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!

amen to that !

I was not making a comparison between the 2 countries. I was pointing out that when you take medics out of the equation, as they do in Afghanistan where patients don't have a choice, women and babies die.

As I said, I have nothing against homebirths, yes it is a choice but I worry that women are making a choice based on inacurrate information.

In reply to the lady that pointed out this is not an RCOG conference, true, but maybe attend one, see childbirth from our side as well from the natural childbirth point of view.

Agreed the thread was initially intitled "Please can you tell me why you are going to have/ have had a hospital birth" but as it had quite blantly turned into a hospital bashing conversation I felt I had to say something.

Please don't forget I want the same as you, a healthy mum and a healthy baby!

But in what way are medics being taken out of the equation here? Am confused.

Because in my first hospital birth, didn't see a doctor at all. "only" the qualified midwives. And in my second (which was a planned home birth, but still ended up in hospital because of lack of midwives) still just midwives.

And had access to ante-natal care, again midwife-led. And then access to post-natal care, again, midwives.

If had had homebirth, as planned, as far as I can see, living close to the hospital and being low-risk, the only difference I can see is that if had gone to plan, would have birthed in my own bed rather than in a hospital room. And would have had one-to-one medical care in my house rather than shared care.

People choosing to give birth at home aren't "taking medics out of the equation". They are choosing to have medical assistance in their home environment.

Thing is we are not taking medical care out of the equation by having a home birth and it is misleading to imply that. I had amazing care at my home birth from two midwives, also having the knowledge I could be taken to hospital should that be something that needs to happen. I also understand that death is a part of life and sadly it occasionally happens but risks are there in everything we do.

Also I think the reason that it may have turned into a hospital bashing conversation at times is down to just how little respect many parents receive when in hospital or from various medical professionals. To be treated like you are stupid, just on a baby production line or not being told the whole story about your treatment because they don't think you need to know is awful. Many of us who have fought for home births are just trying to get a attentive and personal care in surroundings that we can depend on to be clean and pleasant and allow our needs to be attended too quickly and efficiently. If all hospitals allowed this I am sure no one would question it but they don't. The fact that so many people come out of hospital having had a hideous experience which the hospital is not willing to acknowledge just compounds it all.

Your assertion that 'when medics are taken out of the equation... women and babies die' is simply not true. I would not for one minute suggest that medical care in pregnancy or birth is always unwanted or unnecessary - far from it. I am also happy to accept that, on rare occasions, things can go wrong and badly so. Medical advances that allow those women who truly need help to have it, safely and effectively, are invaluable and I thank god sometimes that I do work on a UK labour ward and not in Afghanistan!

But your statement implies that all women and babies are at risk of dying if they are not cared up for under the medical model. Surely you are not really so narrow-minded as to think this is truly the case? I have seen obstetricians do brilliant and life-saving work. I have also seen those same obstetricians intervene aggressively with labour just because it did not adhere seamlessly to outdates and rigid hospital protocols - with disastrous effects for mother and baby.

You have still failed to produce the 'accurate information' you say we are all ignoring. Please provide it and I for one will be happy to discuss it with you - I'm sure you'll get plenty more offers too!

This is not a hospital-bashing thread at all; it is about women discussing their needs in childbirth, making their own decisions, thinking hard about their choices, refusing to be pushed into something they feel is not right for them, thier baby, their family. Perhaps that is what you find so 'very frightening', after all?

(Please excuse shocking spelling - am flicking between here and essay!)

FSP- am not shouting in my following posts, but addressing your post, and want to differentiate between your text and mine.

I was not making a comparison between the 2 countries. I was pointing out that when you take medics out of the equation, as they do in Afghanistan where patients don't have a choice, women and babies die.

THERE IS A MASSIVE DIFFERENCE BETWEEN TAKING MEDICS OUT OF THE EQUATION AND HAVING A HOME BIRTH. I WOULD CERTAINLY NOT BE HAPPY ABOUT FREEBIRTHING OR DELIBERATELY NOT CALLING A MIDIWFE FOR A HOMEBIRTH. BUT CHOOSING TO HAVE A BABY WITH MEDICAL CARE AT HOME IS NOT THE SAME AS HAVING NO ANTE, INTRA AND POST NATAL CARE DUE TO WAR/ LACK OF FUNDS/ LACK OF MEDICS ETC

As I said, I have nothing against homebirths, yes it is a choice but I worry that women are making a choice based on inacurrate information.

WOMEN ARE MAKING THEIR CHOICES BASED ON MANY THINGS, NOT JUST A THREAD ON MUMSNET. NICE, RCOG , RCOM, NCT AND AIMS ARE NOT PROVIDING INACCURATE INFO SURELY? LOOKING AT BOTH SIDES OF THE ARGUMENT IS IMPORTANT. 20 WOMEN POSTING ON HERE TO SAY THEY HAD A POSITIVE HOMEBIRTH IS RELEVANT.

In reply to the lady that pointed out this is not an RCOG conference, true, but maybe attend one, see childbirth from our side as well from the natural childbirth point of view.

I AM CHAIR OF THE LOCAL MSLC AND ATTEND MONTHLY MATERNITY CARE FORUM MEETINGS AND AM IN NO DOUBT THAT CHILDBIRTH CAN BE A DANGEROUS BUSINESS. DOES NOT MEAN I WOULD INSIST WOMEN ONLY BIRTH IN AN OBSTETRIC LED UNIT, IN A HOSPITAL IS SAFE.

ARE YOU ALSO NOT IN FAVOUR OF VBAC OR VAGINAL DELIVERY OF TWINS ? POTENTIALLY HIGH RISK SITUATIONS THAT TEND TO TAKE PLACE IN HOSPITAL.....

Agreed the thread was initially intitled "Please can you tell me why you are going to have/ have had a hospital birth" but as it had quite blantly turned into a hospital bashing conversation I felt I had to say something.

IF WOMEN ARE BASHING HOSPITALS, LOOK AT WHY ! LACK OF CARE, LEFT ALONE, INFECTION, FEELING DISEMPOWERED... HOME BIRTH IS NOT SIMPLY ABOUT SAFETY.. IT IS ABOUT FEELING SAFE, IN CONTROL, HAPPY, COMFORTABLE AND GETTING WOMAN CENTRED CARE. MAYBE ONE WOMAN ONE MIDWIFE WOULD MAKE WOMEN MORE COMFORTBALE IN A HOSPITAL SETTING.

Please don't forget I want the same as you, a healthy mum and a healthy baby!

ABSOLUTELY, BUT HOMEBIRTH IS A SITUATION THAT CAN GIVE THAT TOO.

"I have nothing against homebirths but it should be a truly informed decision and forums like this with comments like "My homebirths were brilliant" does not count as level 1 evidence based research and therefore not contributary to an informed decision."

I absolutely agree.

Perhaps you'd like to point women here towards some good quality, recent studies, based on a UK population or a developed country with a history of midwifery led care which would lead them to question their assumption that homebirth is safe for low risk mothers and for their babies.

As for anecdotal 'evidence' - don't you think there are enough posts on mumsnet from women who've had dire obstetric emergencies happen at their births whose lives and whose babies' lives have been saved by obstetric intervention to balance out the tiny number of positive homebirth stories with good outcomes? Women are not stupid you know!

fsp

To even compare the UK and Afghanistan in the same sentence makes a mockery of your arguement, as women in any 3rd world country like Afghanistan commonly start out with a hb in their boots, have undiagnosed medical conditions and are undernourished to the extent that thier reserves are very low for any insult that may occur in labour. A PPH of 1500mls will be unlikely to seriously harm a woman here who has a hb of 12, while a similar bleed will most likely kill an Afghan woman if she starts out with a hb of 6.

Afghan society accept that there is a high maternal and infant mortality, because they don't have any choice.
Its a great thing that people like yourself do, to go to these countries and undoubtedly save lives and make a huge difference to many of these people.

However, in the UK, we dont need obstetricians to provide all the care for women to save their lives. It is accepted that giving birth carries a small risk and most of these women on here are prepared to accept that to have a baby, so how about comparing countries like Holland or New Zealand which have very high rates of homebirth, with the UK. Much more direct comparison, and see if all homebirthers in these countries need obs for a safe birth, or if midwives will do.

How many women do you think seriously look into how dangerous it is to have a baby in the UK, or where to have a baby, short of choosing this hospital or that? The women on this site may be a cross-section of the birthing public, but (with the greatest respect to the mn population)they are a small minority of more aware and slightly more alternative thinking people who are basically a peer support group, and that gives them every right to share stories and experiences and also to be more aware of their birth options than the general population. Most women I see in labour ward have never really thought much about homebirth, alternative positions etc, and are more than happy for you to do whatever it takes to get the baby delivered for them

I also dont subscribe to the 'every ward is a germ filled cess-pit' theory, as the teaching hospital I work in in central London is actually very clean, and if there are no 'sick' people in the place, as in the general medical and surgical hospital population, why should there be a big risk of c. diff, mrsa etc. There is not!

I wish you could attend a homebirth and experience the difference that it makes, having a low risk birth in a familiar, comfortable environment, surrounded by your own things and without the policies and protocols in the hospital. You might not change your mind, but I bet you would understand it a bit more.

Sorry all if this is a bit rambling (again) but I could write a book every time I start on here!

Everyone knows that obstetricians generally see birth as a medical emergency waiting to happen - of course they do: obstetric disasters are their bread and butter.

That's why countries where low risk women are routinely seen by obstetricians and have their babies delivered by them have such high c-section rates - because medics pathologise normal birth.

ds2 was born at home - because he arrived so quickly that we didn't have much choice in the matter!

Like other people that have posted here, I didn't see a doctor at all during my pregnancy apart from the appointment when I said 'I'm pregnant' and she said 'Jolly good, carry on'. I had a fantastic birth experience, about as good as I could possibly have expected for the first time and the midwives I saw were fabulous. Oh yes - midwives! In this country, midwives ARE medical care. They are highly trained professionals.

I have had 2 children, one in the US and one here. My daughter was born in the US in hospital OB lead, couldn't fault the care in any way. I wouldn't have had it any other way, esp as she was 5 weeks early, however she was excellently delivered, cared for and born completely healthy. My son was planned on being domino delivered by midwife in hospital. However birth plans don't always go to plan, but I am very happy to say he was born at home. I was very fortunate to have my own midwife, who I had seen from day 1, with us the whole time, along side 2 others, (1 was trainee). Again I couldn't fault the care. I would say that each delivery is individual and has to be treated as such. I enjoyed both my experiences and if I choose to have any more children would judge the situation at the time for what was needed.

The problem is the balance has swung the other way towards home birth and believe it or not hormonal expecting mothers are not always going to make the best balanced decision. WE seem to have lot focus that all we really want at the end of the process is a healthy child - Its not all about the birth ... there are several years after of childhood to follow which could be seriously compromised my a baby not getting the oxygen or immediate aftercare it may need if at home. Midwifes aren't paeditricians and the birth may go fine but what if the baby needs help when it comes out. 10 mins journey from hopsital can still lead to irreversible devlopment effects

Its is ridiculous that the government suggest home birth should be offered to every mother. Yes, probably hospital used to be too interventional in the birth process that that is changing and within saftey limits women still have a lot of free choice in their labours and the option to be in a midwife led unit so they dont even have to see the "evil" doctor if it all goes well. In fact I think women are now being pressured towards home birth, natural labours and breast feeding. and made to feel guilty if they dont follw the new trends. The attitude towards women who opted for elective section or bottle feeding in my antental class was disgusting - like they had to justify their decision - but those who went for no pain relief or put their babies at risk by going for home breech were praised!

I know i'm being inflammatory and I'm not actually against home birth just think we need to make rational choices and not be carried along by the home birth band-wagon. My cousin made a sensible choice had her first 2 babies in hospital with no problems so had her next 2 at home and everything was fine.

what about "low risk" first time mothers? Apparantly its just as safe at home in hopsital. Well I was one of them and could have had my baby at home.. chose to go to the birthing suite - ended up with un diagnosed post-term breech baby of good size which had not been picked up my midwife or consultant who were both very experienced and gave good antenatal care. Had an urgent C section- baby was fine: skin-to skin immediately, breast fed in recovery. excellent surgeon, anaesthesist and post op care home and up and about inn 2 days. Have a happy intelligent 2 year old now and so grateful. If i'd laboured at home, with his size and position and my anatomy his head or shoulder would have got stuck and we'd be in real trouble and he may not be here today... and I was a "low-risk" mother suitable for home birth. Unfortunately low risk is not "no-risk" and is worth bearing in mimd if you do have your baby at home. at the end of the day decied whats more important the home birth or the product and be prepared to live with your decision. If you are then go for it...

wishing all mothers and their babies the best for a safe arrival wherever it may be x

Hated being in the hospital made my stress levels rocket and less able to cope with the paid. Was starving hungry and didn't get fed, was left on my own for long periods of time as the midwife was busy seeing to lots of other labouring women. couldn't get any rest/sleep afterwards because of snoring mothers, crying babies, lights on, visitors late at night, women being brought onto the ward all hours of the night etc.

Argh, promised myself I would not post again on this thread, but it is addictive

Augusti, I agree with some of what you say, but must disagree with many of the points you raise:

• the pendulum has most definitely not swung towards home birth - yet. You only have to read the many, many threads on MN alone to see that lots of women are still being denied the homebirths they want, for a variety of often spurious reasons. I have never heard of a woman being pressured into having a home birth - quite the opposite is true, ime. The home birth rate across the country is still not much more than 3% - hardly a pendulum swing. MN is a skewed sample!

• as for the option of being in a mw-led unit, great - that's if your area even offers a mw-led unit, because very many don't; if the mw-led unit hasn't just been closed down; if you fulfil the often very strict requirements; the mws on the unit haven't been called over to cover labour ward, etc, etc, etc. For an awful lot of women a mw-led unit simply isn't an option, please don't imply that it is.

• same goes for 'choice in labour' - yes, hospital units pay lip-service to choice and freedom from intervention but when it comes to the crunch there's many, many women out there who would say their birth experience didn't involve an awful lot of choice. Sadly there is still a world of difference between what's proposed as best practice and what actually happens in maternity units across the country.

• the assertion 'that all [my italics again!] we really want at the end of the process is a healthy child' is misleading. Yes, of course all parents want a healthy child, but to say that's the only thing that matters is to dismiss the very real and very distressing consequences of traumatic birth for some women. Women with PTSD, for example, report over and over again their feelings of guilt, anger and distress at being told 'come on, at least you've got a healthy baby' when they are going through psychological agonies after the birth. It's been said so many times on this thread already but I guess I'll have to say it again. Women who choose home birth are not choosing it because they selfishly think the process is more important than the end result. It is impossible to have a proper debate about homebirth while this simplistic suggestion remains uppermost in the minds of so many.

• finally please don't suggest that pregnant women can't make sensible, well-informed decisions because of their 'hormones'. It's grossly insulting. We gave up on the idea of the wandering womb quite a few years ago, you know...

Right, rant over Back to work!

"The problem is the balance has swung the other way towards home birth"

Yes - we now have a ridiculously high homebirth rate of ........ 2%.

And of course all low risk mums are badgered into considering a homebirth by their midwives. Not.

"and believe it or not hormonal expecting mothers are not always going to make the best balanced decision."

Are you serious? That we're not capable of making sensible choices for ourselves and our babies because we're pregnant?

" WE seem to have lot focus that all we really want at the end of the process is a healthy child - Its not all about the birth ... "

Women who opt for homebirth also want a healthy child first and foremost and it's insulting of you to suggest otherwise. The evidence on the safety of homebirth does not support your view that it places babies at unnecessary risk. The outcomes for the 2000 babies born each year after planned homebirths are comparable with babies born to low risk mothers in hospital, with fewer homebirth babies being born with low apgar scores or in need of special care.

"I know i'm being inflammatory and I'm not actually against home birth just think we need to make rational choices and not be carried along by the home birth band-wagon." Yes - and homebirth is a sensible, rational choice for women who want to reduce their risk of c-section to themselves without putting their babies at additional risk.

" My cousin made a sensible choice had her first 2 babies in hospital with no problems so had her next 2 at home and everything was fine."

And if she'd had a c-section with her first for 'failure to progress' (most common cause of c-section and far more likely to happen in hospital than at home), would you still be saying it was a 'sensible choice'? Of course you would!

"If i'd laboured at home, with his size and position and my anatomy his head or shoulder would have got stuck and we'd be in real trouble and he may not be here today... and I was a "low-risk" mother suitable for home birth.

The evidence supports the view that the majority of breech babies can be born safely vaginally, if an experienced practioner is present. Incidentally - how long was it between diagnosing that your baby was breech and your c-section? More than long enough to transfer in from home I'll warrant, had it been diagnosed at home.

"at the end of the day decied whats more important the home birth or the product and be prepared to live with your decision. If you are then go for it...

I think this comment is rather nasty - you're insinuating that people who opt for homebirth are more interested in having a nice 'experience' than in having a healthy baby. You make the point that you're 'not actually against' homebirth, but everything else in your post reveals your real opinion on this issue which is that you think homebirth is intrinsically risky, and that women who choose it are making an irrational choice and putting their birth 'experience' ahead of their baby's health and welfare.

Personally I wish that anti-homebirth shroud wavers like yourself would stop for a minute and actually do some reading around the EVIDENCE on this subject - it would challenge your assumptions and your prejudices.

Augusti,

It's a shame that your baby wasn't diagnosed as breech before the event and so decisions had to be made in haste. DH and I were more fortunate in that we'd heard mutterings that DD was breech from 30 weeks so we were fairly prepared.

We do not feel that we put either DD's or my life at risk by birthing her at home. She was 9lb 12 and born at 41+3. I didn't use any pain relief because I wasn't in pain - believe me I'd have been straight for it otherwise!

We put a LOT of thought and consideration into our choice. We did a lot of our own research as we did not feel the NHS were presenting the information on ways of delivering breech babies in a balanced fashion (and having read the Term Breech Trial paper that's even more true).

The only reason we were prepared to go ahead with a home birth was because we could use an independent midwife with a lot of experience in breech birth. I realise we were very fortunate in this and it isn't an option that's open to every pregnant women.

Our evalutaion of the risks involved in home birth, hospital delivery or C/S meant that this was the right decision for us.

I'm glad you had a positive outcome and that your child is thriving But please don't make sweeping statements that suggest people in my situation have taken unnecessary risks.

sabire, it is less than 1 % where i live !!

augusti - i find it quite patronising and insulting that it is thought that pregnant women are somehow so at the mercy of their hormones or their pregnancy, they cease to be able to make a rational decision about where they wish to give birth.

as for MWs badgering women to have a homebirth ! If only ! I have supported a number of women who have had to ask for , then demand, then insist on a homebirth...... i wish it was offered to more women.

also, the anti home birth posters are forgetting a very salient fact: some women have a catastrophic outcome in hospital. i don;t see anyone saying, 'you chose to give birth in a hospital, look what happened, i hope you can live with that...'

it is not a question of the desire for a homebirth being something that overrides anything else.. but giving due credit to the importance to a woman's mental health of how they baby gets here.

its quite high where i live i think....midwives very supportive.

"but giving due credit to the importance to a woman's mental health of how they baby gets here."

Yes - and given the fact that the greatest cause of maternal death is now suicide related to PND in the year after birth, this is obviously not something that's unimportant.

that is quite frightening, and as a mum who had severe PND brought about by a traumatic birth experience amongst other things, i can believe it. do you have a reference for that?

no-one is saying one size fits all, but being pro homebirth is not being reckless or foolhardy and it is more respectful of womens' choices than the assumption that they are too hormonal to make a good decision, IMO

The last CEMACH report has all the info, lulu (sorry, can't get used to the chicken name!) - google why Mothers Die - it makes illuminating reading. Must get around to grabbing a copy of the new report.

It's in the CEMACH report. (confidential enquiry into maternal and child health).