Am I being unrealistic?

[anewjourney]

This will be my first baby and I have my heart set on a home birth.

I don’t want to be in a hospital with unfamiliar smells, sounds and people. I feel like it would stress me out and make me scared.

I want to be in my own surroundings with as many or as few people as I want.

I want my partner to be able to stay with me the whole time and afterwards for as long as I need and as long as he wants.

I would like a natural birth if possible and have read that intervention is far less likely at home.

I would like the option of a pool and if I was at home I know that I would be able to have one without worrying if it was free.

I have been reading tonnes of the stories on homebirth.org.uk and they sound lovely.

Do I have my head in the clouds for thinking this is a realistic option or am I being stupid?

Obviously I know that births rarely go to plan and there’s a chance I’d need a transfer, but I’d love to at least give it a go.

Would love to hear some stories

That was my plan (had the hot tub out ready).

Didn’t get near it, unfortunately. I had a midwife prepared to get me into hospital at any cost. This intensified when i went overdue and when she examined me after being in slow labour for almost 3 days at 41+12 she told me that I was not in labour, would not be going into labour anytime soon and that my baby would die. After 3 days without sleep I broke and went to hospital to be induced, where I was informed that I was already 3cm dilated and they’d give me the gel to speed things up.

Ended up with a spinal, a forceps delivery and PTSD. DD is an only child and will remain so. Whilst I’m glad they got her out safely I find it hard to forgive that bitch.

A friend had a very lovely homebirth with hers though, so it’s certainly not unheard of.

It depends on whether you have any risk factors (of course you may not know until after giving birth). My midwife pushed me to have a home birth with my first child but in the end both of my labours were extremely slow and need intervention(not that I got adequate treatment in hospital either but unfortunately there are no private options within reasonable driving distance so I was always expecting a fuck up regardless of where I gave birth). I haven't heard of any particularly bad gone birth stories. The worst one the midwife came and left saying that birth wasn't happening any time soon. Less than half an hour later woman went into labour, midwife was Unreachable, husband delivered the healthy baby and the carpet was ruined.

I had a lovely home birth with my DD, nearly 3.

I should have had 2 MWs but DD came so quickly the MW cancelled the other one.

I did hire a pool but we didn't fill it in time and I think if it was up and filled I wouldn't have wanted it anyway.
I had a TENS which got me through 95% of it all, and G&A 10 mins before she came out.

I was fortunate that it all went smoothly. MWs were totally on board. We're 20 mins from closest hospital/labour ward.

I'd say go for it. It's not unrealistic, but be prepared for an alternative outcome.
Good luck!

Newmumwithquestions:

Here (SE London) they send one midwife when they believe you're in established labour (you/your partner phones them and they ask questions) and then call the second when the birth is imminent. I believe this is so that should urgent treatment be necessary, they have one to care for the mother and one for the baby.

A pp mentioned 'home comforts' in quite a disparaging way - a mother choosing her comfort over her baby's safety is the implication. This is nonsensical: the more comfortable and relaxed the mother, the safer the baby. Stress lengthens labour. Obviously there are situations where a hospital birth is the safer option, but that's because of the balance of risks in an individual situation. There's no risk-free birth and no 'right' answer, but we seem content to blame or judge women - there are babies who would have lived had they been born at home and vice versa - we're so lucky that it's rare for birth to end in such tragedy.

No matter what you decide, I highly recommend a book called Stand And Deliver. It’s full of stories from women who found their birth experiences to be positive ones, whether they were planned and uncomplicated home births or unplanned crash c-sections. The only common theme (other than a baby out at the end) is that the women themselves took great joy in their births. I found it incredibly uplifting and comforting.

Thank you for the stories

ChaCha I will order that book!

I went for home birth with my first and ended up in hospital where he was born with forceps. The midwives were very conservative and decided to go to hospital to be safe as things weren't progressing. It was all very calm and controlled and at no stage was I or the baby in any distress.

I got very negative comments from some people afterwards along the line of "see you were wrong to try as it was a failure" but I still think it was the right option for me. I had a 36 hour Labour and was able to do almost all of it at home.

Second was planned c section and where I am you can't do HB after a section so won't be able to try it again.

Main thing is to be prepared for the plan to change but that is the same for any birth plan.

I was disappointed with the care for both my births in hospital, the focus being on birth. Both times they had a bed shortage so I was woken at around 5am to be moved off the high care ward because they needed the bed. With DS I was moved 3 times in 24 hours to make room for others and with DD I had to go onto an antenatal ward because they had no space anywhere else. I would have loved to have been at home instead.

If you are undecided, maybe a birthing centre is the way to go?

You can read an unbiased and non-sensationalised analysis of the latest study into the risks of home birth for first timers here

www.nhs.uk/news/pregnancy-and-child/births-at-home-or-in-hospital-risks-explained/

Not unrealistic. My friend did this, also first time mother, all went to plan. There is a greater risk to you and baby though, that you would have to understand and accept. You are swapping the reasonably likely risk of more intervention at the hospital, for the very unlikely, but potentially extremely serious risk of a bad outcome for you and your baby if further from help if needed. It’s not an unreasonable choice to make, but it’s your choice.
I personally went for a hospital and was glad I did, as my baby would have been brain damaged otherwise (nhs stat for my baby’s issue was 1 in 40000 births, so the extremely unlikely thing does happen and as I found out, not just to ‘other people’).

How far pregnant are you OP? Are you considered low risk?

Give it a go. Be prepared that you might get it. 2 midwives HAVE to be present (in all areas) and if they aren't available you'll have to go to hospital. Or you might get transferred- a significant amount of women do. But it could be just lovely. Good luck

I was induced in hospital and had the lights in the room dimmed so a hospital both doesn’t mean bright lights if you don’t want that

How close are you to the hospital? Is a midwife led unit an option? The MLU I was in was amazing - birthing pool, couch, birthing ball, dim lighting, bubble lamps, unintrusive midwives. And when it transpired that DS had turned, got stuck and had the cord around his neck and heartbeat had massively dropped I was whisked into theatre in the consultant-led unit within minutes and he was delivered safely. If I'd have pushed for a home birth (like I originally wanted) the outcome might not have been so positive.

Loads of good advice here. For me the thing that really rings true is around being prepared to accept change once things get started. Don’t be too set on wanting a specific kind of birth as it can lead to real disappointment. I know four people who opted for home birth and only one of those actually.had the home birth thy wanted, the other three all ended up travelling into hospital either during or after the birth of the baby. Good luck!

My first birth was dim room, music etc very calm. I couldn't imagine that it would have been any calmer at home.
My second was induced and active labour went so quickly that baby was born on the ward rather than a birthing suite not ideal but not the agony I expected. I then went on to loose 3 litres of blood with doctors fighting to stop the bleeding.
It's anybody's guess what would have happened had I not been induced or if I hadn't been in hospital.

Not unrealistic! I had a home birth for my first too. I was so glad that I had decided to when we were all curled up in our own bed 3 hours after he was born (and then we ordered pizza )
I was prepared to transfer to hospital if needed and new that my ‘plan’ was not a given. I also knew and understood the risks but trusted the midwives to tell me if we needed to transfer.

I’m fairly certain that it would not have gone as smoothly in hospital because I hate them and would have been very anxious (at home I was completely relaxed through almost the whole thing.)

Good luck OP! I read The Homebirth Handbook by Annie Francis and found it really useful and reassuring.

I had my first (and only) at home. Midwife tried to put me off, not sure why. I was 40 at the time. Hospitals make me anxious so I was determined to avoid it if I could.

It was the best experience of my life so far. I felt completely relaxed and in control. Had two midwives who were very hands off, which suited me. Had my baby in birthing pool in my front room. Then went to recover on the sofa with a glass of champagne with my new baby. Midwives checked us all over, delivered my placenta, then left.

You’ll have the naysayers who think that the only option is hospital, but it isn’t. Best wishes for whatever you choose, and it is your choice, no matter what people may try to tell you otherwise.

I have had 4 homebirths, including our first 10 years ago, and am now planning another for May.
You do not know how your body will labour, this is true, but I saw no reason to expect the worst. You are an adult and know how far you are from the hospital if it is needed, you know what your pain threshold is like.
My midwife was happy to support me for a home birth with my first as he was in the right position, I had had a normal pregnancy, we weren't far at all from teh hospital (DD1 would have been born on the ring road if we'd tried to get to hospital when she was on the way, but we'd moved by then!)
I also had a pool for all my births and can't actually imagine giving birth on 'dry land'!

By all means try for a home birth, it’s what I wanted for my DD. However do not set your heart on anything, that is the most important advice I could give to anyone about to give birth. You just cannot plan how it will go.

I went 15 days over, my hopes of home birth went out the window. It was a hugely stressful time, mainly because I had my heart so set on a home birth. I ended up being induced, early labour on a shared ward, active labour on the labour ward. It was the opposite of what I wanted and I took an awful lot of time for me to get over my disappointment of how my birth went.

Unfortunately there are just so many aspects of birth you cannot predict. My DD was breech at 41 weeks, meconium in the waters etc etc.

Have home birth there as an option, but also plan for a birth centre birth, a labour ward birth, induction. Everything - have a plan for it so that any eventuality isn’t a shock and disappointment.

@zzzzz pain relief options at home can range from pain management like tens machine and birthing pool (both of which you need to provide) and depending on area to gas and air and pethidine (both are carried in my area but I think I have to get the pethidine on prescription in advance). Epidural can only be had in hospital.

People talk about scary anecdotes with regard to birth place choice and credit location with a favourable outcome. The worst outcome that happened among my friends was after a low risk birth in a midwife led unit. Sometimes, bad things just happen and everyone having made reasonable decisions and taken reasonable action to manage risk doesn’t change that. All you can do is make the choice based on your reasonable assessment of risk. The doubling of risk stat re homebirth that is always inevitably trotted out on these threads btw represents the risk for first time mothers with homebirth. Adverse outcome for baby is 1 in 190 in hospital, 1 in 110 at home (this includes emergency transfer). This comes from the major, nhs commissioned birthplace study in 2011.

Speak to your homebirth team if you have one. The evidence for continuity of care is very good, yes some women are transferred in to hospital and that’s because you have midwives on high alert and a lower threshold for transfer. The evidence for first time mums show it is safer to give birth in an MLU, then homebirth then hospital

"The evidence for first time mums show it is safer to give birth in an MLU, then homebirth then hospital"

This is completely untrue, assuming you want to include outcomes for the actual baby, of course. Babies born at home to first time mothers with no other risk factors are nearly twice as likely to die or be seriously injured.

Someone earlier mentioned 1 in 190 in hospital v 1 in 110. Put that way, it doesn't sound like a big difference and like its a figure so small as not to worry about. But it means that almost twice as many babies will die or be seriously injured (think oxygen deprivation leading to lifelong brain damage) in a home birth. And these extra babies would have been healthy and well and alive in a hospital birth.

By all means, people have freedom to choose. They should not however make such important choices when the facts are hidden or fudged or expressed in a less clear way because they are uncomfortable or don't align with someone's preference.

The latest data I can find on pubmed shows 0.18% death rate in hospital and 0.15% at home. Where are you getting the data to suggest death rates are higher at home?

@sandsnakeofdorne it will be the birthplace 2011 study which remains the most comprehensive study of impact of birthplace choices. However, that stat relates to adverse outcomes, not deaths, in first time births at home. To describe the stat another way from my previous 110/180, it’s 9.7 adverse outcomes per 1000 births at home, vs 5.3 adverse outcomes in maternity wards. www.npeu.ox.ac.uk/birthplace
Let’s not let facts get in the way of telling women how to assess risk and plan birth though, ay ;)