I am going to write in your notes that you are advised AGAINST a homebirth!

[ShellyBobbs]

This is your fifth baby and you are a high risk of PPH.

Talk about shocked, this is what I was told yesterday after my 20 week scan. This is also despite 4 very healthy pregnancies and deliveries - the last one being a homebirth. This doctor seemed set in concrete with her opinions and there was no room to maneuver. Now I'm not stupid, I understand that there is some risk but she didn't want to discuss how it could be managed if it did happen at home, just 'I do not advise it'.

As a matter of interest the last doctor I saw at my 12 week scan was all for it and thought homebirths were a great thing. I'm under a specialist due to hypothyroidism which has no bearing on a homebirth.

Just venting really, seems like my area must have hit their homebirth figures for March 2015!

Yes agree with booboo. Can we help you formulate your letter to be as clear and concise as possible.

booboo, how do you mean misleading? That's what she has written in my notes, advised against homebirth as 5th child.

I'm going to speak to the other doctors I see first, see what they say about it - but thanks for the offer I may take you up on it another time.

There are some doctors (or need midwives) who advise strongly against homebirth whatever the circumstances. There is almost religious ferver against homebirths and a lack of respect for community midwives.

If you have a history or precipitious labours then a homebirth or at least a domino delivery may well be a safer option. A community midwife can do more to help you if you have a pph than an unassisted birth in a layby.

I suggest you look at the website www.homebirth.org.uk

AIMS is a charity that helps to support women's choices in labour and may well be able to advise you on how to enforce your rights.

www.aims.org.uk/

Forget about what she wrote in your notes. She wrote her opinion about the best birth option for you, she is trained and paid to give this opinion, it should be recorded and if you chose to disregard her professional opinion this should also be recorded. You have no grounds of complaint on this point as such so the answer to your thread going by title alone is that YABU.

But YANBU to complain about the information imparting and decision making process.

Really, I've been looking at the website on your first link as part of my research before my hospital app. it's a wonderful site with extremely useful information, I'll have a look at the other site tonight.

I see what you're saying Boo.

Will you see the same doctor at your next appointment, or will you see a different one? Maybe a different one, or your midwife, would be more willing to explain the rationale behind what the first one said to you, and how much higher your risk actually is - and as I said earlier, if you have the facts at your fingertips, you are better placed to make the right decision for you.

SDTG it will be a different one. The first one I saw was all for it and couldn't see any reason why I shouldn't if I continued to have a healthy pregnancy, That is why I was so gobsmacked. I'll speak to my midwife too and see if it would be a problem from their point of view.

I think you would be well within your rights to make a complaint against the fact that the doctor didn't provide you with any reason or information as to why she was advising against a home birth, but not because she wrote it in your notes. As the PP said it's her opinion, and she is paid to give it to you, she is also paid to prove she is doing what she considers in your best interests. By writing it in your notes she is simply covering her own back.

I wholeheartedly agree with you though in that you need more information and speaking to the midwives should help. Let us know how you get on!!

I was told this too - amongst lots of other 'risks' which weren't qualified at all by stats or my circumstance. In the end I had opted for induction in hospital, despite having had 4 hb's totally straightforward births, no excessive bleeds etc etc.

hosp birth was fine too btw - quick, npormal blood loss.

for me it came down to confidence, after being told about all these greater risks I just lost confidence in my body. this lead to me opting for managed hosp birth, which is what was preferred by docs. unfortunately i found this route a bit more distressing and had a couple of princessy weepy moments as the induction didn't work at first, then had to make decisions about water being broken etc which is insanely minor in the grand scheme of things but felt so out of touch with what was the right thing to do etc.

a very helpful doctor came to see me and said 'you have the same body as before, it will all be fine' - it was and realising that it was still the same body that had birthed my 4 other children well, was a great comfort.

essentially what more rambley, sleep deprived self is trying to say is this:

it's your choice; you have the same body as before; there are always risks; whatever you choose make sure you feel that it is the right thing for this pregnancy and birth and for you now. pph is slightly increased at 5; but the mw's and docs at hospital seemed totally unworried by that and were reassured by the fact that i hadn't had abnormal blood less before. they advised me to have the synto injection though - which i did. all was fine.

good luck x

...not giving me the option of a homebirth is just wrong in this particular case

She isn't preventing you from having the option though is she OP? It's not as if she won't let the mws come to your home to take care of you. You seem pretty confident that the doctor is wrong and you are right, so I don't see why you are even questioning this tbh.

Since you are questioning it, IMO if the doctor wasn't clear (and it does sound like she was a bit vague and not very forthcoming with the info you wanted), maybe you should make another appointment with her to ask for clarification. If you really don't think you will get anywhere with her, ask to speak to a different HCP.

FWIW, personally, I would feel quite uncomfortable going against her advice without seeking further information in RL from a HCP, (especially re PPH, which sounds bloody terrifying and can quickly become a life or death issue). In the nicest possible way, an article from Google and a bunch of opinions from MN does not a doctor make!

But OP hadn't got information from google - she had information from a previous doctor who thought it was OK.

If this doctor had said that she didn't advise it now because of some change in OPs circumstances, that would be something to consider. All this doctor has really said is that she is anti-homebirth, for reasons only known to herself, because she didn't communicate them. (She might never have even seen a home birth.)

I get the feeling ShellyBobbs is well informed. I don't think that anyone has given her nutty advice. Childbirth is a risk however a baby is born.

If it makes you feel any better, my midwives have refused to even discuss a home birth with me for DC5 so I'm not going to bother having the conversation with my consultant. And that was before everything started going wrong in this pregnancy.

My midwives refused to discuss homebirth with me too, so there was no discussion. It was bliss.

It's funny because the reason I was registered at THAT hospital was because they were the closest for homebirths.

At the 11th hour, with a week to go and my refusal of being booked for a sweep, I was asked why not and explained that I don't consent to internals, which sent them into a tiz and to finally glance at my birth plan and notes which had missing blood tests and scans.

I had been telling all who would listen that I was having a homebirth but somehow no-one was every interested. That's what you get when you never see the same midwife twice I guess.

I wish you the best of luck wherever you give birth.

Maybe you are now beyond a cut off age? I was under a cut off age by two weeks for my last. In no way could I have had a HB after that, or had my babe gone into overtime - just the rules there for everyone's safety.

I'm intrigued as to what that cut off age was.

Part of the issue with medical advice generally in pregnancy is the medical profession' s inability to accurately communicate risk factors to parents. Advice ends up being anecdotal without taking into account the personal circumstances of the patient.

They can't actually refuse you a home birth, Venus, only advise against it.

Since replying to this thread a few days ago, I have given birth to my fourth child and had a severe PPH with a loss of over 3 litres of blood. I had planned a home birth but transferred to hospital due to labour not progressing at home. TBH, I would have stayed at home against advice except that I had no confidence in the midwife who was present so decided that I felt more comfortable in hospital. I've had two home births previously, one of those being a large (10lb 4) baby born 16 days post due date. Both my previous home births went very smoothly.

This baby was born 40 mins after we arrived at the hospital. Seconds after she was born, the blood gushed like turning on a tap and the room was full of people. 2 syntometrine injections didn't stop the bleed - a drip, compressions, manual removal of placenta and packing did stop it without surgery.

I don't believe that I would have died at home had we not transferred in. But I do think it would have been a frightening situation that nobody would want.

It's true that pph risk increases with each child. But an increased risk doesn't equal a big risk. And we take risks every day. It's also true that most PPH isn't sudden, or severe. I think what I'd want to know is exactly how it would be dealt with at home - can the midwives set up a drip? I know they carry extra injections. I would definitely have a managed third stage in future having had physiological ones before. Do the community midwives have the same training to deal with pph? The midwife i spoke to on the ward told me that they have a regular pph drill with a dummy, which is video recorded and played back to them sothey have to watch themselves dealing with it and discuss it. I also chatted to my own midwife today who says she has seen it managed at home but undoubtedly the delay ingetting to hospital has made the sisituation riskier and led to more blood loss than a hospital situation. Ibelieve I would have survived that pph at home but possibly not without surgery and a much longer recovery. So I don't know what I'm saying really except that it's a matter of a calculated risk like so much else in life.

What a nasty doctor. Whatever the facts / opinion, it's no excuse for not having a proper conversation about it.
Have you seen www.homebirths.org.uk section on PPH? (I doubt your doctor has). Worst case scenario (which doesn't sound likely anyway) how far are you - ambulance times - from the hospital? IF it's not far then I think she is being totally totally unreasonable.
ON the other hand, saying "I'm noting that you are advised against it" is not the same as saying "you are forbidden from doing it". My MW are super pro-homebirth but sometimes they have to write stuff in my notes and apologise for doing it but explain it's just a formality. My MW at last birth delivered two babies at home after offiically (and seriously, in those cases) advising mother against it. It was all fine.

p.s. If you see that dr again, can you tell her "I am going to write in your notes "obnoxious patronising cow"?

The Dr is following nice guidelines.

"Risk factors for postpartum haemorrhage

1.16.7 Women with risk factors for postpartum haemorrhage should be advised to give birth in an obstetric unit where more emergency treatment options are available.

Antenatal risk factors:

previous retained placenta or postpartum haemorrhage

maternal haemoglobin level below 8.5 g/dl at onset of labour

body mass index greater than 35 kg/m2

grand multiparity (parity 4 or more)"

Yes, but .... she didn't bother to explain that to OP, which seems to be what's put OP's back up. From the information given OP had one risk factor namely 5th baby. Does that make her 'high risk' or increased risk? With a consultant unprepared to discuss things further, she has no way of evaluating the information given, which contradicts information given earlier.