Homebirth in the UK?

[Soon2under2]

I'm having a very hard time making up my mind about this one and was hoping to get some insights from mums who've already experienced it or who are considering it as well. I'm not from the UK originally and the NHS is still a bit of a foreign concept to me. I gave birth in a London hospital to my firstborn in 2023 and my experience was dreadful/ traumatic. Long story short, I got very unlucky with the midwife on call that day, she had started literally 10 days prior and had no desire nor interest whatsoever to support nor guide me, which resulted in many complications and ended up with an instrumental birth, with many unfortunate consequences. The lack of care and continuity was appalling to me and shocks my entire family and close ones when I share my first experience. Long story short, I don't trust the NHS nor their staff. At all. This time around, I want things to be different. I hired a doula who suggested a home birth. I love the idea of it, feeling very comfortable at home, I could have my toddler and husband close to me and everything about it sounds lovely. Apparently, two midwifes would be sent to my home and would immediately send me to the hospital with an ambulance, should something not look right. They wouldn't take any risks, wouldn't wait to send me there, even with the slightest of concern. My main worries though are: sometimes, even if everything looks good, things can go wrong at the last minute and an ambulance would probably take too much time to send me to a doctor/ hospital. Even if the midwives could do certain things, sometimes you just need a doctor/hospital. The doula assured me that complications like this only happen with medications, which I wouldn't have access to at home anyway, but that doesn't convince me. The other thing is that I was induced last time around for high blood pressure at 38 weeks even though my entire pregnancy was very smooth. This puts me into the high risk category, because I'm likely to have it again, even though I'm doing everything I can to keep it down during this pregnancy and I could very well not have it this time. Also, I'm 36, which technically puts me into the high risk category as well. So many people around me tell me how beneficial/ incredible a home birth is, and then I read and see other horror stories that make me think it would be risky/ unreasonable decision. I'm so lost. Does anyone feel strongly about this subject too and want to share their thoughts?

Partly why I wanted a HB - hospital wasn't clean -toilet/shower unpleasantly dirty - it was a fight to get a drink and wasn't given any food in hospital despite staying overnight and to midday after birth - was supposed to take own painkillers and put where I couldn't get to and wasn't allowed any NHS one - and got shouted at a lot by staff often for following another staff member instructions.

Actually birth was fine in MW led unit - after care was none existent - so own bed clean bathroom and access to food and drink and over counter pain relief I recovered so much quicker and had fewer bf problems.

There are personal pro and cons - medical ones and lots of unknowns - so ask lots of questions get as much information as possible and then decide.

I doubt that took into account doing a home birth with no functioning ambulance service as backup......surely alters the risks a bit....

You realise that independent midwives generally can't get indemnity insurance......

@Suncream123 if anything, hospitals have got more dangerous in that time. More CQC inadequate than ever.

Homebirths are category 1. I asked the midwives this question and they have never had any issues getting an ambulance if needed, very quickly. Look at the covid response - a huge reason for pulling homebirths was ambulance availability, they ensure that they are adequately supported and if they aren't they don't offer them. Anyone planning a homebirth should ask this question of course, I did and was reassured.

Ambulances are taking hours to get to heart attacks and strokes, 12 hours to get to broken hips. A baby's brain survives 3 minutes without oxygen. If you believe that you'll get a timely ambulance in the UK in 2024 you are deluded.

Reassured in what way? Because without knowing the demand at the time, they can't make you any reliable promises.

https://www.google.com/amp/s/www.bbc.co.uk/news/uk-england-london-64238528.amp

2023

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4029797/

Even urgent transfers in home births take an hour

https://www.ombudsman.org.uk/making-complaint/what-we-can-and-cant-help/how-we-have-helped-others/ambulance-delay-added-distress-after-home-birth-complications

https://www.northerntrust.hscni.net/2022/01/19/temporary-suspension-of-northern-trust-homebirth-service-provision/

Home births suspended NI 2002 as no ambulance cover

This was my point - they are suspended if there is no ambulance cover, as they also were in 2020 during covid.

I am very happy with the decision I made and it's up to the OP and all other women to weigh the pros and cons.

https://www.google.com/amp/s/www.bbc.co.uk/news/uk-england-sussex-55545882.amp

Need I go on??

The UK currently does not have a functional.ambulance service. As A GP I have sometimes driven critically ill.patients to hospital to avoid delay, rather than sitting and watching our only oxygen tank deplete.

There is no timely ambilance service now but you really think that will be acknowledged by suspension in an election year?

"As far as I was concerned, a positive birth experience is when mum & baby go home healthy"

But @Meadowfinch leaving with significant mental and physical trauma from an instrumental delivery isn't going home healthy? This is everything that's wrong with the current maternity system!

Op no one can tell you what is right for you. I had a lovely home birth for my second, but being near to a hospital and uncomplicated pregnancy and previous birth helped that decision.

You can always plan for a home birth and change your mind at any point. There are fantastic books podcasts and Facebook groups with a wealth of knowledge to offer so do as much research as you can and do what right for you. Wishing you all the best!

@Suncream123 I don't understand your point?
Individual trusts can and do suspend homebirths unilaterally. It's nothing to do with the government and elections.

What about all the stories about ambulance delays?

You don't get it. Ambulance response times are unsafe long before home birth are suspended. They have been unsafe in London for at least 2 years. Have all home births in London bee suspended?

I don't live in london. I was reassured speaking to my midwife for my area who said that they regularly liaise with ambulance services to ensure they can be supported and will close the service if it can't - this has been done on a number of occasions over the past couple of years.

The midwives in the homebirth team here also have additional paeds first aid training just in case (but have never needed it - they are a new team 3 years old) and carry additional equipment for resus. They are highly trained and will transfer at the slightest sign of distress.

Going into hospital is also not a neutral decision particularly given the state of maternity units.

I don't feel this discussion is helping OP any further so I am bowing out. I'm certain I made the right decision for me (1 hour labour and I wouldn't have made it to hospital anyway) and I am glad you feel the same for yourself. I will advocate for homebirth all day long and I'm glad it was available to me otherwise I would have been free birthing.

The London point was to make the point that they don't suspend every time ambulance response times are dangerous.

I'm glad you had a good outcome.

I would be surprised if there is anywhere in the UK where a timely ambulance response can be guaranteed. And even if it is, it'll be too late for a shoulder dystocia before you're off the phone to 999.............

@DappledThings You don't like the thought of blood going down your drain? I'm sure worse things have gone down there!

Good job no one is forcing a home birth on you then isn't there @Suncream123 ?

Absolutely. I like my children born where there are specialists available if something goes wrong.

Home delivery is for pizza........!

And I like(d) my children born in my home with 2 dedicated midwives to me and my baby and where i felt safe and secure and had the safest birth available to me.

I see no need for all that mess, not just going down the drain but getting to the shower in the first place, in my home when I can leave it all somewhere else and come home cleaned up. There's no advantage to me in a homebirth and only downsides.

The risk levels and lack of access to possibly required specialist care are one thing but others have covered that. The general muckiness of the whole business isn't something I'm particularly squeamish about but I see no need for it to come home with me!

Absolutely home delivery is for pizza because babies are born, not delivered.

Of course.

When you leave it to nature to birth them, with no-one helping to deliver, large numbers of mums and babies die. But never mind that.