Would you recommend a homebirth??

[Thankyouandgoodnight]

And do you end up dripping slime, goo and yuk everywhere????

'Aspiration is much more likely in the home setting' - really? Any chance you could direct me to the research that proves that?

My ds also got stuck (SD) and didn't breath spontaneously.

Midwife bagged and masked him on the bed and all was well.

I come back to the point I made earlier garnettopaz, which you haven't addressed. If homebirth was so much riskier for babies than birth in hospital, why how do you account for the fact that this doesn't show up in the research? (or at least it doesn't show up in good quality, large scale studies on the safety homebirth in Europe).

anyway i always knew i'd never win the argument - just wanted to see if we could get a balanced argument here - unfortunately none of the mums who have had a difficult home birth seem to give their opinion on these types of threads and while all of you had a fantastic experience, i also had a fantastic experience delivering in hospital - from where i stand the main advantage of a home birth is the added comfort for the mother and while hb have been found to be "at least as safe" as hospital deliveries i can't understand how anyone would take the risk however small it may be because if something goes dramatically wrong home is definitely not the place to be! - i don't agree that if doctors were to be involved the delivery is more likely to be "non-natural" but then i'm biased - yes i am a doctor but not an obstetrician- i've been there too many times when split seconds made the difference - but as i said this is only my humble opinion and i think the fact that so few doctors choose to deliver at home should send others alarm bells - perhaps it's because doctors understand too well all that may go wrong - did not mean to cause offence and i'm sure many many other mums (some of them close friends of mine) will go on to have very good home births - just it's not something that i would ever consider just because i think that my dc safety is paramount and my comfort comes second - again just my opinion

I don't understand why so many doctors are against HBs. My first GP refused to come out and do my son's newborn check because she didn't agree with it

I trust my MWs specialist knowledge and experience more than a GPs broader more generalised knowledge.

And things go wrong in hospital too.

you do realise that a mw's specialist knowledge is in delivering the baby and not in taking care of he/she once born!!

yes things do go wrong in hospital too - humans at work unfortunately however you cannot have all the expertise available in a hospital at home

No I didn't realise that because it is not the case, certainly in my local area.

Newborns born at home are checked over within 12 hours by a specialised senior MW or GP, and they come to your home to visit. You remain in the care of your MW team for the next 10 days if everything is well, and they will visit daily or as necessary depending on how you are getting on. You are then passed to the care of the Health Visitors.

MWs knowledge and expertise most certainly does not stop at birth.

garnettopaz, I don't understand why you still consider the main advantage of hb to be 'the comfort of the mother'. it is a great advantage to be sure, but as others have posted (thanks snaf)

Home birth halves your chance of section, halves your chance of instrumental delivery, decreases your chance of PPH, decreases your chance of getting a 3rd or fourth degree tear, improves breastfeeding rates, raises APGARs, actually reduces the need for resuscitation (which all midwives are well trained in should it be necessary anyway)...the list goes on. And from a physiological pov, the mother's comfort levels are actually extremely important in the progression of labour, reducing the likelihood of fetal distress and facilitating a safe delivery.

that's considerably more than just comfort, surely??

I don't see the hb/hospital birth choice as a competition btw, with a 'best' kind of birth being either one or the other. some women (I suspect you would be one) would be so stressed by being at home that it would be pointless trying for a hb.
each to their own, but it is certainly not the case that women who choose hb are doing so because they care more about their comfort than the safety of their baby, which is a tad insulting if you don't mind me saying so

did you watch the panorama documentary about hospital births that was on last year btw? scary stuff. can't say that having an untrained volunteer reading my baby's heart monitor during the labour would exactly inspire me with confidence! at least with a hb you get 2 actual trained midwives on hand.

i don't agree that if doctors were to be involved the delivery is more likely to be "non-natural"

You can agree or disagree with this statement, but the EVIDENCE supports the view that midwife led care results in lower levels of instrumental and c-section birth for low risk mothers.

EVIDENCE also supports the view that overall, homebirth is no more risky for low risk mothers and babies than hospital birth.

Of course you will get individual cases where the choice to birth at home will result in additional complications. You also get individual cases where the choice to birth in hospital results in additional complications.

As a doctor one would hope you would would be swayed more by what the medical literature has to show us about the importance of place of birth, than by anecdotal evidence. After all, aren't you supposed to practice 'evidence based' medicine?

But there you go - there's none so blind as folk.

dear all - just a question to everyone - does anyone ever wonder why the majority of doctors seem to be against hb? it seems they ignore all the evidence that morocco has mentioned and choose hospital deliveries in the majority of cases - seems like a five star restaurant where the chef and all his family and friends never want to eat at that restaurant - if i knew of the latter i would wonder whether i should eat at that restaurant!

That analogy is completely meaningless - sorry justathought.

I assume you're suggesting that chefs equal doctors and restaurants equal homebirths, right? Problem is that, as a rule, chefs work in restaurants, have an intimate knowledge of how best to run them, etc. The same can hardly be said of doctors and homebirths, can it?

The fact is that women who have homebirths (and the men who support them through) plus midwives who attend homebirths are, by an overwhelming majority, absolutely in favour of them. Even those women whose homebirths didn't go to plan do, mostly, still support them (there are always exceptions and I acknowledge them completely).

The people who don't support them are - again, by an overwhelming majority - those who have absolutely no first-hand experience of them. A doctor's training does not even touch on the subject of birth at home - except perhaps to dismiss it as the raving madness of a bunch of treehugging loonies intent on risking their children's lives for selfish fulfillment. They are of course entitled to their opinion

But, in the main, doctors are to home births what chefs are to tree surgery. That's why doctors rarely "eat" in that particular "restaurant".

I wonder how many Doctors see 'natural' childbirth where only gas & air / water / pethidine are on offer for pain relief (i.e. what is available for a home birth or in a birthing centre). I am assuming that the majority of births they see are closely linked with induction & epidurals etc and all the medical associations that come with those generally speaking. Plus, having worked in hospitals myself, it is oh so easy for the 'bad stuff' to influence the stats in your head. I mean that you are so aware of what can go wrong and see what you consider to be 'too much' of it, that you can have a warped view of the real data and clinical evidence.

There will be phsyiological alterations in the birthing mother's state purely in response to induction and epidurals that, generally speaking, predispose to other interventions.

Do correct me if I'm wrong.

And by definition, doctors only see the bad stuff where childbirth is concerned. That's so important to why there is this polarisation of views - they simply have no real experience of normal childbirth (again, I do realise there are honourable exceptions to this rule). Doctors are there when it goes wrong because that's what they're there for. But, as Marsden Wagner says - fish can't see water. If you're surrounded by just one thing, you lose perspective and your appreciation of alternatives.

I was talking to a med student just yesterday. He was lucky enough to have been present at a normal, unmedicated birth and was completely amazed. He couldn't get over the fact that the woman managed without drugs and, in his words, 'just pushed this massive baby out' He was still talking about it at the end of my shift! I hope it stays with him, but I have a feeling that it might soon be superceded by epidurals, PPHs and emergency sections. What a shame that will be - for everyone.

Just a quickie - I know people dont usually opt for t, but can you hve meptid/pethedine at home? Or just g and a?

You can have pethidine at home, but ime quite a lot of mws dont like to give it because of the possible complications with respiratory depression/feeding probs in the baby post-birth. You would have to have it prescribed by your GP and keep it in the fridge at home until you need it.

What about meptid? Thats what iv had last two times, and wouldnt really like to face labour without it.

I think it's the same deal although some controversy about its suitability for hb here

starlight - mine turned up (with the G&A) when I was 2cm. I had been in agony for ages before then but just getting nowhere. IME they are there for you when you need them not when the book says you need them.

I do think that it's important not to 'slag off' Doctors when discussing this emotive topic - to me, midwives, nurses, doctors etc are all part of one big team with their own expertise. Indeed, each individual health care practitioner is going to be able to offer expertise that is unique to them too. Different skills are needed in different situations and if and when that situation occurs, you really do need the right man for the job. If the data shows that for a low risk pregnancy / birth history, midwife led care both antenatally and during labour etc gets better results, then that is how it is. It doesn't negate the need for medical assistance should it be required but it does negate the need to commence on a medic led pathway from the off. I would have thought

No slagging intended - I've got the utmost respect for (most) doctors. It's not a job I could do, that's for sure.

But we cannot get away from the fact that they are trained in treating pathological processes. Normal, physiological childbirth is not their sphere of expertise. Therefore, giving birth in a hospital consultant unit will almost always involve the input of people who are simply not sufficiently experienced in the field. In what other area of healthcare would this ever be the case?

I agree.

No offense to midwives but for years, farmers have managed to oversee the birth of the majority of their lambs, calves and piglets. They only get the vet in when life is on the verge of being lost. It's years of experience, knowledge and instinct that enables them to be experts in this normal process.

I liken midwives to a vet in this instance though they don't have all the equipment (but a vet wouldn't either) and medical expertise to hand but they are competent at working out in the field and know when to refer on and can anticipate trouble.