Home birth vs hospital birth

[ILoveMYbumpy]

Hi,

I'm having my first baby so was wondering if any ladies had any advise on home births vs hospital births? Has anyone had both ? Or has any one had just hospital or just home births? Any advise would be great

Naturally if there's any issues or complications the choice will be out of my hands.

Hi Op, I had one of each and I loved both my births.

My first baby was a hospital birth. It was fantastic in that it was my first baby and we were both healthy and ok and it was fairly quick by first birth standards. But I didn’t have my community midwife there who had supported me all the way through and is amazing. We were put in a side room as I was only 2-3cm upon arrival, and we were pretty much left to it until I was screaming a couple of hours later (and bit DH oops 😂) and they came in and didn’t even examine me but took me to delivery.

I demanded an epidural at that stage and they started to prep me for one, which obviously you can’t have at home! However, DD1 had other plans and they checked how dilated I was and I was ready to push. She was born face up about 20 minutes later by ventouse. I had no idea she was back to back until then.

They looked after me well after with tea and toast etc however I don’t know if this is a first baby vs second thing, I did feel like they didn’t believe me about how much pain I was in. I’d never met any of the people caring for me so I did ask their names to be polite and they said “there’s no way that baby’s coming tonight, you wouldn’t be able to talk like this if it was.” And she was born as I say about 20 minutes later.

They didn’t diagnose her tongue tie, I had to suffer through terrible agony and was told “it’s supposed to hurt” whilst breastfeeding those first few weeks when a specialist finally diagnosed severe tongue tie and we had it cut. By then my nipples were utterly ruined!

Any way, my second birth, I actually started a thread on here when my waters went! And she was born 6 hours later in my living room. The mess was contained to an old duvet we had laid out (DH said “I’ll prepare the arena” whilst I sat on our toddler’s potty with my waters gushing out 🤣) and also on those disposable mats. None of which I saw or noticed because the midwives took care of it all, and DH just binned the duvet. I even shit myself whilst pushing but it was all discreetly got rid of!

I feel like I ‘felt’ everything more at home. I was more in my head, calmer, breathed better. We had Portrait artist of the year playing in the background (Dh and my lovely midwife both can’t stand it - after Dd2 was out they said what do you want to watch and I said can we start the series again as I missed it all and in unison they said NO! Ha!) The whole time it was so chilled and I was so in control of it all made it feel like less of a big deal? Which was so good. I had a couple of big contractions where I said I can’t do this I need to go to hospital. But then I started pushing and that part is far easier than the contractions before. I was able to have my lovely community midwife there this time who took me up for a shower afterwards and stayed drinking tea and eating biscuits with us for a few hours after. I had stripped the bed that morning so DH, new baby and I slept on the sofa (baby in Moses basket) that first night as there was no way we were putting bedcovers on that night! I woke up in the morning and there was a new baby in the sitting room and it felt like a crazy dream lol.

DD2 also had tongue tie - but my midwife saw her latch on immediately and I said straightaway “she’s tongue tied like DD1” as I knew the clicking sound and feel of it. Midwife didn’t even check she just referred me straight away to the specialist again (the same lady!) and I was right. Tongue tie snipped within 3 days of birth.

I felt so much more listened to and believed and respected with my homebirth, I was never left alone, I had someone checking myself and baby constantly. But if it had been my first, I think I would choose to be in hospital. You just don’t know how you will cope with the contractions, it is very overwhelming first time round.

Hope it all goes well and you get a positive happy birth, be it home or hospital.

I had two in hospital, and the third at home. All births were straightforward, but for the second I went into hospital at lunchtime, was home by early evening, and I just thought, why on earth didn't we stay at home?

So for the third, we did. I had gas and air at home too, only the last hour was painful, and that's not too much to get through. Best bit was that our two other DDs were there to welcome their sister to the world, they were able to hold her within minutes, I was so pleased to have made it seem like a normal life event to them, I hope they will remember that if they ever have children themselves.

I did find it was so much nicer being in my own surroundings, I could go in and out of the bath in labour, and find a comfortable place to lean on to give birth upright - let gravity do some of the hard work!

Good luck whatever you decide.

I had two in hospital and my third at home. The home birth was truly one of the most amazing experiences of my life, just perfect.

But nothing, absolutely nothing, would have convinced me to have my first baby at home. It's just too risky because you have no clue how it's going to go. If you've had a baby before at least you have some idea.

Good luck though, whatever you decide.

I would never personally go for a home birth as I like the cleanliness of a hospital birth and my flat is far too small for a birthing pool etc. However if I had opted to have DS2 at home he probably wouldn’t have been here. My waters were broken after 4 hours in labour in the midwife led unit with just a birthing pool and a bit of gas and air. There was meconium in the waters so I was rushed to the labour ward and had him within the hour. He also had his chord wrapped round his neck which the midwife didn’t notice until I was crowning so I had to push him out sharpish and the emergency buzzer was pulled as a precaution. If I hadn’t managed it I shudder to think what would have happened.

If I had had my daughter at home she would be dead. Cannot thank the hospital enough.

I had my first in hospital - very quick straightforward birth. Lovely midwife, no issues at all. She was born in the evening so I stayed the night. Only negative was we had to wait hours for the doctor to discharge us, and I just wanted to go home.
As the 1st was so straightforward, we decided on a home birth for the 2nd. As it was, she came in the space of 35 minutes from the first twitch to her being born. Husband delivered and we wouldn’t have made it to hospital at all.
Lovely calm time afterwards, no mess, own bath & bed. Amazing feeling 🌟

Both of mine have been straight forward births that have escalated into life or death in less time than it would take to drive to our local hospital.

@soooooooG

Both of mine have been straight forward births that have escalated into life or death in less time than it would take to drive to our local hospital.

You raise a good point. A factor in our choice of home birth was that we live less than five minutes drive from the hospital, and could get there fast in an emergency.

Although, I would probably have still gone for home birth anyway, because I was very low-risk with no. 3, and had two easy (and fast) previous births - like @Winnithegreat, not sure we could have made it to hospital anyway if we'd lived an hour away, say.

But for a first birth, which are not usually so fast, I am not so sure. It might depend on relative anxiety - in hospital (stressful if you don't like them) vs. long way away (also anxiety-inducing if you suddenly need medical help).

To be fair though, studies have repeatedly shown that home birth is a valid choice for low-risk mothers, even first timers. Nothing in life is completely risk-free, and it's possible to feel very strongly about wanting a home birth, and I think mothers should be supported if that is their choice.

All mine were born at home so I don't have a hospital experience to compare to, but I wouldn't change a thing.

Never had a birthing pool (seems to be the assumption home birth=birthing pool. It doesn't).

I had one midwife with me from the start, then two for birthing bit (actually had three with me for my middle one, an experienced and wonderful student midwife) -i don't know if this happens in hospital.

All my births were straightforward really, no stitches etc. Aftercare I think is same as hospital? Midwives stayed with us for at least 3 hours afterwards, doing paperwork, checking baby, helping with feeding where needed. Then daily visits until handover to health visitor.

I found the hospital based midwives didn't know much about the homebirth process in our area, first times, but we now have a dedicated homebirth team- ask and ask again if you're not sure. Whatever you decide, you can always change your mind on the day.

If you have a sudden and unpredictable complication like cord prolapse or shoulder dystocia, your baby has 3 minutes until brain damage kicks in. A 999 call takes more than 3 minutes.

I wanted a home birth but baby had other ideas and my waters broke at 35 6. So I had a hospital birth. I'll be honest, it was very medicalised in the beginning but thanks to antenatal class we were able to ensure I only had necessary intervention and tests not just because it's routine.

EG I had monitoring set up in a standing position so didn't slow anything down being on my back. I had to ask for this. EG Why do I need a blood test? Antibiotics?

Top tips: Asking what happens if we wait an hour? What are the alternatives? Agree what pain relief you'd want if a home birth VS if a hospital birth so that you're ready when it kicks off. I knew I wanted pethidine if I ended up in hospital and it saved me from the worst pain during transition! Stay mobile!

DD1 was a hospital birth. I gave birth alone, no medical staff and DH trying to find people.

DD2 was born at home with two midwives present at all times plus a student midwife.

My experience is the medical attention is better during homebirth so more likely to pick up problems earlier.

I have had 2 hbs and 1 in hospital.

My home births were well supported, empowering, safe and respectful experiences. I was listened to, observed, cared for and I treasure the memories.

I cannot say the same for my hospital experience at all.

There is no way my hospital experience was safer, I received barely any care and no one listened to a word I said. My homebirth I had the undivided attention of 2 extremely experienced midwives - undeniably safer. Proximity to a facility makes no odds of no one is giving you the slightest bit of attention or consideration.

I had both. First was hospital and horrendous. Too much clock watching and intervention. Second was at home (apparently I'd have had to have a caesarean if I'd been in hospital) and his birth was wonderful despite him being upside down! We had the tv on and, whilst I was in the thick of it, there was a woman on the drama we were all watching (midwife and exh!) who was also in labour, it was so fantastic! Go for it OP!

@sparemonitor

If you have a sudden and unpredictable complication like cord prolapse or shoulder dystocia, your baby has 3 minutes until brain damage kicks in. A 999 call takes more than 3 minutes.

I asked about shoulder dystocia and what happens, and was told that the exact same manoeuvre (basically forcing your legs back against your chest and doing an episiotomy) would be done in hospital or at home so I'm not sure there's any difference there. Because the baby is so far down by then they can't resolve with a c section.

I have had both. First child was a hospital birth 6 hour labour and text book but I have a massive phobia of hospitals.

Second birth a home birth, it was amazing, so much more relaxed just left to get on with things, felt so much more in control as in my own space. 1 hour 42 minute labour. Birth all ok but post birth had a massive PPH and lost 6 pints of blood due to a cervical tear and retained placenta. I was blue lighted in but it was all controlled, met at the ambulance by the consultant and anaesthetist and whisked in to surgery and had 2 transfusions. Was in high dependency for 3 days but I am still a massive advocate for home births. I didn't get the ending I would have hoped for and really just wanted my own bed and shower but it was all handled so well if I had been having one (I'm not) I would have had another home birth.

What’s your transfer time to hospital, OP, including the possibility of needing it during rush hour traffic?
What’s your plan for handling a) acute fetal distress or b) major haemorrhage?
Your home midwives cannot perform even a simple forceps lift out, let alone an emergency Caesarean section.
They do not carry a shock pack of O neg blood, for massive intrapartum haemorrhage - every hospital obstetric unit has six units on immediate standby.
They can perform only basic neonatal resuscitation - whereas the hospital has a paediatric crash team and NICU constantly available.
Unless you have a crystal ball, you have NO idea whether you will be one of the unlucky mothers who will need emergency intervention. And in labour, things can go catastrophically wrong in a matter of minutes.
It’s your choice to gamble with your life, but you are also making that choice for your baby too.
I’m a retired anaesthetist, who has not only treated many such emergencies in hospital, but my own second child would not have survived a home delivery. Think very carefully before making your decision.

I had a meh hospital birth, a great home birth, a terrible home birth, and a good hospital birth.

95% of that came down to the health care professionals involved. Any other generalizations about how you will treated, whether you will be rushed, how often you will be examined, how attentive the midwives will be, I found that the place didn't matter in that - it was 95% the HCPs and 5% my body & baby's body (though I can see the latter being bigger if either were more uncooperative or unstable than mine - like with a stuck shoulder, my HCPs just rotated me around and out the shoulder popped, others don't have that so easy).

It's a roll of the dice each time no matter where on both of those, though the latter there are some risk factors that can be kept in mind (along with how far to the hospital). With the former, the best I can recommend is to know and have someone support you on the off chance you get an asshole (really should have sent terrible homebirth midwives packing after they started giving me orders before walking through the door. I knew they were unsupportive, but didn't know what to do about that and already had a lot of medical anxiety about not pissing off HCPs which is why I was having a home birth in the first place).

@PinkPlantCase

FYI Homebirth midwives carry the same drugs and equipment to deal with a PPH as a midwife lead unit.

Really? They've got a full resuscitation team, an operating theatre and 20 units of red blood cells and FFP, have they?

Until you have seen a good-going PPH, you have no idea what is involved in treating one. It's beyond naive to think that 2 midwives can reproduce what a hospital can offer.

But the great majority of home births that are predicted to be safe are safe. Only tiny numbers of women without risk factors like placenta praevia have a massive PPH. As PPs have said, it's not straightforward as to whether home or hospital birth is safest for low risk pregnancies.

I support women having the choice of home birth, but I also support them making a properly informed choice. Telling them nonsense about what midwives can provide at home does not support home choice.

@MissLucyEyelesbarrow they do carry the same equipment as a midwife lead unit. It’s what I was told by midwives when the possibility of PPH was discussed prior to my planned home birth. Note I said midwife lead unit not delivery ward. Lots of MLUs or birth centres are stand alone.

It’s also stated on NCTs website. www.nct.org.uk/labour-birth/deciding-where-give-birth/giving-birth-home/home-birth-complications-eight-things-reassure-you

With my first I didn't even consider it for the mess, complications reason. I nearly ended up with an emcs anyway.

Second I didn't want my daughter being disturbed either by the noise downstairs or disturbed in the mental sense of seeing her mum in pain and not knowing what the hell is going on.

Hospital all the way for me

I forgot to say my midwife led unit is still closed due to Covid and won't reopen this year.

[quote PinkPlantCase]@MissLucyEyelesbarrow they do carry the same equipment as a midwife lead unit. It’s what I was told by midwives when the possibility of PPH was discussed prior to my planned home birth. Note I said midwife lead unit not delivery ward. Lots of MLUs or birth centres are stand alone.

It’s also stated on NCTs website. www.nct.org.uk/labour-birth/deciding-where-give-birth/giving-birth-home/home-birth-complications-eight-things-reassure-you[/quote]
The midwifery equipment that the midwives carry is the same as midwives on a MLU, but midwives on a MLU cannot treat a PPH either. A significant PPH is not treated with midwifery equipment, but with transfusions and emergency surgery. Midwives can - depending on the cause of the PPH - perform certain procedures that can buy time, but the underlying cause of the PPH needs emergency surgery.

The big difference with an MLU, compared to a home birth, is that most of them are next to hospitals, so women in difficulties have instant access to full hospital facilities. Even in MLUs that are not on hospital grounds, they will typically have emergency kit that home birth midwives do not have, including blood products. Crucially, they also have more staff than are present at a home birth. In a resuscitation, you need a lot of people.

@BiBabbles

I had a meh hospital birth, a great home birth, a terrible home birth, and a good hospital birth.

95% of that came down to the health care professionals involved. Any other generalizations about how you will treated, whether you will be rushed, how often you will be examined, how attentive the midwives will be, I found that the place didn't matter in that - it was 95% the HCPs and 5% my body & baby's body (though I can see the latter being bigger if either were more uncooperative or unstable than mine - like with a stuck shoulder, my HCPs just rotated me around and out the shoulder popped, others don't have that so easy).

It's a roll of the dice each time no matter where on both of those, though the latter there are some risk factors that can be kept in mind (along with how far to the hospital). With the former, the best I can recommend is to know and have someone support you on the off chance you get an asshole (really should have sent terrible homebirth midwives packing after they started giving me orders before walking through the door. I knew they were unsupportive, but didn't know what to do about that and already had a lot of medical anxiety about not pissing off HCPs which is why I was having a home birth in the first place).

Definitely this.

I had a hospital birth for what was supposed to be high risk twin delivery. DH very nearly got to deliver DT1 in a sideroom, after rescuing me from the toilet, and no one but him noticed DT2 was crowning as they were too busy doing what they should have done earlier. None of this was in the theatre where it should have been.

Fortunately, nothing went wrong during the delivery. Getting them to do something about breathing difficulties afterwards was uphill.

@MissLucyEyelesbarrow as you say the birth centres and home birth midwives carry the first line of treatment for PPH. Their aim is to keep the mother stable as a hospital transfer is arranged. As with a stand alone MLU. I don’t think anyone planning a home birth thinks they can have emergency surgery at home and I was always made well aware of the statistical chance of transfer.

For me and others this didn’t outweigh the benefits of Homebirth even with a first baby.