Home Births 'have been suspended' in my area

[waldorfsalad]

I had my first mw appointment today and told her I was considering a homebirth. She said that the trust has suspended homebirths atm due to staff shortages etc. Its temporary but she doesn't know how temporary and it may not be resolved by the time I come to give birth.

I am fairly certain that they cannot not let me have one but I don't know what to do next.

Hi Waldorf,

I am pretty new to the HB stuff, but I'm sure they can't do that. They have to provide HB care by law.

Contact AIMS. And read up on the letters you can send to your SOM, here:

www.mumsnet.com/Talk/1365/573041

In fact, join that thread, as we're all planning HBs and there's lots of info on there already. I hope to build quite a library on it by the time I pop (at home!) in March next year.

Good luck - let us know how you get on.

God this annoys me. I'm sure you're entitiled to a home birth.

How DARE they try to tell women where they should do this very basic, fundamental, vital, life changing thing?

The way in which respect is pitted towards the medics as baby-extractors, rather than the mothers as birth givers, has never failed to amaze me. Why have we women let it get like this? It's so wrong.

Sorry to be dramatic but this winds me up at a very deep level.

pah, well they'll know well in advance that you're planning a hb.
it's up to them to make sure they have enough staff to cover it. they CAN and should get bank staff in if they have staff shortages

hi, i too have planned a homebirth.i am using an independent midwife though.this can be an option but i have to pay for her.however i am very shocked at what you have been told.i didnt think they had the ability to suspend homebirths???are they also going to suspend the hospital births that need more intervention/expense and staff as the lady giving birth feels uncomfortable with the place she was forced to give birth in? sorry to sound a bit cross but it really annoys me that in this country we have such poor maternity care choices.

I may be wrong but surely a homebirth requires fewer staff? Certainly less money, as you aren't staying in hospital and using resources/beds.

I was told there was a govt push towards more home births a while ago?

sorry

I think that officially there is a government push towards home births. The reason that I want one is because for my last birth, in hospital, I hardly saw a mw so strictly speaking a home birth will take more staff as I should have a mw. I had a midwife constantly for the last 20ish minutes but in the previous 7 hours in the labour room there was probably only someone there for around 30 mins in total. I was waiting for a labour room for hours and there was hardly any staff around at all. That was nearly 3 years ago and they clearly haven't sorted out their staffing problems since then.

I'm not against hospitals, I just don't want to give birth on my own.

That's very poignant actually

Mind you I had a home birth and was left to it for the first bit...they turned up for the last hour and a half, when I was 4cm gone

That was about half my labour.

Hospital was pretty rubbish really. If I have to be in that much pain I would rather do it somewhere familiar where I can decide what I do etc. and nobody else can hear me screaming!

Have you seen this petition yet?

the driving force behind my planned hb is the rationing of care I received on the antenatal ward. Post natal care was also v. bad again for the left hand not knowing what the right hand was doing and was also a total nightmare.

Ain't no one will drag me onto a ward to give birth because I am not taking part in the lottery of outcome on there.

My 'shortage of midwives' letter is on the thread already pointed out. feel free to use what you can of it.

you are NOT legally entitled to a home birth - and a home birth requires more staff as a qualified midwife has to be with you from start to finish. In a hospital a midwife can look after more than one woman in the earlier stages of labour. If they don't have enough staff then they don't have enough staff - they don't keep a supply of midwives in the cupboard.

Are you not nervousal?

OP, have you thought about possibly getting a doula to help you through the beginning and transferring late? Or an Independent mw for a HB?

This may make interesting reading for you, nervousal:

"In 2006 the Nursing and Midwifery Council clarified the midwife's professional responsibility (NMC Circular 8-2006) as follows:
'Whilst an employed midwife has a contractual duty to her employer, she also has a professional duty to provide midwifery care for women. A midwife would be professionally accountable for any decision to leave a woman in labour at home unattended, thus placing her at risk at a time when competent midwifery care is essential.'

It goes on to state that 'should a conflict arise between service provision and a woman's choice for place of birth, a midwife has a duty of care to attend her. This is no different to a woman who has walked into a maternity unit to receive hospital care. Withdrawal of a home birth service is no less significant to women than withdrawal of services for a hospital birth.'

So when I wrote my trust not so long ago, this is how I ended my letter:

I therefore expect a midwife to attend when I call the Unit stating that I am in labour. I wish to stress that should the Midwifery Unit of --- NHS Trust deliberately fail to provide a midwife when I go into labour and anything untoward occurs to my baby or me, the Trust would have left itself wide open to legal action, and a considerable amount of negative publicity. I can assure you that my family, with the support of AIMS, would vigorously pursue such action as we shall hold you and the Director of Midwifery personally responsible for this failure.

Metaphorically speaking, they do have a cupboard full of midwives somewhere. they are called 'bank' midwives who are fully qualified. Much the same as schools hire fully qualified supply teachers in times of shortage. They hire them when they are short staffed on the ward for whatever reason. Why is that any different from sending a mw to a home?

They can also hire independent mw's on contracts if needed

I believe the first approach s to write to the d of mw, stating you are planning hb, and asking them to inform you by X date what they are doing in order to ensure this.

There are a few trustrs who claim they have suspended HB's, sadly. But lots of trusts will try anything initially to (it seems) work out who is prepared to fight. Which is sad. Quite often though it's resolved the minute you put up a fight.

I was told NO to a HB; broke my heart, my situation was that as DH worked a fair commute from home and I am 60 miles away from anyone who could care for my kids (2 are SN), I was petrified I would be left to labour at home alone, with nobody to take the boys (expected, and had, a quick delivery- had DH not ahppened to be on a day off when baby was born, he'd not have amde it). Social Servces refused help with childcare, so I would literally have had to deliver at home alone with the aid of an autistic 8 year old!

Amazing how quickly they changed their minds though when i wrote to the Obs with a letter from AIMs

NMC circular doesn't give a woman a right to a planned home birth - just says that a midwife has a duty of care to attend if she goes into labour at home. pretty risky strategy to depend on this if trust are understaffed as midwives will have duty of care to all the women in the hospital too. You can expect one to attend all you want - if they don't have any they can't send them. Of course you could sue on basis of circular - but that doesn't help you at teh time.

And there aren't a huge bank of trained midwives. Even if there are there may be financial reasons why they are not able to use them.

none of the if ands our buts you have raised, nervousal diminishes the professional responsibility which the NMC has outlined for the care of a woman in labour, despite where she is in labour.

we are talking of planned homebirths here. It is someone's duty to prepare a rota to cover this scenario and others like unplanned hb's where 2 mw's still attend.

Saying other women are on the ward blah blah is one of the poor excuses my mw initially put up to me. Why should I feel guilty and deny my entitlement over the failure of the Trust to properly plan for such a predictable eventuality?

They have to expect that some times will be busier than others and provisions of extra staff have to be made.

The money thing is a red herring. The more we allow them to cut funding, the more the funding will continue to be cut. Allowing sorry excuses based on budget gives them permission to continue to withdraw vital services.

My crap care in my first pg was due to this rationing of service on the ward. Why do I want play Russian roulette with that again? I'd rather stay home without a mw for as long as possible, which is what most home birthers do anyway, by choice, and then call a mw when labour is well underway.

The crap care i received 3 yrs ago haunted the entire first year of my dd's life and I had antenatal depression in the first half of this pg due to the fear that I may have to go back on a ward.

We should be demanding adequate midwifery cover for all mothers in labour, rather than making each other feel greedy for demanding the type of birth we want.

Sadly, in situations of such shortage, you have to shout loudly to get that which you are entitled to. The same goes for getting support for children with SENs etc.

You go for it, waldorfsalad. Make some noise, and demand your chance to try a home birth.

kiskidee, I will sign the petition you linked to earlier in the thread.

nervousal- I wonder what you would propose for my situation as outlined below then? really felt- and still do- that mine was not optonal yet still had to fight.

The nhs trust is obliged to provide 'maternity services'. IMO my nhs trust is failing to do that. I have no confidence that when I go into labour, there will be a midwife available in the hospital and I would rather deliver at home alone than in hospital alone. I will think about a doula or independent mw though.

If you go into labour and are having a home birth, a midwife doesn't abandon their patients on the ward to hold the hand of someone who is 1cm dilated, but they do have to pay for an on call community or bank mw, which it seems they don't have to do if a labour ward is crammed and understaffed.

My SIL almost died 3 months ago after her bodged hospital birth and is now infertile. I am not a lentil weaver who wants to be surrounded by candles and whalesong. I just want a mw to attend the final stages of my labour and delivery. If this could be guaranteed in hospital, then I would be quite happy to go in.

I understand that the nhs is not a bottomless pit but if women in hospital were given the minimum official standard of care the a homebirth would be cheaper. It is only because 1 mw is looking after over 10 labouring women that hospital births are economical.

My nhs trust is now offering nucal fold scans for free which it didn't a few months ago so they can't be all that skint. They also have the resources for the community midwife to sit with me for 20 mins to 'discuss' why I am not taking advantage of this service.

waldorfsalad - are you in my area?? I had my booking in on monday this week and was told the exact same thing by my midwife. Nuchal scans have been introduced recently too....do you have a recently refurbished maternity ward at the hospital?

I was very sceptical about her statement but didn't want to 'rock the boat' at the first appt as had crap support first time round and was trying to build a relationship with her. I am determined to have a VBAC and whilst I'm not convinced I want to do it at home this time around it wouldn't normally stop me from making a point... embarassed to say that I let it go...

I'm know its done to push mum's, particularly those who don't have the knowledge that choice IS supposed to be available to us, down the preferred route of hospital deliveries, thus enabling the reduction of budgets through the sharing of midwifes round many mums in labour. It makes me so cross that you have to be sooo strong to get what you are entitled to, and pregnancy and motherhood is all daunting enough without engaging in battle with the NHS, not when it should be available as a matter of course.

calsworld - My hospital is Derby City. Its very nice with lovely en-suite rooms etc. (I spent a lot of time in there with my SIL). I really wouldn't mind a hospital birth if there wasn't an almost criminal lack of care.

I thought it was worth reviving this thread with the following information.

Another MNer in London was being denied a home birth on the same idea that the Trust had cancelled all HBs due to staff shortage.

A midwife claiming to represent the Supervisor of Midwives came for a meeting at her house to discuss her HB. The MW really came along to talk her out of it. There were quite a few misrepresntations made by this midwife along the way. By contacting Beverly Beech at AIMS and the Home Birth.org website, this MNer was put in contact with someone who has a lot of power at the Royal College of Midwives who contacted her Trust on her behalf.

Because quite a few unethical things were said and done to her in the course of things, the RCM seems to have slapped the wrist of this Trust.

The best thing now is that this MNer is now having her Home Water Birth, with an Independent Midwife, and paid for by her Trust.

I am sharing this story in the hope that other people take courage from in and do not give in to excuses like 'we don't have the staff to cover home births.'

When this MNer asked if she was the only one requesting a HB, they told her oh, no, lots of women ask but they always give in when we say X,Y,Z to them, leaving her to feel like she was being unreasonable.

definitely worth sharing that foxytocin.

it is unfortunate not to mention unethical, as you say, taht women often have to fight for their legal right to give birth at home..

i woudl always advise anyone being denied a HB or a waterbirth in hospital or VBAC etc.. on spurious grounds, or grounds of not enough staff/trained staff.. to contacat AIMS.

i was lucky enough to meet Beverley Beech recently at a midwifery conference, and she is so , so passionate about this, and will absolutely do everything in her and AIMS power to get you the birth you want.