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Childbirth

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Original poster

Totally epic post but I really need help...

26 replies

ruthmollymummy · 26/01/2009 19:35

First let me say I love you all! and I'll try make this as short as poss!

Have had major challenges setting up homebirth. Community midwife v anti-HB and made me feel really crap after every appointment and conversation.

So finally got it arranged - triumph. 39 weeks today. Got a phone call friday from said evil midwife to moan again and she mentioned that I had a pph after dd's birth. (which I wasn't even aware of!)

So. Go to ante-natal clinic today for check, consultant doctor is called for who tells me he wants me to be give birth in hospital in case it happens again.

I'm not anti hospital, don't really have a problem with them other than being against intervention wherever possible and would just prefer to be at home.

chances that I'll bleed to death on the way to the hospital are so small I'm ignoring them but having to transfer straight after birth would be crap. I would rather be at the hospital the whole time than have to transfer as soon as baby born.

But I'd rather do it all at home! What do I do? Dig heels in, stay at home and risk having to transfer and guffing up the whole experience or just suck it up and go have a waterbirth at hospital?

(p.s. this might be my only chance to do a homebirth cos I'm not having millions of kids and every time I get preggers there's a 50% chance that I will HAVE to give birth in hospital because of underlying antibody probs...)

THANK YOU!

OP posts:
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theresonlyme · 26/01/2009 19:37

Probably way off and maybe not sympathetic but my gut feeling question is - what is more important a home birth or extra support in case of problems?

lindenlass · 26/01/2009 19:38

transferring's not that awful. Wouldn't you rather spend all of your labour and birth at home then just nip into hospital aftewards if necessary, than spend half of your labour somewhere uncomfortable and unfamiliar and birth your baby there too?

handmedownqueen · 26/01/2009 19:40

why not just give birth in hospital with six hour discharge.....? I am biased being am eidc myself but in my experience if things go wrong in obstetrics they go badly wrong in a lifethreatening way very quickly and you really dont want ot be involved in a transfer at that point. PPH is a big worry, I hd the experience as a vey junior doctor of holding a mums hand chatting about her newly delivered baby then in the blink of an eye realising i could not find a pulse because of a massive PPh

Northernlurker · 26/01/2009 19:44

I wouldn't risk having a pph at home. I had quite a minor one in hospital and there was a lot of blood! You are at some increased risk of it happening again and the more children you have the harder your uterus has to contract afterwards anyway.

How far away from hospital will you be? Worst case scenario is that you bleed very, very heavily before you get there and have to spend a long time in hospital with transfusions etc. You probably need to think about how long it would take to blue-light you to assistance if you did have a bad pph.

BoffinMum · 26/01/2009 19:44

I am a big HB fan but I would go in! Never thought I would say that!

PPH is really not funny.

TheBurnsifiedEffect · 26/01/2009 19:48

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lindenlass · 26/01/2009 19:49

Look here - might help you decide

TheBurnsifiedEffect · 26/01/2009 19:50

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MustHaveaVeryShortMemory · 26/01/2009 20:06

Follow the link from lindenlass and go to 'but what if...?'

Can you find out if there was a reason for your blood loss? For example did you have any intervention? That could have been responsible. It can't have been that bad if you didn't know it had happened!

Can you see another midwife? Sounds like she has been looking for a reason to say "no". Good Luck.

BetsyBoop · 26/01/2009 20:06

just checking on the risks

an "average" person has about a 5% chance of PPH.

If you've had one before that risk triples

info from here

Only you can decide what level of risk you are happy to accept to get your home birth.

I'll just add that I had a massive PPH (estimated as 2.4L) after an el c/s for DS and I was VERY VERY glad I was in the hospital, it gets scary VERY quickly.

Given that I won't give a personal view as I'm not exactly impartial

Original poster
ruthmollymummy · 26/01/2009 20:11

I lost 900ml after a long induced labour which ended in forceps delivery. I think that that could be to blame for the blood loss?

But it would take me 20 mins to blue light it to the hospital...

OP posts:
Northernlurker · 26/01/2009 20:19

well my non-medical view is that it probably was the labour and intervention that caused your blood loss last time....but that 20 minutes away is too long and I suspect thats why your midwife has been negative about this.

MustHaveaVeryShortMemory · 26/01/2009 20:20

Just been looking on a couple of other sites including pregnancy.about.com/cs/postpartumrecover/a/pph.htm. Certainly intervention and being induced both increase your risk of pph. Probably not unfair to say they caused your pph?? Assuming you don't have to be induced you can rule that one out and there wont be any forceps at home so.... Personally I would go for the homebirth. But if you feel anxious about it and think that anxiety would affect your homebirth then maybe you should go to hospital. Alternatively see another midwife. Your current one is clearly very resistant to you delivering at home and certainly wont inspire any confidence. Would she deliver your baby?

Original poster
ruthmollymummy · 26/01/2009 20:27

No this midwife isn't to see me any more cos I got very hormonal on Friday after our conversation and sent an email to her boss to say I didn't want her near me again!

I'm maybe not quite getting how real it is because its the last on a long list of reasons - all stupid up to this point - not to stay at home.

I just wished someone had looked at my notes months ago and noticed the pph. its rubbish I've been thinking its all going to go my way up until three days ago - surely thats a tad late to notice something like that when planning a birth!!

OP posts:
Rolf · 26/01/2009 20:27

I had a pph after DC3. I think a lot depends on the reason for your pph. In my case it was probably because I was doing too much - charging up and down long corridors to see DD1 in SCBU. Do you have any indication as to why it happened?

I had an lovely unplanned homebirth with DC4 and transferred to hospital afterwards for Group B Strep observations. The transfer was absolutely fine. The midwife came with me in the ambulance, I was in my own room in a MLU and didn't have to see a single doctor.

MustHaveaVeryShortMemory · 26/01/2009 20:31

So you could ask whichever midwife you see next if she thinks the intervention was to blame for the blood loss? In which case would it be reasonable to press on with a hb? Or see an independent midwife - but this is not cheap.

Lulumama · 26/01/2009 20:37

but there is a PPH, that is just on the cusp of a PPH, is it more than 500 ml? can;t remember , and a PPH as in 2.5 litres like betsey

if it was a PPH you did not even know you had, it can;t have been a serious, blood transfusion epic bleed.

it is ultimately your decision to make, if you know of the risks.. and the supervisor of midwives should make sure your care givers are prepared to support you or to assign you different MW

my friend has had a homebirth after previous PPH, she did transfer in but by the time she got there., all was well

it is your decision to make

Lulumama · 26/01/2009 20:43

i would definitely check how muych your blood loss was

also intervention and a tired uterus means more likelihood of blood loss as the uterus can go all boggy and not contract down , this can happen after a long labour or one with a big big baby too...

Original poster
ruthmollymummy · 26/01/2009 20:46

notes say blood loss was 900mls not nothing but not huge major woah. Was woozy after but didn't need transfusion etc.

OP posts:
lou031205 · 26/01/2009 20:55

I would go in.

BoffinMum · 26/01/2009 21:06

Can I qualify my earlier statement - I would go in but consider hiring an independent midwife to go with me to make it bearable.

mrsfossil · 27/01/2009 13:48

I really want a hb but had to have a emergency section with last one. I could dig my heels in and insist on being at home but if things go pear shaped then its full on emergency blue light etc. Just think how distressing that would be. Last time i didn't have a great experience but it was just as bad for dh as he watched me being wheelled off in a hurry. He then had to wait to see if everything was alright.

I know most women want that "perfect birth experience" I do but I'm not going to risk putting my dh and ds and myself through that possible trauma of a blue light transfer. I have to consider them as well. Safety has to come first. But I know its disappointing I would love a hb had my haert set on it.

StarlightMcKenzie · 28/01/2009 20:24

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StarlightMcKenzie · 28/01/2009 20:27

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tittybangbang · 28/01/2009 22:30

What is the risk of you having a pph? How long would an ambulance take to reach you? What can the midwives do for you at home?

These are the questions you need answering to make a coherent decision for yourself.

I suspect that the risks of a catastrophic pph are probably extremely small - otherwise there would be a consensus among all the health professionals caring for you that a homebirth is unwise.

I do feel for you - I had similar pressure with my second, as I had gestational diabetes. Luckily for me I found a supportive independent midwife and went ahead and had my baby at home. By the time I had my third nobody tried to persuade me out of another homebirth, despite my having had a previous macrosomic baby, previous shoulder dystocia and mild polyhydramnios. I actually ended up transferring in during my third labour for failure to progress, but once I got there had a normal birth, which was really exhilerating. I don't regret starting off at home and transferring - it was the best thing for me. I think if I'd been in hospital from the start I would have ended up with a c-section.