Everyone is pressurising me to have a homebirth and it is pissing me off

[CharlieAndLolasMummy]

NOW before I start, I have NO problem with HBs. Have one if you want it. They are statistically safe and everything, and for some people are going to be great.

BUT I am so bloody fed up of people who have had one, in often very different circumstances to me, telling me that I "really ought to go for a HB".

Here is why I do not want a home birth

1. I have 2 kids aged 2 and 4. I do not want my younger child at the birth, it will freak her out and I will be the only one who can comfort her (and I know this because she is MY child, I don't care how many other kids see their mother bellowing swear words, she will NOT cope)

I don't mind the 4 year old being there at all, but the mws want someone assigned to look after him and that means an additional person in the room, which I don't want.

1. I am extremely noisy when giving birth. Anyone who says that my kids and (less importantly) the neighbours will not hear me bellowing away is talking out of their ar$e, sorry. They have NOT heard me in labour.

1. I really do quite like going to the midwifery led unit. I have done it before. They are very, very kind, they give you food, they run you a bath, they have NO stairs to schlep up and down, and after the birth I can make up excuses to get myself a bit of breathing space. They also limit the number of non-family visitors at one time, and anyway, I can always go for a 6 hour discharge.

1. Oh and I tend to lose a lot of blood quite quickly in labour because I have fairly quick labours (about 1 hour each from 5 cm to delivery.) I don't want to faff with cleaning this up, I know some mws do but I have also heard that some don't. I don't want to worry about it.

1. And I want to use their huge warm pool without having to worry about my dining room ceiling.

But no one gives a crap about any of this. I am getting "oh this is baby #3, are you having a hb this time" and when I say "no, probably not" I get this glazed look and a recitation of why I should have a hb, which bears NO relevance to my situation. I KNOW it is pretty safe, I KNOW that for some people it is a wonderful bonding experience with their dcs-it just isn't for me.

Oh and I know its the lentil weavery equivalent of having old women come up to you a week before you give birth and say "gosh, I expect you really would like to hear horror stories about how dangerous childbirth can be" but it is SO annoying, noone is listening to me, they are just reciting this mantra and it is SO SO annoying.

Sorry, needed to say that. It feels like it is all I have heard this last few weeks.

i support you totally but for prob dif reasons

im now of the mind that some people obsess about birth too much - id rather spend time getting excited about the new person about to arrive than about the way it is going to come out

i think that within seconds it is old news and im not that interested in how long it took, how few drugs were used, what music was playing etc!

do whatever you like and if anyone says anything irritating say 'im soooo bored talking about birth'!!

Advice to all pregnant/new mothers:

Whenever anyone looms into view with a self satisfied smile and what looks suspiciously like a wad of pamphlets under their cardigans, offering 'friendly advice', do the following:

1. Place fingers in ears.

1. Screw eyes tightly shut.

1. Repeat the following, until 'friendly person' has gone:

La la la
I can't hear you
la la la
I can't hear you
la la la....etc

Sorry, but this earth-mummy mafia really pisses me off. I recently saw a lovely young mum with a beautiful well-cared for eight week old baby in tears in a shop because she was going to have to stop breast feeding due to repeated infections. She said she felt guilty.

Guilty??

If I had insisted on a home birth, first time round I'd have ended up in hospital anyway (undiagnosed breach) and the second time we'd both have been dead (uterus almost ruptured).

You do what suits you.

Good luck

Harriet, I really hope the IM comes through. That is a really tricky situation.

I do tend to agree with you, actually, newgirl. One of my real bugbears with the NCT antenatal classes is that they are (at least round here) 90% about the Birth and very, very little about the next 20 years .

But then those 4 page birth story things just make me yawn...

Speccie-have just read thread, am so sorry for your friend. It does make me think, actually, especially as I already have kids.

Bobbiewickham has sound advice

I've just read Speccie's thread and am so sorry to hear her story. I do agree about the NCT - the NCT teachers I know present a completely unrealistic view of labour and birth. The whole "natural birth" movement seems to me to be a kind of "disease of affluence" phenomenon. Most women in the world would give their eye teeth to be able to give birth in a proper hospital, with qualified staff and really effective pain relief.

SpeccieSeccie,
I'm terribly sorry for your friend, her family and all her friends - what a terrible thing to happen.

But you're wrong to imply that 'the NCT and their ilk' (by which I presume you mean the Royal College of Midwives as they're the other main organisation outspoken in support of homebirth)are irresponsible to promote the availability of homebirth as a viable choice for women in this country.

All the current research shows that mortality rates for homebirths are comparable for that of similar women giving birth in hospital, and that morbidity is lower, for both women and for babies.

Nobody can deny that in very rare cases the choice birth at home will result in an avoidable death, and statistics are no comfort if things go terribly wrong - BUT babies will also die as a result of their mothers choosing to birth in hospital rather than at home - logic says it must be so, otherwise the mortality rates for hospital births would be lower than those of homebirths, when in fact they're not.

In any case - none of us can know how these things will work out - we can only make a choice as to where we will give birth based on our personal preferences and the evidence on safety.

Anyway, I'm sorry for your friend, but please don't let her terrible tragedy turn you against an organisation (the NCT) that's done so much to make birth a more humane experience for women like ourselves.

I think its tricky re the NCT.

There is SO much variation between teachers

I have class-supported NCT classes. In doing this, I have seen some fabulous teachers, mainly (but NOT entirely) those who are ex mws/doulas or whatever themselves, and who have given birth fairly recently.

I have also seen some shocking classes, including my own antenatal group, where the teacher literally had either somehow not been on any training in the last 20 years, or at least, had slept through it. We were told that babies given pethadine WOULD become drug addicts, that epidurals inevitably led to a spiral of intervention that resulted in a c-section, and that everyone could breastfeed, so bascially only crappy mothers didn't. 5/8 people on the course ended up with a c-section, for which she had refused to prepare them (because there were 1 x twins, 1 x diabetic and 2 x breech in the class, 4 of these were actually pretty much anticipated, at least round here where the c-section rate is appallingly high .

It was dire and if she hadn't had M&S custard creams I doubt we'd have finished the course.

So have mixed feelings about the nct. I volunteer with them sporadically and they have the ability to do an awful lot of good. But there are among their fabulous teachers, some crappy teachers employed by them, and they are peddling a load of rubbish.

"some crappy teachers employed by them, and they are peddling a load of rubbish"

I have observed quite a few antenatal classes, and attended them as a mother myself - NHS and NCT (NHS first time around, NCT refresher with my second).

I wouldn't argue that all NCT teachers are great, but personally I've seen more shocking bad practice in NHS classes personally - really poor teaching, and more non-evidence based and out of date information.

OK - regarding the statistics on home births:

1. I studied Statistics as a module of Economics at university. The reason it is worthy of study is because it is literally possible to extrapolate almost anything from any data to fit in with any agenda. Hence the phrase 'Lies, damn lies and statistics'. Home birth advocates are quick to quote statistics.

2. My friend's tragedy will be recorded as a 'hospital birth' - as that's where she actually had the baby. But it was the home birth part of it that was the problem. Hence the problems with home birth being recorded as so low - they've all been rushed to hospital. Not saying that this isn't a good thing, obviously it is, but it does skew the home birth figures.

3. When things go wrong in labour they go wrong quickly and they go wrong seriously. Many midwives are brilliant and the monitoring equipment they have is definitely part of the reason women feel secure. BUT all the monitoring in the world can't help you if you need a c-section/transfusion right now.

As I said on the other thread, I'm not anti anyone having a baby anywhere they like. What I object to is a minimizing of the risks of birth - it is dangerous.

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I think women should give birth where they feel happiest and most relaxed so their bodies can get on with doing the business.

"I think women should give birth where they feel happiest and most relaxed so their bodies can get on with doing the business."

Jennifersofia - I don't want to pounce on you, because I appreciate your sentiment but it is waffle like this that causes some of the problems. Undoubtedly, it would be wonderful for all women to feel happy and relaxed as they give birth. However, most women do not feel happy and relaxed on an operating table and absolutely undoubtedly this is where some women have to give birth if they are to avoid serious injury or death to themselves or their baby. Not all, obviously, just some.

Speccie, I completely agree. I don't want to jump on anyone but the notion of "their bodies getting on with doing the business" is profoundly unhelpful. Our species walks a very fine line between walking upright and having very big heads - both of which have contributed to making us the multi-tasking, continuously learning miracles that we are - but at the cost of making birth extraordinarily perilous. The newborns of no other species fill the entire birth canal in the way that human newborn heads fill our birth canals. A very high proportion of unattended births will end in mishap, minor or major, for mother and/or baby. That doesn't mean that a homebirth, for a woman with no contraindications and attended by competent midwives, will be disastrous - but it's always going to be a minority sport in a society where other options exist.

Speccie
I guess I'm a bit surprised that your friend was encouraged to have a home birth when she's 45 min from the hospital. I wonder what my IM would think of that. I'm within 15 min of one (10 going hell for leather in an ambulance) and theoretically 17 from another. As you say, though, every second counts in an emergency and I'm so so sorry to hear about your friend.

In Alaska where I have a number of friends they are often miles from hospital, and home births abound. It's not realistic for everyone to decide they're going to rent some place closer for a few weeks in advance. I wonder about their stats there. As very much an aside, my mother's friend had five children in the woods in Canada w/her husband delivering.

I'm nervous about home births because of my emergency CS last time - things went really wrong really quickly. However, it could well have been the combo of the syntocinon/epidural i.e. interventions at the hospital which contributed to the problem. Baby came out with an apgar of 9 after all the pandamonium, so I don't really feel I understand what might have gone wrong with the management of the labour.

"OK - regarding the statistics on home births:

1. I studied Statistics as a module of Economics at university. The reason it is worthy of study is because it is literally possible to extrapolate almost anything from any data to fit in with any agenda. Hence the phrase 'Lies, damn lies and statistics'. Home birth advocates are quick to quote statistics."

This sort of argument is so often trotted out in response to an assertion that the research supports the argument for homebirth. Be fair - what other way is there of proving the case that homebirths have a similar mortality rate to hospital births if it's not with reference to the mortality and morbidity figures?

You can be sure that if the mortality figures for homebirth were significantly higher than those for hospital births anti-homebirth individuals would use them in support of their case that hospital is the safest place for women to birth.

I agree that the research on this isn't water-tight, but there's enough consensus on this issue for the government in the UK to recommend, after long consideration of the most important studies by panels of medical experts, that low risk women here be offered homebirth as a safe alternative to hospital.

Neither we, nor they, are stupid. We're all aware of the problems inherent in statistical research, and all the major bodies involved in discussion of this issue in relation to policy place a very high value on the lives and the health of mothers and babies.

"2) My friend's tragedy will be recorded as a 'hospital birth' - as that's where she actually had the baby. But it was the home birth part of it that was the problem. Hence the problems with home birth being recorded as so low - they've all been rushed to hospital. Not saying that this isn't a good thing, obviously it is, but it does skew the home birth figures."

No - I'm sorry but you're mistaken. The studies that have formed the foundation for the government's current recommendations on place of birth include those babies who died following transfer from home in the homebirth mortality and morbidity statistics. In other words, they record mortality and morbidity according to the place of booking (which in your friend's case was home) NOT where the birth actually occured.

"3) When things go wrong in labour they go wrong quickly and they go wrong seriously."

No - this is also not true for the vast majority of women who need an emergency c-section. The single main reason for emergency c-section is for 'failure to progress' in labour, not for severe fetal distress. Crash sections under general anaesthetic are rare.

"As I said on the other thread, I'm not anti anyone having a baby anywhere they like. What I object to is a minimizing of the risks of birth - it is dangerous."

That is YOUR opinion, not a point of fact.

All the well trained and experienced midwives I know, who deal with the reality of birth every day in their work would refute what you say, that birth is intrinsically dangerous. They know that a healthy mother, who's had good antenatal care during pregancy and is given one to one care by a skilled midwife in labour, (within reasonable reach of obstetric care should the need arise) can feel confident that she and her baby are very, very, very unlikely to come to any serious harm.

I also think it's worth pointing out that in the Netherlands about 30% of births take place at home, and they have some of the lowest infant mortality figures in the developed world.

Personally I think it's a bit unfair of you to accuse homebirth advocates of naivety, ignorance or manipulativeness when you yourself, from what you say, are clearly unfamiliar with the evidence on this subject.

"A very high proportion of unattended births will end in mishap, minor or major, for mother and/or baby."

No - this is not generally true for healthy mothers who've had appropriate antenatal care who are delivering a full-term baby.

The high mortality and morbidity statistics associated with unassisted births are skewed by the large number of women who give birth in this way who've had no antenatal care, who come from high risk groups and who are delivering a preterm baby.

Sympathy. Am completely in favour of home births, breastfeeding, lentil slings, the lot. But more in favour of mother having the birth she wants as the first few weeks are so important and if you feel things haven't gone right it can be so very tough and dispiriting. Similarly with breastfeeding. The mother of a friend (who had PND) had "words" with her daughter's HV because she was loading on the guilt when my friend's PND was obviously going to get so much worse because breastfeeding was going so badly. Get a t-shirt saying Unwanted: Free Advice.
(except I just gave advice. but you know what I mean)

I think when you know someone who has had a tragic outcome to a birth, you will forever have your opinions coloured by that outcome.

Babies die in home and hospital births. That is a fact. I cannot imagine the grief of speccie's friend, and it must be horrific to endure.

That does not mean that homebirth per se is dangerous. but it would be hard to see the wood for the trees right now.

there has been a lot recently in the press about maternal and neotnatal death in hospitals, and yet, the reverse argument, of have your baby at home never seems to be accepted.

women have a right to give birth at home , the vast, vast majority who do so will have looked into it carefully, and made an informed decision, possibly more so than someone who has their baby at hospital, because that is what everyone else does.

on the whole, unattended births have a positive outcome, if a labour is going too quickly for help to get there, it is usually becsue it is very straightforward.

but this is not about unattended birth, this is about homebirth or hospital birth.

every birth has risks. and some of those risks can be avoided by being at home. some cannot.

again, speccie, i am truly sorry for your friend;s loss

Very very sad for your friend Speccie.

I have to say, i found the NCT helpful and very informative, overall - just that one thing fromm my teacher.

But the need for people to be aware and fully in ownership of the facts and thier own decision would make me loathe to advise nother person what they should do - for reasons which Speccies expeience make only too clear. which is why I think the OP's aquaintences should keep thier opinions to themselves - unless asked.

Evangellism has no place in decision-making around events like birth. Facts and risk assessment (on both sides of the choice)does.

"I do agree about the NCT - the NCT teachers I know present a completely unrealistic view of labour and birth."

Which is .... what? That birth without routine medical intervention such as ventouse, forceps and caesarean section is possible for the majority of mothers, given good care?

How is this 'unrealistic', when it reflects the views of the Royal College of Midwives?

There's a huge debate in midwifery and obstetric circles right now about how to reduce the amount of unnecessary intervention because it's recognised that unnecessary interventions damage the health of women and babies and cost the NHS money it can ill afford to spend. The RCM has even gone so far as to set up a website to support midwives in raising rates of normal birth. The NCT's stance on birth reflects this agenda and I cannot see why they should be blamed for being 'unrealistic'.

Which is The whole "natural birth" movement seems to me to be a kind of "disease of affluence" phenomenon.

No - the NCT is not promoting 'natural birth' - they are promoting 'normal birth'. There is a difference. When they started out in the 1950's natural birth was their big issue - the NCT was set up by mothers who objected to the way women were being treated in hospitals - routine induction at term, routine episiotomies, pudendal shaves, being forced to give birth in the lithotomy position, having partners excluded from the birthing room, not being given a choice over pain relief (women were often given large doses of pethidine in labour in those days without being consulted first). The NCT was instrumental in changing the way pregnant and labouring women were treated by doctors and midwives. Now they campaign for women to have one to one care in labour and for improvements in birth environments - what's not to like about that?

Of course there will be some NCT teachers who have lost sight of the informed choice agenda, but they're NOT the norm, and it's not fair to hold them up as representative of the organisation as a whole.

"Most women in the world would give their eye teeth to be able to give birth in a proper hospital, with qualified staff and really effective pain relief."

I think that if you could ask, you'd find what most women want is the chance to have a healthy baby and to get through the birth with as little risk to themselves as possible - whether that's in hospital or at home with a skilled care giver and a hospital within easy reach. It's not the lack of hospitals alone that makes birth so risky for women in developing countries, it's malnutrition, early teen pregnancies, pregnancies following infibulation, malaria, undiagnosed diabetes, rickets, HIV, lack of antenatal care and lack of trained birth attendants. In these countries really simple, low tech improvements can make a huge difference in mortality rates - like providing traditional birth attendants with basic training, and making misoprostol available (reduces bleeding after birth and doesn't need refrigeration).

Anyway, I'm sick to death of the homebirth issue being stereotyped as a sort of silly middle class indulgence. I'm a homebirth rep and I get calls from all sorts of women who for one reason or another feel a strong need to have their babies at home. The reason why it's become a 'middle class' thing is because in the last 30 years or so it's only this group of women who are empowered enough to actually get a homebirth, who are aware that it is an option and who are confident enough to press their case with often very ill-informed care givers.

Totally agree witht he alst post and the bit about evangelism.

DS1 came close to beinga hospital mortality because of poor care- they lost my blood tests and the Ob wouldn't come out without them, so a hospital birth is anything but a guarantee. Of course there are certain cases where babies woudl be alive ahd they been born in a hospital- but what aboput cases like my cousin (admittedly older but a child death nonetheless) who contracted MRSA after a 'routine' op? maybe he'd be with us had he not been kept in?

Ther HAS to be a wide range of birth options because there is a wide range of Mothers. Some motehrs like my sister albout very well but feel safer in a hospital- fair play to them. Me however- my second labour stalled every time I approached a maternity unit (presumably after the issues with ds1) and I suspect had I been able to delvier at home, would have been far shorter and less worrying for the MW (who were about to transfer me to a alrger unit for emergency c section when ds2 appeared).

This one will be born here I hope. not because of soem big issue with hospital births- ds2's MW ewere kind and caring, as were the ones who delivered ds3. but I ahve very specific circumstances such as disabled kids (ds1 and ds3) who can't be just dropped with a neighbour, and my nearest family are over an hours drive away, as is DH when he's at owork. my only chances of delivering with DH there are if I albour at home, or am induced on a set date, which si what will happen if I need to change my plans. Situations like mine are fairly rare I know, but that's the thinga bout childbearing- all sorts fo women with all sorts of backgrounds do it, and therfore there needs to be as much choice as possible.

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You did well pruners to interpret that post!

Note to self: Get new glasses appt booked this week!