1st baby - homebirth or hopsital birth? Need help to decide

[mumsiebumsie]

Hello all,

Sorry for yet another homebirth question - am in a quandry and hoping for some advice.

Am due in 3 months - I keep swinging back and forth as to whether I should plan for a homebirth or hospital birth.

In my heart of hearts I want a homebirth however I think that what is bothering me is that this is my first baby. I have no idea how I may fair. I could be way off here but I think that for mothers on their 2nd or 3rd pregnancies, they have some idea as to the pattern of their births and so can (with some accuracy) predict whether they will face complications that require hospitalisation.

But with me, I have no idea if I will face a currently unforeseeable issue and then really regret that I wasn't in hospital.

So my question is - with your first child - would you advise staying at home, or going into the hospital? Or should the fact that it's my first child really not factor in my decision at all.

TIA.

It's up to you, obviously, but all of the friends I know who planned for a home birth with their first baby ended up having to rush to hospital in the end. They & their babies were all absolutely fine, & obviously this is in no way a scientific sample, and I'm only talking about 4 people anyway.... but I do think the point you make about not having any idea of what it's going to be like is a good one - with a subsequent birth you do at least have some idea of what to expect! Is there anywhere available to you that might offer something in between? A midwife-led unit attached to a hospital, that sort of thing? That was where I had both of my dds, and it was great - I never saw a doctor at all, no unnecessary interventions, and somebody else to clean up all the mess afterwards.

But if your nearest hospital is reasonably close at hand, and your pregnancy has been straightforward and you know in your heart of hearts that what you really want is a home birth then go for it! Even if you do end up having to go to hospital at the last minute, that's not the end of the world and everything will almost certainly turn out okay. Good luck!

Hi, my DD was born at home. She is my first baby. My experience of labour itself was positive & I feel that being in my home environment strongly contributed to this.

I wouldn't worry too much about complications (only low-risk pregnancies are considered for homebirth usually) as you can always transfer should this be necessary & you will be given a scan to check presentation of the baby beforehand. Being at home will ensure the continuous attention of a midwife (not a luxury you generally receive in hospital) & they will err on the side of caution.

I do remember reading that when 1st time mums do transfer to hospital the majority of the time it is for additional pain relief rather than due to complications

Good luck & don't be afraid to go after what you want .

P.S. The midwives cleaned up for us at home but there wasn't much mess TBH. Getting into your own bed afterwards is BLISS.

Can I just second fran? I too had my first baby at home last October and it was an amazing experience!

My labour was long and painful but the whole experience of having her at home was so positive. DP was completely involved, we had 2 fabulous experienced midwives, there was barely any mess and we all got to go to bed together after the midwives left. Spending our first night together as a family in our home, in my own bed with proper cups of tea was fantastic!

I'd really recommend it!

Thanks so much for your responses.

Yes attached to my local hospital is a birthing centre which is midwife lead which could be a compromise. But still love the idea of being at home and tucked up in bed!

It's also a good point that there's a high possibility I could be transfered anyway.

But because I do tend to dwell on the negative - I keep envisaging a situation that is immediately critical where there isn't time to transfer to a hospital. i.e. baby is successfully delivered but isn't breathing due to mucus in the lungs or something. Sorry to be morbid but I'm just thinking can midwives really deal with ANY situation that presents itself. For example - if a baby is delivered not breathing - can they deal with that?

What are the scenarios where being at home would be fatal? Or are they so rare that it's pointless discussing them?

BunnyLebowski thank you so much for your experience! That's so lovely.

I've just had a similar dilemma mumsiebumsie, except it's my 2nd birth (I'm VERY risk-averse ) and have planned a homebirth this time. My reasons are mostly to do with practicality - few childcare options - and recognising that all the reasons I wanted a hospital birth last time ended up not really applying:

1. I wanted all the expert help on hand - but in hospital all the paeds disagreed with each other and I ended up being sent home after 5 days by the last one who was furious at how ds had been 'over-medicalised' (feeding, not birth issues). In retrospect I should have discharged myself on the first day, but did not have the confidence to do so.
2. I wanted to leave all the mess behind - well I left MY mess behind but had to clean up someone else's blood every time I wanted to use the loo.
3. Naively I expected a sterile environment, which I did not get. In fact ds picked up a persistent and unusual bacterial eye infection whilst in hospital which took 3 months to resolve.
4. I expected 1-to-1 care but half the time was left alone with dh while labouring, even though I was 9cm when I arrived and had ds 2 hrs later.

I am guessing that there ARE risks if certain things happen and you are at home instead of at hospital, but for me the things that are far likelier to happen all make me plump for a homebirth. We are also about 3 mins from hospital on a blue light, which I figure is the minimum time they'd need to get ready in theatre for anything urgent anyway. So that has figured in my thinking as well. If I was a long way from hospital I think I would probably reluctantly plan for a hospital birth.

Jimmy thank you very much for your input.

All the points you made are things that concern me - i.e. less than clean environment, staff over medicalising the birth and possibly the aftercare, not having 1-1 care etc. The idea of cleaning other people's blood off the toilet seat is enough to make me bring up my lunch! I rarely use public toilets so that really would be too much for me!

I'm 7 minutes away by ambulance - but about 1 minute from a private clinic, I wonder if me or baby would be allowed to go there in an emergency?

Thanks for your account - glad to see there are people as risk-adverse as me, I just like to weigh up ALL the pros and cons which can sometimes mean that I never come to a conclusion! This pregancy is going SO fast though that I need to get a move on.

Maybe it depends on the hospital though.

I've had two babies in two different hospitals. The first wasn't a positive post natal experience but the second was great. They even brought me tea and toast (with marmalade!) after the delivery (and the same for my husband).

First hospital had a dirty shower, second didn't.

My second was very quick and really could have been a home birth. I would have a home birth if I wanted a third birth but I wouldn't have considered one for my first child, and still wouldn't.

I had my first at home and would not have swapped that experience for the world. I did transfer after the birth because the placenta wouldn't budge, but I still would not have changed the way I did it for anything.In fact, my few hours in the labour ward convinced me I had done the right thing. They were understaffed, women were screaming blue murder across the corridor, I was left to my own devices for hours on end (not that I needed constant attention at that stage, but I never saw the same person twice) and my DH had to leave. The home birth on the other hand was peaceful and wonderful and all at my own pace.

My reasons for wanting to do it at home were so that I could do it my own pace as I was worried that if I was in hospital and failing to progress or something, then I would feel pressured (or more readily request) an epidural which might lead me down the "cascade of intervention" where I ended up with more serious interventions. As it happens I didn't have any pain relief - I'm not boasting, I am not one of these people who think those who do without deserve a medal or that everyone should/needs to aspire to that, it just wasn't necessary for me.

The other bonus of having a homebirth is that you should have 2 dedicated midwives who will stay with you even if you do have to transfer (at least thats how it worked with mine), so its a way of getting more dedicated care no matter where you actually end up having it.

From my reading on the matter I believe that statistically outcomes for low risk home and hopsital births are the same. If I remember orrectly there are a few, rare complications in which a hospital transfer could make all the difference (cord prolapse, being one), but being in hospital is not a guarantee of a good outcome in those cases anyway, and they are rare. Good luck with whatever you decide.

(sorry had to go and feed baby mid post, so apologies if someone else has alrady said all this)

P.P.S. Would recommend www.homebirth.org website if you've not checked it out already, as it has lots to links to relevant research. Also found Sheila Kitzinger & Ina May Gaskin helpful reading.

I think for a first baby I'd go for a hospital birth. Or as a compromise a midwife led unit at hospital.
I am pg with no.3. The first 2 born in hospital and both straightforward deliveries.
I was planning a homebirth for no.3 but after hearing horror stories from colleagues (I work in the hospital as an anaesthetic nurse) I am more inclined to go to the hospital again.

Sorry if thats not a very popular answer, and yes lots of people have fantastic homebirths, and Id love to have one too. But I just cant get that odd percentage out of my mind that go terribly wrong and might not have had they been in hospital.

Im not sure Im helping you, just giving you my opinion

Had a homebirth with my first... was fantastic. If there are any probs at all then they will transfer you in and the baby's heartbeat is regularly monitored.

If you want one-to-one care, clean environment, comfortable surroundings and no strange people bobbing their head in the door (and up your fanjo) every 5 mins then I'd say do it.

But get a birthing pool. There is limited pain relief and it will help.

mosschops you are helping. I need a variety of answers. As mentioned it's the small percentage that go wrong that I keep focussing on - perhaps unreasonably so but that's just my nature.

19fran76 I have checked out that website but it was a while ago so is worth another look

sausage thank you for your experience - it's lovely to hear a real life story. The care of 2 midwives is really an added bonus for me. Very worried about being left alone.

Alison thank you for your input - it's interesting to hear that from having had two children you still wouldn't consider a home birth for the first one. A lot for me to think about.

I'm kind of steering towards the midwife lead birthing centre that's attached to the labour ward of the hospital. Not quite what I wanted but thinking it may be the only thing to relieve my fear of the worst happening and me being far from hospital. But I still don't feel happy with that result either - is anyone ever FULLY happy with their decision??

Joesmummy very succinct answer - thank you!

Fingers up fanjo makes me feel slighty sick -a few times is okay but I know in hospital they can check you numerous times, they did to a friend of mine - until she eventually refused to be checked again.

I think you should go with your strongest instinct.

I never even considered a homebirth - knew it wasn't for me - but if it's what you want in your heart of hearts go for it. They'll have ambulances with sirens blaring if you have any problems and you can be in hospital within minutes!

my ds was born at home, first baby as well. It was a fantastic relaxed birth, very quick as well. I had a fantastic doula who I think made me very confident about it. When i was debating the home birth, I asked my doula if it was a good time to do it for the first birth. She basically said, it is the best time to go for a home birth, because it sets your birth history for the future. As long as low risk, your birth is likely to go better with less need for pain relief and less intervention than if you were in hospital.

If you can find a doula you like, I would highly recommend hiring one.

Generally midwives say, they can tell problems ahead of time, and you would have time to transfer to hospital if necessary.

If the anxiety you are feeling about worst case scenario is not going to be alleviated much by statistical evidence about home births/focussing on other positive aspects to this choice then it probably isn't for you. I agree with Mrs Mattie, follow your instinct. That will be how to be at peace with your decision, I reckon.

Riven I've read many of your previous posts so find your input very valuable - although a rare case it still highlights the risks that need to be weighed up - thank you.

MrsMattie that's the problem I don't know what my strongest instinct is!!!

audrey no money for a doula But like the idea of the first birth setting a pattern for the rest - never thought of it like that.

Thank you so much guys for your input - must log off but will be back tomorrow it see if there have been any further posts.

Thanks again

My only advice is, if you decide to go for the hospital option, make sure you go round a couple of times beforehand and familiarise yourself with the delivery suite and the midwives.

Birth is an 'animal' thing, that your body does without your logical mind being involved. Animals head for a safe, familiar environment and give birth often at night, in darkness. Hospitals are brightly-lit, unfamilar places. So if you're going to be there, make sure you are familiar with it - you will feel happier/more relaxed, and as a result may need less pain relief/intervention. (Source: Jean Liedloff, can't remember the name of the book)

I planned a homebirth and transferred in for slow progress and it was fine - in fact it was great. I am so glad I planned it at home, and was happy to deliver in hospital knowing I'd made the choice myself at the time it mattered.

You really need to be asking your midwife these what if... questions - that is what they are there for There's also a fab "what if" section on the www.homebirth.org.uk website.

I read somewhere that a third of first-time homebirths end up in hospital, but only a tenth of second-timers. So as long as you are prepared to go in I would go for it.

I'm planning a hb for number 2 due in a few weeks as I had quite a stressful birth with ds in hospital.

Yes Picante I think it's around 40% of first timers that transfer.

I was almost one of them - at one stage I threatened DP with all sorts if he didn't get me to a hospital! Luckily the lovely midwife arrived with gas and air and I reconsidered!