Right to home birth

[fooolofbeans]

I don't want to drip feed but likewise don't want to write an essay.
Is my understanding the European Human Rights Law allows a woman to choose where and how to give birth.
I know there was a recent trial where the midwifery team were within their rights to refuse a home delivery.
However I'm low risk and have no contraindications to a home birth. At my most recent antenatal appointment my midwife suggested they may withdraw my option of a home birth as I have cancelled two OGTTs due to work commitments. I have since had the test and all was fine. But surely all tests/interventions are my prerogative to refuse and the suggestion of withdrawal of a home birthing option seemed like a veiled threat to make me comply. I will say however if there are any issues that may contraindicate home birth I will comply with full investigations.
Any thoughts on this? Are they within their rights to refuse a home birth based on no evidence of risk but simply missed appointments which were cancelled and I have now attended?

YY of course totally agree that women should have the right to a free birth even though I think it's a bit crazy - my opinion on others' birth choices isn't really relevant!

I just think it's important to be clear on the difference between home birth and free birth as I think some people do confuse the two. With a home birth you still have a midwife to look after you - and make the call about a hospital transfer if it becomes necessary.

Sorry, what is OGTT?

I had two homebirths and they went beautifully (dcs 4 & 5)
I had no objections initially but with DC 5 my midwife went a bit weird on me at about 30 weeks.
She kept telling me I was anemic and a super multi gravida (I think that is the term) so was no high risk.
I wasn't anemic, I had slightly low HB which I fixed by taking supplements and I wasn't a SMG. One of my DCs is adopted so my DC5 was my 4th birth child. That doesn't put me in a high risk category.
She kept going on about how I could bleed to death (PPH). I had no history of PPH.

She wouldn't have any of it and started trying to force me to go to hospital. She told me that she wouldn't be able to attend me if I was at home and she was off duty but she would come in specially if I went to the unit.
Apparently I could transfer while in active labour and go home straight afterwards.

The idea of getting in a car whilst contracting, hanging about being booked in, giving birth and coming straight home did not appeal to me and I couldn't see how that would be safer than having a HB. I could get home and have a PPH surely?

Anyway. Turns out she had only ever been to one HB, back when she was a student, she didn't like them.

I think you may have a MW who doesn't like HBs.

Good luck.

OGTT = oral glucose tolerance test

I had to have the GTT in my first pregnancy due to family diabetes. I had planned a hb which didn't happen in the end. No diabetes for me.

With second pg, one midwife told me I didn't need the GTT this time around; at about 30 weeks I had a different me, who said that if I didn't have the GTT asap she wouldn't recommend a hb. I had it and had my hb and was blue lighted to hospital after due to a retained placenta

I've had three home births. My GP tried to block the first one, telling me 'have this one in the hospital, sweetheart, and then we'll maybe have a think about it for your next one'

So I changed doctors really quickly (I was 39+5!). I loved my home births.

Personally home births aren't for me at all, too risky for the child if a problem ensues, but I see it's your choice and you're happy with it

I have to say I wouldn't be keen on a midwife that perhaps wasn't keen to home birth ... I'd want someone who was competent enough to know when things are going wrong or comprehends when things
Are going well. Also a plan of action should an emergency hospital trip was necessary
A private midwife is probably your best option

As for your complaint - I'm not sure why you booked a GTT twice when you had a clinic as clinics tend to be the same times each week? You can cancel clinics in advance
Too, Perhaps your midwife was
Concerned you hadn't planned things effectively or thought thing s
Through ?

I didn't have a OGTT with any of mine.

What is the criteria?

flumpybear I received the OGTT appointments by letter with 2 days notice I didn't book them. Yes clinics can be rearranged but a lot of my patients had hospital transport booked and it wasn't feasible to cancel the clinic.
But thanks for assuming I booked appointments knowing I had clinics and then cancelled them. Why not give people the benefit of the doubt?
I've reached my limit with my community nhs antenatal team and have booked an independent midwife which is a HERO!

OGTT criteria is previous gestational diabetes, type 2 family history or obesity. It may be done later in pregnancy if symptoms are present or the baby appears to be large for gestation. Some London hospitals are trialling a screen everyone policy which will be interesting to see if any ladies deemed not at risk get picked up as having GD

Oh and certain ethnic groups have a raised risk too and so are screened

Where are you op?

I'm north east and my midwife from the start was very pro home birth. I didn't want one, but from my very first appointment she made it clear that it was an option should I want it. She did also tell me that she personally loves home births and always hopes for one. A few of my friends opted for a home birth and all commented that they felt supported. I'd just assumed that our experiences were normal. It saddens me to realise that this is not the case.

Thanks all for the wonderful support, it's really helped to hear your experiences and help me advocate for myself.
To the others who have made assumptions about my knowledge, risk taking, made suggestions without facts on my circumstances, how nice of you to be so supportive of my choices at this vulnerable time in my life on a site dedicated to childrearing. Yes sarcasm isnt helpful but neither would my true thoughts on your opinions.
Have a read of pregnant women's human rights and have a think about how you speak to women about their choices

There are always people who make really strong comments against home birth.
I screen that stuff out.
People will always say 'but what if???' and there is a perception of hippy dippy morons wanting candles and unicorns.

I wanted a safe, secure environment for my births and I didn't feel I would get that at a hospital.
I had TWO midwives plus my midwife student friend.
My house is clean and I live within 15 minutes of a hospital.
I had no risk factors.

Yet strangers thought I should listen to them and go to my local, busy hospital for my births 'just in case'. Just in case what they couldn't tell me.

I don't think women would take it very well if every time they wanted to discuss hospital births some loon popped up and berated them for being selfish and putting their baby at risk.

On one hilarious occasion a mum at the school gates when on at me for being selfish and how she would never do anything so dangerous to her baby. She then went on to tell me how funny it was getting told off by the MWs for hanging out the window and having a fag whilst in labour.

mrsDV people, I've come to realise, are often idiots!! Smoking out the window in a hospital IN LABOUR (!) Yes getting reprimanded for this is 'really funny', giving birth however in a calm home environment with 3 midwives is total madness.

I think for me, my first labour was so frightening we both nearly didn't make it, the fear of "what if" is in my mind. That's why I chose hospital for my next two labours. I know a lot of women who have had home births and they have gone well . But I would be terrified

I just had my first baby and my preference was the midwife-led unit, a birth centre attached to the hospital. They could - and did - just transfer me to the delivery unit if necessary. But I do think they are very quick to transfer you and I wonder if it was completely necessary; if I'd be at home with one or two experienced midwives it could still have been fine.

*been

Yes my independent midwife has a 5% transfer rate for homebirthing FTMs and I think the NHS is 40%. They're very risk averse, which can be negative or positive depending on the situation. My hospital is actually closer to my home than the midwife led unit

I was told when in labour I wouldn't have a homebirth having not had a word said before. The midwife used a sneering tone and very patronising.

I think I ended up having ds at home partly to spite the horrid midwife

I choose the homebirth originally because I wanted one-to-one care in labour and to be able to use a birthing pool. Also the evidence at the time was that for low risk women like me it was the best option especially because I lived less than 3 miles from two maternity hospitals.

I found AIMS very helpful. I've had both babies at home.

movingonup I'm so glad you found the first birth positive and went on to have your second at home. Midwives seem to fall into two camps. Those that know best and disregard patient choice and those who are patient centred and listen to your hopes for your birth and discuss it with you as an equal. Unfortunately I've encountered mostly the former but now have a star of an independent midwife who is committed to advocating for my choices whatever they may be

I did still feel like I had been run over by a truck after first baby. I felt euphoric and invincible after the second!

I had NHS midwives and an expectation that I would probably never have met the midwife who would deliver before - which is what happens where I lived. First time (with horrid midwife) I had a named midwife (HMW) and shared care with GP. Second time round I actively asked for my care at the maternity unit and with GP to avoid HMW and never saw the same MW twice. They were all very supportive of my choice for homebirth but I had my bull-shit-o-meter finely tuned just in case. Actually I found one midwife a bit much as after the birth she kept going on and on as if I'd done something especially amazing rather than having an ok time of it while getting to stay at home. Amazing is being left on your own in hospital in an over stretched and under resourced unit where you are ignored while you are scared and in pain... and then deciding to have a second baby at all(!)

I have also received excellent care on a maternity ward when I almost delivered at 27 weeks and I am very grateful I have all my family because of modern medicine and C-sections - so I'm not anti-hospital either.

I'm pro-choice, pro-informed decision making, pro-support for women from conception through to the end of the first year after birth and pro-excellence in maternity and postnatal care. I am pro respecting the woman as a person in her own right with the capacity to understand and make the right decision for her and her baby unless otherwise indicated and then we're talking court orders not ignoring or overriding by HCPs.

If you can afford an independent midwife then it seems a no brainer to me to have one. Good luck with your birth - hope it's text book in the best possible way

Thanks moving great post. Totally identify with all your sentiments. Fingers crossed for smooth sailing but what will be will be as long as baby is OK, my desire for no trauma and a positive experience will be the cherry on the cake

OP you seem very combative of anyone who may say the slightest thing you don't like

yes flumpybear you're quite right. I'm in real defensive mode given the experiences i've had in the past 8 months.

You said: As for your complaint - I'm not sure why you booked a GTT twice when you had a clinic as clinics tend to be the same times each week? You can cancel clinics in advance. - You made assumptions when you made this statement rather than ask questions and i felt under attack and needed to explain myself.

Sycamore suggested I put my beliefs before the health of my baby which i found deeply insulting, as i've said before this is a much longed for baby and have explained my reasons for birth choice. Which have been backed up by many posters who have made similar choices.

The overriding approach from the NHS antenatal care ive received is that I'm a first time mother with no understanding and I've had to fight for what I want and am consequently now quite defensiveness of perceived criticism of my choices, my human rights to choice of care have not been respected and I find this disgraceful.

I spent 5 hours today (wednesday)in a hospital ward being monitored due to shortness of breath, tachycardia and lightheadedness. it turns out i'm severely anaemic. This is despite telling the midwives at every antenatal appointment that my Hb drops rapidly as soon as my ferritin begins to drop and that supplementation has been the best course of treatment in the past. Each midwife dismissed this as my Hb was in normal range and so refused to test ferritin. my Hb and ferritin are now below reference range, the consultant on the ward was most annoyed that their time had been wasted when I'd frequently told my midwives of my concerns. It seems patient centred care doesnt exist in my midwifery team and they know my body best. I'm now upset that I'm so short of breath that my hope to remain physically fit and strong in preparation for the birth will be difficult.

So yes I may be defensive but I feel I have every right to explain my choices when assumptions are made about my motives.

I'm sorry that you have had so little support from the midwife team. Where I live we have a high rate of home births and it is encouraged by midwives.
My own dd was born at home before the midwife got there! It was a wonderful experience and I felt so much more in control than previous one which had been in hospital.