Please can you tell me why you are going to have / have had a home birth?

[CranberryMartini]

Because I just don't get it!

DS would most probably have died if I'd have had him at home. His heart rate dropped rapidly and needed a ventouse delivery with a resuscitator (sp) on standby. It was scary but I felt surprisingly calm with all the doctors and midwives around.

Why are you prepared to take any risk with your baby's birth? I can vaguely understand a home birth if it's not your first child and you know what to expect, but your first child?

I've also heard (could be wrong) that it costs the NHS £3000 to fund a midwife to do a home birth.

And doesn't it make a huge amount of mess?

Sorry I really don't want to offend anyone with this post and I would like to hear your reasons for choosing a homebirth. Try to persuade me to have my second at home!

Amerryscot - no, problems don't always arise 'before' labour. Or because of intervention. They can happen out of the blue. When going into anything people should know all the info.
Hypoxic events happen with no warning and happen at home or hospital.

I was never going to be a candidate for a home birth having had a significant (non pregnancy related) ilness.

However my baby became very distressed, very very quickly in second stage and required a rapid delivery (turned out there was a large loop of cord which descended into the birth canal with her and she was being starved of oxygen). I did not appreciated at the time quite how close to the bone things were.

Statistics are fine - but they dont matter a jot when it affects you! After this experience i would not contemplate a home birth

My hospital experience was much better than anticipated - I had an older 'salt of the earth' midwife who kept me calm and the medical staff were great.

I am not saying this to upset or disrespect peoples views - just to tell you mine!

good luck

well lots of others have given the same type of answers as I'm going to but here goes:

First off whilst I appreciate the worries the OP had given her healht history that doesn't mean its okay to imply that any mum who has a home birth is putting her baby at risk.

here are my reasons and risk management;

I hate hospitals - and being emotionally/ mentally vunerable during labour I thought would increase my distress and decrease my ability to communicate effectivly or to cope with the pain etc

I wanted my birth partner to be my OH

I didn't want to have random medical students/ changes in Doctors during my labour

I wanted to be in my own surroundings so that in the event of a long first stage I could make a cuppa, relax with a DVD, pace the living room, go out and sniff the rosemary bush in the garden, hug the cats etc etc

I had no risk factors for birth and was healthy and fit

A homebirth meant I could guarentee beign able to have a pool (we hired one) and a comfortable low bed/ kneeling stool/ birth ball etc etc

Once DS was born it was me, OH and DS all cruled up in the fmaily bed for our first cuddles

DS didn't have to have the first day/few days of his life in a hospital, his first view /touch was his dad catching him and his first cuddle was in his mums bed.

I didn't run the risk of nasty hospital bugs

I didn't have to eat crappy hospital food

what if something had gone wrong? - well we live 5 minutes drive from the hospital and quite frankly given the bloody awful layout of our hospital I would possibly be there faster from home than if I had to be transferred from the birthing unit to the emergancy areas or vice versa.

"A homebirth meant I could guarentee beign able to have a pool (we hired one) and a comfortable low bed/ kneeling stool/ birth ball etc etc"

Does this stuff actually, really, honestly make any difference?

I had a pool and a birthing ball in hospital and I couldn't have given a rats arse if they were there or not, I didn't even know because every contraction dragged me back to hell.

The only thing I regret about my hospital birth was waiting so long to ask for an epidural.

I could never contemplate a home birth because of that pain, the fact that my body, god and nature had all turned against me and were torturing me to an inch of my life. The sadness, anger and despair. The lowest, darkest place I have ever been. Am I the only one who remembers?!

(Sorry I'm a bit drunk)

Um, well I remember the pain. But not feeling the way you did, when I had dd in hospital (had epidural and pethidine).
Had ds with gas and air, planned homebirth but in hospital as no midwives. And I can honestly say that while it hurt, it is one of my happiest memories.

I had a really positive first birth in a hospital. Having said that, I was only there an hour before our DD was born. Was 7cm when we arrived, so no chance of them ignoring me or leaving me alone for hours! But the midwife was fab and the aftercare was very good. Despite this I am planning to have our second at home.

I can totally understand that some feel more comfortable in hospital, but I know I will be happier at home. I am also now confident that my body can cope. I truly believe (and midwives tell me it is true) that the more relaxed you are, the easier your birth experience will be. It's therefore no more "selfish" to choose to give birth at home than it is to choose to give birth in hospital. Surely what's best for you is best for your baby.

Sparklyjen - you have to remember that people's experience of pain is different. People's labours are different and so yes some women find the accessories you have the freedom to use at home a benefit (plus you can have some pain relief). I had a homebirth without pain relief, yes it hurt but I didn't really find it a negative pain and plan to go through it again in February with no pain relief unless things are different. I guess its just personal but as far as pain goes its the most intense I have ever experienced but I would rather go through it with a point and an end in sight than experience some of the other long term pain I have from various injuries that I have to live with.

Sthmum - I'd recommend you read some Ina May Gaskin or even Michel Odent.

I had a very positive birth experience at home with my DD 3 months ago, no pain relief, with a doula, my DH and two midwives present. I had their undivided attention, I feel sure they would have spotted anything untoward, and we live one mile from the hospital. As it is I had to transfer for retained placenta (but home again six hours later).

I had done loads of birth preparation, am very fit and healthy, and kept an open mind about transferring since I know it's common for first babies. My labour was 17 hours start to finish with 3 hours of pushing. I know for a fact that in hospital they'd have whipped the ventouse out long before that stage, however my baby was in no distress and the wonderful midwives just sat on the sofa and let me get on with it. Knowing that they (and I) trusted my body to birth that baby, in my own time, was incredible. I was high for days afterwards, with the natural endorphins. The most difficult but amazing experience of my life. I hope to have a homebirth next time too.

My baby is very easy and happy and I like to think it's because she had such a gentle arrival and unstressed parents. I am scared of hospitals and am really happy that I had an uncomplicated pregnancy so that homebirth was an option. There is no way I would have taken any risks with my own health or my baby's, and if there had been a hint of a complication I'd have transferred immediately.

I know that having had 2 babies, both 9lbs with no pain relief, that people's experience of pain is very very different. For me, od as it sounds, the pain is sort of part of it. I knew it was going to stop, so although it hurt like hell, and made me quite sick and faint, It was all coming to one llovely climax and my baby was born.

I had 2 short labours, but 1st time round had 2 hours of pushing - and again, had I been in hospital I suspect not only would I have been encouraged more to have pain relief, I would have ahd some intervention by then to get the boy out. 2nd time, it was so straightforward it was ridiculous, but I was scared at the prospect of how much it would hurt - and I wasn' wrong. Still did it with no pain relief at all.

Don't get my tone wrong - I'm not saying pain relief is a bad thing - it didn't suit me, but I was the first to ask for Morphine when I had my appendix out!!

i wouldn't have wanted a birthing ball (too wierd for me) or a pool either, home or hospital.

I booked a homebirth with an independent midwife with both my second and my third babies, despite my pregnancy being labelled as 'high risk' (I had gestational diabetes and was known to be carrying a very large baby with my second).

I chose to have my baby at home because I felt it was safer for both of us.

At my local hospital the vast majority of women give birth sitting on the bed. Also, as someone with GD I would have been pressured into having EFM and I would have been deprived of food during my labour. I felt that labouring in these circumstances, my chances of having shoulder dystocia were far worse in hospital than at home where I would be able to birth in an upright and open position, have freedom of movement, and maintain my strength by eating sensibly during labour. However, despite my better mobility etc, in the end my second baby did get stuck on the way out during my homebirth and an ambulance was called. It was outside my front door within 3 minutes, and the second arrived four minutes later. In the meantime my midwives had freed my baby, resucitated him and we were able to send the ambulance away.

I look back and feel vindicated in my choice of homebirth. Opting for IM care at home meant that both my midwife and I had been able to discuss the issue of shoulder dystocia and make plans for what would happen in the event that it occured. Both of us were physically and emotionally prepared for what happened, which I'm sure was part of the reason why my midwife was able to deal with it so deftly and why I emerged from what was a fairly dire obstetric emergency with no emotional, or physical scars. My son needed help to breath (bag and mask), but after that was in excellent condition and breastfed straight away. I had no perineal damage to speak of(despite my son's weight - 10lbs 12oz, and the manner of his birth). I accept that things might have turned out differently - of course they could have done, they DIDN'T, and the outcomes for me and my baby were excellent, far better than they would have been in hospital I'm sure, where I would have had to cope with panicking midwives; I suspect the SD wouldn't have been resolved as deftly, and I probably would have sustained a lot of perineal damage, as it's the hospital protocol to do a large episiotomy as a first line of response in cases of SD.

I've really looked at the research on the safety of homebirth in comparison to hospital birth and I appreciate there are things we don't know - the research isn't water-tight. However, going on what we've got you have to arrive at the conclusion that homebirth is at least as safe or safer for low risk mums and their babies as hospital births. Yes - out of the 2000 women in the UK who choose to birth at home every year there probably will be a tiny, unlucky handful who'll lose their baby or end up with a very sick baby because of their decision to birth away from high tech medical care. The thing is that this seems to be balanced out in some way by other homebirthing mothers ending up with better outcomes than they might have had in hospital. Logically it must work this way, otherwise we'd see higher overall rates of baby deaths and injuries among homebirthing mums, when the actual figures seem to suggest that morbidity is lower for both mothers and babies who make this choice.

Most people who work in maternity care accept the fact that women sometimes end up having unnecessary interventions in hospital, and for a small number of women these interventions will have a disasterous outcome (I'm thinking of the increased number of stillbirths in pregnancies following c-section, the increased rate of infertility after c-section, and the small number of women who end up losing their womb after a c-section) but nobody ever points out that some of these things might have been averted had the mum in question birthed at home. In other words, when there's a poor outcome at home, it's really easy to blame it on the choice of birth environment, but when there's a poor outcome in hospital, birth environment is never fingered as a cause, even though logic and research tells us that sometimes it MUST be.

I know none of this is any comfort whatsoever to a mum who's chosen a homebirth where things have gone badly wrong, but to someone who's still in the position to make a rational choice based on what they know about the risks and benefits of hospital vs home, it's really important that the facts are out there in the public domain. Low risk mums need to know that going on current research, opting for a hospital birth doesn't improve their chance of taking home a healthy baby and DOES increase their chance of needing major abdominal surgery, with all its attendant risks.

Needmorecoffee - your story is heartbreaking. You did your very best for your baby and for all your other children and it's cruel that you should have ended up paying such a heavy price. I hope you find some answers to the many questions you must have about what happened to your baby and why, and some peace of mind.

Sparklyjen - according to the new Nice guidelines on intrapartum care, all low risk mums should be offered the choice of labouring in water as it has a marked impact on the take up of epidurals. In other words - there is research supporting the view that it reduces women's need for pharmacological pain relief, as do having mobility, upright positions, having one to one continuous support from a female birthing partner, and labouring at home.

Personally I've had two 30 hour labours, one in hospital and one at home. In hospital I became so desperate for pain relief that I 'had' to have an epidural; the long labour at home was just as painful, but I coped because I was in my own environment and had loving support from a good midwife and doula. IMO women who labour at home aren't generally 'brave' and don't have lower pain thresh holds, they just cope better because they're more relaxed and they feel better supported.

Hi, very interesting thread.

I have just one daughter who I had in a midwife-led unit. I was lucky enough to find the process about as easy as I think one could reasonably expect for a first-timer - gas and air, forgot to ask for anything stronger, fast but not excessively painful labour, only went in a few hours before my daughter was born (think I may have been in transition in reception while they were telling me I should have phoned first as if I was in any way rational at that point). Apart from that one small point, though, I had a great experience and was really lucky with the whole thing.

When or if I have my second (and supposing that I am low-risk again), I am very interested in having a homebirth. We have no friends or relatives close by who could take my daughter in a hurry if my partner and I had to rush off to hospital and I would not like to have to get her out of bed in the middle of the night and rush off to hospital with her. I don't suppose she would be allowed in the room so it would mean labouring alone without my partner's support and he was absolutely great the first time. I don't want to do it without him, really. If my daughter was allowed in the room, the whole thing might be pretty weird and confusing for her and possibly very upsetting. I think it might be easier to cope with all this at home where she could be downstairs with all her own toys etc while all the mess/fuss was going on and in a familiar environment. My mum had my brother at home when I was 15 months old and I don't remember a thing about it. But I do worry about complications etc, I don't see how you couldn't. I'm not considering a home birth for number two because I hate hospital, but because I think it might be better for the whole family.

I had a home birth for both my children. Obviously I had no idea what labour and birth would be like but I know what I am like and I felt that for such a physical, intimate and NATURAL process, my body would open and respond better in comfortable surroundings with my husband and a midwife. I am also a pessimist so was prepared for labour and birth to be excrutiating. Luckily for me it wasn't. My first labour was about 10 hours, my second 5 hours. Both times I needed nothing for pain relief. This was not out of some weird stoic/health conscious reason but simply because I got into a place where I was calm and could cope. Obviously I am extremely lucky in that there were no complications but I would recommend this experience to everyone who can have a home birth as they are experiences I look on with joy. I'm not some bean eating worthy type (honest), I'm just very stubborn and trust my body.

the midwives do resucitate at home. My dd was resucs and then blue lighted to hospital. My feeling is that the delay in getting her onto the NICU and using the head cooling thingy has made her brain damage more severe than it would have been and thus, far more disabled than she could have been.
When a baby isn't breathing and hypoxia is already killing brain cells, getting oxygen and treatment can alleviate the cascade effects of chemical necrosis in the brain.
Now, most babies of course, don't suffer like that, but I wouldn't want to be more than 5 mins from a NICU. To me, it isn't worth the risk just to avoid some of the more unpleasant things of hospital.

CM, I'll tell you why I had a home birth, no option really, waters broke whilst in bed at night and 40 minutes later ds born on rug in hall with my head squashed up against the radiator . Ex h wanted to "get the car started" but was told in no uncertain terms to "ring a fucking ambulance the head is coming out".

Mixed views really, but on balance wouldn't have chosen a home birth.

(Rug cleaned up a treat by the way).

I was in labour for about 24 hours before I asked for an epidural. I spent almost all of that time at home, with a tens machine, upright etc. Once in hospital I used gas and air (hated it), bounced on a giant ball (and fell off, which was mildly amusing) and sat in a birthing pool.

I was relatively happy up until the time I got in the pool, hospitals don't frighten me and I felt very safe with my mum and an absolutely lovely midwife and pleased that things were progressing at long last. After about 45 minutes in the pool though, with the gas and air making me feel sick and confused, I was desperate for an epidural. I tried to describe the pain earlier, won't go there again!

My conclusion therefore is that no amount of comfortable surroundings, freedom to move, water etc. would have helped me deal with the pain and a home birth would have been incredibly traumatic for me. The worst part of the labour was after I had asked for an epidural I remembered that it was about 2 a.m. on boxing day and was convinced in my terror that there would be no doctors around and that I would have to carry on with this pain...

So I worry about first time mums choosing a home birth, when they don't know what to expect. I couldn't have handled it.

Sparklyjen - I think the important thing to take from your posts, and others is that the choice should be there, and clear, impartial information available to all mothers- fisrt time or otherwise.

the research suggests that knowing you are going to be at home can make labour faster, easier, and less painful for SOME women. I believe that labouring at home, and knowing that at some point you will be travelling to hospital must increase the stress - when do you go? will you get stuck in traffic, will you be turned away etc... and will therefore make labour longer and more painful.

There seem to be 2 main threads here - firstly the question of safety, and secondly the question of comfort (the "selfish" side). Homebirths are not inherently more dangerous, but as needmorecoffee experienced (so for you) if things go wrong, there will always be that question of "what if".

In terms of pain - as i think has been said to death - we all experience pain differently - I would never have an epidural for ANYTHING! becuase they scare the shit out of me. I was offered one for the appendix op - when I went into screaming gasping hysterics they soon offered a GA. It doesn't mean that those who went without thinnk anything less of those who had epidurals. But you can't argue with the stats that say the more pain releif you have, the more likely you are to have intervention. Whether this is cause or effect is the question.

Labour is a wierd thing - why do some women "pop" them out? Why do some babies arrive late, some early? Everyone's experience is different - but we should all be offered the same choices about where we have our babies, and the fullest info possible.

A comfortable, stress free environment where you feel in control seems to be a big reason for choosing home birth. For those who want to or are advised to go for a hospital birth, as I did, there are a few things worth bearing in mind to help achieve this too (well they worked for me anyway):

• ask to wear your nightie/t-shirt throughout labour rather than changing into a hospital gown
• bring in a couple of your own pillows - much nicer than the wafer thin hospital ones
• if your room doesn't have a birth pool, use the bath if there is one in the early stages
• bring your ipod with you - i found my chill out playlist great in the early stages of labour and my gym mix really good in the final stages (though will never be able to listen to the Prodigy again..!)

-ask to talk through your birth plan with the midwife, and stress to them if you'd rather avoid assisted delivery (ventouse,forceps etc) if at all possible

• ask that everyone involved in your labour introduces themselves to you and explains their role (stops you feeling there are randoms in the room)
• don't feel that you have to give birth in a set birthing position (i.e. propped up on a bed) even if you and your baby are being continuously monitored or you have a mobile epidural. I had epi and monitoring, but still asked to be able to try different positions (OK they were still on the bed but they really helped)
• if you don't want medical/midwife/nursing students present then specify this (I asked not to have them)
• if your midwife is not present at any point and you need her, then press the call button and get her (or send your birth partner out to track them down!. Don't ever feel you are being abandoned to get on with it and have to put up with that.
• if you decide you really don't click with the midwife you've had assigned to you, then ask if they might be changed (or get your birth partner to do this). It's such a big event - you don't want to have to go through it with someone you don't click with.

I'm a homebirth contact for the NCT in my area so I talk to a lot of mums who've chosen to have a homebirth. I've been doing it for 3 years.

Personally I've not met anyone so far who's regretted their choice to book a homebirth, including women who've had to transfer in labour because of complications or a need for pain relief. I'm not saying these women don't exist - but I suspect they're a very small minority.

I transferred in from a homebirth myself with my third baby because my labour was so long. I was 5cm at 10am on Monday morning, 7cm on Tuesday night and didn't give birth until 4pm Wednesday afternoon! I transferred in at 10am on Wednesday morning for some synto to get the labour moving. Once I got into hospital I had a normal birth. I'm convinced that there was a very good chance I would have ended up with a c-section for failure to progress had I gone into hospital at the start of that labour. I would have been expected to labour on a drip (because of my gestational diabetes) and I would have found it very difficult to have coped with a three day labour had I spent the whole of it on a bed, within 2 feet of a monitor. In any case, there would have been huge pressure applied to do something after 24 hours of active labour because of hospital protocols. What saved me at home was being able to go out for walks, being able to get into my own bath, my own bed, rummage in my own fridge, sob into my own pillows!

I think it makes so much sense for 1st time mums to have homebirths, or domino births at the very least (midwife stays with you at home until late on in labour).

I understand why low risk mums choose hospital - with my first it wouldn't have occurred to me to choose a homebirth because I didn't know anyone else who'd done it - I thought you had to be an earth mothery, super confident birth ninja to go for something like that. I wish I'd known then what I know now about the realities of hospital birth and about the safety issues.

Have to say though - I do have some concerns about lots and lots of women being encouraged to choose homebirths. I worry about how well qualified some NHS midwives are now to do them. I suspect that many have little experience of true physiological birth because of the high rates of interventions in hospitals. The most dangerous thing is for midwives to bring a hospital birthing culture into the home. I also know of someone who lost a baby at home, possibly because of the ineptitude of her midwives - they didn't have the correct resucitation equipment, didn't monitor her properly in second stage and panicked when it came to resucitating the baby who was born very flat. Independent midwives that I know are so rigorous about their training and preparation in this area - many of them have opted for more advanced training in infant resus. than your average community midwife, and they are scrupulous about doing their drills - they have to be because they don't have the same institutional backup, and of course they have no insurance either....... If I was thinking of having another homebirth I'd always go for an IM (as long as they still exist that is!), because of the higher likelyhood of complications in my case. If I was a low risk mum I'd be happier about booking with the community team.

Excellent LOL Sabire! I might rename myself 'BirthNinja'!

I have only had one full-term baby, and I gave birth to her at home.

I've read this whole thread, and it's commonly said that it is about risk management, and which risks you are willing to take. The risks of complications occuring is greater in the hospital, but the risks of those complications causing damage is somewhat greater at home. That is what I see as the trade off, and a decision I was willing and able to make.

As people have posted, just booking a homebirth (regardless of whether or not it occurs) decreases your risk of eventual Caesarean section or instrumental delivery by up to half without any effect on the intrapartum mortality rates. Some people have asked 'what if?' and how would you be able to live with yourself? That question in itself shows that home birth is not irresponsible - it shows that it is the most responsible type of birth, as you take a lot of the responsibility onto your own shoulders. The same question can easily be asked of those who want to give birth in the hospital - how would you live with yourself if your baby died from a hospital borne infection that could have been avoided at home? How would you live with yourself if your baby was accidentally given Co2 instead of O2 through a mask when minutes old and ended up brain dead? Or had their spinal cord severed in a ventouse delivery? All these things have happened, I'm not trying to scaremonger or attack in the least, but people just need to understand that giving birth anywhere, anyhow carries risks. It's really all about which set of risks you like the look of best.

With regards to the OP and her query about her own birth had it happened at home. I had a low risk pregnancy, and was so relaxed labouring at home without the need to go anywhere that pain relief never occured to me. My daughter was born in meconium stained waters, with a nuchal cord and decels in the 90s. She was still born normally and naturally at home with no mention of transfer or emergency. Apgars of 9s for her, not a stitch for me. I actually shudder to think what could have happened to me beyond my control had I faced that situation in a hospital. I know it's not the case for everyone but I do believe that the belief in normal physiological birth is undermined in the hospital, and that women are not given the chance to labour normally without the 'threat' of intervention hanging over their heads.

I haven't any idea what it must be like to spend the postpartum period in a hospital bed, it sounds unappealing from what I've read on this thread! I do agree with what has been said about getting more rest though, I took my dog for a walk when my baby was 15 hours old

I would have no hesitation to go to hospital to give birth to my future children if at any time during pregnancy or birth I felt that we needed medical help and intervention. I really think it should be the exception rather than the rule, though. It's really not good enough to routinely induce, augment, cut and anaethestise women all for the 'what ifs' of life. Too much of medical practice, especially obstetrics, midwifery and paediatrics, is governed by legal worries and precedents. If I need medical assistance to give birth to my child, I would want it to be based on the needs of myself and my baby at that moment, not on the protocols, legalities and indemnities that are all too common, I fear.

I guess I'm trying to say that I can understand the desire to give birth at home, I can also understand the desire to give birth in the hospital. Each woman should be where she feels the most comfortable at any given moment. There are risks to both places, some births will always have horrible outcomes regardless of where they took place, and some bad outcomes are caused by the limitations of either hospital or home environments. The screening process for home births is adequate as far as I'm aware. Everyone involved in each births wants it to go as well and as safely as possible. With regards to statistics, homebirth statistics are often skewed by unplanned, or unattended births which have a higher risk of complications, just as hospital birth statistics are often skewed by the fact that high risk births have to take place there. Here is a simple study from the netherlands where homebirth is more prominent:

Attendant: Obstetrician, Place: Hospital, # of Births: 83,351, Perinatal mortality per 1,000 births: 18.9

Attendant: Midwives Place: Home # of Births: 44,676 Perinatal Mortality per 1,000 births: 1.0

From this site:

www.gentlebirth.org/archi...s/galesaft.html

I can only hope I've added at least something to this discussion and not rambled my own opinions too much. I'm sorry for the length of the post! It's been interesting reading, ladies, long may intelligent debate and informed choice rule!!!

Really good points there Rohan, but the only thing I can focus on is that you took the dog for a walk 15 hours after giving birth!!! I had difficulty waddling to the loo

LOL at nigglewiggle. fortunately I was snuggled up in bed at 15 hours post birth (with very sore legs) and felt very sick.

How the HELL did you take the dog for a walk??????