Home birth question

[Hikoridikori]

I just have a home birth question...

How can it be that some people opt for a home birth so that they can have a calm/natural birth despite all the risks?

I mean that the baby could be in an undiagnosed breech position, the heart rate may drop and a doctor may be needed, the mum may have blood pressure issues, excessive bleeding can follow after a bad tear that needs transfusion, the baby may need to go straight to NICU because of breathing or other issues etc.

All these mums that go for a home birth how can they not be scared about something not going by the book?

In my mind a medical sterilised environment is less scary than how scary are all the risks I mentioned above.

Please don't get me wrong, I fully respect different opinions. I just want to understand the logic behind this decision.

I suppose people have their own views on risk. I had a home birth with child no 2 as I didn't want to be away from my first born. I lived about a ten minute drive from big maternity hospital and knew they would get me there if there was any sign of things going wrong. I had a straightforward first birth, I was 21 so I had no reason to think problems were likely.

I think it's got a lot to do with your perception of the risks of birth and your feelings about a medical environment. I was like you: I was nervous about the things that might go wrong, but generally feel in safe hands with doctors/in hospital, so for me that was the more relaxing prospect. But a lot of people, for a variety of reasons, feel uncomfortable, unsupported, sidelined and generally not safe in a medical environment. If you also have a general view of birth as a normal, ordinary thing that most women come through unscathed (which isn't NOT true - I was just personally more focused on the potential complications - which are not the norm, although I don't think rare) then I can see why a home birth might be preferable.

Different strokes for different folks.

The care I had for my homebirth was fantastic – far better and more attentive than I got for my hospital birth.

When you have a homebirth you get midwife all to yourself for the duration of the labour, with a second midwife arriving for delivery, to deal with the baby. One on one care.

All through labour, the midwife sits with you and encourages you, checking regularly that everything is going to plan – any problems would very likely be picked up far, far sooner than they would in a hospital where one midwife may be responsible for multiple labouring women and you just get someone popping their head round the door every hour, until you're ready to push.

I felt much safer and better cared for at home – I knew that there was a car outside and a hospital only 10 minutes away if it was needed.

The evidence shows that there is very little difference in outcomes between births at home and in hospital for low risk pregnancies. The specific risks are different though and that's what each individual woman needs to think about.

I don't feel particularly safe in hospitals and knew I'd get more focussed attention from a midwife at home. Most (but obviously not all) of the things that can go wrong at home happen fairly slowly, so you have time to get to hospital. My DH is almost phobic about hospitals and I knew he'd cope better at home. So overall I decided the risk/benefit combo of a home birth suited me better than a hospital birth.

I loved my births (I know how lucky I am!) so I feel I made the right decision.

I'm going for a home birth as my first was born 2 hours in active Labour ... so as the second is meant to be faster it's either at home or at the side of the road ... I prefer at home
I have said if their are any issues or anything pipe I will go for a ELCS as it's just the travel time I have an issue with
However home birth is just as safe as a MWL birth

Yes for some women the medicalized environment is less scary. But for others like myself it sends cold shivers down our spines, mainly the lack of respect I’ve experienced in such environments. I cannot recommend home births enough, both mine were born at home.

I think many people have experienced harm and trauma precisely from that medicalised birth environment. Homebirth is shown to be as safe for the baby as hospital and less likely to lead to unnecessary interventions causing harm to the mother.

I had a home birth for my 3rd. The reason was that I had easy births, they were fast, and I was very uncomfortable in hospital being too tall for the bed.

I had two midwifes attending (one for me, one for the baby), and hospital was close enough that it would be fine if things went wrong.

As it was I had an amazing birth experience - 4 1/2 hours of labour from start to finish, didn't need stitches for the first time, and I was tucked up in bed with my littlest one when DD2 got up at 5am to say hello. The midwives didn't need to do anything except catch the baby when she came hurriedly out and do her APGAR scores.

If I could have more children I would definitely have another home birth.

I was privileged to be there for a friends home birth, 1 midwife throughout and 2 midwives towards the end.

One of my hospital births, I barely saw my midwife as she was looking after me and woman in next room. Once I was at pushing stage I did finally get the full attention of midwife.

I have 3 children, all were home births. Before my first I went to a birthing class where the midwife work-shopped a scenario where someone asked this exact question and we acted it all out under her guidance. Basically the monitoring in the home birth situation would result in removal to hospital much earlier as a precaution than they would worry in a hospital situation, the result was that on a time line, both mothers would arrive at being given intervention at the same time. For me home birth was the only thing I ever wanted, hospitals freak me out. I had 2 midwives to myself at home and they stayed with me from much earlier point in labour than a midwife would have done in a hospital.

Statistically the risks of home vs hospital are similar (with the exception of certain medical issues that mean a hospital birth is necessary). Most women with a straightforward pregnancy can choose where to give birth based on their personal preferences. Some find the hospital environment reassuring (or want access to pain relief), and would give birth there by choice , others do not.

My hospital birth: left to get some rest as the birth wasn't imminent and the midwives were running between patients. Plus it was handover time. Result... I gave birth completely alone while DH looked for help.

My home birth: two midwives plus student midwife, didn't go anywhere, just concentrating on me and DD.

The home birth definitely felt safer. Thats before the risks of driving myself to hospital during heavy snow...

My second child was delivered at home. I had an almost picture perfect pregnancy and wanted to surrounded by my own things during labour. She was born at 3:15 pm Christmas Day. I had a lovely turkey dinner prepared by my mother at 7:30. We all went to bed at 9pm. It was such a peaceful experience.

I felt much, much safer at home. Everyone I know who have birth at my local hospital had massive amounts of intervention, and several had PTSD. The people I know who had home births were all ok, and when they did need to transfer for a caesarian/forceps delivery, they were all absolutely confident that this was because it what they needed.

You do know that for any woman who has already given birth and is having an uncomplicated pregnancy, a hospital is more dangerous than the home birth. But I never see people asking those women if they are scared if the added risks of choosing a hospital birth.

I would never opt for a home birth because, like you I see all the negatives and they far outweigh the positives.

Hospital births need to improve though.
One big factor is if anything did go wrong and may baby was damaged, I'd never forgive myself.

Having had a baby in hospital first time then 2 at home, I would never have a baby in hospital now. I see it like eating your dinner in A&E in case you choke.
I do live 8 mins from hospital though (in an ambulance) and it would take that long to get me from the labour ward to operating table if I had the baby there.
Also, I had a midwife with me at home. Midwives are the ones who train the paramedics - so I always felt in safe hands. I also had one midwife one on one with me at home the whole time - in hospital I was left alone for hours, until I had been pushing for 30 mins on my own (they didn't believe I could have progressed that quick so turned my alarm off and left).

I planned (but didn't have in the end, because of Covid) a home birth for my second, because hospital had felt like such an unsafe environment when I had my first - I was left entirely unmonitored for all but the last 40 minutes of my labour due to staff shortages and also a refusal to listen to me. I did a lot of research, and the best and most recent showed as a second-time, low-risk mother home wouldn't be riskier for me. It was also the recommendation of my midwife (again, until Covid changed the situation) that I consider home birth, so I was actually following medical advice. I really resent your implication that it was some sort of foolish or selfish decision that I took 'despite all the risks' for the sake of my own birth experience.

Does any one have any ideas of age limit - I’m 40 in may but 2nd birth and first one was straight forward .

I'm dreading my hospital birth. I will have one, in case of an emergency medical situation, but I also know I will be coerced into interventions that will make that more likely.

Very interesting views!

I had a completely opposite experience with my first as I had to be induced for medical reasons and then I was monitored all the time (baby and contractions) and the midwife never left my room.

Despite all this, the emergency button was used and a doctor was needed to deliver the baby safely which was scary… If I were at home, even with a 10min drive with an ambulance it would have been too late. I remember the doctor was saying that had 5min to bring baby out…

Maybe it’s my experience that gives me this scary view about home births.

Now I am expecting DC2 and I can’t even consider a birth center because it’s not at the same town as the hospital, it’s a 15min drive.

I would rather be in a hospital!

For me the more instruments and people I see around, the safer I feel as I haven’t experienced birth as a natural thing but as a medical thing…

Very interesting views though, thanks for sharing!

Because there are rarely any true obstetric emergencies. Meaning that most life threatening emergencies can be preempted or spotted early by experienced professionals (midwives), and birther can therefore be transferred to hospital before anything has even actually 'gone wrong'.

With a home birth you have 2 midwives present, just for you. In hospital there's no way of knowing how many women a particular midwife is looking after at the same time as you - and with staff shortages it is very concerning.

People act as though midwives aren't medical professionals, and that having a home birth is basically the same as having a baby alone at home - and it really isn't. I personally believe that free birthing is a very dangerous choice, but would be entirely confident in a home birth (I live 5 min from biggest mat hospital and nicu in county - I wouldn't have considered a home birth with my first as I lived 40 min from nearest hospital with zero traffic, let alone rush hour).

@Hikoridikori

Very interesting views!

I had a completely opposite experience with my first as I had to be induced for medical reasons and then I was monitored all the time (baby and contractions) and the midwife never left my room.

Despite all this, the emergency button was used and a doctor was needed to deliver the baby safely which was scary… If I were at home, even with a 10min drive with an ambulance it would have been too late. I remember the doctor was saying that had 5min to bring baby out…

Maybe it’s my experience that gives me this scary view about home births.

Now I am expecting DC2 and I can’t even consider a birth center because it’s not at the same town as the hospital, it’s a 15min drive.

I would rather be in a hospital!

For me the more instruments and people I see around, the safer I feel as I haven’t experienced birth as a natural thing but as a medical thing…

Very interesting views though, thanks for sharing!

Your view makes sense, OP, but you would never have been at home giving birth to your baby as said medical issues were spotted (hence induction), which is why you needed to be in hospital. Even someone who had been planning a home birth would have been in hospital in the same circumstances as you.

FWIW OP, they pulled the emergency buzzer on me because baby's heart rate dropped suddenly on monitor (I'd been pushing terribly for an hour, terribly because I couldn't feel the contractions to know when to push, because I'd had an epidural, which I had because I was panicked by the intensity of the contractions, which were medically induced and left on 'too high' of a setting for too long according to second midwife at shift change - first midwife barely even spoke to me, said induction I wouldn't even have needed if midwife the day before hadn't given me a sweep without telling me during a VE and popped my waters); doctor waltzed in demanding I'm taken to theatre for forceps and potential emcs, midwife cuts an episiotomy and baby slips right out - perfectly healthy, no issues. Likelihood was an issue with the monitor, rather than with my baby.

I think it's about understanding personal risk as opposed to just statistical risk. I wouldn't have had my first at home. But seeing as that labour went smoothly, I knew that my risks would be much lower for subsequent births. And I knew my own home had far lower levels of mrsa and c-diff than the local hospital 🙄

It's also worth remembering that very few "emergency" situations go from zero to sixty in 3 seconds. Midwifes attending home births have quite a low threshold for transferring to hospital if they have any concerns whatsoever.

@Fredstheteds

Does any one have any ideas of age limit - I’m 40 in may but 2nd birth and first one was straight forward .

There's no limits at all. It would be worth listening properly to any concerns your midwife raised, but ultimately, your baby, your choice

Despite all this, the emergency button was used and a doctor was needed to deliver the baby safely which was scary… If I were at home, even with a 10min drive with an ambulance it would have been too late. I remember the doctor was saying that had 5min to bring baby out…

You would never have been being induced at home? No one would recommend that someone had a home birth where induction was needed. And a lot of 'sudden emergencies' in hospital would have been flagged as causes for concern requiring transfer hours earlier if the woman had been labouring at home.

MN is absolutely packed full of women who believe they and/or their baby would have, without doubt, died if they'd had a home birth. I absolutely believe that that's what they sincerely believe but the statistics show that this is actually a much rarer outcome than the many posters who believe they were moments from death would suggest.