Homebirth

[SamLDN]

Looking for home birth stories. Positives/negatives....
I’m thinking about it. The thought of the mess puts me off and also needing to rush to the hospital if anything goes wrong. At the same time would be nice to be at home, especially with all the COVID restrictions etc at the hospital.

Would love to hear your stories to help me decide 😀

I had homebirths with my four DCs. Very few complications.
One was back labour so that took 30hrs
One had cord wrapped around neck, so midwife had to pause me mid-pushing she could unloop it.
Did tear for first 3 and midwife gave me local numbing injection and did the stitches (once she’d checked the baby over).
On 2nd baby my placenta took almost an hour to come out after the birth. Midwife was on verge of getting me to hospital when I stood up, had a big contraction and it just dropped out.

Had same midwife for all four. She had an assistant/trainee midwife as well, but this person changed each time. There wasn’t much mess as I recall and my DH and the assistant did the cleaning up. I personally do not like hospitals. Also childbirth in west is very medicalised with almost a schedule you have to follow to avoid interventions. Like must dilate 1cm every 1-2hrs or be augmented. Widespread practice of breaking the waters instead of letting them break naturally. Using ventouse or forceps if pushing is deemed to be going too slowly. It’s all too much? Nature doesn’t go by a man made schedule.

@RosesAndHellebores I don't think there was any blood on those towels, just the one that got thrown away. They'd just got damp/ been on bathroom floor. That's how little blood and mess there was. Very happy to sacrifice one old bath towel to the bin for the sake of an excellent birth.

@Woodpecker22

'Not necessarily true. If it goes badly, it can go bad really fast, and seconds matter. I used to assist with neonatal resuscitation, and there is no way I would ever have a home birth.'

Resuscitation equipment is brought to home births. I was told exactly the same proceedure is followed at home as in hospital. In addition you are likely to have the most experienced midwives doing it at home rather than in an understaffed labour ward.

I am not anti-home birth, but women should decide where to deliver on the basis of the facts, not half-truths.

When things go wrong at a delivery in hospital, you press an alarm and get:
The obstetric team (at least 2 doctors)
The paediatric team (at least 2 doctors plus expert nurses)
At least one anaesthetist
The intensive care team

If you need emergency surgery, you can be in the operating theatre in a couple of minutes. If you need a transfusion, you can have it in a couple of minutes. If your baby needs resuscitation and transfer to NICU, there will be a team of 4-5 expert doctors and nurses to make it happen safely and quickly.

Two midwives, no matter how experienced, cannot reproduce what a hospital can offer when things go wrong. But, in most cases, things don't go wrong - or at least not in a catastrophic, high-speed way. That can happen, but the odds are on your side.

@MissLucyEylebarrow or like me you can have such a poor midwife that she missed the fact that the baby was in distress. My husband picked it up.

By the time the red button was hit the baby was too far down the birth canal for a caesarian. The Dr gave me one more push while he got the forceps ready and a more senior midwife cut the cord before ds was born and before his head was out. I think it was the sight of the forceps and I shall never know how but I got the baby out in that push, bursting a blood vessel in my eye doing so. He was very very blue and took ages to resuscitate and spent the first night in SCBU. No long term harm but I think theybwere worried.

Paradoxically I did not need stitches- only a tiny tear. But I have had a bladder repair and probably will need a repair of my anal sphincter in due course - it is currently manageable but I'd prefer very much not to have to manage it.

Had that silly midwife sought assistance the first time the baby's heart dipped there could have been a controlled and well managed caesarean. I shudder to think how close ds was to brain damage.

I'm not saying for a moment that hospital birth is always safe, @RosesAndHellebores - and I'm very sorry to hear what happened to you. Home birth is safe for the majority of low-risk pregnancies.

My comment above was specifically about the idea that two midwives at home can follow exactly the same procedure as a resuscitation in hospital. They can't. They can give CPR in the same way, but it is impossible for two individuals to give the same level of care as a hospital team.

I do think in my circumstances however an experienced and capable midwife may have got me to hospital before everything went pear shaped. Possibly by knowing the baby was posterior and discussing the potential labour with me. We then could have made the decision to transfer hours before the baby got into trouble. Has I been told the baby was posterior I would have requested a section.

I had a home birth with my 3rd, because my 2nd came so fast we barely made it to hospital- he was out within 30 secs of arriving and being shown into a room!

My home birth was lovely, took about 5 hours from waters going to baby in arms. I gave birth standing up leaning on dp, to a very long 9lb12 baby boy. I'm really glad I went for a home birth, but I don't know if I would have if my 2nd had have been less of a rapid birth. I'm 39 weeks with baby 4 and I will be going into hospital for this one. I did consider another home birth, but I'm 37 now and this being my 4th I feel in my gut that I'll feel safer at the hospital. That being said if I go fast with this one, things might end in a surprise home birth!

All those trying to say that emergency treatment isn't available immediately at home, it's worth pointing out that theatres with staff fully scrubbed and ready for you don't happen in hospital either. Staff are busy and even in crash sections you may wait for the patient before you to finish their procedure and for staff to be gathered from their on call sleeping space (which may be their home) and get scrubbed and gowned. Etc etc. Everything is dependent on circumstance.

Hospital births are not risk free, they just present different risks.

I've given birth at home and in hospital. The care, attention and respect I received during my home births were incomparably better to the lack of care, dismissal and upset I was subjected to in hospital.

My home births were absolutely amazing. Truly treasured experiences where I felt so safe, with dedicated 2:1 care that was planned in advance and specific to me and my needs. The NHS midwifery team that cared for me through my pregnancy were v v experienced and I had my named midwife for most of my antenatal appointments as well as at the birth. Being able to move around with soft furnishings, cushions, blankets etc really helped me labour, as did having cold drinks from the fridge and what I fancied to eat on hand. I loved washing in my own bathroom and getting into my own bed with dh with us the whole time.

(In hospital it was too hot, too loud, too bright, no privacy, dh had to leave, the bathrooms were really far away with no room for the baby but also didn't feel safe to leave them on the ward alone... Etc etc.)

I actually wish I could have another baby to have another home birth!

In an emergency in hospital, you will be in theatre and having a section in minutes. In dire emergency, the section can even be performed in the delivery room (extremely rare, but I have seen it happen).

I don't know why posters are always so desperate to deny the truth: there is no way that a home delivery can reproduce the emergency care of a hospital. Would an emergency in a hospital be left to two midwives? No - because two people cannot do all the things that an obstetric emergency requires.

But most low-risk births go smoothly and most problems do not need instant treatment, so there is time for a transfer to hospital if required. Women should be free to choose a home birth, but it must be an informed choice.

@MissLucyEylesbarrow when speaking of informed choice do you also think that factual information should be available: ratio of midwives to women, percentage of women left alone until transition, percentage of midwives who are just downright rude, no of times a new mother has had to mop someone else's blood out of a shower or off a toilet before using it, number of times unit has contained a prisoner or someone has been arrested at the unit in the last month, whether there is actually any kind nursing on the post natal ward, whether something other than burnt toast is available when a woman has laboured for 30 hours.

And that's without adding in the consistency of advice or as I think is becoming important the number of women with botched births who require surgery sometimes 20 years later which is often not available on the NHS or not readily available unless a woman is very assertive. The NHS has a very long way to go towards transparency in maternity care.

I honestly think that had I had the misfortune to have lived in East Kent or Shrewsbury I would have moved had I wanted a baby. I am 60 now and can absolutely affirm that QEQM's maternity department has had a bad rep for at least 45 years - I grew up there and have friends there and it is a disgrace that it took a tragedy happening to a professional and articulate couple to drag it out into the open.

Add in the fact that often (in London at least) whilst a mother can chose a maternity dept that is outstanding in every way to have her baby, the post natal midwives often come from the poor hospital that the woman would not have touched with a barge-pole.

[quote RosesAndHellebores]@MissLucyEylesbarrow when speaking of informed choice do you also think that factual information should be available: ratio of midwives to women, percentage of women left alone until transition, percentage of midwives who are just downright rude, no of times a new mother has had to mop someone else's blood out of a shower or off a toilet before using it, number of times unit has contained a prisoner or someone has been arrested at the unit in the last month, whether there is actually any kind nursing on the post natal ward, whether something other than burnt toast is available when a woman has laboured for 30 hours.

And that's without adding in the consistency of advice or as I think is becoming important the number of women with botched births who require surgery sometimes 20 years later which is often not available on the NHS or not readily available unless a woman is very assertive. The NHS has a very long way to go towards transparency in maternity care.

I honestly think that had I had the misfortune to have lived in East Kent or Shrewsbury I would have moved had I wanted a baby. I am 60 now and can absolutely affirm that QEQM's maternity department has had a bad rep for at least 45 years - I grew up there and have friends there and it is a disgrace that it took a tragedy happening to a professional and articulate couple to drag it out into the open.

Add in the fact that often (in London at least) whilst a mother can chose a maternity dept that is outstanding in every way to have her baby, the post natal midwives often come from the poor hospital that the woman would not have touched with a barge-pole.[/quote]
Completely agree with the first bit (don't live in London sp don't know how things work).
Aa I said to my home visit post natal check midwife 'until doctors, midwives, and nurses treat patients as people not statistics and textbooks o have and will continue to have little respect for each individual' yes some are amazing, but an awful lot are not and when medical staff defend shoddimg practice and treatment they do themselves no favours.

I work with numbers,data and statistics all day - you cannot just choose the ones which are convenient.

Remember that just under 12% of planned home births for first time mothers actually end with a transfer to the hospice.
I was one such. Mostly to get away from my midwife who made mistakes during my labour and then I couldn't trust her for the delivery, so my transfer was an elective one.

I don't know if anyone has mentioned the research that says that women who plan to have a homebirth, even if they later transfer and deliver in hospital, have better outcomes than those who plan to birth in hospital. Join the Facebook for up Home Birth Support group UK for more evidence based info and stories.

@InTheFamilyTree

I don't know if anyone has mentioned the research that says that women who plan to have a homebirth, even if they later transfer and deliver in hospital, have better outcomes than those who plan to birth in hospital. Join the Facebook for up Home Birth Support group UK for more evidence based info and stories.

But surely that’s because they by definition have low risk pregnancies or they wouldn’t be planning a home birth? The low risk causes both the planned home birth and the better outcomes.

All those trying to say that emergency treatment isn't available immediately at home, it's worth pointing out that theatres with staff fully scrubbed and ready for you don't happen in hospital either
This did happen for me. There was a dedicated theatre for emergency sections that the midwives literally ran me into for my crash section. Of course it could have been occupied . But it was a dedicated emergency section team/theatre.

Yes, my point is that another woman may be in there and the staff may be occupied elsewhere. The on call neonatal doctor could be in A&E, or on the neonatal unit. The anesthetist covers all obstetrics including planned C sections etc. No one is stood around gloved and gowned ready for action. Hospitals do not have the resources to have people underoccupied to that extent. Believe me, I've worked in them for decades.

My home birth midwives would make a call to the hospital, who would take the same time to prep for theatre as they would take if I was there and I would transfer into a ready facility if it was required. Likely, given that I actually got cared for at home, my mw would have noticed the problems in a v timely manner as opposed to ignoring me and telling me I was nowhere delivery like they did in hospital.

What I could have articulated better earlier is the fact that whilst a small proportion of women have higher risks or emergencies arising, providing acute emergency care for them is too often at the expense of the quality of clinical and nursing care for the majority who do not need an emergency delivery.

I also think many issues could be identified in advance if there were higher standards for all women. I saw a midwife two days before ds was born - no mention of a posterior presentation yet I am advised all midwives can tell. Nor was there any mention of it when I was admitted in early labour.

My lesson was learnt for the next time when I insisted on consultant led care (I was actually high risk). The consultant identified the baby was breach, a failed ecv took place and a section booked. Surprisingly the baby turned at 38 weeks and elected not to have the CSection but only because the consultant promised he would ensure a highly experienced and excellent midwife was with me for the birth. In the event I had two because Labour was v fast and there was meconium in the waters. One, called Hawa, was incredible and I knew the minute she arrived I was safe. It was an amazing birth and only then did dh and I truly realise the horror of ds's birth. And it could have been avoided.

But surely that’s because they by definition have low risk pregnancies or they wouldn’t be planning a home birth? The low risk causes both the planned home birth and the better outcomes.

This was a like for like study. It compared low risk women who started labour at home vs low risk women who started labour at a midwifery led unit or hospital. The home birth group - even if they were transferred - had the best outcomes for women. (Outcomes for babies were the same for second time babies, slightly less good at home for first time babies). So it wasn't actually the low risk status that improved the outcome, it was the home birth setting. There have been several more recent studies showing the same thing; there was a big Canadian study a few years ago that looked at worldwide outcomes and concluded that home has the best outcomes for low risk women too.

But surely that’s because they by definition have low risk pregnancies or they wouldn’t be planning a home birth? The low risk causes both the planned home birth and the better outcomes.
Do you not think the researchers thought of that rather obvious comparison all the women in the study- home birth, hospital or birth Centre- were low risk.

@littleredberries

Remember that just under 12% of planned home births for first time mothers actually end with a transfer to the hospice. I was one such. Mostly to get away from my midwife who made mistakes during my labour and then I couldn't trust her for the delivery, so my transfer was an elective one.

I think its more than 12% for first time mums, I think its about 40% and then 12% for second time or more. Fewer than 5% transfer for urgent reasons though, most are to access more pain relief.

(I assume you meant hospital not hospice )

If we had a home birth DS would not have survived. He went from fine to emergency C section in about 5 minutes.

I don’t qualify due to previous complications but personally I wouldn’t anyway as I’d feel a lot more comfortable and relaxed in a hospital with all the staff and resources close at hand.

Having said that, the hospital where I’ll be having DC2 is fantastic! I think it depends on your situation, and what your local hospital and home birth team are like. You can always request a visit from the home birth team to discuss any questions and take a tour around the maternity unit in the hospital to compare.

Another option could be a midwife led birthing unit if there is one attached to your hospital as a happy medium? Good luck with whatever you choose!

@CroydianSlip

Yes, my point is that another woman may be in there and the staff may be occupied elsewhere. The on call neonatal doctor could be in A&E, or on the neonatal unit. The anesthetist covers all obstetrics including planned C sections etc. No one is stood around gloved and gowned ready for action. Hospitals do not have the resources to have people underoccupied to that extent. Believe me, I've worked in them for decades.

My home birth midwives would make a call to the hospital, who would take the same time to prep for theatre as they would take if I was there and I would transfer into a ready facility if it was required. Likely, given that I actually got cared for at home, my mw would have noticed the problems in a v timely manner as opposed to ignoring me and telling me I was nowhere delivery like they did in hospital.

As the person who has had to run to theatres for a cat zero section, this is not true. Most "emergency" c sections don't have to happen immediately, and yes, there is faffing and waiting. For the small number that do need to happen NOW, things happen very quickly indeed.

@SelkieQualia really interested to know what percentage of low risk women require a cat zero c section?

Small, but it's one of those low probability, high consequences things.

There's also neonatal resuscitation. A baby can be born needing resuscitation, with little warning. If they really need it, seconds matter. There's no way one midwife on her own can do anything like what a neonatal crash team can do.