HB NOT booked; what right would woman have if she phoned in labour and requested HB?

[asur]

Am just curious... I know that if there is a HB booked and when you phone in labour and they say that they are suddenly shortstaffed and you'll have to go to hospital, there is a distinct right to demand a MW be sent to you.

What would happen though if you hadn't booked a HB in the first place? Should they still send a MW if you refuse to go in to hospital?

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I didn't think the risk assessment was mandatory... guess it depends on health authority though.

I am generally just curious. Was on babieseverywhere's thread about her problems getting HB booked and wondered what would happen if they said to someone they weren't 'allowed' one but then they phone in labour and say they ARE having HB...

if you stood your ground I'm sure you would get a midwife in the end. Not sure however that arguing over the telephone and trying to arrange on the spot would be ideal whilst labouring. If you could get someone to do it for you, who wouldn't eneter into any kind of negotiation then you would probably be quite succesful.

yeah, argueing while in labour isn't ideal... It's just my mind at the moment - have been doing a lot of reading on HB/freebirthing and has got me thinking about different situations and what would happen. (eg. does a freebirther 'book' a hospital birth and just not go? do they have to get a MW sent out to get the relevant forms to register birth etc)

The hospital cannot make you go in under duress. But I would do everything you can to book and plan a homebirth in advance of your due date so that there is the least amount of negotiating. I work in sales, and even I didn't want to negotiate when in labour! I also think that if your house is set up, you have adequate support around you, your birthing partner is aware of birthing etc and is calm, then if they do only send paramedics, you have a much better case for them calling in a midwife, than if you and your birthing partner looked unprepared and chaotic. I laboured at home for 18hrs which was amazing until I asked to go in to hospital as DD wasn't budging (large head, large baby and stuck etc). But I would absolutely labour at home again, and if lucky, would give birth at home next time. There was no rush, no timing, no need for me to do anything other than labour. For me, that was just the way it should be. Do what you can in advance, and then stick to your guns.

Quote from AIMS site from here

"If, when you ring for a midwife when you are in labour, you are still told that a midwife cannot attend because they are short staffed, we suggest that you, or your partner, responds as follows:

'What is your name and your status? (Make a note of who it is). 'I have no intention of putting myself or my baby at risk of travelling in labour to the hospital and exposing us to the additional risks of a hospital delivery. If you fail to send a midwife and any untoward event occurs which can be attributed to your failure to provide a midwife you can rest assured that my family will take appropriate action'.

So far, in every case to date that we know of, the Trust has provided a midwife. You may also wish to ensure that the authorities know that there are problems in your area so you could also send copies to the contacts listed below."

thanks BabiesEverywhere - I had read that but wasn't sure if that would cover someone who hadn't booked a HB in advance... Guess it just depends how helpful the person is on the phone at the time... All hypothetical for me just now anyway... We'll see

i doubt a freebirther would have any antenatal care or contact with any midwives.

i thought hte whole concept of free birth was freedom from any medical 'interference'

i would absolutely not support anyone who wanted to freebirth.

AIMS has lots of info re homebirth rights.

Maybe not very helpful... but if the hospital is already short staffed, not sure why they should be obliged to send somebody to your house.
The hospital where I had my ds was running on the bare minimum staff wise and fair enough it's not fair on you, but that's not the midwife's fault. In an ideal world there would be enough staff for everyone to have their first choice, but this isn't the ideal world....
I am all for homebirths but will be a lot easier if you did it with the approval of your midwife and didn't have to resort to threats over the phone.
Sorry not suggesting the op would do that, just my opinion

I think that legally a midwife is obliged to attend a woman in labour ( though I believe there are times in hospital when women have trouble exercising this right )
Have you thought about an independent midwife? They are very expensive and obviously big issues with them being uninsured, but you would then know that you would have one there.

I am expecting my 4th child any day now and although I am planning a hospital delivery, I have quick labours so have arranged a contingency with the community midwives in case I don't make it to the hospital.

They told me that ordinarily, if I was to call the hospital and say that I was in labour and had left it too late to get to the hospital, they would call the on-call midwife who may or may not live near to me. In my case it could easily mean that I would be without a midwife and would have to depend on paramedics to deliver the baby. I've been given the mobile phone numbers of my local community midwives, so that if I leave it too late I can call one of them and be pretty much guaranteed midwife care at home if necessary.

I've also been told that if when I decided I need to get to the hospital it's the rush-hour, I'm to call 999 rather than get DH to drive me in. It's about a 20-30 minute drive usually but a good hour in the rush hour.

Depending on the speed of your labour, you can argue all you like on the phone to the hospital but if there isn't a midwife who can reach you quickly there's not much they can do about it. And I'd much rather know that if I was delivering the baby at home, the midwife looing after me was prepared and had all the resuss equipment with her.

If I was delivering at home with my local midwife, I could trust her to deal with an emergency - eg baby not breathing, pressure on cord, PPH, shoulder dystocia etc. I'd be much more nervous if I was being looked after by someone I'd never met and had no idea of their competence.

Lulu - I believe some freebirthers do have antenatal care, sure it was Worktostaysane was planning/hoping for this in the last freebirth thread I read. ( I could be wrong though)

Bonnie - totally agree that it's far from ideal world when it comes to childbirth here (unfortunately)!

littlepink - indie mw wouldn't be for me and far too expensive. My situation is strange though.

Rolf, you make a lot of good points and it sounds like your mw's are very sensible. Good luck with your birth

Why do people assume that homebirths take midwives from the ward? Community teams do them - the ones who come out to you afterwards! gets my goat that the taking m/w from the ward line always gets trotted out by at least one poster on any homebirth thread.How it works is that the area is split up into neighbourhoods each neighbourhood has one or two midwives on call ,if they are at another birth, then an on call from another team comes, if you live on a trust border, they might even be from a different trust, CMW's do do shifts on the labour ward or MLU in most places, but not when they're on call

jamila169, I agree. Also don't forget their are fully trained midwifes on the bank staff and independents as well if the trust run out of community staff, no need to take staff out of hospital.

their there are

Im due to see my mw next week for my 28th week app.
Wanting to discuss HB, a bit nervous due to not getting one first time round.
I obviously have few questions to ask.
Anyone reccomend any I should be asking in case I missed any or what to say if they start trying to talk me out of it again.
Thanks

In my area any woman who wishes a homebirth will be supported to have one whether she is suitable or not. Midwives will go on call from the community team.

There are no midwives oncall for unplanned events, so it is an ambulance that is sent and the woman is brought to hospital.

The main reason for this is health and safety and the lone worker. Midwives could be called to unfamiliar areas and often the ambulance had arrived first anyway.

Much better to plan homebirth at outset.

no1putsbabyinthecorner - read up on AIMs and homebirth site for lots of info and just keep telling yourself there is no reason for you not to have the birth you want and then they can't talk you out of it. Good luck.

Mears - thanks for that info, health and safety reason makes sense. totally agree that it is better to plan a homebirth, just sometimes difficult. Won't go into my situation though coz that would just start a different discussion.

Agree with Mears that in the NHS trust that I work for, there are no midwives on call for a situation like you describe.

A midwife from the birth centre or delivery suite will attend an unexpected delivery at home or an imminent delivery, but would not attend to care for someone who phoned up in labour asking for a homebirth. There simply are not the available staff to do this, and there are no bank or on call staff waiting for a phone call at 3am who would be able to come in for this, never mind having the experience in homebirthing or the confidence to do it.

Anyone in our area who wants to book a homebirth is referred to a small team of midwives who caseload mainly very young or vulnerable women (and homebirthers!) but they are not on call except for their own clients, so cant be called upon to attend homebirths, and our community midwives do not do homebirths (no 'out of hours' cover in the community).

So in the case of the central London trust I work for, you would not even get an ambulance sent, but would be given the advice that you should come in to labour ward. If the birth is imminent, and you phoned up again and could not make it to hospital, then a midwife would be sent out, but you would not be getting the good experience of a planned homebirth, instead you would most likely get a frightened and stressed midwife who has probably never even seen a homebirth. Im sure thats not what you would want.

Obviously I dont know your situation, Asur but if you really want a homebirth (which is an amazing, magical experience), then I really suggest you book one with your local hospital instead of risking disharmony and unpleasantness while you are in labour.

I second the booking one in advance option.

Obv there is more to your circumstances, which we aren't aware of, but I really would suggest it isn't a good idea to leave until labour before trying to get a m/w out.

End of pg and start of labour is stressful enough imho without the wondering whether anyone will attend you, or if you'll have to dial 999!

Can you not discuss with your m/w your concerns?

I appreciate that my views won't be too popular, but is there a reason that you are unable to get a homebirth (i.e. risk factors calculated are too great for them to agree to one)? Or is it due to lack of funding?

I do see how it would be lovely to have your baby at home, but as someone who has major complications in pregnancy, I would not want to if there was any risk attached to it. At the end of the day it is more important that your LO is born safely. Nor would i like to think that my insisting on a homebirth would be taking funding away from the hospital care that other people (more high risk) would receive.

HOMEBIRTHS DO NOT TAKE STAFF OR FUNDING AWAY FROM HOSPITAL BIRTHS. THEY ARE A REASONABLE USE OF RESOURCES.

women are legally entitled to give birth at home. low risk pregnancies should be offered home birth as the default option IMO.

where and how you give birth can have a lasting effect on a woman's psyche and how she feels about future pregnancies and births and her baby... so yes, i think a woman should be able to choose, and not be guilt tripped into worrying about deprivign other women of anything. which is a fallacy anyway

if tehre are not enough midwives in hospital, that is not the fault of the woman labouring at home.