Home birth - the down sides?

[Lakedeal]

Hi all

I'm seriously considering a home birth for my first baby but struggling to find good quality information about the potential risks. I have read the Birthplace study and know the risks of a negative outcome are higher for first time mums but it doesn't give information about why.

We live 10 minutes from the hospital (by car) and I would absolutely go the minute a midwife advised it. Ideally I would discuss this with my regular midwife, but she's away at the moment and the midwife filling in with her just said I should let them know my decision at my next appointment (in two weeks' time, when I'll be 35 weeks).

Any insights or reading recommendations would be great - I know a lot of people have had brilliant experiences, I just want to make sure I'm making an informed decision.

Failure to progress I mean!

Unplanned home birth then in hospital as DD was early and retained placenta. DS in hospital, bit still pretty much delivered on my own I say the MW caught the baby not delivered (Also pem). Also they were too busy following protocol didn,t realise how far gone I was, despite me telling them how quick my first was. So birth wise home was better, after care 2nd was better but more due to no retained placenta so no d&C.

No way I’d have a home birth for a first baby, sorry. My labour was amazing, happy and smooth sailing - until it wasn’t and I required a crash section to save my child’s life. We’re talking approximately five minutes from everything being fine to being rushed into theatre. Not worth the risk.

Babdoc: "Fair enough if you want to risk your own safety and survival, but it’s rather tough luck for your poor baby if the shit hits the fan, is it not?" I can see how your personal and professional experiences would make you feel like that, but everyone has to weigh up the evidence and make their own choice. Plus mothers and babies die in hospital too. I'm a pathologist so I only see the bad outcomes.

I agree with the majority of posters that I wouldn't have a home birth for a first pregnancy. I had my second child at home and it was a really positive experience. The gas and air valve was defective so I did it with very little pain relief, which was a minor problem.

I had home births with babies 2 and 3. I felt that the care and monitoring I got at home was far far better than in hospital with baby 1. I think they (2 midwives and one student, all dedicated to me) would have spotted any issue and had me in an ambulance up the road before anyone in hospital (caring for multiple women and made me feel like an annoyance) had come in to check on me...

Also, I have had dozens and dozens of people tell me that they/their baby would have DIED if they’d tried to have a home birth. However, the statistics don’t bear this out. More likely that the midwives would spot a problem and have you whisked off to hospital.

I wonder if it would help if you looked at what people who have had a first birth at home say on a different website to Mumsnet.

Shallow but as my mum said to me 'why would you have all that mess in your own house'
Birth is incredibly messy. The poo with every contraction, the wee, the blood, the fluid, did I mention the blood? The vomit.

I believe advice is to have plastic sheeting/shower curtains to contain the fluid, the blood, the vomit.....or you can leave your bed/sofa/carpet untorpedoed and give birth in a fully wipeable hospital.

I had a home birth for my first, it was a positive experience.

I wanted to feel comfortable and I felt my body responded to the environment really well.

Would agree with another poster, you're more likely to have an intervention in hospital and they wouldn't offer the option if it wasnt safe. I think if you have the mindset of risk and danger with birth then dont do it at home. I didn't see it that way, as I was lucky to have a straightforward pregnancy.

I had a straightforward first birth in hospital and I was asked a few times if I'd considered a home birth for my second. It wasn't for me and I thank god every day I didn't choose that route. My second birth was again, very straightforward with no interventions and just gas and air for pain relief (easier than my first). It was in the birth centre but due to something rare and unpredictable I haemorraghed and was whizzed through your labour Ward and was in theatre very quickly to save my life (baby was fine). Who knows what would have happened if I'd been at home - best case a lot of blood on my floor and a very stressful and scary ambulance ride. Worst case, death. Not worth it to me, especially with the option of a birth centre next to labour Ward.

I had a hb with dc3. For me t was safer because I have unusual labours - which are low risk with correct management. A hb meant I was more in control of the process and my mw was better informed about my labours. It was a massively positive experience. However, if I'd had dc1 at home it could have gone horribly wrong - simply because of the peculiarity about my labours which no one could have known beforehand. In hospital it wasn't well managed but it was managed and we were safe.

I would not hesitate to encourage someone to labour at home and transfer for delivery if they are close like you (you'd possibly need to book a hb if you wanted to do this, there is no real provision for this approach these days I don't think. However I would hesitate to suggest a hb first time round, simply because no one knows what their body will do until they are doing it.

Good you had the option of a bith centre next to a hospital. Not everyone has that option sadly.

I'm very glad I was in hospital with dcs 1 and 3, as both children, an I am still here to tell the tale.
We are so wonderfully lucky to have the option of full medical care, for FREE in the UK. I can't understand why you would take the risk.

As you are close to the hospital, you can still spend the first 15 - 20 hours labouring at home, and then go in when you are a bit nearer the actual birth.

Someone upthread mentioned birth being messy and not wanting that at home. My home birth really wasn't very messy at all. I had some plastic sheeting down and all the action happened on that. Afterwards it got folded up and disposed of. Surprisingly little mess, actually, and certainly no scrubbing or wiping down required afterwards. I don't vomit in labour, thank God. DH just flung a few towels into the washing machine and that was it.

The thing is, it is a fact that medical interventions are more likely in hospital. So lots of people discuss all their hospital births and say how relieved they are they didn't have a home birth, but they wouldn't have needed those interventions at home.

All other mammals need safe, quiet, dark spaces before labour begins. If they are disturbed, labour will stall. This is the same for us too. The drive to hospital in labour, the bright lights and strangers in and out of rooms can be enough to stall and painfully slow down labour, leading to epidurals which increase the need for interventions, leading to forceps and ventouse or c sections because of exhaustion etc.

I was told by midwives that you do not receive emergency help faster in hospital. When a midwife has concerns they will contact the hospital and have the surgeon or other HCP on stand by so you can go straight in from ambulance. In a hospital, you still have to wait for the surgeon. Because you have two to one midwives at home, issues are generally picked up much sooner anyway. Obviously this isn't the same advice for those who live somewhere rural.

I have had one hospital and 2 home births. I think there are pro's and cons to both. All my midwife friends have had home births. My home births were much shorter (common for home births) and being able to go straight to my own bed helped enormously with recovery. However (and I hate scaremongering on this subject) I have a very low pain threshold and don't think I'd have a fourth home birth unless they started offering epidurals at home. I know many mother's who have had home births though and noone else has ever admitted they struggled without stronger pain relief.

I did 2 HB. I also didn't want to have any interventions. The risk increases with each additional person who attends you.
I was fully prepared to go to the hospital at their first concern.
I made sure I read in great shape with lots of yoga and was as prepared as possible. I fist hypno-birthing and used the Birth Skills book by JuJu Sudin (AMAZING!!)
I research like mad and practised as many distraction based skills for the contractions in prep.
I was very confident going into labor.
I had a water pool too deal with the blood and poo.
Both were fast. I didn't use gas or air. I birthed the placenta myself.
I felt in control of the process.
If you're fit and healthy plus it makes you feel supported and confident - go for it!
Your mindset had a massive influence on the labor constantly progressing.
However, I was so ready, I was 1-2cm dilated by the time the MW did her first check for DC1. That's how much I was in the zone in my head.
It is a risk but it can also be empowering and liberating.
(I am aware I turn into Ina May when I talk about birthing! Lol 😂)

The thing is, it is a fact that medical interventions are more likely in hospital.

Well, yeah. Think about it- hospital births include in their numbers medium and high-risk pregnancies, multiple births, home-births that went wrong, people who wanted an epidural, setting off a cascade of intervention... Makes perfect sense that their risk of interventions is higher.

Fact remains that my family member had the baby's cord around its neck and were she not labouring in hospital the baby would have died.

@user1333796

Making faux comparisons with other mammals isn’t helpful, unfortunately. No other mammals have the extreme pelvic width to skull diameter ratio of human females. We evolved this way due to our large brains requiring a large head and our walking upright on 2 legs requiring a narrow pelvis. The trade-off for these is that childbirth inherently more risky in humans as there is very little room for the baby to exit. So going to a dark, quiet place alone to give birth like a fox or a chimpanzee is generally not going to cut it for us.

And someone else mentioned that the risks are very small. However looking at the probability of a risk occurring is only conducting half of a risk assessment. You also need to take into the account the consequences if the risks did occur. Here, the chances are small, but the potential consequences are as serious as it’s possible to get. Thus, for me, a home birth for a first baby would fail the risk assessment.

I had a hospital birth with my first and a home birth with my second. My second birth was great.

I did get transferred in for a PPH (6.5 pints) after my home birth. It was caught early, an ambulance called and here with 4 minutes and whizzed straight in to theatre.

I'm not having anymore but if I did I would still have a home birth if a low risk pregnancy. I felt so much more in control. I felt safe and calm.

I’m planning a homebirth for my second. I labour very fast so I don’t want to risk giving birth en route to the hospital!

With my first birth no one would believe that I was in labour so I laboured alone in a bathroom on the antenatal ward. The ward was very busy and I was pushed to the bottom of the priority list as I ‘wasn’t in labour’. I was induced which I believe has higher risk of fetal distress no on bothered to monitor my baby’s heart until I was pushing despite my telling them I was in labour for hours! Hospital protocol was that the fetal heartbeat should be monitored every 15 mins. I’m convinced that if DD didn’t get stuck I would have had a completely unassisted birth in a bathroom with no midwife in the hospital. Coincidently, I had to wait 1.5 hours for a theatre after it was decided that I needed forceps and/or a c-section. Therefore, even with a hospital birth theatres are not immediately available.

With number two I’m having a homebirth as at least then I will have a Midwife with me who should be able to pick up on an problems as early as possible rather than being left to labour alone for hours in the hospital!

Lots of scaremongering on here, check out home birth UK on Facebook for some more information and people's experiences. (Both positive and negative) and good links to evidence based information.

Just to be clear the two midwives attending bring full resuscitation equipment for the baby should there be a problem.

Babies being born with the cord around their neck is surprisingly common, this happened at my home birth it was removed, no further intervention required.

Also the birth place study compares likelihood of intervention / complications against other low risk pregnancies. Of course it would make so sense to compare it against medium and high risk pregnancies. It was a pretty huge study so obviously the methodology was well thought out.

We went to a monthly Home Birth group, and couples would come back with their baby and speak about their birth. There may be one local to you.

Have had all 3 children at home. I don’t have a hospital birth to compare it to, but all 3 births were very positive experiences and I do think a lot of that is to do with being at home. It changes the dynamic with the HCP - they’re guests in your house. I definitely felt safe and comfortable which is important as childbirth is such a vulnerable and undignified thing! Yes it’s slightly riskier for first time births which is something you have to weigh up. The risks are still statistically very tiny and in hospital you are more at risk of unnecessary intervention.

When I was thinking about home birth with my first, I went along to the home birth workshop at the hospital. It was very helpful for answering my questions. The midwives on the home birth team were all very experienced. They explained that usually in birth things don’t suddenly go wrong - there’s a process and if at any point they feel you need to go to hospital, or you want to go to hospital for whatever reason, they will go with you. They don’t take chances. It helps that we live pretty close to the hospital. I decided that I’d start at home and see how it went, and transfer into hospital if and when I needed to. Almost half of first time planned home births end in hospital so that’s something else to consider.

As it happened, I didn’t need to transfer to hospital, and went on to have my subsequent two births at home too. Second two births were extremely quick so I might not have made it hospital at all. For me home with 2 midwives certainly felt like the safest place.

I think the most important thing (given that both home and hospital births are extremely safe in the UK) is that you feel safe. If being at home would stress you out then there’s no point in having a home birth. It’s a very personal decision.

OP youre probably better off speaking to a home birth group, midwife or someone else who knows what they're talking about. Read some books and studies.
People like to spout things like "oh it's so messy", "everyone I know would have died if they had a home birth", "the risks are really high". The research doesnt pan out for this and shows that home birth is equally safe for low birth second time mums - going into hospital can lead to other interventions which wouldnt have been needed at home.

*low risk second time mums

I really wanted a home birth but my labour lasted 72 hours. The first 48 I managed on my own then I got the midwife out so I could have gas and air which j was on from 5.30am.
By evening I was still going but they ran out of gas and air!! They went to get more and when they returned I had an hour of labour on absolutely nothing and was desperate for the gas but a piece of the canister was missing!
So at that point I lost it and I got an ambulance to hospital.
Staff were ready and waiting for me, gas and air coming out my ears and I got an epidural too.

In hindsight I should have just gone to hospital from the get go. For number two I'd maybe consider it but I think it's too risky for your first