too, although it often gets overlooked.

I attempted home births for both my babies but both ended up in hospital. I was transferred in by ambulance both times. Ended up with ventouse for DD and forceps for DS. Agree with PP about going in to it with an open mind and not seeing it as a failure if you go in. My birth plan was to come home with a healthy baby..... that was all.

One thing I would say is that there are positive and negative stories for both locations - and unfortunately babies do sometimes die wherever you give birth.

In my opinion these are the positives of Home Birth:

• you and your husband are likely to feel more relaxed and calm at home with no buzzers/bright lights/etc.
• You can use your own loo and shower/bath etc (good if you are a bit germ phobic)
• You are likely to have two midwives all to yourself as they are supposed to aim to have two in attendance at time of actual birth, one for you, one for baby

-Your DH is less likely to feel 'useless', a common complaint in Hospital -You can't forget nappies/clothing/clean pants if you are at home

Negatives of Homebirth:

• You may have to transfer in while in proper labour, in my experience getting in an ambulance while contracting and looking less than my best with the neighbours curtains twitching was not my finest moment!!

-Once you get to hospital they are more likely to see you as a bit of a 'problem' because you are a prolonged labour and they haven't monitored you from onset so are more likely to push for an intervention/quick delivery. -Even if you deliver perfectly and baby is fine etc if you need stitches you may have to go in for that anyway - check with your team how many of the Midwives can suture and if they offer that at home.

Have you considered or got access to a Birthing Centre? Can be a much nicer 'home like' environment but with the safety of being on the hospital site??

I had a homebirth yesterday with my first baby - it was wonderful. Would highly recommend it. Had a horribly tiring long latent stage which was crap but would have been home for that either way of course. I didn't have any pain relief except paracetomol though because they misjudged when is be ready to push so entonox wasn't there. I think in hindsight that was a good thing as I could really listen to instructions when pushing and I didn't tear.

I'm glad I didn't read this thread when I was trying to make up my mind about whether to have a home birth! The scare stories haven't put me off, but I can imagine they'd put off some first time mums which is a shame.

we had both boys at home but we were fully in the hands of the midwives.
they were happy to proceed, each time they made notes it was carefully being assessed as to whether we could stay at home.
I had 100% confidence that if things were not progressing in an average way that we would be transferred and I would have gone with that. My pregnancy had been textbook.

My first labour took 36 hours from start to finish and I loved being able to settle in for the long haul at home.

The ONLY thing that I feel would have been better in hospital was the embroidery that I needed, and I have no way of knowing if that is true. The midwife who stitched me up decided it needed to be very tight and within a day or so of birth the stitches had split apart. v v ouch.

DS2 was born very happily at home but with all of the above caveats, we would have gone to hospital at any time.

3 HBs here - and like you, very close to hospital.

a) midwife WILL bring gas and air - so you will have access to that at home

b) they can also bring pethidine (tho the ones local to me were v discouraging about it - basically said if you need pethidine, you should go to hosp)

c) your doula is just there to help you out, they don't replace the midwives in any way

d) you get SO MUCH MORE MIDWIFE ATTENTION at home. 2 midwives by the time of delivery: 1 for you, 1 for baby. I know NOBODY who got that level of labour care in hospital (unless a v complicated birth)

e) most problems develop very slowly, and there will be time to transfer.

f) even 'crash' CSs can take time to set up in hospital - if both theatres are already in use then however urgent things are for you, you still have to wait. And if you need to transfer in you'll be 'waiting' in the ambulance

g) close friend attempted a HB after 2CS and her uterus ruptured - interestingly she knew FAR before her (v experienced) midwives that something was wrong and insisted on being transferred to hospital, where she eventually had another CS and they are both fine

You don't need to make your mind up yet! Wait until 30-something weeks and see how you feel then.

That's really interesting Faster about your friend. "A feeling of impending doom" is actually something that we were taught was a symptom of a uterine rupture!

OP, I had a home birth with my first baby. Loved it. Loved the most was that I got in my own bed afterwards and had a shower in my own bathroom and all of that. I'm also a midwife who mainly does home births and I would say why don't you ask the community midwife to come round for a chat? She can talk you through the pros and cons for you, discuss any fears etc and maybe help make things clearer. Good luck x

You don't actually need to decide until you're in labour.

Doesn't matter that DH isn't 'fully on board' either as ultimately, you are the one who will have to go through labour and birth. It's easier if he supports your choice, but not essential.

The not deciding till you're in labour is an excellent point - that was how I looked at it. I just kept going and if at any point it seemed like I'd be better off in hospital I would have gone in. I was also deliberately (as far as I could be) emotionally uninvested in a home birth, I would have been happy to take medical advice and gone in if anyone was worried.

Chunderella, we had a pool both times (it was an oval fibre glass thing with 2 liners) it took about 30 mins to put together and fill.

this was it, it was mahoosive and brilliant to be able to stretch out

My friend did when giving birth to her first 7 months or so ago. Positive experience from what she's said. She spent a lot of time on hypnobirthing and had really good control of her breathing which is what got her through the worst of the pain.

Exactly 8 years ago I was in early labour with DC1, using my contaractions (5 minutes apart) to time the food I was cooking. After I'd cooked the food, I watched television with DP for a while, called the doula and midwife, laboured a bit more intensely and less than five hours after the quinoa was cooked, I was snuggling DC1 without having to leave the house. Given how much my labours slowed down/stopped with each home birth just from having the midwives arrive, I'm pretty convinced that my two simple straightforward home births would have required lots of interventions in a hospital setting.

If you are at home you will get a midwife to yourself for the whole labour and two for the actual delivery. Maybe some babies who tragically died in hospital would have lived if they were born at home because the problem would have been picked up earlier by a midwife who was giving the labouring woman her undivided attention? It's not as clear cut as hospital = safer.

I looked into this when I was pregnant with dd and iirc the big study which someone linked to above showed that for first timers, hospital births were very slightly safer. However there was no research into the impact of the distance from the hospital, so as someone who lives five minutes away from hospital, I felt that I was close enough not to run any additional risk - as someone said above it would probably take the hospital longer to prepare an operating theatre than it would for me to get there. I felt that in my case, the benefits of one to one midwife care and the psychological benefits of being in an environment where I would feel relaxed, outweighed the risk of those five extra minutes. Whether you decide the same is your decision alone, but make it based on the facts and not scaremongering.

Chunderella I'm hoping for a homebirth in a few weeks time and have a birth pool ready. My MW asked me not to get into it until after they'd arrived and seen how far along I am. She did say that baths and showers were fine and to have as many of those as I wanted. Apparently there's just something about the larger volume of water that seemed to relax women that little bit more than a bath or shower and can sometimes slow things down more than you'd want? :-\

I'm a first timer so I have no personal experience and I don't know if what she told me is just her personal opinion or "official" guidance but it might be worth checking with your MW to see what they think? X