Home birth with first baby

[Didi1994]

Hi,

Just wondered if anyone had any advice for home birth with my first? Lots of people look at you like you're a bit mad when you say that's what you're planning! We live 5 miles from hospital but hoping to hypnobirth and have water birth at home. I have heard that quite often the NHS will okay you for a home birth but try and back out very last minute saying there will be problems providing two midwives because of their rota etc... anyone had any experience of this? Thanks :)

I could have easily delivered both of my DS’ at home. However, I did sustain to bad tear after the delivery of my first DS that required surgery.

Tbh I was one of the lucky few who found labour pain manageable, I didn’t need any pain relief, or gas and air and I wouldn’t consider that I have the highest pain threshold.

Good luck OP and do what’s right for you, just be prepared to be flexible in case your plans don’t work out.

The NHS don't 'let' anyone have a home birth - its is entirely the mothers decision.

FTMs are mainly transferred due to lack of progress, or requesting epidural etc - the risk of c section / forceps and ventouse is reduced. There is a minor increased risk of an adverse outcome, but it's very minor.

I'm planning a homebirth with my first, and the negativity from some people is ridiculous. There is always a risk regardless of where you give birth, you just need to weigh up what is an acceptable risk to you 😊 I was told by my best friend I was f'in crazy and she would be dead if she hadn't been in hospital - no medical professional ever told her this, it's just what she assumes because she had a bad experience.

Good luck OP!

You absolutely can have a homebirth for your first. You should, however, be prepared and open minded about the possibility of transferring to hospital if necessary. Women generally labour better when they feel safe and comfortable in their environment. In the majority of cases there is no increased risk with being at home versus being in hospital - arguably you will have better monitoring at home as you will have a midwife with you all the time, rather than sporadically. Unless you live a long way from the hospital there is no reason to believe that you would be putting yourself or your baby at any greater risk by being at home. Do your research and make the decision based on your particular circumstances but don't be put off by people scaremongering.

I had planned a homebirth for both my first and second child - neither went to plan and we ended up transferring as an emergency in both cases. The first birth ended in a very quick emcs and the second a ventouse. My third child was born quickly and easily in the pool at home and it was wonderful :-)

Every woman and every birth is different. All the best with whatever you choose.

I had my first and third at home. My midwife was very supportive and actually suggested it. Knowledge is power. Gas and air and a tens machine. Was even stitched at home which was the worst bit to be honest. I watched favourite movies and listened to music. All very relaxed and lovely. Second child was an undiagnosed breech and had to have a section once in labour as that's when they discovered the breech. Fucking horrendous from start to finish. I say good for you and go for it! But yes, ignorant people who don't know much about natural childbirth will judge and call you crazy or brave or similar.

I had a homebirth with my first and second. Both were amazingly calm deliveries, with two midwives present. The trust where I work are super supportive of home births. Occasionally we can't facilitate a homebirth due to being super super busy, however that situation can change really quickly. They can only recommend you coming in, if you want a homebirth they should send someone

I had homebirths with all of mine and was in my 30s and 40s. It was great. Hospital two or three miles away. Do your homework, be prepared to be flexible and be prepared for everyone to think you're some sort of martyr/earth mother for not wanting to be in hospital.

I would not be here if I had attempted a home birth, nor would my baby. My friend’s baby has life limiting brain damage resulting from a home birth. Please read up on risks.

I had a very straight forward pregnancy and was spoken to about a Home birth by one of the midwives. I didn’t want one but could see the benefits - no hospital stay, comfortable surroundings etc.

I am one of those who think you’re mad. The chance of needing hospital is high with a first birth. I was low risk but there’s no doubt my child would have died if I hadn’t been in hospital. Birth can be going so well and then go so wrong in a heartbeat.
I do,however, massively support choice and if you can be confident of two midwives then you should be comfortable with your decision

Chances of a transfer with a first home birth are around 4.5 in 10, so not 'high' by any stretch. Most transfers are also at the mothers choice and not actually to do with any complication during the actual birth.

I would have loved to have a home birth, I hate hospitals and I had a wonderful, empowering labour with just a bit of gas and air. I remember thinking about halfway through ‘I should totally have done this at home’.

Everything was brilliant until it wasn’t - and then I had approximately FIVE MINUTES of time to play with before it became imperative for my baby to be born immediately. I was rushed into theatre for an emergency section. Let me reiterate that my labour up to that point had been absolutely textbook, straightforward and brilliant. I was positive, calm and in control. But when things went wrong they went wrong FAST. No amount of hypnobirthing or postitive thinking or active birthing techniques will help you in that situation when what you need is immediate medical intervention. It’s likely my dc would have been dead or being damaged if I’d been at home.

I’m genuinely not trying to scare you - labour is wonderful, i loved it, I strongly encourage you to use your hypno techniques, move around, get comfy and advocate for yourself - but please understand that if things go wrong you may have literally minutes to act.

Best of luck with you labour and birth whatever you decide to do.

Would also like to point out that at homebirths you are monitored ALOT closer than in hospital so any issues are usually picked up alot quicker. In hospital the midwives usually have more than one lady to care for, they rely on women being hooked up to the monitors to keep track of baby and only check the traces now and then. At a homebirth you have one on one care, you are watched alot closely and they check babys heartbeat etc alot more often.

My midwife told me last week that the threshold for transfer is a lot lower with home births - ie they would be calling for an ambulance much sooner than a MW would be contemplating intervention were you in hospital.

There's always a risk...this is childbirth, we all know the risks involved. But if you feel comfortable at home, have a low risk pregnancy etc then go for it. I'd highly recommend the water pool, it was pure bloody bliss

I live 25 mins from a hospital & had to transfer for my second child after having first at home. If I was having a third I would still go for a home birth

The hospital experience was so disempowering ; no one asked about natural delivery of placenta, they kept asking for me to have gas/air because I was asking for explanation as to what was going on etc etc etc

Do your research & no you are not mad!

“I’m genuinely not trying to scare you - labour is wonderful, i loved it, I strongly encourage you to use your hypno techniques, move around, get comfy and advocate for yourself - but please understand that if things go wrong you may have literally minutes to act.“

Although interestingly, evidence doesn’t show poorer outcomes for babies of low risk first time mums who labour in freestanding MLU’s (where any obstetric input would require transfer by road), or for low risk second time mums who have a homebirth.

There must be something going on in hospitals which increases risks to babies in some other way, as you are undoubtedly right - sometimes a mum will need a category 1 c/s for a good outcome.

Midwives do have a lower threshold for transfer in with a homebirth.

For all the people who say 'if I had had a homebirth I would have died', most of those people wouldn't have even been having a homebirth anyway unless it was against medical advice. Being induced? No homebirth. Augmented labour? No homebirth. Meconium in waters? No homebirth. It is very, very rare that something goes catastrophically wrong in a very short space of time and also being in hospital does not guarantee that if something goes wrong in that way, that a good outcome can be achieved.

If you have no risk factors then absolutely it is safe to plan for homebirth, that's not to say that considering length of transfer is unnecessary but just because some people 'feel' that you are being foolish doesn't make it true. Anecdote does not equal data.

Everything comes with risk. If you are the one in a million of something then the rest of that million unaffected are irrelevant really. You can only go by the evidence, look at the context and work out how that relates to you personally.

I had homebirth with DC1 and planning another for DC2.

Your doula sounds negative and ill informed, are you sure she's the doulafkr you?

Round here HB is pushed as the first line option for low risk pregnancies. It's cheaper than other options and the staffing levels are only an issue if they've got multiple HB's on same shift. Community MWs do the HBs on a rota so you're not dragging two mw's off a ward.

I was monitored very, very closely throughout. Significantly more so than had I been left to my own devises in an MLU.

It is very, very rare that something goes catastrophically wrong in a very short space of time

Well, yes, but unfortunately in this scenario, one instance of bad luck is enough. I was actively advised to have a homebirth, was keen on the idea, and as i said above, thank god I didn’t because if I had, my son would likely be dead. I appreciate that’s rare. But it’s not a risk that I personally would want to take, given my experience. Saying that, I’d absolutely support the OP’s right to make her own decisions on this and to do that she needs to hear from people who’ve had great homebirths and people who’ve needed emergency intervention, so that she can choose for herself armed with the facts.

For all the people who say 'if I had had a homebirth I would have died', most of those people wouldn't have even been having a homebirth anyway unless it was against medical advice. Being induced? No homebirth. Augmented labour? No homebirth. Meconium in waters? No homebirth.

This certainly isn’t true for me or for a random sample of my nct group. Need for intervention bore little relation to obvious prior indicators like these. Obviously anecdote doesn’t equal data, but it’s not been my experience.

You can suddenly need intervention or escalation of monitoring and that's not possible with a homebirth. Worse case scenario baby dies, mum dies. It's serious stuff.

Frankly anyone wanting it for a first delivery I would think they are not aware of the risks or reckless with cognitive bias that their case will be fine

Anyone who has had a vaginal delivery without significant intervention in the past and has a baby in a good position of a reasonable size, I'd say home births can be wonderful. (But even then, there may be risk and you cannot always predict that, eg, postpartum haemorrhage, fetal distress)

Had home birth with my 3rd. Was amazing! Sadly midwife didn't make it in time as all so quick! Euphoria afterwards was massive- like I had been on drugs I think go for it if medically there is no reason not to. And you can always transfer to hospital. The feeling of being in my own bed an hour later and with the other 2 kids coming in in the morning was priceless.

Must add that 3rd was born in Belgium where NO ONE has home births. Everyone thought I was mad (it was a planned home birth, jus not
planned that the midwife missed it!). The midwife prenatal care was excellent and I really built up a relationship with the 2 midwives. You dont get that in hospitals mostly. Be sensible and be prepared to be flexible. Homebirths are NOT more unsafe than hospital births but clearly things can change quickly.

“It is very, very rare that something goes catastrophically wrong in a very short space of time and also being in hospital does not guarantee that if something goes wrong in that way, that a good outcome can be achieved.”

Yet, I know of one woman who was text book low risk and now has a beautiful little boy severely brain damaged as a direct result of not being in hospital (the court ruled this was the case so not my “opinion”).
Wonderful when it goes well and I wish a straight forward birth for everyone but if you are that person whose baby gets life limiting disabilities, the stats won’t be of much comfort.

My daughter was a first born, home birth and it was bloody brilliant, we had a water tub (though that didnt work too well) and i m looking at the bit of carpet she was born on!!!
Her Mum didnt need any pain relief, not even gas, it was a very relaxing experience, even for me!!! i was the nervous one!
However, local MW was really against it and we had a few scares as NHS laid it on a bit thick with the risks etc

Its not for everyone but it can work.

I was high risk and home birthed my third.

You've got a doula you can trust for good advice so I think you'll be fine. Yes they do try and tell you to come in but make it clear you aren't and they will come out.