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Childbirth

Share experiences and get support around labour, birth and recovery.

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Original poster

To home birth or not to home birth?

32 replies

mersmam · 31/12/2008 09:45

I'm expecting my 4th baby at the beginning of May, and I'd be very grateful for anyone's advice/ opinion/ expertise regarding whether or not I should have the baby at home.
My first baby was born in hospital - straightforward delivery (although I had an episiotomy) but a very stressful generally unpleasant experience.
Baby number 2 was born at home while DD1 was upstairs in bed - completely problem free delivery, probably the best childbirth experience I could hope for!
Baby 3 was also born at home. He was big (9lbs 4oz - and that was a week early) His shoulders got slightly stuck on the way out, the midwife quickly sorted it out but advised that she wouldn't like to see me deliver a baby any bigger than that at home. I decided there and then that the next one would be born in hospital.
Now I'm not feeling so sure about it though. I hate the thought of going into hospital and I have no-one who I am really comfortable leaving my older three children with (I'd love it if the baby could be born while they were at home in bed like with my second birth!) My community midwife is open to the idea of me having a homebirth, but my husband is not keen on it given what happened last time.
I think my third baby may have been so big because I had to take a course of steroid tablets a few days before he was born for a bad chest infection (I have asthma) - does anyone know whether that is likely to make a baby bigger? If I knew this one was not going to be as big I would almost definitely opt to stay at home...
Anyway, any advice from anyone on what I should do would be most appreciated! I know it's my decision in the end, but other people's views always help me to think a bit more clearly...

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keels26 · 31/12/2008 10:08

I think that you might just have to wait it out for a while and see towards the end of your pregnancy how big this baby is, thats what I would do. How close to the hospital are you, would they be able to get you there quickly if they had too? The idea of having a homebirth while the kids are in bed sounds wonderful and if thats what you want then I think you should try and aim for it, depending on babys size.
Also I am sure that steroids in pregnancy can make baby bigger, my dp was born prem at 34 weeks and was 5lb, and Im sure thats because his mother had to take steroids.

AtheneNoctua · 31/12/2008 10:22

Can you pay for private scans? If so, I would get a few of them around say March/April and gauge the decision then when you know how big the baby is. But, be aware that size scans can be not very accurate. But, it might give you an idea.

If the baby is expected to be large, then I personally would not have it at home. Seems a bit risky. Unless maybe if the hospital is less than five minutes away in heavy traffic.

Original poster

mersmam · 31/12/2008 10:22

Thanks for your comments keels. I'm very close to the hospital - only five minutes (and that has made the decision much easier in the past!) But I'm worried that if the baby is stuck at a critical stage that 5 minutes would make a drastic difference... I agree that I should probably wait until nearer the time to decide for def, but I don't know how accurately a baby's size can be predicted (the midwife said DD2 was going to be tiny and she was born three days later 8lbs 3oz!) I was wondering if I'd be entitled to have a scan at around 38 weeks to check on the size (can scans predict size??)

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AtheneNoctua · 31/12/2008 10:23

Where are you? The Fetal Medicine Centre in London is excellent with regard to scans. But you would have to pay for them.

Original poster

mersmam · 31/12/2008 10:24

Thanks for the answer before I posted the question AtheneNoctua - it would be a struggle for us to afford private scans - I was wondering if I'd be entitled to have one at the hospital for free given that I'm aiming to save them money by having the baby at home- but probably not I'm guessing!

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Original poster

mersmam · 31/12/2008 10:25

I'm up North I'm afraid so it would be a bit of a trek! How much does a private scan cost roughly?

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Tortington · 31/12/2008 10:26

i'd go where the drugs are

Original poster

mersmam · 31/12/2008 10:28

You can have the drugs at home Custardo but I prefer to avoid them (apart from the lovely gas and air!)

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Original poster

mersmam · 31/12/2008 10:30

I know some people think the idea of a homebirth is mad, but for me it's the fact that I don't have easily available childcare for the others that makes it a much more stress free option.

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ILikeToMoveItMoveIt · 31/12/2008 10:33

So baby 3 was shoulder dystocia? The homebirth.org site has some very interesting facts on shoulder dystocia, I would encourage you to read it.

From what I remember, SD has as much to do with the baby's presentation as it does with its size, ie a small baby can still present with shoulder dystocia because of it's position.

There are manouvers (sp?!) that all MW's should be familiar with when presented with SD. I think one of them is called the McRoberts.

There can be warning signs of SD. for example if the baby's head turtles (starts to crown, then slips back up again repeatedly).

DS2 was born at home, all 9lb 11oz of him with no problems

Original poster

mersmam · 31/12/2008 10:47

Thanks Iliketomoveit, that's very encouraging and I will definitely have a look at that site.
Another thing I wanted to ask about (while I'm speaking to all those of you with expertise!) - with both my second and third baby I've had the urge to push before the midwives arrived. I was told on the phone to fight against it and not push, and also with my third when the midwives arrived they told me not to push for a while (it was the hardest thing I've ever done at that stage NOT to push!) I was wondering what is the problem with pushing too early? With my second baby the urge passed after a few minutes and I had the feeling that if I'd pushed when I first felt the need she might have come out there and then rather than a very painful hour later.
Does anyone know why midwives tell us not to push? What happens if you push too early?

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ILikeToMoveItMoveIt · 31/12/2008 10:55

You can get the urge to push before you are fully dilated and you still have something called a cervical lip covering the babys head. If you push while you still have a small bit of cervix covering the baby's head, the cervix becomes swollen and the baby can't make its way down. It can then take a matter of hours for the swelling to go down.

However, it is possible for a MW to hold back the cervical lip while you push the baby past it.

My MW only arrived with 15 mins to spare and by that point I had already been pushing for 10 mintues as I couldn't not push. Maybe they wanted you to hold on so you wouldn't deliver before they got there?

Original poster

mersmam · 31/12/2008 11:02

Yes that was true for baby 2, but with baby 3 the midwives told me not to push after examining me - so I'm guessing it might have ben something to do with the shoulder dystocia - perhaps they could see there wasn't enough room for him to come out in the position he was in... Anyway, thank you again as I'm feeling much more positive towards the homebirth - will just have to get my husband to read this and see what he says!

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sarah293 · 31/12/2008 11:03

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belgo · 31/12/2008 11:04

Difficult decision mersman.

I have had three children. First in hospital, second at home but was a difficult birth with large amount of blood loss. Third birth was also at home, an easier birth but huge amount of blood loss afterwards, that the midwives dealt with very well.

But I am too scared to give birth again at home. I would be terrified right the way through labour that I would bleed to death (maybe a bit over dramatic, but you understand I'm sure).

The problem is though, the thought of giving birth in hospital really doesn't appeal to me.

My solution is just not to have another baby, which of course doesn't help you, but if I were to give birth again, I would first talk to a consultant about my options, and probably choose a hospital birth. I can't bear the thought of that terror of losing blood again.

Original poster

mersmam · 31/12/2008 11:16

Yes Riven I agree that the distance from the hospital does not make that much of a difference. but I suppose given the comments above about the size of the baby not being that important the risks of the shoulder getting stuck are no more for me than any other mother... I don't know if there are other risks associated with the baby being large. I know 9lbs 4oz is still not the hugest baby ever, but I am normally only around 8 stone so it was very big for me.

Belgo, I have not had the problems that you have had in the past (I can DEFINITELY understand how they've put you off giving birth at home again) I don't have a consultant though so don't have the option of seeking their advice (although mumsnet is probably just as good )

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Joolyjoolyjoo · 31/12/2008 11:20

I compromised- had all mine at hospital, but the mws respected my wishes and were very hands-off, which was lovely. Had 3 very relaxed and uncomplicated labours, and got a 6hr discharge, so was home eating Chinese take-away by teatime - best of both worlds, I felt.

Is it maybe worth having a chat with your mws so you can try to get a hospital birth with a home-birth feel? Or change to a different hospital?

ILikeToMoveItMoveIt · 31/12/2008 11:30

If I was in your position, I would read up on SD as much as possible and make a list of any unanswered questions you have.

Then sit down with your MW (make sure she knows you would like an in-depth chat with her, rather than the usual 5 minute appointment!) and talk through every scenario and how it would be dealt with. Maybe it is worth asking your MW to see if she can get hold of your birthnotes for baby number 3 and see what they say about your 2nd stage? They may answer some of your questions.

Also, look into optimal fetal positioning (OFP) here as this will give you information about getting your baby into a good position.

Original poster

mersmam · 31/12/2008 11:31

That sounds great Jooly! I'd actually love to change to another hospital with more of a homely feel but neither of the two hospitals near me are like that - they both seem very 'hospitalish'! I don't want to opt for one further away as my labours have each got quicker (the last was only an hour and a half) and one place i definitely do NOT want to have the baby is in the car... Also my labours have all been late at night (between 11pm and 3am) which makes it harder to get someone to look after the other children (and that causes another delay) Was it easy to get a quick discharge? I get the feeling that if the baby was born late at night my husband would have to leave when it was all over and then come back in the morning, I'd end up getting no sleep and I'd have to wait around for ages for all the discharge formalities (that is what happened with my first baby) - not what I'd like at all.

Does anyone know, if you give birth in hospital at say midnight, can you say to them at 2am 'Right we're leaving now!'?? I don't suppose they can physically lock you in

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Original poster

mersmam · 31/12/2008 11:32

Great advice again Iliketomoveit - thank you so much.

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sarah293 · 31/12/2008 11:38

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ILikeToMoveItMoveIt · 31/12/2008 11:38

You are very welcome

Original poster

mersmam · 31/12/2008 11:49

The mental picture of them chasing you down the corridor makes me smile Riven If I do go into hospital I'll just have to be more assertive and leave when I want. Was the community midwife OK with you after that? Did they still give you the same level of care at home afterwards?

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BoffinMum · 31/12/2008 11:57

I've got a similar issue because I am also having my fourth, and the last was a nine-pounder who had a compound presentation. The hospital are going to scan me at 36 weeks to try to guess the size, and I am doing a lot of sitting on a kneeling chair in the meantime to make sure the baby gets himself into a better position for the birth. The midwives aren't fussed at all though, and seem happy for me to have a home birth.

Original poster

mersmam · 31/12/2008 12:06

Did you ask for that 36 week scan Boffinmum or did the hospital recommend it? I will have to get myself a kneeling chair....

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