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.

mumsiebumsie search on my name for my story - planned homebirth, baby wrapped twice in cord, cut free, blue, thready pulse, no breaths. For all of that there was not a shred of panic and it was a fantastic experience. Did it again two years later!

Community midwives and homebirth teams will practice these drills very regularly - it is not in their interests to not be able to cope. Speak to your midwife and get a feel for how pro homebirth the team is in general, and ask specific questions about the scenarios that worry you. I'm sure she'll be able to set your mind at rest, but ultimately you do have to be comfortable with whatever decision you make - don't pressure yourself either way

I totally agree with Loopymumsy - her suggested approach sounds really sensible.

I had a homebirth with my first. It was a really fantastic experience (although painful!). My first thought after dd was delivered was 'I want to do that again'! (I guess this was due to a combination of gas & air and mega endorphins).

I'm 39 weeks today with number 2, so hopefully I'll being doing it again in the next few days!

As several people have said, all the evidence points to it being as safe as hospital birth (for the baby, safer for the mother) for low risk pregnancies.

The horrible truth is that you can't guarantee that nothing will go wrong, wherever you are. I did lots of reading around the risks of home vs the risks of hospital and made my decision on the balance. I'd second Bertie's recommendation of www.homebirth.org.uk - lots of well referenced discussion there.

In my area, the transfer rate is 30% for 1st babies and 10% for subsequent labours. Almost all transfers are either for slow progress or additional pain relief.

My cousin was transferred because of slow progress but still found the whole experience very positive and is very glad she started at home.

Good luck with your decision and the rest of your pregnancy

read this thread for my birth stories..

www.mumsnet.com/Talk/_chat/794536-A-request-What-do-I-want-Birth-Stories-When-do ?pg=3

i had my first at home, went well.

I suspect there are some MWs that look for any excuse to transfer a HB and this will account for some of the high transfer rate in first births (which tend to longer in duration). Certainly my booking-in MW was known not to have any HBs.

also: looking through hospital births many people transfer from home in labour anyway. My hospital sometimes doesn't admit util labour well-progressed anyway. I found it good to be in the right place the whole time.

if you're happy with it, go with it.

I planned for a homebirth - got the pool, did the yoga, relaxation CDs etc. Then when I went overdue I did acupuncture, driving on cobbles, sex, nipple tweaking - everything. Really wanted a homebirth but ended up in hospital for induction after I went two weeks overdue and then had to have emergency section three days into induction. Got home three days later and then DS rushed back in as not gaining weight as I had no milk, then I was rushed back in with dangerous infection.
Looking back I wish I had been less set on homebirth as it felt like I went through a domino of failure - couldn't go into labour, couldn't progress, couldn't give birth naturally, couldn't feed my baby. It left me very shaken but consultant told me that it was just bad luck and nothing I could have done would have got the baby out as he was completely stuck. I guess what I'm saying is plan for the homebirth but be open minded about the fact you might end up in hospital and it won't be your fault. My best friend pregnant at same time sailed through homebirth and it was the best experience. Every pregnancy is different and I hope all goes well for you.

Hi all,

Thank you so much for inputs.

Epic post on it's way:

tearinghairout - I will definitely go and visit the labour ward and birthing centre - at the moment it's hard to imagine myself there (as I've never seen it!) so it's definitely something I need to do.

loopymumsy that's the best advice ever. I really didn't know I could book a homebirth and then transfer in if I wanted to. I presumed that unless something was going wrong then I would have to stay at home - stupid of me really - as if they'd refuse to admit me just because I'd changed my mind. Interesting that a report has found no avoidable infant mortalities due to having baby at home.

bertiebotts I do ask my midwife questions and she is soooo pro homebirth which is lovely. But I really value advice from real woman who will give honest accounts of their experiences. My midwife was very much "I love homebirths, homebirths are great, they never go wrong, you should have one" - just felt like she was rather biased!

sparkle I'm going to go off and search for your account now - sounds very traumatic but from the tone of your post I'm presuming all was okay? I will definitely give some "what if" questions to my midwife - I always get tongue-tied when I speak to her so will think them through beforehand.

footstep I think that despite knowing deep down that you can't plan for every single eventuality I want someone to tell me you can! Logically however I know that's not the case and need to get over it. Why I'm so obsessed with something going wrong I don't know - not normally like this in "real life".

opinionatedmother I'm going to pop off and take a look at your link - thank you.

Germom that's some valuable advice. I'm appreciating more and more that you need to be prepared to go with whatever you need to do to deliver your baby safely, rather than have heart set on a particular plan - thanks for your story.

So last night I thought I was certain that I would book in at the MLU. Now however I think it's a good idea to plan the Homebirth I really want, with the full back of always transferring should I or the MW think I need to. I very much pictured myself having to struggle through at home no matter how hard I was finding it, but seeing as so many 1st timers transfer in that's clearly not the case.

I think I'm feeling slightly more comfortable with planning for a Homebirth now - thanks everyone.

That's the thing mumsie, it honestly wasn't traumatic, because of the calm and secure way the midwives dealt with it. They absolutely knew what they were doing, did it with minimum fuss and panic, and as a result had a calm and happy mum and baby at the end of it. You have to connect with your team and I was very comfortable with them all along, and it did help that it was my known midwife who did the delivery too. We were asked if we wanted to tranfer for checks afterwards (also partly due to the fact that I'd just had chickenpox the fortnight before!) but we declined after checking that it was a solely precautionary suggestion and not for any diagnostic reason. Our second homebirth wasn't without it's 'excitements' too, in that he had a shoulder dystocia which did resolve with a McRoberts manouvre, and we also saw on delivery that the cord had completely snapped away at some earlier point!

Homebirths can and do go (drastically) wrong, there are tales on these boards to prove it. To deny that is foolish and you're doing absolutely the right thing in thinking through the possibilities and talking through your fears and thoughts. I am very pro homebirth for those that want the opportunity, but it is not one that should be forced on mums to be. Ultimately it is your decision - you have to be comfortable with the position you take, but you also do not have to justify it to anyone - feel free to take my oppinions on board and then tell me to bog off!

sparkle no wouldn't dream of telling you to bog off because you've been very balanced in your response.

As you mention I'm just trying to weigh up the pros and cons and really understand where I will be most comfortable.

The two issues you mention "shoulder dystocia" and "snapped cord" (that sounds painful by the way!) would it have made any difference if those issues had arisen in hospital? In that, would being in hospital have stopped it happening or meant it would have been resolved diffently etc?

No, not in my case. That is, they could both have arisen anywhere, and the cord separation wasn't apparent until after he'd been born so wouldn't have been noticed in hospital either. It wasn't painful, for either of us I think - as I say we didn't even know until afterwards. He had about four inches or so of cord attached to him and the rest emerged later firmly attached to the placenta. The effort of getting him out with the shoulder dystocia is probably what snapped the cord - it couldn't have happened more than a few seconds to a minute before delivery or he would have shown deteriorating vitals, and he didn't.

And the process of trying to resolve the dystocia would also have commenced the same in hospital - changes of position (I had one leg stuck out at a very weird angle, but it felt quite comfy and did shift him a bit - dh said I looked as if I was trying to climb an invisible mountain!), followed by McRoberts (flat on your back like a beetle - helps shoot the buggers out ). I don't know what would have happened if that hadn't have worked - shoulder dystocia can and does give midwives nightmares as it can be extremely serious if you can't get baby out quickly, and the force with which they are pulled out by forceps can cause permanent nerve damage in rare cases.

I expect in the home situation she would have done an episiotomy for more room, and beyond that I didn't actually follow up. One to add to your list of questions. He wasn't a huge baby either - only 8lb 4, so it's not the case that it only happens to 10+ lbers. First baby was 6lb 9 and with a very long cord - probably why he got wrapped in it so badly - small baby = lots of cord + lots of room = tangled mess!

I think the reason I can feel so positive about what seem to be quite complicated and frightening circumstances is because of the atmosphere and confidence that exists for me in my own home. The sense of belonging, of rightness, security, and safety. I wouldn't be as crass as to say that positive thinking means you can avoid problems - birth is a game of chance - but I do feel that you can help put yourself in a certain frame of mind to help cope with potential situations, iyswim.

I had planned to have my first in a midwife led unit that was further away than my local hospital as I am really quite phobic about medicalised environments... anyway, about 7 hours in i really couldn't cope and couldn't imagine having to sit in a car for 30 mins to get to the midwife unit so ended up in hospital.

As it turned out I had a fairly positive experience, all thanks to a shift change at a crucial point. But there is part of me now, with hindsight, that wishes i'd stuck with my orginaly intentions. There was no medical reason for me to go to hospital, but if I'm honest I was panicking and very anxious and I hadnt bargained for that at all! Next time I hope i will be more confident and in control of what i think is happening!!

What i'm saying is, plan for the birth you want. If that is at home then you are better to be prepared for that. You really don't know what will happen or how you will react - you have the right to change your mind at any time, but changing from a hospital birth to a home birth isn't going to happen! And even if you end up getting transferred for the last bit, I believe that the longer you are able to stay at home the better, if i'd have had two midwives and some entinox by my side I reckon I'd have gone a lot, lot longer!

Good luck, whatever you decide!

i was the same as you mumsiebumsy, in the end i booked the home birth and my MW advised me to see how i got on, if i was scared or anything else then we can go to the hospital at any point!

in the end i went to hospital before i even rang my midwife, absolutley pooped my self panicked and went to hospital!!

in the end it was the best thing i cud have done and my baby was born with a really bad shoulder dystocia.

i think you should do what your body tells you to do, mine said go to the hospital and it was the right thing to do!

dont worry too much tho, some people have straight forward births with no probs so opt for homebirths and then have complications. there are always risks but if you are calm about the whole thing then it will all be ok.

good luck

sorry haven't had a chance to read all threads but i had my first baby at home and it was a really positive experience..
having spent some time in hospital early in the pg with hyperemesis (being v v sick) i knoew i didn't really want to give birth there unless i had to.
i did my research so that i felt happy about what we were actually deciding to do, but the hospital is a one min drive from where we live so that helped me make up my mind!
I had a doula and would REALLY recommend this to you as a first-timer - its hard to explain how reassuring it is to have someone around who understands what is going on - my labour was very long and the mw only popped in and out a couple of times before the last couple of hours and i think dh and i would have got v stressed and anxious if we had been on our own and quite likely ended up in hopsital.
I am expecting dc2 next week and hope it will be another HB, and i am having the same doula again - hoping it will all be just as positive if perhaps a lot quicker!
All the best to you as you make your decision

sparkle thank you for your detailed post. It's reassuring to know that you being at home didn't impact on the two events you experienced and infact helped you get through it calmly! I can't imagine myself being quite as calm as you though but I think that being at hospital would have made me panic even more.

Chunkamatic I think I'm beginning to realise that electing to give birth in hospital now really will limit my options later on. It's nice to know that next time you'd stay at home even longer. Being my first I don't know how much I'll panic but will try to hold on for the MW's and gas and air!

Amy I do wonder sometimes whether I'll know what my body is telling me during labour. I was 2.5 months pregnant before I realised which no one could believe. I'm just not very in tune with my body I don't think, so do sometimes worry if I'd know what to do. But hopefully instinct will kick in!

fairylights A lot of people have recommended a doula. I really don't have spare money however if you think it was so invaluable I may take a look into it. Obviously my DH will be there but in terms of support I think he'll be close to useless! Not meant in a bad way but I just think he'll be overwhelmed by it all. Really glad your homebirth was such a positive experience and all the best with DC2!

hi again mumsie - yeah the money aspect of having a doula was a big stretch for us and has been again this time but perhaps have a look at the doula UK website and maybe get in touch with them - i know there are trainee doulas who will sometimes do births for free so that they can "pass" their training, and i also think that other doulas might be willing to be flexible about money etc.. in fact i think if we were really struggling my doula would have been willing to negotiate . Perhaps start a thread asking doulas what they think! I know my dh would say (possibly even more strongly than me!) that he was REALLY glad we had a doula..
all the best again

yes, i really can't go on about a doula strongly enough. they are heaven sent. honestly when my doula came over after the birth to visit and i went to write her a cheque, i really would have written any number she asked for. but if money is tight, i would look into trainee doulas, it will really take the pressure off both you and DH and give you confidence in the whole process.

if you go onto doulas uk and search doulas in your area, any on the white background down the bottom are trainee doulas and will likely offer services at reduced rates.

from what i can see the birth package (a couple of prenatal discussions and attendance at the birth) is about £300 for a qualified doula and about £150 for a trainee. keep in mind that individual doulas may be happy to negotiate though, particularly trainees if they are looking to build up their experience - i think they need to attend a certain number of births before they can become qualified.
hth.

It makes sense to have a first baby at home if possible - because it reduces the likelyhood of you needing a c-section, which makes all pregnancies that come after (don't know whether you're planning a big family!) less likely to be complicated as well. And there's no evidence that first time mums having babies at home have worse outcomes than first time mums delivering in hospital - the opposite if anything.

I had my second at home, and transferred in with my third for failure to progress. I didn't find transferring in at all traumatic - I was ready for it (after three days in labour at home!) and went on to have a normal birth once I got to hospital. I wish I'd had my first at home as well. I probably would have ended up transferring in with that too (long posterior labour with big baby) but suspect I would have come out of it in better shape for not having spent 36 hours marooned on a hospital bed.

Hi Mumsie,

I had a text book pregnancy and labour until my waters were broken and dd got into distress and was delivered by ventouse. If I were you I would go for a hospital birth because you dont know how you will cope with the pain or any complications that may arise. However you could have a 4 hour discharge rather than stay on the postnatal ward. This would allow you to cuddle up in bed with dp and spend time as a family.

This will be my choice when I have a second baby as delivery suite were fantastic but postnatal was dirty (used measuring jugs full of wee and blood in the toilets) and dh got sent home very quickly after dds birth.

Regarding the doula, I didnt have one myself but I did have my mum with me, as well as my DP. It wasnt planned that way but i was so so glad to have someone who I trusted and who I knew had done this twice before, it really helped to calm me down.

This was also valuable as my labour highlighted a severe anxiety disorder in my DP, or so it seemed at the time! It's not just worth considering that you dont know how you'll react, but if it's your partners first time as well you've got no guarantees they won't totally freak out!!!!