Help! I need some help re: homebirth - 35 weeks and panicking!

[electra]

I'm sorry for those of you who have read my posts about home birth before but I am coming up against a lot of opposition and I feel very stressed and totally unsupported.

There has been some concern in this pregnancy that the baby is a bit small. At my last scan (last Friday), however the sonographer found that the baby does not have IUGR and the doctor on the day assessment unit said everything was 'totally normal' Today the midwife who is negative about me having a home birth examined me and said 'oooh it's tiny' and has referred me for another scan. Fair enough, I do think it should be checked on before I get to term but she is clinging on every little thing she can to pressure me into having this baby in hospital.

She keeps on about

my medication (I have bipolar disorder). My psychiatrist, who specialises in the care of pregnant women says my meds will not impact on the baby in a way which would mean that I should be in hospital rather than at home and she totally supports my wish to have a home birth. My midwife, however seems to be ignoring her advice and instead has taken to producing a document, produced by a pharmacist which cites 'tiny risks' to the baby

she keeps saying I look skinny. While I haven't put on a lot of weight I am certainly not malnourished.

She thinks that because the baby is small it will get distressed when I go into labour. I said that I will transfer if there is evidence that the baby is in distress but that at the moment I have been told it is happy in utero.

I am getting so stressed about this now, because I am getting near my due date. I think that I should produce a document setting out why I want a home birth.

Does anyone know of any evidence I can use which will counter these reasons she gives? (I find them wishy-washy at best). She has basically said that because I am not a text book case this time, I should be in hospital. I think this is unreasonable - why should I be in a book to be able to get what I feel I need??

She knew me in my other pregnancies and keeps saying 'you're different from how I knew you before' - just because I now have a diagnosis attached to my notes.

Please help - I need to calmly set my arguments out so that she can't keep ignoring my point of view. I do believe that if I give birth at home it will be much less of a stress on me mentally. I need to be able to walk away from this as unscathed as possible and I do find labouring in hospital very hard and unsettling. I already have two children, and they need me to recover from this so that I am there for them as I am now. After I was ill the last time, it was a huge trauma for them both and it has taken me nearly a year to rebuild my relationship with them.

you have evidence from experts i.e the sonographer, obstetrician and psychiatrist.. you don;t need any more

see the supervisor of midwives ASAP and explain that your mw is being unsupportive and obstructive to your wishes for a home birth

even without supporting evidence, you can make an informed decision to deliver at home regardless

speak to AIMS if necessary

Lulumama - she is the supervisor of midwives...

oh bollocks. AIMS is your next step... or head of midwifery.. is there more than one supervisor? speak to consultant midwife too?

If the sonographer and the doctor are happy with the size of baby, that sounds good enough to me. She is just looking for excuses. To do her justice, she is trying to do her best for you- it's just that she is not necessarily in a position to decide what is the best in your case. The doctor and the psychiatrist are much better placed to do that.

I agree cory. Thanks for replies. She apparently thinks her estimate of baby's size, using a tape measure is more accurate than a scan! A week ago today, I was told that I had nothing to worry about. I can't believe that she is now ignoring my psychiatrist's advice in favour of a print out from the pharmacy.

If it comes to it you can just stay at home when you go into labour. Don't ring her, ring the on-call midwife and explain that you don't want your own one to attend you. You can prepare for this by writing to her to request this even if she is the supervisor of midwives but I'd also follow Lulumama's advice and contact AIMS. It's your decision and you sound very well informed to me.

She is right to ensure you are as informed with as much medical information as possible, but she is wrong to imply that it is anything other than your choice or to undermine your decision.

If you are worried or nervous you won't labour well and increase your chances of needing to transfer. This is why you need more than just your 'rights' to have a homebirth, you need to have support in the run up and during, of your decision and coping strategies.

Good luck!

can't advise on what to do but you have my sympathies. it is clear that she is just trying to think of reasons to say no. stay strong and just insist, but I appreciate you do need support from her and the other midwives. The skinny thing is absolutely ridiculous, we all carry differently, I am 38 weeks and look very silly because have a thin body with a massive bump attached..

be reassured that there are many supervisors. they are just midwives who are meant to support midwives and women make informed choices about care!
yours doesnt sound supportive. put your intention to give birth at home in a letter to the head of midwifery. also include the fact that you would like to be cared for by a midwife who will support your plans for home birth. AIMS can help you draft the letter.
you dont have to see your current midwife again if you request not to.
do you think your baby is small compared to your other babies? do you have any concerns about the growth. scans can be pretty inaccurate at assessing weight.
ultimately it is your right to birth at home or not.

Have you come across the homebirthUK mailgroup? There are a lot of women that have fought the same battle, although for a whole host of different reasons, who could give you a lot of support and/or advice.

AIMS can give you sample letters to use and could probably suggest whether there's an alternative point of contact if the MW being obstructive is the most senior MW.

I think writing a letter (to whoever) is the best course of action at this time - a lot of women seem to get very little support until they put things in writing, when suddenly all the "problems" that were around disapear... I'd be tempted to tell her that you have been through these issues with the relevant professionals and that you will consider any further discussion of them as harassment (but then I do seem to have my belligerent hat on at the moment ).

Hope you can get the support you need and deserve sorted out soon.

My Mum had her first baby in hospital and had a dreadful time and most of the rest of us were home births afterwards as she was calmer there. My Mum had a breakdown while pregnant I think and again some years later and certainly bipolar "madness" as we call it runs in our family so that's probably what my Mum had. She wasn't on medication though. If all the medical people except the midwife say you'll be OK, then the next thing that will ensure a good birth is YOU feeling secure, safe and comfortable. If you feel you'll be best at home you'll probably be right. If medical stuff occurs meaning you have to go into hospital you're prepared for this so that's OK.
I planned a home birth but had meconium in the waters so went in ambulance to hospital just 10 mins away and baby came 4 hours later.
Great thing is you'll probably get a different midwife for the birth anyway. I think you can probably still change midwifes now can't you?
Is your midwife an advocate of any home births? She's probably not just being against YOUR home birth, but most or all home births.

Thanks so much for your replies

This midwife knew me during my other two pregnancies and actually delivered dd2. She is usually supportive of home births, but it has become clear to me that if there are any circumstances that are not completely straightforward she wants you in hospital. I don't think this is reasonable and I very much dislike being slotted into a system.

I live 8 minutes from the hospital by car, and if there was any sign that the baby was in distress I would of course, transfer.

I will contact AIMS and see what they think the best thing is now. I also read the yahoo group - thanks for that.

good luck! i think it's unfair/unlucky for you that your mw has problems around a woman with mh diagnosis, which is what this grasping at straws for ant-HB evidence seems to indicate to me. do try and remember its her problem, not yours and try and shake off the stress she is causing you!

Thanks merryberry. It is hard because she is making me feel like I'm being so unreasonable when she is the one ignoring clinical evidence.

Well, yesterday I had to go to the hospital for monitoring and I had a chat with the doctor who was reviewing my notes. He said that he could see no reason from the outcome of my scans why a home birth should not be my plan at this point and when I told him the midwife had felt that her palpitation of my tummy was more accurate, his reply was 'HUH....no comment' The hospital advised me to speak to my GP and ask that I see a different midwife in future. I do think that it is unfair that after every anti-natal appointment I am left feeling stressed.

trust your instincts and do what you feel is right. you have carried babies before and will know if this one feels smaller or bigger. you are also the expert in how and when this baby moves and would know if there is cause for concern. you are the expert on your baby, as you know it intimately and you are the one least likely to take any risks. you could really do with a supportive midwife for the rest of your pregnancy.

My third was supposed to be IUGR, on the sayso of one sonographer at 20 weeks pregnant. I had to go for 2 weekly scans for the rest of the pregnancy to check the baby was still growing. Every single one (in retrospect) turned out to be giving incorrect predictions of her weight- the sonographers were convinced she was small, ergo they found her to be small. It was mad. She didn't feel small to me.

In the end I got so fed up I asked for a referral to the Harris Birthright Centre (Prof Nicolaides). They thought she was a perfectly average weight and couldn't understand what charts my hospital were using to diagnose IUGR.

She was born at 42 weeks at home weighing 7 lbs 9 oz.

My point being that sonographers do get it wrong about weight and size and a second opinion is always worth having.

btw- obs consultant felt my tummy at 39 weeks + 4 days and decided she was about 6 lbs. Midwives weren't sure, but weren't unduly worried about the baby. I laughed and bet her between 7.5 and 8 lbs. She accepted the bet. After the birth, she asked the midwives what the weight had been and roared with laughter when told! A good sport, it turned out...

Thanks for all your help and replies. I have contacted AIMS who have advised me to write a letter to the managing director of the hospital stating that I am having a home birth and to ask for the midwife not to attend to me any further. She was very helpful and hopefully now I will be able to sort this out!