Home birth with first baby and succenturiate placenta

[ShrinkingViolet83]

I'm 34 weeks pregnant and I thought I'd made the decision about where to have the baby but now I'm dithering again and would like to ask for advice and other people's experiences. I was always quite nervous about childbirth but then I started reading quite a bit about home birth and started to think that I could cope with it and wouldn't feel as scared and out of control as I thought I would in a hospital. At the beginning of pregnancy I was certain I wanted a home birth but then I kept encountering people (including a couple of midwives) who made me feel like I was being irresponsible for considering a home birth with a first baby. Then at 20 weeks the scan showed an extra lobe on the placenta separate from the main bit, which theoretically could mean that only part of the placenta may be delivered and I could be at increased risk of heavy bleeding. The position of the placenta is fine and my midwife suggested that the risk is a small one but the consultant at the hospital suggested that I might want to rethink the plan of having a home birth. My midwife said that the consultant was being overly cautious and she would still support a home birth but I got scared and decided that a hospital birth would be safer for me and the baby. So I've spent the last few months trying to convince myself that I want a hospital birth and that everything will be fine but then yesterday I went to an active birth class run by two lovely midwives who were very positive about home birth. I told them that I'd wanted a home birth but been put off and they said that I've still got time to decide and that I might want to give it some more thought. On the way home I admitted to my husband that I still really want a home birth and he said that he'd be happy with that and that he'll support whatever decision I make. I'm quite an anxious person and I'm torn between feeling scared by the idea of a hospital birth and also scared of the (very small) increased risk of something going wrong if I have my first baby at home. I'm 31 and healthy, I've had no complications with this pregnancy and I live close to the hospital. Does anyone have any experience of home birthing with a first baby or of the weird placenta thing (either in hospital or at home)? How did it turn out? Thank you in advance for helping with my dithering.

I had one of those placentas, I face birth in hospital just because I wanted to not due to the placenta. For me it came out easily and quickly and didn't cause any issues. Good luck with whatever you decide

www.vasapraevia.co.uk/vasa-praevia/women-in-risk-groups/
Have you had a colour Doppler to rule out vasa previa?

Hospital births can be absolutely beautiful and fabulous so don't read all that natural childbirth guff that will persuade you that you'll be given enemas and made to lie on your back strapped in. They're very accommodating to whatever you would like to try, positions, eating in labour, equipment like pools and squat bars and.....whatever you fancy. Nobody has ever 'pushed' any kind of pain relief etc. I've had two in the hospital. Having said that I'm booked for a homebirth for my third, just because I've done it twice before and had no complications either time (not to say that nothing will crop up this time, it can all be very unpredictable.) If I do end up transferring then I'm completely fine with that, it's just for ease of having two little ones at home that I would like to try to have baby at home, not because I think I wouldn't get a lovely birth in the hospital. DD1 was born with just a bit of gas and air, two lovely midwives in the room as the sun came up over Brighton with an amazing view out of the window of Kemp Town being lit up. Fantastic! I was home a few hours later too, so no long stay or anything.

I don't know, the decision is yours but I just wanted to say that so that you don't rule out a hospital birth based on the idea that a hospital is a horrible place to have a baby. Can really be just fine and there are things going to for it, change of scenery as labour can, especially the first time, go on and on and on, mess and shouting being done elsewhere, if something were to happen you wouldn't have to transfer and probably more reasons that my pregnancy addled brain can't think of right now!

Thank you for your replies.

Lacey: It's reassuring to know that your birth was fine, thank you.

BlackTreacle: I'd never heard of vasa praevia so will ask my midwife about it. I haven't had that test but from a quick skim of the website you posted it seems like they test if you have the weird placenta plus another reason for being considered high risk but I'll ask about it anyway, thank you.

ZsaZsa: When I'm feeling rational I am aware that hospital births are not a total nightmare scenario. Our hospital has a new midwife-led unit with birthing pools and mood lighting etc. so it would be possible to have a birth there that has some of the same qualities as a home birth. Part of what I've got into a state about is that I went to the maternity unit a few weeks ago because of anxiety about reduced foetal movement (the baby turned out to be fine, s/he was just having a lazy day) and I ended up stuck on a bed, strapped to a machine in a boiling hot room with nothing to drink and was left alone for an hour because the midwife was called away. Obviously I was anxious anyway and was not there under good circumstances but I got very stressed in that environment and couldn't imagine having a good birth there. The hospital doesn't allow people to go and have a look around until they're actually in labour so that would be my only experience of the maternity unit pre-birth. I need to calm down about the idea of hospital birth because even if I do plan for a home birth I could still end up being transferred. I also have a pregnancy-addled brain and it tends to catastrophise. Thank you for your perspective.

I know, but your birth wouldn't be like that at all. There would be no need for you to be on a monitor continuously and the midwives were off because they were present when someone needed them most, which next time will be you and your baby! :D (you'll have your birth partner and your own snacks and drinks too)

I was going to say, was thinking about your post a lot, that you need to make peace with the idea that you could be there regardless of planning a home birth.

I hope that wherever you are you have an amazing birth. Good luck with your decisions!

x

To be honest risk of heavy bleeding is one of the complications which really puts me off home birth (and I'm considering one for DC2). Can you imagine how scary it would be having delivered your baby beautifully to then bleed heavily? My friend haemorraged in a hospital and she said it was terrifying, she looked over at her husband and baby and could feel herself 'passing out' and wondered if she'd die and be leaving them to it.

I would definitely get some more investigations done and advice as to the actual increased level of risk.

Also, I had DC1 in a bog standard hospital room, no mood lighting, no pool, just lovely midwives and DH playing some music. DS got stuck and needed ventouse but it was still an absolutely wonderful experience despite not being all 'typical wonder birth'.

I would agree that hospital births can be amazing. Mine was, obviously apart from the pain the environment was lovely and I was never strapped to the bed, could move about as I wished, get in the pool etc. And all the mess eg blood was cleaned up for me and I got help with breatfeeding afterwards. I'm sure home birth is wonderful bit being in a midwife led unit can be as well

Thank you all for your replies. You're all very kind. I definitely do need to talk to the midwives a bit more. When the placenta issue first came up I found it really difficult to get a straight answer about exactly how risky it is. I think they were trying not to seem like they were pushing me in a particular direction but it wasn't entirely helpful. I need to go back and ask more insistent questions. I am working on making peace with the idea of a hospital birth. I thought I had but then I got myself into a state again. I'm blaming the hormones. This is definitely not a good time to be making big decisions. Thank you all for your help.

Hi Viôlet,
I'm probably going to say something you don't want to hear. Don't do it. I myself am a bit of a control freak and on a purely personal level I would want a home birth. But it's not just me, it's my whole family. I wasn't offered a home birth for my first because of a blood condition, but if I had my daughter would not be here. 5 hours after a perfectly normal birth she stopped breathing and was resuscitated by midwives and then taken to NICU. If she was a home birth she would have died.

The bottom line is you don't know what birth is going to do to you and your baby. The underlying cause of my daughters problem was speed of labour. Nothing I knew about before I gave birth. Please consider the big picture of you, your baby and your DH.

Also don't just talk to midwifes, talk to other health professionals including GP. They tend to have a more whole person overview.

Hello Violet, I am in a similar quandary to you, for different medical reasons.

After weeks of going back and forth I realised that I was never going to be able to bottom out the issues and the risks enough to make an "informed" decision - the consultant and midwives don't agree (as yours don't) so what chance do I have of coming down firmly one side or the other?

So for us, the decision is now about will I (very unexpectedly) be more relaxed in a hospital environment because I know there will be "someone to catch us if we fall", or will I be able to relax more at home simply because it's home. Because whichever location allows me to relax more gives us the best chance of the happy and uneventful birth we are hoping for.

And no it doesn't help trying to make these decisions when hormones are doing most of the thinking for you

Try to do as much research as you can on this specific condition. Then you can make an informed choice.

With how you've described it there shouldn't be a problem with the actual birth or a risk to the baby but it appears that you might have an incomplete third stage which will require you to go into hospital after the birth. Which is a different scenario from a mid labour transfer.

I had a post birth transfer after a hb. I think if you prepare yourself mentally for that eventuality then it will be easier to cope with.

Due to my own fears I would never have a home birth as I always err on the side of caution. I had two brilliant hospital deliveries and both my boy's were induced.

I have seen first hand what a PPH can do and I can assure you that it's not just a bit of blood, it is literally liters. The last PPH I assisted in resulted in ventilation in ITU.

I always work on the premise of peace of mind. If the absolute worst happens will you still be happy with the decision that you made. Only you can decide that.

Best of luck with your delivery

Thank you all for sharing your experiences. I had a midwife appointment this morning and she wasn't able to give me much more information but is going to try to arrange for me to see a consultant so I can ask more questions. She also said that it might be possible for me to visit the maternity ward beforehand so I can feel a bit more prepared and less anxious about a hospital birth. It's worrying me a little bit that a couple of the scary experiences described here happened a few hours after the birth - if the birth seems to go smoothly we're meant to be discharged within 3-6 hours - but it still might be sensible to go for a hospital birth. I really appreciate you all taking the time to discuss this with me.

I just wanted to come back on here to update you and to say thank you again for your responses. After having another scan and an appointment with the consultant I agreed to a hospital birth and then spent the rest of pregnancy trying to properly make peace with it by reading reassuring books about birth, speaking to midwives and having a tour of the maternity unit. My main midwife knew I was feeling anxious about the hospital so she spent a lot of time talking to me about it when we went through my birth plan and she made sure the staff in the maternity unit understood and would make things as much like a home birth as possible.

My daughter was born on Tuesday in the hospital birthing pool. It was a straightforward, uncomplicated birth and the placenta didn't cause any problems. So I could have managed a home birth but I appreciate the advice from people on here who said that you can't know in advance how things will go. All of the midwives were absolutely lovely and I felt very safe and supported. The birthing pool was wonderful, and was something that I wouldn't have had at home.

Even though a healthy baby is the most important thing (and she is healthy and beautiful and I adore her, I just wish she would let me sleep a bit more) I think that the birthing experience does matter and makes a difference to the beginning of parenthood so I'm really glad that I was able to feel okay about things and to have a positive birth. So thank you to everyone who helped me to come round to the idea of giving birth in hospital. I really appreciate the support I've had from real life people and Mumsnet.

Congratulations! That's really lovely news