Consultant against 1st time births at home - your advice

[Annie75]

My consultant says that she wouldn't recommend first babies being born at home for two reasons: not having adequate resusitation equipment on hand should the baby deteriorate immediately after birth; not being able to offer blood tranfusions should the woman need one and/or suffer a large loss of blood. I can't quite see why first births should be different from subsequent births as surely every birth is different?

I'd desperately like a home birth for all the advantages listed repeatedly by women on this and other message boards (the ability to relax in my own home, avoid medicalisation and intervention, labour at my own pace etc etc). I'm not put off by her comments as I reason that I live a max 15 min journey to the hospital should I need an urgent transfer, will actually benefit from increased monitoring by my midwife prior to a homebirth, and will hopefully have adequate warning signs should anything go wrong. I am also having additional scans prior to the birth to monitor the baby's growth.

Any thoughts about first-time home births or the consultant's concerns? Thanks

Annie, I transferred from home to hospital with DS2 as a result of complications during labour. Midwives rang ahead and the initial examination at the hospital was actually in the operating theatre, while the team assembled around us and DH got his operating theatre kit on next door. I thought then and still think now that the attention can be better at home than in a hospital and if you are happy with the transfer time, the risks are limited. Like you I was living close to the hospital.

and without wishing to hijack the thread, Xenia, if you value your anonymity on this site, as you seem to, can I suggest you keep the story about the DT's various birth locations quiet? As you say, very unusual, and given that you yourself have written about it, it does make you pretty easy to identify. Just a thought...

I know quite a few people who have had their first at home and quite a few who have started off at home and ended up being transferred. Most of them were very happy with the way things went even those who were transferred at the last minute. Most who have gone on to have second babies have chosen to have homebirths again. I personally had my first in hospital and my second at home, both were good experiences but I did stay at home a long time before going in first time as I was desperate to avoid intervention, in hindsight a bit of gas and air at that point would have made the experience a little more pleasant!

I am very glad I had my first baby in hospital. We had an emergency which hadn't been foreseen, and the doctors had 5 minutes to get him out. Luckily there was an empty operating theatre next door. If I had attempted a home birth, my baby would have died and I might have done too (massive PPH).

My story is a rare one, but it shows that not all emergencies can be preempted, and sometimes every second really does count.

I love the idea of home births, and I am all for it if it's your second or subsequent birth, but I wouldn't advise anyone to take the risk for a first birth.

What are the stats???...why are you more likely to have problems in your first labour than in subsequent labours???

My first was a hospital birth, 2 subsequent were home births, 3rd due in a few weeks and hoping for a HB again.

Its a very personal thing - you come across as very clued up in your post - and if your midwife is supporting your decision and there are no medical reasons specific to you, then go with your instincts! Do you have a birthing partner/DP who is supportive of a homebirth? That can give you more confidence to stick to your guns too.

Remember you can transfer in at any time, so even if you decide on a homebirth, you can change your mind. If you go in, you might be able to go straight home from the delivery suite, or use a birthing centre as a compromise.

Good luck, it really is a fabulous experience, but wherever you have your baby its still amazing!

obviously have no idea how many children I have, that should be 4th due...

dur! Baby-brain!

Didn't want to say anything foxy!!

I'll start writing it on my hand ...

Better your belly...like when you get taken into theatre for an op...right arm says 'Cut here please'

seems like I was luck with my labours in that I had one midwife attending me throughout each labour - me alone, no other mothers to attend to at the same time as me - twice this was during an incredibly busy time for the maternity unit

Hi Annie, I have to say I would definitely not go for home birth with first baby. 1st labours are a different kettle of fish to any subsequent ones. No amount of home comforts can compare to having good medical care on stand-by. If either you or the baby needs something doing so quickly that every second counts, then well........ I wouldnt count on an ambulance paramedic having any paediatric resuscitation skills / what if you need a transfusion/fluids and they cant get a line in......15 mins for them to get to you.....5 mins to do what they can....15 mins to get you to hospital. Sorry dont mean to be scary here obviously some people have very successful happy home births- but its a bit of a lottery whether you do or not. And yep- in a labour unit lots of very skilled people literally are sitting around waiting to be summoned at a moments notice.

I have to say, I find it an utterly bizarre suggestion that paramedics would not have a) neonatal resus skills or b) cannulation skills. They are, after all, the ones on the front line of emergency situations and quite used to siting cannulas in extremely tricky, stressful situations and performing primary resus. Tbh, I would trust a paramedic over an SHO anyday

However... this is one of those subjects on which never the twain shall meet, opinion-wise. All I will say is that none of the points raised here against home birth are really any more likely with a first than with a second, third or fourth birth. But in the end, it's personal choice and what you, the person giving birth, feels most comfortable with.

Annie, whatever you decide to do, have a lovely birth and don't forget to tell us all about it!

Thanks for recent posts. Sorry to hear some of you had traumatic births and needed emergency treatment. I do take your points that you can never be sure of how it might go and that it can be a real comfort and necessity to have emergency staff on stand-by should you need it.

I spoke to my midwife yesterday and she said they do carry basic resus equipment and are trained to use it, but, more importantly, they should spot any potential problems needing a transfer ahead of time.
I feel encouraged from the posts to stick with my original plan to have a home birth, but subject to mine and the baby's health remaining good. I reason I can transfer should I have any problems or change my mind and I'm going to make sure I'm (and DH) v well informed about any potential probs. I'll let you know how it goes in August!

Re familiarising myself with the midwives in my area, was told that that's virtually impossible as any number of them could be on call at night (slightly more predicatable during the day). What a shame - would be nice to have an idea of who might deliver my baby, but there we go. If I had to put one thing at the top of my birthing comforts list, it would be having the same midwife throughout the whole process. I know it's not practical in this day, but it would be lovely to have continuous care through pregnancy and labour.

Good for you Annie, you sound very sensible -Don't underestimate how important a positive state of mind is when giving birth!

Good luck with it

Your consultant sounds like a medicalised muppet. Sorry.

If its any help, I think most children in the world are NOT born in a hospital.

I think as long as all your chck ups are fine, then why not?

And dont forget that first time births have a habit of being LONGER than 40 weeks.

Go for it Annie!

xxx

Annie,

If you want the make sure you know your midwife you could go for an Independant Midwife. I used an IM and it was the best decision and money I ever spent.

Annie

This is a fascinating thread for me, as I'm hoping for a homebirth for my first too (due end Aug). My GP told me the local hospital would discourage me from a HB for the first baby but actually when I met my assigned midwife she presented all three options (hospital, birthing centre, HB) with no bias whatsoever - I was very impressed. I also realise am v. lucky to have a MW-led birthing centre in my borough. Have since met NCT teachers who were very encouraging. They assured me that community midwives LOVE doing HBs and that there's a strong chance of having a student midwife (as well as the midwife of course) who will stay till the end for the experience. I live one mile max from a hospital which is very encouraging.

They also made me realise that only experienced and confident MWs would choose to do HBs. Which reassures me that they would know if/when to transfer. Makes me feel like I'll be in good hands as obviously I won't know what to expect not having had a baby before!

Good luck with your upcoming appointments and scans, I hope it all goes well.

Annie, it makes a huge difference to have positive support for it. I thought I wouldn't be able to have number 4 at home, more chance of haemmoraging or something, but my mw's were so enthusiastic and told me of course I can. They just love a HB.

Good luck with yours!