39 weeks - homebirth planned but a 3rd GP tried to put me off today!

[bigbadmom]

I'm 39 weeks today and all set to go for a home birth but once again have been thrown by GP's remarks. Went in today to pick up a prescription for pethadin (it's taken me two GP appointments, three phone calls to GP after he originally refused to prescribe as it's a controlled drug - despite it being on my AN notes that I had discussed with midwives and had booked GP appointment to get some, a letter from the midwives as further back up, and two trips to pharmacist who don't have it now 'til tomorrow - I can't believe the palava!). Anyway - GP number three used my visit as an opportunity to outline the risks of home births. His line (and the others) is that home births are basically a lottery. If you're the unlucky one in a thousand you may end up dead. Now my confidence is shot through again. I had really wanted a home birth, and now I'm in massive doubt and feel like I'm putting my and my baby's health at risk.
What each GP basically said was that "if you've seen as much I have then you wouldn't recommend them" - ie: 20 years of practice (in one case) has opened their eyes to the risks. Main ones cited were loss of blood and risk of there not being an ambulance / traffic being awful - therefore risk of death before getting to hospital.

Does anyone have any honest views here? Have I been unduely taken in by the Davina McCall school of homebirth evangelism? Should I just go and have the baby (at St Mary's Paddington - a great hospital 10 mins away form here in an ambulance) rather than push away at home with all the associated risks? I don't expect anyone to have the answer but I just need a bit of clarity here. I'm annoyed at how the midwives are all unanimously pro-home births and refuse to really even acknowledge the risks, whereas the GP's are so unanimously anti. It makes it very confusing for hormonal and expectant mums! I'm all set to go at home with birthing ball, TENS, hypnobirthing CD and birth bag etc...but now thinking about actually going into hospital afterall.
Any input much appreciated.
Thanks for your help,
BBM

I had a home birth and I had constant attention from a midwife during the labour. I would not have had that had I been at hospital!

Go for your home birth, especially as you are only 10 minutes away from hospital.

bad things happen in hospitals too sadly. but if you are a normal, low risk pregnancy, then being at home is as safe if not safer than being in hospital

your GP is not an expert on birth

if you are 10 mins away from hospital and you need to be transferred in you will get there quick enough in an ambulance.

have your previous briths been straightforward?

if you bleed after birth MW can administer synto to help control bleeding via injection, and transfer in if necessary.

have a look at the www.homebirth.org.uk site to remind yourself of all teh positives of homebirht

my midwives could also put a drip in with a colloid drip if I had needed it due to massive bleeding.

lulu beat me to it with the HB website.

stay positive - its your baby and your body.

xx

There don't sound terribly supportive.

There are some risks associated with giving birth, anywhere.

Homebirths are usually straight forward and have less interventions.

If you are healthy there is no additional risk to being at home when giving birth. The issue arises if a transfer is needed, but you are close to the hospital and good midwives are trained to advise a transfer berfore danger points.

There are benefits to homebirthing, level of intervention, reduced drugs use, relaxed enviorment, family around, less likelihood of infections.

BUT really the best place to give birth is where you will feel most safe and confident. For me that is at home but for others it is at hospital. It has to be your call.

Thanks both of you - first birth my waters went, contractions took a while to build up so I was induced and had an epidural. DD born about 12 hours after I went into established labour. There was one point when the midwife said he'd need to use the venteuse but in the end my daughter corrected her position naturally. All pretty common for birth no.1 no?

Thanks for pointing out that GP's are no experts on births - I hadn't thought of that!

Will definitely look at that site.

You've just said your hospital is ten minutes away so I wouldn't worry too much about any issues that might require transfer to hospital.
In fact, there is a lady on my antenatal thread that had a homebirth saturday but didnt stop bleeding so had to be taken to hospital and have a transfusion. She's home now and fine.
Unfortunately some HCP's seem to think working in the medical profession means they know all there is to know about anything slightly physical, they don't.
If your mw's are fine I'd be inclined to listen to them and look forward to your home birth.
Good luck.

Just seen other messages. Like you say, we're close to the hospital here which has got to be a massive positive. Also reassuring to know that there are other means available to mw to stop the bleeding - colloid drip, synto etc.

If anything feels like it's going to go wrong, I am pretty close afterall. Just a slight worry with busy London hospitals that things will get held up...but I have to put my faith in things working out! And def I feel very relaxed at home, esp. now I've got all my 'kit' together...

Thanks again - I think our midwives have got a good reptuation...I like them anyway and they did a great job first time around.

Thanks for restoring my faith in having a homebirth. The GP made me feel like I was irresponsible and impressionable. It's nice to know that there are so many pro home-birth mums out there. Did anyone actually have one themselves though?

If I were you speak to your midwives and ask them to reassure you regarding the points that your GP has made. I'm sure they will be more then happy to reassure you.

bigbadmom, are you due April?
On the due April antenatal thread I think we've just had about three/four homebirths, why not come and join us and ask them about it.
We also have quite a few ladies planning a HB.

I've had two home births and there were both very successful. If I have another baby I would definitely have another hb, (barring insurmountable medical reasons).

Good luck and fingers crossed for a great birth.

Bigbadmom - GPs only ever see birth in three situations:

(1) When they are bloody terrified students who are called in during an emergency - and are probably scared witless by the experience
(2) In general practice when things go horribly wrong - a GP who does not support homebirths will not agree to attend them unless it's in a dire emergency so obviously the only ones he will get to see will be worst case scenarios
(3) His own kids births.

Frankly I wouldn't pay any heed. If your midwives are supportive I would say go for it. Besides which, most hospitals these days are so understaffed you've got more chance of the two midwives sitting there in your house noticing and reacting to a developing problem than you do on a busy labour ward where you have four midwives per woman and the only other staff available are scalpel happy consultants.

there is another thread that could do with you, WMMC, 'how to give birth in the labour ward' or something..

All the evidence states that homebirth is no more risky than hospital, you can change your mind at any point and mws are trained to spot issues before danger arises. chocolate is right doctors rarely get to witness a normal birth, good luck

Victorian Squalour - yes I am due in a week's time! Will def join your antenatal thread - fab - thanks...

Thanks everyone - brilliant brilliant, feeling so much better already. Will definitely join the WMMC thread as well. After I've administered supper to a bustling 20 month old that is!

Really grateful to all who've advised. Still surprised that only one in 200 births is a home birth (at least where I live, in NW London - according to the GP's). But good to know that it's a positive minority.

Tis here bigbadmom.

Thanks Lulu - I've just found it!

I had a home birth. First baby, 9lb 12, breech, 7 hours start to finish. My GP still shudders whenever he thinks about it (and my midwife said that's why he wasn't invited!)

I had a PPH. It was very undramatic - just a tear that wouldn't stop bleeding slowly and that was in a very akward place to stitch. By the time I'd transfered to hospital it had stopped and I didn't need a transfusion.

We're already planning a HB for any future children.

WMMC is definitely right on GPs and birth - if you have to see a GP again and they start giving you grief, ask them how many births they've seen and then how many of those births have been at home... (go on - dare you )

My GP refused to come out for my first HB to do my DS's newborn check. Thankfully I didn't let her put me off and promptly changed GPs.

I've had 3 HBs (one hospital - the first). Each one was a pleasure. Nothing like cosying up in your own bed, having had a shower in your shower, and with a cuppa in your own mug. Bliss.

Have yours and enjoy it. Good luck!

Good luck with your HB

I was to have one with my DD but ended up in a horrible hospital for a week, being medicalised. my waters broke early with meuconium, and babs was in distress.

when i first went to my Gp, she was unsupportive as well, so I do know how they can make you feel like you're a looney and dangerous to boot. I changed my Gp after the birth, as it turns out she was really unsupportive afterwards as well! I have a lovely paedritican now who specialises also in women's health.

Any self respecting midwife worth her salt will advise you to go to the hospital if she so much as sniffs something going a little off the beaten track..
With you only 10 mins from the hospital, I wouldn't worry about whether or not to have a HB at all - just try and get some lovely rest and enjoy the last few days of being a pregnant lady.

You sound like a very well organised mother- with your tens kit and your pethadine and ball - that's a lot less then they will be able to give you in some hospitals.. and you get your own midwife the whole time in your own private space - how lovely.

and even if you decide to have your labour at home and have to go to the hospital in the end, for some reason - or no reason at all other than your choice - it still is better than labouring in the hospital, without your home comforts.

Good luck!

Am willing to bet my bottom dollar that none of the 3 gp's you saw have ever seen homebirths. They have probably seen babies who have been traumatised and born in poor condition after complicated long hospital births. They have probably seen mums who have bled too much after drawn out labours that have been so interfered with. They have probably never even seen a normal low risk mum having a normal birth in hospital and don't know how normal and wonderful it can be. If homebirths really were this dangerous then the NHS would not be promoting them. The government would not allow them and women would not want to have them.

In 14 years as a midwife I have never had someone who has had a normal birth bleed so much as to need a blood transfusion straight away. I did have one lady who had a big bleed when the baby was a week old and had to come in for a transfusion. But they are hardly going to get everyone to stay in for a week just in case are they?

Bigbadmom, have you seen the recent study into homebirths published at beginning of April? I'm not very good at links but think it appeared in Journal of Obstetrics or similar name. Can find out if you want.

It found that homebirths are slightly less safe for babies. Maternal mortality was about the same overall, maternal health was good for those who stayed at home throughout but "significantly worse" for those who transferred to hospital.

I don't want to be the voice of doom and gloom, but you should go into it armed with as much information as you can. I'm one of the rare women who would have died along with her baby during a homebirth - and yes, I do know it's rare - but was encouraged to have a homebirth as supposedly low risk pregnancy and am so relieved I didn't.

I can see why people are evangelically in favour of homebirths. I'm sure homebirths are a wonderful experience if it all goes well, and it must be lovely to be in your own bed, get into our own bath, etc. But make sure you know all the risks first.

The recent study appeared in the BJOG, and a summary is given here. They found, amongst other things, that outcomes were better than average for women with a completed homebirth, but significantly worse for those women that transferred. This finding in particular has come in for quite a lot of criticism for a number of reasons, including:

• the authors make a series of assumptions about unplanned homebirths and their outcomes, as planned and unplanned homebirths are not differentiated in the raw data. Therefore there is no accurate figure of infant mortality related to planned homebirths.
• the time at which women transferred is not differentiated. The "transferred" group includes all women that planned a home birth but wound up in hospital, irrespective of whether they transferred due to preterm labour, before labour or due to complications during labour.
• you would expect the outcomes for women that transferred due to complications to be worse than the outcomes for women with a straightforward birth. What you need to know is how the outcomes of those women compared with women labouring in hospital with similar complications, and that was not investigated in this study.

Or to put it another way, "lies, damn lies and statistics". To me the Birth Day Trust study seems more meaningful, as this compared like with like.

Aha, thanks Tangle.

But isn't the study saying infant mortality was higher in general for the homebirth group?

I may have misunderstood it of course. Why do they do studies like this at all if the results are so hard to interpret?