Meet the Other Phone. Only the apps you allow.

Meet the Other Phone.
Only the apps you allow.

Buy now

Please or to access all these features

Childbirth

Share experiences and get support around labour, birth and recovery.

Right to home birth

99 replies

fooolofbeans · 11/04/2017 04:48

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?

OP posts:
Mollyboom · 13/04/2017 10:29

Low risk home births are fine, but they can still go horribly wrong, which I find is very under acknowledged. I don't need links to reports thank you I have access to peer reviewed studies in medical journals. If you read my last post what I object to is the constant disparaging of medical intervention in pregnancy. It just feels as if people are happy to take medical intervention when required, but quite often ignore or disregard medical advice when it doesn't suit their idea of birth.

TheFirstMrsDV · 13/04/2017 10:32

What on earth are you spaffing on about Molly

Who is eschewing medical intervention?
I gave birth with two and half medical professionals at the foot of my bed and supported by a vast medical agencies ie. the NHS.

This kneejerk reaction to homebirths as entitled and hippy dippy is exactly what I was talking about earlier on this thread.

A doula do an EMC?
WTF is that about? I had mw at my home and hospital births and I would have been fucking amazed if any of them, in any setting, did an EMC.

Stop reacting and try thinking

What has your DH being a consultant got to do with anything?

Mollyboom · 13/04/2017 10:33

Another scenario which comes up often is obesity and pregnancy. Yes there are many obese women who have relatively straightforward pregnancies but I hate the criticism levied at medical professionals who have pointed out the very real risks to obese women. They are not being rude they are pointing out the risks which you can't pretend don't exist.

MovingOnUpMovingOnOut · 13/04/2017 10:33

Birthplace study from 2011 results here and they do show homebirth as being a more risky option for first time mothers and a less risky option for subsequent births. An important thing to note is that an adverse outcome varies so I've included a second link (accessible from the first) that has definitions of adverse outcomes and these can vary from extremely serious including death to less serious like bone fractures.

www.npeu.ox.ac.uk/birthplace/results

www.npeu.ox.ac.uk/downloads/files/birthplace/Birthplace-Q-A.pdf

TheFirstMrsDV · 13/04/2017 10:34

Low risk home births are fine, but they can still go horribly wrong

What do those peer reviewed articles tell you about the outcomes of HB that go 'horribly wrong' compared to hospital ones?

Because I (not my husband) have worked in the field of childhood disability for a very long time and I see a lot of kids with birth injury.
Do I really need to reveal how many of them were born in hospital?

Births go horribly wrong, period.

NameChange30 · 13/04/2017 10:36

Interventions can save lives but they can also be unnecessary.

For example, continuous monitoring while strapped to a monitor and unable to move. How necessary is that unless intermittent monitoring or other indications have shown with certainty that baby is in distress? Why aren't labouring women offered wireless monitoring as standard so they can stay active and in the most comfortable position for them?

That's just a small example of an intervention that does not prioritise or even consider the mother's wellbeing and comfort.

Mollyboom · 13/04/2017 10:37

My DH deals with high risk pregnancies and many which were not considered high risk but then end up in hospital, you tend to get an idea.

MovingOnUpMovingOnOut · 13/04/2017 10:37

Molly, are you on the wrong thread love?

Mollyboom · 13/04/2017 10:40

I've said my piece now but would like to add that OP, I genuinely hope you have a straightforward birth and a healthy baby. Perhaps don't stress and at this stage concentrate on looking after yourself.

fooolofbeans · 13/04/2017 10:41

Thanks for the support all Flowers
'You don't need links to reports' mollyboom?
How about looking at stats on interventions in different settings listed on NICE CG190 and then come back to us.
Also perhaps look up what a doula is too?

OP posts:
fooolofbeans · 13/04/2017 10:46

Mollyboom' I wasn't stressed just looking for thoughts. And have received lots of positive and supportive comments. Perhaps don't stress me with your odd scaremongering comments if you feel I shouldn't be stressed. Thank you for the kind wishes for my birth and baby

OP posts:
TheFirstMrsDV · 13/04/2017 10:48

Your OH works with high risk pregnancies?

So what the hell would he know about homebirths, let alone you? Confused

MovingOnUpMovingOnOut · 13/04/2017 10:50

An interesting finding of that place of birth study was that although adverse outcomes (serious and less serious included together) were more likely for a homebirth for a first timer (and that was a statistically significant finding) the cost of those births were still the lowest. Lower than FMUs or obstetric units and AMUs. That's interesting because they used "standard health economic criteria" which is effectively a cost benefit analysis. More here: www.nice.org.uk/process/pmg4/chapter/incorporating-health-economics

Molly, as you have access to peer reviewed studies (like everyone else who can Google) why not read them? Cochrane reviews are free to read as a perk of NHS provision so open to anyone eligible for NHS care. Marvellous stuff :)

AGnu · 13/04/2017 10:52

In my first home birth I was told my baby could be stillborn while I was pushing. He was fine, the midwife had a bad back & couldn't get in a good position to monitor him.

Second birth I was talked into transferring mid-labour despite telling them I wanted to push. Apparently I was only 7cm so it would be at least another hour. They had to stop the ambulance halfway into the 7 minute journey to the hospital because he was crowning.

Currently pregnant with DC3 & I'd give anything to be able to afford an independent midwife or a doula. I have zero faith in the local home birth service. I saw midwives for my appts who were really supportive but the ones that turned up when I was in labour were complete strangers who right from the off seemed to see it as an exercise in how quickly they could convince me to transfer! I did refuse to have the MW from my first labour involved in my care the second time round & have already checked that she's not still there this time. Probably should've made a complaint against her but I'd met her at a home birthing group & knew she had a bad back so felt sorry for her. I could've complained that they'd sent someone who struggled to provide adequate care, rather than complaining about her personally, I suppose.

MovingOnUpMovingOnOut · 13/04/2017 10:58

I did have a little chuckle at the "how dare you not just do what you are told?!" tone and the comments about accepting screening but then having our babies at home. How very dare we exercise our rights as patients to be part of the decision making process! Grin Grin

Deciding to have a homebirth is a decision that needs to be made carefully using evidence. That evidence comes from medical examinations and tests.

Fundamentally I think there is a misconception that anyone who has a homebirth is thoughtless and doing it on a whim or some loony who doesn't believe in modern medicine. I have never met anyone who has actually had a homebirth who hasn't given lots of thought and gathered the information to make an evidence based decision weighing up the potential risks and benefits. I know about 6 people personallly and many more indirectly. All intelligent women.

Algebraic · 13/04/2017 11:11

I know what you mean OP about the priority given to baby's health. I had to get scanned for swollen, painful legs to rule out a blood clot. Once it was confirmed all was fine the unit discharged me. I asked what it could be if not a clot and was told "to be honest, we've done our duty and checked there's no risk to baby". I was told I wouldn't really get an answer. Found it a bit strange.

Girlwhowearsglasses · 13/04/2017 11:19

Haven't rtft OP but I don't think anyone's mentioned AIMS? They give really good advice and are the people to go to regarding pregnancy and labour rights. They know all the rules and protocols and what you need to say/cite and what you're entitled to.

They have advice sheets too and a yahoo group with midwives giving advice on HB

Good luck

MovingOnUpMovingOnOut · 13/04/2017 11:25

I mentioned AIMS but I think they deserve a second mention - they're great :)

fooolofbeans · 13/04/2017 11:27

agnu some independent midwives can't practise at the moment if a trust forbids it. Most are managing. I'd recommend contacting www.imuk.org.uk/
Their priority is giving women the best possible care and very often are highly amenable to payment plans according to whatever you can afford. I'm paying £10/week (total cost £3000) and will pay more when I can afford it but they really stressed the point if I wanted IM care they would help me make it work. They operate on trust and don't ask for any financial contracts and have never been let down. It just goes to show how kindness and compassion go such a long way Halo

OP posts:
Elanetical · 13/04/2017 12:10

often ignore or disregard medical advice when it doesn't suit their idea of birth

A home birth is not an "idea" of birth, it's a better option in certain cases than a hospital birth. And like a PP, I know no one who has blithely persisted in having a home birth because they believed that it's all candles and unicorns - everyone I know who has had a home birth has been very well-informed about the place of birth choices available.

I chose a home birth because I felt it was the safest choice for me and my baby as hospitals make me incredibly anxious due to bad previous experiences. And all of the HCPs I spoke to during both pregnancies were very supportive of me having a home birth, there was no "ignoring" medical advice.

Consultant obstetricians are just as prone to confirmation bias as anyone else. They frequently see the worst birth outcomes; they don't see births without interventions. And naturally they also understand and believe in their own competence in dealing with birth emergencies, so obviously they will think hospital is safer.

But the reality, backed up by any number of scientific studies, is that it just isn't that clear cut to say unequivocally that hospital birth is good and home birth is bad.

As a PP said, bad things might happen during birth regardless of where it is. Very few of those things happen without warning, and expeditious transfer from home to hospital when needed deals with most of them. The ones that do happen without warning can go badly wrong in a hospital environment too, so it doesn't automatically follow that all problems can be avoided if in hospital.

There is also a strong argument that some bad outcomes could be avoided if the mental state of the labouring mother was better managed to promote oxytocin release and limit cortisol/adrenaline release. And also with experienced midwives monitoring the woman in labour (and home births tend to be attended by experienced midwives).

(Not all consultants of course, I had a lovely one when I was under the home birth midwife team who was very supportive of home birth).

AGnu · 13/04/2017 12:58

Thanks foool! That's good to know!

ToadsforJustice · 13/04/2017 18:20

I've had three home births. All without any issue - for example, making a sponge in the morning, have baby at lunchtime - sharing said sponge with MW and a cup of tea by 5pm.

Nearly everyone I knew tried to put me off having my babies at home. I appreciate all HCP advice, but I always felt that it's my body and my baby. I didn't like being "told" what to do. I didn't feel that the HCP and I were a team, discussing issues and procedures. I felt that I was expected to go along with their decisions- without any consideration of my consent. Any questions or challenges to policy were met with open hostility. I am a nurse and if I treated any patient of mine with eye rolling, tutting and a dismissive attitude, I would expect to be disciplined.

Good luck with your homebirth OP. Thanks

fooolofbeans · 24/04/2017 21:46

toads

" I always felt that it's my body and my baby. I didn't like being "told" what to do. I didn't feel that the HCP and I were a team, discussing issues and procedures. I felt that I was expected to go along with their decisions- without any consideration of my consent. Any questions or challenges to policy were met with open hostility. "

YES THIS!!! the baking if the sponge pre birth to then have with the midwife sounds very civilised and domestic goddess like.
I'll be offering the custard creams round if I haven't eaten them all!!

OP posts:
60percentbanana · 25/04/2017 11:44

It's my intention this time round to book a home birth, all being well. My belief, based on my previous birth experiences, is that it cannot be any less safe than what I have experienced in hospital.

My second pregnancy was an induction at 40+10. Despite telling the hca I was in labour and begging for help on five occasions over the course of five hours after the onset of contractions, I was patronised and told that I can't be in proper labour yet and I should take a nap or a bath, refused to consider that I might be labouring and refused to call my husband until I had been examined and found to be 4cms. She caved on my final tearful begging and got a midwife to fetch me two paracetamol. End result, when the midwife finally arrived willing to examine me she found me giving birth on the dirty floor of the antenatal side room, alone, no husband, no pain relief, no monitoring of the baby or myself whatsoever, and my baby was born less than two minutes after she entered the room. My notes were manufactured by a midwife sat at the end of the bed afterwards to show that my labour had only taken 30 minutes rather than the true five hours. A few hours after the birth the hca returned to tell me she was clocking off now, but hasn't I been lucky to have laboured and birthed all on the antenatal ward rather than having to transfer, and said it with no sense of irony whatsoever.

Third pregnancy - again 40+11, refused induction, this time a home birth, attended by two fabulous midwives and a student. They were with me for about four hours and continuously monitored and cared for both the baby and I. I have absolute faith that if something had started to go wrong, they would have spotted it at the earliest opportunity and my transfer would have been very quick.

Fourth pregnancy, yet again overdue and refused induction. I agreed with this one to deliver on a midwife led unit connected to a consultant led unit because, though I didn't want unnecessary intervention, I recognised that perhaps I was more overdue that I had previously been and this tipped the balance of risk. In honesty I also felt shoehorned into it - shroud waving in the one hand, coupled with suggestions that a birth on the midwife led unit would be a home-like experience etc. On arrival I was taken to a birth room but on reading on my notes that I had refused induction and was over their standard 40+10 overdue she asked me to leave and go to the consultant led ward. I pointed out the birth plan put in place a couple of days before with the superintendent midwife to cover this eventuality, and the midwife said she would have to personally discuss the matter with the superintendent before she could allow me to stay, and the care plan was meaningless. So whilst she disappeared to try and make phone calls at 3am, I was left labouring unmonitored again, with no pain relief, having been told not to unpack my bags as I wasn't stopping. An hour in, my husband had to run out and get someone as I was pushing, and the baby was born a few minutes later.

In short, I have had four births so far. My first was medicalised and rightly so, but would have been equally safe had it been a home or hospital birth to start. My second was a hospital birth which would have been safer as a home birth - had anything been wrong during the birth the midwives wouldn't have known. My third was a safe home birth. My fourth was a hospital birth which, again, would have been safer at home due to the lack of care received.

Whilst I realise that the plural of anecdote is not evidence, I cannot discount the experiences I have had in deciding what is safer for my baby and I.

New posts on this thread. Refresh page