Low intervention - homebirth

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Hi. Just wondering if any ladies are currently pregnant and planning a homebirth?

I have self referred and noted on my form that I’ll be having a homebirth. I have my first booking appointment in 2 weeks.

Just looking for some positive stories on the process so far and how to navigate avoiding landing on the intervention conveyor belt.

not looking for opinions from people who are against homebirth/haven’t experienced it

So it comes down to this whole 'whole birth will be fine as long as I trust my body' rubbish. I'm not sure why we see so many maternal deaths in countries with few midwives then, if what's required is trusting your own body.

You've not given birth before. How on earth will you know if it feels right or not? That's just ridiculous.

We are one of a handful of animals who have highly risky births. I think we're number two just below hyenas, who frequently die giving birth, and their first babies don't survive even if mum does. Nature doesn't care about your survival from childbirth, as long as enough of us survive. Trusting your body can only take you so far.

By the way, you say that a midwife should be able to spot from a distance if something is wrong. You also say you'll accept intervention in an emergency. How do you get from one of those to the other? If the midwife expresses concern, are they to wait until it becomes life-threatening? Or will you allow them to examine you and see if it's okay to continue? The reason that home births are safe is because there's a low threshold for moving you to a hospital. Nothing you've said indicates that you will follow midwives advice, unless it's an absolute emergency, at which point it might be too late.

Forgive me, but I won’t be taking advice on misogyny from a woman who uses phrases like “girls girls.”

Are you still practicing in the NHS?

I ask because you do seem awfully biased.

If you are going to post for advice or to ask for the experience of others, it's best to be precise in your first post. So saying ' I would really prefer a home birth with minimal intervention but realise that circumstances could alter that and I might require medical intervention in hospital...' would have got different responses. A lot of what you say seems naive to some of us who have given birth and know that things can go wrong quickly. If you don't want to hear that, it's your business, but others feel that thinking of every eventuality suits them better.

Gosh I’d replied to your OP and hadn’t, and still haven’t read the subsequent 400+ replies.

I’ve read a few and am surprised by them! There is a lot of misunderstanding and misinformation here OP.

glad you found the group. Like I said, be mindful about the information you get from social media. Sometimes spaces dedicated to one specific cause can become echo chambers of ideology or misinformation. Stick to credible sources, Doctor Sarah Wickham is an incredible place to start. She is a midwife who has collated so much good and relevant evidence and presents it in a concise and easy to understand way. I love her books, but I am a bit of a nerd for anything maternity related!
Since I’ve been pregnant for the first time myself I’ve returned to some of her deep dives to refresh my knowledge and I’ve found her books and website so so helpful. There’s a lot of free info on her website if you can’t buy her books.

Theres nothing to say you won’t have a beautiful home birth. There are so many variables in pregnancy and birth, and it’s important to make informed decisions about how to proceed to keep safe. Birth is a physiological process that our bodies are designed to do, but nature isn’t perfect and isn’t always kind.

One of the challenges I’ve found so far is finding the balance between a positive mindset around birth, so things like belief that my body can do it (as mindset is so important!) but also not being tunnel visioned so if it comes to it and I do need to accept interventions to keep safe, that I won’t feel like I have failed or feel disappointed in how things have gone. It’s a tricky balance but I think just going with the flow and keeping positive but aware that quite often we as women aren’t in charge, but that actually are babies are most of the time!

That might be a bit rambley but those are my thoughts!

I will add, there is a reason that so many midwives reject the medical model and choose home births for themselves.

Okay, So let me just believe you for a moment when you say you're a midwife.

You are attending at a home birth, the rule is hands off and observation only. You spot something that may mean all is fine, but may mean a catastrophic complication is arising. I'm sure you can think of about a dozen of those scenarios. If that complication arises, they REALLY need to be in hospital. So one of them is an emerging risk.

Do you:

1. wait until the risk fully emerges before doing anything about it?
2. suggest mum is transferred at that stage?
3. ask to perform further examinations on mum to gain further information?

I'm guessing it'll be 2 or 3. How would you feel as a professional about just sitting and waiting for 1 if mum declined 2 or 3?

Come on OP, if your baby was in distress and heart beat was dropping, how would you know? How would the midwife?

LOVE THIS!!!!! 💖

Ok, so you are assuming that you could persuade her for 3 by building up rapport and trust.

However, if she said 'no, I want you to observe only unless it's an emergency' then you'd have to follow that obviously, but would you feel uncomfortable with the risk she was taking.

When she's been asked, the OP has not given any indication she'd accept anything other than C. If that was the case, would that concern you?

Purely from a place of education, before anyone jumps down my throat.

If a woman declines any physical monitoring, communication or examination, beyond being in the same room, does that not increase risk?

My assumption (and it is purely an assumption) is that whilst a midwife may be trained to see visual clues, they’re not going to do that as quickly and effectively without physical contact, and would only see the problem after it’s started, and not necessarily whilst it’s developing/in it’s early stages, when a non-trained mum might miss those signs to tell anyone.

Home birth aside, the location doesn’t particularly matter to me, that would be my concern with a low involvement birth. I might know my body, but I don’t know better than a trained medical professional.

I get that, and frankly the main reason for you to be documenting like crazy is because of the increased risk of things going tits up, and you don't want to be found liable.

You detailing the conversations doesn't alter the risk to mum or baby, but it handles your professional risk. From a professional perspective that's what counts and mum is entirely within her rights to decline whatever she wants. But you're also human and being asked to observe an obstetric car crash and to cover your back, rather than intervene can't be easy, and can't be what your think it's the wise decision from the mum to be.

You didnt. You just said were opting out. Other PPs suggested it might be a good idea to have one.
That's all. Why the need to be so defensive ?

@Babyboomtasticyou didn’t ask me, but I will answer as a MW.

firstly I feel it’s pretty important to communicate anything we see emerging in a timely manner to the labouring woman. I wouldn’t sit on anything concerning and then all of a sudden blindside her with it when it’s about to turn into an obstetric emergency, that would be crazy.

you’re right it would be a mixture of 2 or 3, but it depends how you do that. She might have already stated in her birth plan and/or verbally that she’s declining X intervention. So if things change and I feel that assessment or intervention is now indicated then it’s about having a conversation around that, what the situation is, what’s changed, what’s the risk, what’s the rationale, what’s the benefits if it. It’s about giving information so they can decide for themselves.

How I feel doesn’t really matter. As long as I’ve done my job, given my advice and recommendations as per guidance/evidence and documented everything factually then I’m satisfied.

There might be things that happen that you disagree with but that doesn’t matter. You’re there to support the woman and make sure her choices are as informed as possible. We aren’t the police, people have human rights and can birth wherever and however they like.

I can think of one home birth that was starting to go south and the woman was declining transfer when I felt it was necessary but that was her right. I kept the unit informed all along and made sure my documentation was spot on. She delivered and agreed to transfer in postnatally. Baby ended up going up to NNU for a couple of hours for some obs but all was well. The records were pulled and reviewed due to the unexpected NNU admission so I got to have a chat with senior MW’s about it and all was fine, no issues with my practice or anything I had or hadn’t done. We batted about some hypotheticals as a team like what would we have done if this, that or the other had happened, how would they have responded in my shoes etc, it was good for my learning and offered a good amount of reassurance for future practice.

Thank you so much for taking the time to reply to me. The misinformation on here has come across as an attack/offence which has sent me into a natural defence mode... to which I have then been accused of having a bad attitude and defensive.. can't win really.

Dr Sara Wickam is a fantastic resource, I have two of her books, in your own time and homebirth. I also have Rachel (can't remember her surname) rite of passage book - I thnk that is what it's called. It's red.

Thank you for your advice and for sharing this with me. I completely agree with finding the balance - I am positive but also very much aware of risks. Fortunately, I have a great support system with my husband. 💖

Thank you. You seem perfectly sensible. It was the other poster who said she's a midwife, who has spent pages and pages defending the idea of a completely hands-off birth, where the op has indicated preference 1, not 2 or 3.

Whilst you can only act with consent, and therefore would be bound by that, that's different from encouraging someone to decline monitoring for an emerging threat.

It's surely concerning if a midwife is encouraging this, and saying that it doesn't increase the risk.

How is this defensive.. Poster said that people have given advice about the 12 week scan, I said I didn't ask for this advice.. How is that defensive, it's factual?