Cold feet about homebirthing??

[LittleDoe]

I'm 32 weeks pregnant (with first baby) and up to this point have been really convinced that a homebirth is the right choice for me. However in recent days, I've been beginning to get cold feet. My main fears are that either the baby does not breathe on its own after it is born, or that another serious complication arises that could be treated successfully in hospital but not at home (obviously with worst case outcome that the baby dies or is brain damaged in some way).

I presume these are normal concerns/fears for homebirthers, but does anyone have any advice as to how you got yourself comfortable with the risks etc?

After having been so pro-home birth for most of my pregnancy, I now think I'm going to give in to the "system" because I am so concerned about something bad happening and ultimately blaming ourselves forever. (DH is actually very pro-HB but clearly just wants to support me in any decision I make).

If I'm getting this worried about it should I not be having the baby in hospital (and then maybe considering HB for second DC, assuming there is one)?

Bear in mind that some events are unpredictable, but for most cases the hospital intervention has caused the problem (i.e. induction of labour, supine position, epidural. In a home birth scenario, the threshold for transferring you into hospital is very low. For example, meconium in the liquor in hospital would simply mean putting you on a CTG perhaps, but would probably mean you transferring in from home (unless baby was about to be born any minute!) Midwives are trained in resussitation of the neonate, and many are more proficient than a junior paediatrician. A hospital birth is not a risk free option, I can assure you! There are no guarantees of safety in life, and particularly so in childbirth, but assuming all things were equal I would choose home every time (and I speak as a nearly qualified midwife with one hospital birth and one home birth of my own). In hospital we create problems and then say 'Oh aren't we wonderful we saved your baby!' All the research shows homebirth to be a very safe option for low risk women. Every labour is a trial, there is no guarantee that your second would be any 'safer' than the first. However, having said all that, much of what happens in labour is related to what is going on in your head so you have to feel safe and cared for wherever you are. Good luck!

I was absolutely set on a homebirth but ended up being ambulanced into hospital. No interventions or anything needed in the end but the midwives will monitor you and DC and tell you in no uncertain terms if they have any concerns which make them think you'd be better off in hospital.

For me the whole point of a homebirth was to be more relaxed (in familiar surroundings, etc). If the idea of it is making you more tense then maybe it's not worth it for you? You don't really have to make the deciscion until you see how labour is going, just because you're planning a HB doesn't mean you can't change your mind and go into hospital at any point during your labour.

I was comfortable with the risks involved but I don't live far from the hospital so I knew an ambulance could come and get me there within 10 minutes. I wouldn't have continued at home once the midwives were worried about the amount I was bleeding.

I had a homebirth and my baby didn't breath when he came out. The midwives took it completely in their stride. They didn't panic at all, rubbed him down and gave him oxygen. He took his first breath at 2 mins and is now a completely healthy two year old.

My dd also didn't breathe when she was born, but the midwife in the hospital didn't deal with it nearly as well. She kind of panicked which made it much more alarming for us. (By the way, DD is also completely fine.)

The care we had at home was massively better than the care we had in hospital. (Although I do think we were particularly unlucky in our hospital experience.)

Because you will have 1:1 and eventually 2:1 care throughout your homebirth, any concerns/problems are picked up very early. You are transferred before the problem becomes serious IYSWIM.

In hospital the lack of 1:1 care means that a mild problem can become serious before it is attended to.

How far away is the hospital?

I had a hb with my first and was reassured that if anything were to go wrong I could be one a ward within 15 mins.

Nothing went wrong though - had 2 qualified and 1 student monitoring me throughout and felt safe and secure at home.

Agree with drowninginclutter - you don't really have to decide now. Labour at home and if you want to go in to hospital you can. If not, you have all the resources required for you homebirth. Including the midwives.

Oh and fear about the birth and the baby are universal, regardless of where you deliver.

Do you need to decide now?

I am considering an HBAC later this year. I am like you - concerned that if anything goes seriously wrong DH and I will struggle to cope, but in many ways I think that HB is likely to be the safest option. My midwife is happy for me to decide on the day as she figures wherever I feel safest is where my labour will be most effective. You can always see how you feel on the day...

Similar exp as drowning in clutter first time. Statistically you are more likely to transfer to hospital from home if you are a primagravida, but that said, you get a great welcome when you are blue-lighted in.

Joking aside, I read up loads on homebirth for DS2, and was quite satisfied that MWs can deal with most problems as they arise and will not hesitate to call an ambulance before things get critical.

It's ultimately your choice, but I don't regret what happened with DS1, as I am quite convinced I would have had a CS had I been in hospital from the outset.

you can always decide on the day if you keep the hb booked.
hippy alert . . . . I went upstairs by myself when labour started and asked my unborn baby if she was happy to be born at home and if there was anything she wanted to tell me about the labour or worries she had. I guess that was my way of making sure I was happy with the decision I was making.

dd was born with cord round neck and needed a few whiffs of oxygen to breath but it was totally unscary and she was fine.

Thanks guys. I totally agree with the point that if it's making me more tense, then it kinda defeats the purpose, doesn't it ! That is exactly what I've been thinking.

But I also know that a hospital birth does not necessarily mean risk-free.

Like the idea of labouring as much as poss at home and then transferring if somehow I feel that at that time, it is the right thing to do.

Incidentally we're about 25 mins away from the hospital assuming no traffic problems (I guess quicker in an ambulance, although that's not a great thought).

I think some nerves are to be expected as you approach your first birth, after all, you've never done it before and you don't really know what it's like, so no matter how prepared you are you still feel uncertain etc.

Having a homebirth can be a wonderful experience. Mine was utterly fabulous, calm, relaxed, easy, euphoric.

I'll tick off the points that you are concerned about and try to ease your mind.

"the baby does not breathe on its own after it is born,"

When a baby is first born it is still recieving oxygen from the placenta via the umbilical cord, so if the cord is left intact and not clamped and cut the baby has time to start breathing slowly and gentley. As long as the cord is intact and the placenta is still attached the baby is not being starved of oxygen. In the event of your baby having actual breathing difficulties at birth then the midwives attending will be fully trained in neo-natal resus and (as far as I know) all homebirth kits include a full resus kit including masks, oxygen and so on. So, if, when your baby is born, be you at home or in hospital, don't panic if s/he doesn't instantly let rip with a lusty wail, but starts breathing slighlty slower. This is ok, as long as the cord is intact and hasn't been clamped. (I'd make the midwives repeat it like a mantra, "the cord is not to be clamped until it as stopped pulsating, the cord is not to be clamped until it has stopped pulsating....")

"that another serious complication arises that could be treated successfully in hospital but not at home"

Like what exactly? That you'll start to bleed massively? The midwives will know how to handle that and will give you iv fluids and syntocin injections whilst blue-lighting you to the nearest hospital. I can't think of anything else that is likely to be catastrophic, that would be a sudden event that could be dealt with in a hospital but not by the midwives in your home.

Sure, crash c-sections happen, but they are very rare, most emergency c-sections are done once the theatre team has been bleeped and assembled and so on, and this takes about 20 minutes, so as long as you are no more than 20-30 minutes away from hospital then you'd get in just in time to be wheeled into theatre, rather than waiting in the delivery room for 15-20 minutes until the staff etc are ready for you.

Most birth complications have signs, (meconium in amniotic fluids or what ever) and the midwives would pick up on these signs and tell you they would like to transfer you to hospital.

Ultimately, don't panic, the midwives who will attend you will be highly trained and experienced. You are more likely to be left with a student or newly qualified midwife if you are in hospital, but this won't happen if you are at home. The best thing to do now is to go over why you wanted a homebirth in the forst place, read your Michel Odent , Shiela Kitzinger , Ina May Gaskin and Grantly Dick-Read books again and remember, if you're a healthy woman having a healthy, normal pregnancy, there is no reason to believe that anything will go wrong.

And finally, you can change your mind at any point and go to hospital, before you go into labour, in the early stages of labour, or in the full-on pushing stage, it's rarely too late to get in the car/ambulance and transfer. However, you may find that you feel fine, you are comfortable and relaxed at home and have no desire or need to go to hospital, and end up with a bliss-ful homebirth like I did. But, if you cancel your homebirth now, you can't really change your mind and decide to stay at home once you are in labour. To be a safe homebirth you need midwives in attendance and they will need thier birthing kit, some NHS trusts deliver this to your house once you are 37 weeks, it includes Gas & Air and all the drugs, resus kit etc that they might need to help you birth your baby. If you cancel your homebirth this equipment will not be readily available, so you can't really decide to stay home after all.

Discuss it with your midwife, by all means, but I'd advise you not to cancel it and to just see how you feel when things kick off!

Does your local hospital have a birthing centre? If so then maybe this would be a good compromise for your first baby if you do feel worried? It does slightly defeat the object of being at home if you end up being tense and scared.

I am very pro-home birth, I had DS in a birthing centre but then DD at home 3yrs later and am planning another homebirth with DC3, however I welcomed the reassurance of having the hospital and doctors/intervention down the corridor in case I needed them when I was having DC1. You get the same level of attention from a dedicated midwife and they try to make it as much like home as possible. They also usually have individual rooms and let DP stay with you so you don't feel so much like you are in hospital.

You could of course see how you feel once in labour and then decide to go to birthing centre rather than hospital.

Good luck, whatever you choose.

Do you have a homebirth support group near to you? (often via the NCT), it'd be a great idea to go to some of their meetings, ask lots of questions and soak up the stories!

Yep, there is a home birth resource group that meets monthly so definitely going along to the June one. I don't actually know anyone who has had a homebirth (apart from my grandmothers - ha ha, not that they're around to ask anyway) - I think I would really benefit from talking to someone directly in my local area who has delivered at home.

Unfortunately there is no midwife-led unit / birthing centre at my local hospital otherwise I probably would choose to deliver there this time around.

Thanks everyone for your comments - all really helpful and supportive.

I just wanted to say that I also had cold feet late in my pregnancy about homebirth, but decided to go ahead with it in the full knowledge that I could change my mind at any point - literally from the first contraction - if I didn't feel comfortable being at home.

Having a supportive partner makes the world of difference to how comfortable you are being at home. My DH was just amazing.

As it happens, I felt very relaxed at home and had DD in the living room. My labour was textbook and I managed with no pain relief except the pool.

I did end up transferring afterwards because of a retained placenta, but it didn't detract from the fab homebirth and to be honest I'm planning one for DC2.

Keep an open mind and play it by ear. The midwives will transfer you at the slightest hint of a problem and I told myself the homebirth midwives are the more experienced ones not the newbies. The one-to-one care I had was excellent. I knew that they were keeping a close eye on everything (having only one woman in labour to focus on) and I felt in safe hands. At the same time they gave me space and privacy to labour as I wished. All in all a very positive experience.

I had a doula and I think that contributed to my feeling relaxed.

A friend of mine planned a homebirth but changed her mind in early labour when she realised the baby was in posterior position. She didn't regret having booked a homebirth because it meant she was examined at home instead of going into hospital and being sent home again (as too early in labour). This seems to happen a lot (women being sent home and told to come back later). I can't imagine anything worse than going to and fro during contractions.

hi there,
i had a HB with my first baby and am planning one again for dc2 who is due in August.. i would just echo naturelover in saying that it is totally normal to have cold feet about having a HB (or any birth for that matter! .. having had a lot of umm-ing and aah-ing when planning the first HB i decided that i would just labour as long as i felt happy at home and was very open to transferring if i felt i needed to. In the end i really felt like i didn't want to go anywhere, not even out of the birthing pool (although of course i would have done if it had been medically necessary) and it was a very positive experience indeed. Even so, i woke up last night getting in a cold sweat about "things going wrong" this time around but managed to calm myself down in the knowledge that its just normal to be anxious about birth and reminding myself of all the positive and very right things that others have said here..
again like naturelover i had a pool and a doula and would highly recommend having a doula (and a pool if you like water!)if it is at all possible for you - especially with your first it is a huge bonus to have someone around who is experienced in birth and my dh was incredibly grateful for her presence in the long hours when not a lot was happening, as was I! I am having the same doula again for dc2. All the very best to you

Hiya OP,

10 weeks ago I had my son, first birth, at home. It was a great experience.

In pregnancy I was very frightened about making the wrong decision. DH and I eventually decided that the only outcome we needed to avoid was one where we either couldn't live with ourselves over the choice we'd made, or couldn't live with a choice the other one had made.

We took a couple of days, having agreed not to chat about it for a bit, each thinking 'can I live with myself/you if I choose this and something awful happens' we each found a bottom-line belief in trying for a HB which we felt we could believe in no matter what.

For both of us the bottom line was different, mine was arrived at through copious research (I subscribed to the British journal of obstetrics, and read avidly!) for DH his process was very different, but very 'him'.;)

My understanding was that in almost all of the emergency situations, bar one, we would be handled the same way at home as in consultant-led care. I found this enormously reassuring.

Happy to post more if any of this is of use to you.

All the very bestest with what you decide.

Love, Weezl xxx

YOu've had great advice on here, so nothing much more to add, except to recommend this book if you haven't already read it.

Thanks everyone - all your comments have been amazingly helpful.

I've now arranged for one of the community midwives to come out to our house next weekend to have a chat (and I guess for her to check we have running water etc ), so definitely all systems go for the HB again. I've realised that it's totally normal to have concerns about the birth no matter where we choose to deliver, and also that I can transfer to hospital at any time should I want to.

MaryHuff - I have just recently bought that book, and I agree that it is really good. I like the fact that it's really balanced.

Weezl - yeah, I would be really interested to hear a little more about how you reached your decision, especially having researched it so thoroughly (sorry if this sounds very lazy from my part - it's not meant to, I'm just really interested in other people's thoughts and experiences!). Only if you don't mind though.

TIA x

It's absolutely normal to get antsy about giving birth at home. We have all been raised in a society that has conditioned us to see hospital as safe, and home as risky when it comes to birth. Even though we research and know the facts - that home is as safe as hospital for low risk women - sometimes I think our social conditioning gets the better of our feelings.

Good luck with your birth - wherever it happens!

Hi littledoe, well you asked for it

my researching took 3 forms, talking to friends about their birthstories both at home and in hospital, and feeling free to ask questions which were brave on my part and brave for them to answer 'what do you mean by colossal pain' or how did you feel more powerful because you were at home, in what ways exactly?' (I've got very understanding friends who really liked talking about birth!!!)

practical researching- looked at midwife led unit, thought about how it would feel to be scared and in pain there, looked at consultant led unit, in both places even looking in the loos, at the waiting rooms etc. Thought about which room in my house if it were there and how I might want it to be kitted out. Sat in a birthpool to see how it felt... I was even going to try gas and air before labour to see how it affected me, but DH wasn't happy!

reading medical literature- I basically bit the bullet and found out which complications would be a nightmare if they happened at home, but ok in hosp, which would be a nightmare in either place... learned about what early signs the MWs would be watching out for, what the likelihood was of bad stuff happening, how long it would take for an ambulance to reach us, and then get us to hospital in an emergency...

Finally I thought about what each decision would mean for me, and what tone that set for my parenthood to be! Hospital birth for me would have been a triumph of my over-cautious risk-averse self. Home birth for me meant I had arrived at a confident happy (ish) place. And I very much wanted my son to experience me the second way. NB, I don't mean at all that this is true for everyone, I feel very strongly that for a lot of people their decision to labour in hospital also represents them at their best, confident happy decision making

I hope those thoughts help, sorry about the delay, I only just spotted you'd asked me to say more! All the very best with what you decide to do!

Weezl xxx

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