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?

Unassisted births are not the same as home births!

Goodness some people really have a bee in their bonnet about something that doesn't involve them.

If you want a hospital birth, great do that. But stop spreading misinformation about home births of you've never had one.

I've seen the consequences multiple times. When you've seen a few dead babies, who didn't need to die, and some women arrive in hospital on the brink of cardiac arrest, who could have had a safe healthy birth, it does give you rather a bee in your bonnet.

OP I'm so sorry about your poor experience. I also had an awful experience with my first birth in hospital so I absolutely understand your reluctance to risk it again.

I would take a bit of time to think through your options and do research and choose what's right for you. I would be mindful however that homebirth advocates are often a bit evangelical about it, spread quite a bit of misinformation and scare-mongering about hospitals (as you've seen with your doula), and can be quite aggressive in downplaying the risks (and unpleasant to those who point them out). It's quite a minefield to work through so I would take time to pick through it all and speak to as many people as possible including medical professionals to inform your choice.

Congrats on your pregnancy and I really hope whatever you choose it goes well for you and baby x

Classic scaremongering and shroud waving. Have you heard of the Birthplace study? But let's not let research get in the way of anecdote

😂

@Suncream123 My IM most definitely had indemnity insurance. Height of Covid, 2020. One of the very best decisions we ever made. Had I my time again I would have had all three of my children at home, no hesitation.

its absolutely the best money I’ve ever spent. I paid in instalments and it was less than many people pay for holidays. My first birth was ok but community midwives weren’t great and refused to support a water birth so I was lucky it was fairly straight but I tore, unnecessarily as a result of being made to push before I was ready. Second and third birth care was fantastic.

I had a home birth with an independent midwife for DD2. Also the best money I've ever spent. Easy and quick birth despite the fact that she was a slightly complex presentation and would probably and been a C-section if in hospital. On her birthdays I paused and say a silent thank you to my amazing IM who gave me back faith in my own body. It was the most empowering thing I've ever done after a hideous hospital birth with DD1 and midwives who were dismissive and unsupportive. (As the 🤣 response to suggestion of research from a healthcare "professional" upthread typifies. I wonder if they ever reflect on how they make women feel when they woman is at her most vulnerable?)

Looking at the statistics is pointless really because human beings aren’t widgets.

If something goes wrong in hospital there will be Doctors on hand to support. If it goes wrong at home there won’t be.

The worst case is you or your baby, possibly both could die. Or as others say if your baby is deprived of oxygen and doesn’t get immediate support they could be brain damaged and severely disabled.

If those terrible things happen and you’re sat there stunned thinking why me, you’ll realise how meaningless statistics now are to you.

Why would you even consider that? Birthing isnt some hippy bullshit experience, it’s one of the most dangerous times in the life of you and your baby.

@Frozenblox Look at the evidence in favour of homebirth! I had my last baby at home and absolutely would again.

Hey OP, midwife here.

Do not, under any circumstances take medical advice from a doula should you wish to hire one. They are there to support you in advocating for you and your wishes on decisions YOU have made an informed choice on, after doing your own research alongside a partner or family member or friend and/or discussing with your midwife and/or an obstetrician. Doulas are unregulated and are not trained medical professionals. I have worked with some fabulous doulas and some completely dangerous individuals. They should be supportive and not coercive or obstructive to professional medical care.

Some trusts have a dedicated home birth team, in others their regular community teams manage on calls to cover a home birth service.

Usually you will be attended by 2 midwives. One for mum, one for baby. There will be a lower threshold to transfer into hospital in order to take into consideration the lack of extra medical support and/or the travel time to hospital.

You are correct in that transfer to hospital takes place via emergency ambulance. Wait times however are out of our control. Our trust has a good relationship with our local ambulance service, in that they will provide us with their average wait times and staff levels, so that any women who begin to labour and plan a home birth can be informed and make an informed decision from there. Personally I waited 45 agonising minutes for an emergency ambulance for my 2 year old son, on oxygen, with oxygen levels in the 80's%. He was well enough to wait, but if I was a midwife waiting for an ambulance for a mother and baby I would be professional and do what needs to be done but also quietly beside myself!

The 'caused by medications' comment is quite frankly ridiculous and disturbing and just cements my initial comments around their (often) complete ignorance and lack of medical knowledge. That is not providing you with evidenced based information and could also be seen as coercive and manipulative. How can you make an informed decision if youre not being presented with hard facts and evidence?

Personally, I would sack the doula and invest the money in an independent midwifery team with an interest in home birth. Please be advised however that some independent midwives are not insured to provide home labour care, unless they have a 'bank'/honorary contract at a local hospital. If they do not have this insurance, and (god forbid) something were to go wrong and you wanted to sue for compensation, you would not be able to as the midwife wouldn't hold the correct indemnity insurance. Something to think about.

I would explore the above options and ponder possible wait times.

Independent Midwives are the way to go!

Also, as a midwife, some of the comments on here make me so sad. I'm really sorry for some of the experiences detailed here, and I hope one day your faith in the profession will be restored some way or another.

Please know that the majority of midwives go to work to make a positive difference, and feel privileged to be present through the happiest and sometimes, sadly, saddest days of someone's life. The majority will strive to be the best they can however we are imperfect humans working within a broken system.

There are huge improvements that need to be made and I am personally trying to make a difference in the trust I work in to make it a psychologically safe place to work and a safe place for women and their families to receive care.

@USaYwHatNow Thank you for your carefully phrased and considerate posts. An honestly meant and heartfelt thanks for your attitude and the way that you do your job. We need more midwives like you but sadly you are working in an underfunded and broken system.

@Hellodarknessmyfriend evidence is meaningless when you’re the one that ends up with a nicu baby or worse. It’s not something anyone who hasn’t been there can fully appreciate.

@Frozenblox Evidence is not meaningless re safety and homebirth.

I planned a home birth with all 3 of mine. 1st I was transferred to hospital in the morning of the second day after midwife broke my waters the night before, when I'd been in labour for hours and no progress. Ended up with an epidural that didn't take but enough pethidine that I could nap between contractions! DS1 was 10 days late and a 40 hour labour, I was shattered.

Second was successful, lovely experience and easiest labour despite DS2 being 9lb5oz.

Third I took myself in before midwife arrived after waters broke on the loo and I noticed meconium and knew I'd have to go in. Lucky I did as had shoulder dystocia (obstetric emergency) during delivery and the room suddenly filled with doctors!