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 :)

NHS encourage it round here if you're low risk. It saves them a lot money over a hospital birth.

There have been cases where babies have died during labour and birth because of poor monitoring or care too, and the hospital has been found at fault. Home births tend to be much better monitored and transfers are more cautious than medical escalations for early warnings in hospital. Birth carries a risk and threads like this, in which people state the risks of home birth, end up presenting hospital as a risk-free option.

OP, you need to balance the risks yourself. Take advice from your own health care providers who know you and your situation better than strangers on the internet.

I had all mine at home, with superbly supportive NHS midwives. They were very clear about their parameters for sending me in during labour. I agree that you might want to think about your doula. They are they to support you, not worry you.

I was actively encouraged to have a home birth with my second, both first and second pregnancies low risk, first birth straightforward full term. I opted for hospital delivery as home birth was honestly never something I would have been comfortable with.

Second birth I had a placental abruption during labour when I was 8cm and just using gas and air. I had a category 1 c section. They had me under GA in theatre and DS delivered within 12 minutes of my initial bleed.

It wouldn't have made any difference at all how closely I was monitored or how many midwives I had attending to me only. If I was not in the hospital at the time of the abruption DS would have died. We were both fine in the end but please look really closely at all the risks.

Good luck with whatever you decide OP and I hope all goes well.

It’s a funny thing. Giving birth should be the most natural thing on earth.

But the reality is its risky. If you are an African woman you have a one in nine chance of dying in childbirth

We are so lucky to have the nhs

But if you’re comfortable with the risk go for it

I had a lovely home water birth with my first.
You aren't far from teh hospital and if your MW is happy to support you then I can't see a reason not to give it a go. You can choose to transfer in if you need

Lightsong I'm sorry you had such a horrible experience. My friend had a placental abruption in her office completely without warning. She was taken to hospital by ambulance and she and her baby were thankfully fine, but it was very traumatic.

Thanks @Finallybreathingout In truth I didn't really know anything about what was happening until it was all over. Placental abruptions are so scarey because they can't be predicted and the doctors said no one is really sure why they happen. I was not overweight, non smoker, early thirties, no accidents, it was just a mystery.

Over here you can’t have a home birth for your first. So different rules in different PCTs. I personally think, if things did go wrong and baby developed issues due to a home birth, I would never forgive myself.

2DC, 2 home births. 2 midwives each time, 1st birth they were there for about 4 hours and for the 2nd, all over and done within 1 hour. I suppose some people would say that I was selfish but studies suggest that home births are £600 cheaper than hospital births and the risks are comparable.
My doctor wasn't very keen (apparently I was an 'untried vessel', made my feel like the Titanic) but the midwives were very supportive.
OP, if you are considered to have a low risk of complication, there is no reason not to have a home birth. Congratulations and good luck with whatever path you choose.

Topics like these always bring up such differing opinions.

I haven't planned a homebirth lightly but have always found it interesting how I have not spoken to or heard of anyone who has had a negative home birth experience. Even those who have transferred for intervention have said their experience was still positive.

The stories I have been told about things going wrong have always been from those who were already in the hospital and not transferred from home. I'm not saying things don't go wrong at home, but it's not as common as is made out. I have spoken to so many home birth midwives around the worst case scenario, and they're either being honest or have very good poker faces because they have no more concern around a poor outcome than if I was in hospital.

The above couple with the research around actual birth outcomes I have done means I am more than happy with my decision.

I know if I went in to hospital my anxiety would cause issues and I would most likely end up with a C-section or a lot of medical intervention, so i dont believe that is any safer.

I am absolutely not downplaying those instances when something goes quickly wrong. What you don't hear so much is the stories of when something goes wrong in the hospital where there is a negative outcome but importantly where it wouldn't have made the blindest bit of difference where the mum and baby were, there would still have been a negative outcome. So if they'd been at home it would have been blamed on 'homebirth' whereas if they are in hospital it would be 'one of those things'.

One thing I forgot to say is that 'labour isn't progressing' is often a main reason for transferring in in labour, as is that the woman wishes to go in (changes her mind and this IS ok to do) or that the woman is requesting further pain relief (again totally fine). Labour not progressing as expected is a big reason why interventions happen, and yes if you stayed at home something might happen to you and your baby and that's why the midwives say to go in at that point so really it's a moot point.

Yes, in Africa people have births at home and more women die but that's not because they are at home, per se, it's a combination of poor nutrition and maternal growth, lack of antenatal and intrapartum care and risk of infection. It's not really a like for like scenario.

The trouble with all of the things is that no, you can't go back and make a different choice and the risks are small but the stakes are high and that's why people are so passionate about this. But it isn't as simple as 'get everyone into hospital ASAP'; we know (from research) that being in hospital, especially on non-indicated continuous monitoring, increases your risk of unnecessary interventions. So ideally we'd want to keep things as low risk as possible, while not interfering where not necessary, but with easy reach of medical assistance if things do go wrong. The ideal I guess...

The most important thing I think is that people choose where they have their baby based on where they are going to feel safest. And not feeling like they have to choose a home birth because they are so scared of hospital or feeling they need to go into hospital early because they are so terrified of labour at all.

I have had two homebirths.

The first was successful, although I struggled in the night when my baby was coughing up gunk. The sort of thing that A nurse would reassure you of if you were in hospital.

The second would have ended in a dead baby has we not lived 5 minutes drive away from the hospital (by ambulance with lights and sirens).

If you were my daughter, I'd tell you not to take any risks.

I don't think you are mad. I booked a home birth for my first, with the encouragement of the midwives (very pro home birth area). I had to go into the hospital due to complications and hospital birth was a bit rubbish - was mostly ignored by midwives despite being classified as high risk, and the postnatal ward was awful.

My second birth was at home and I had much much better care.

If you are low risk and close to a hospital I would go for it. First time mums have a high rate of needing to transfer in, but I would prefer to labour at home for as long as possible then transfer in if needed, rather than spending the whole time in hospital.

If you are booked for a home birth then you are allowed to change your mind and transfer in for any reason, but if you book a hospital birth you aren't allowed to change your mind and stay at home. A few people I know have booked home births with the intention of deciding how they feel on the day. That seems sensible for a first timer.

Yet another thread, three pages in and nobody's mentioned that the NICE guidelines and the study they are based on show almost double the risk of death or serious injury for the baby at home birth for first time mothers. Several first time mothers on here have spoken about how (inappropriately) delighted their midwives were when they chose first time home birth. These midwives appear never to have mentioned the clear increased risk of death to your baby. It's a disgusting example of malpractice to cheerleader women into what the midwives prefer, instead of true informed consent and fully support the mother's decision regardless of the midwife's personal preferences.

Think about it. If your midwife is one who ignored or glossed over the risks when you were choosing home birth, why on earth would you think she or he would be the uber-cautious, risk-averse, constantly monitoring, transfer immediately at first sign of doubt person? She has blatantly shown you she is a risk taker.

It should be malpractice and midwives practicing in this way should be struck off.

By all means, make whatever choice you like. But that choice should never be based on rose-tinted fairy stories from a smiling midwife. Women deserve not to be patronised like this.

I have two children and would possibly have neither had I put "experience" ahead of safety.

Baby number 1 was a v long labour resulting in heavy blood loss for me. She may have made it, I probably wouldn't.

Baby number 2 was delivered in a crash section following a cord prolapse. There were no indications of any problem until there was a serious problem.

Both children are fine. Thank heavens for hospitals.

Best to remember how high the mortality rate of pregnant women used to be. Medical intervention has prevented thousands of deaths other the last century. If your baby is starved of oxygen during labour, you won’t have time to get to hospital, regardless of how close it is.

Perhaps there is a newer NICE study? they dont seem to be home birth averse at all... for low risk pregnancies.
www.nhs.uk/news/pregnancy-and-child/nice-recommends-home-births-for-some-mums/

Thanks @jasjas73 for that link. It is written in the most obscenely misleading way. "Four extra babies" when actually what they mean is twice as many babies died. It's a disgrace that they should be allowed obfusticate statistics like that. And sickening that the issue of safety and life-and-death of women and babies comes below an analysis of what the media thinks.

I surely cannot be the only one furious about this. Babies are needlessly dying, and the information about the risks women are being pushed to take is being hidden. Why is this happening ? Who stands to benefit? And why isn't it front page news?

I'm not disputing the figures, but 0.9% is still a very low figure.

There is also no way of knowing how many births had adverse outcomes in hospital because the mother couldn't cope with a hospital labour, as there's just not enough evidence.

At the end of the day, no one is right, it is down to each individual mother to make an informed decision based on the risks and her priority of them.

No one who is pro home birth is ever so rude about women's choices to have a baby in hospital, so why can't people just respect each other's decisions?

Yes! Do it! Did it with my first and had far superior care than my NCT friends at my local hospital and birth unit. Really recommend it. Worth getting a birthing pool (if only to provide an activity for your partner during early stages). Ignore the horror stories and dig out some positive home birth stories (there is a great group on FB).

If the choice is between 0.5% and 0.9%, and the consequence is something as monumentally important as a baby dying, then that is hugely important. And actually a 1% risk of something is quite high for a one-time event. You would be unlikely to secure insurance for something with a 1% chance. I bet you wouldn't get on an airplane if ou were told there was a 1% (or even 0.5%) chance it would crash. In any case, the point is somebody somewhere has chosen to make it NHS policy to communicate this vitally important bit of information in the most obscure and downplaying way possible. Why is that?

If you want to play with how you present statistics, they could say with something like "home birth is the choice of a vanishingly tiny number of women in UK, only 2.3% make this choice". Instead they choose to present home birth on a footing with hospital birth to normalise it still further. Why are women being pushed in this direction?

I wanted a home birth with DS1 and asked my aunt (she’s a doctor) for her thoughts. Her response was “oh no think of your carpets!!” It made me chuckle, and I never did have a home birth because I couldn’t hack the contractions so wanted to go to hospital.

Be aware of the risks.

Two of my three DDs would not be here now if I hadn't been in hospital for their births, and I might not be either. I suppose that colours my view of the idea of home births, although I do see why some people like them and I had a friend who had two successful ones.

It wouldn't be my choice, but that may be just my own experience speaking.

@sycamore54321 - where and how do you know of midwives pushing homebirths on first time mums and not giving them all the facts? I am a midwife, so was aware of the birth place study. Community midwives where I work present the facts of where the options are for delivery, no one is pushed into anything, just supported in their decision.

I am basing my views on what women have reported as their experience on this thread. And many similar threads on here and elsewhere, where women report that their midwives are delighted they have chosen home birth and show no understanding of the fact that you cannot be considered low risk if you are a first time mother.

My observation is a huge liberty is being taken my midwives in encouraging mothers with all kinds of risk factors into unsuitable home birth. I would be very happy to be wrong on this but I fear I am right.