who is right about whether I should have a home birth, my consultant or my midwife?

[BumptiousandBustly]

Please advise oh you lovely mumsnetters.

I had a really, really horrible birth experiance last time, was induced and left to scream on the maternity ward for an hour and a half, with people having visitors in the other cubicles and going from 3cm to pushing without anyone noticing.

This time, ideally I would like to have an epidural and be lying flat on the bed feeling nothing (not ideal I know, but that is really what I want, it was very traumatic last time).

HOWEVER, given that I dilated so quickly last time, and that it is likely to be even quicker this time - I think the chances of that are non existant, by the time I got into hospital, and was assessed, I would probably already be pushing!

So, given those facts, I thought maybe a homebirth would be better - since I won't get an epidural anyway, isn't it better to be at home, have an actual midwife paying actual attention, be able to go to bed with DH and the baby afterwards. Less disruption for DS etc.

The midwife thought this was a great idea! The consultant says, that since I give birth so quickly, the baby could easily go into shock (DS's heartrate was lower than mine) and that the baby might need specialist care in hospital.

Who is right?

To be clear, the consultant therefore says I should have the baby in hospital.

What does your midwife think about your consultants comments ?

FWIW I have 2 friends who birthed at home for the exact same reason - very very quick transition / delivery - and both had great experiences at home (OK so one managed to have her DP deliver baby over the phone by paramedic advice - but the midwife was there within 10 minutes ). Neither of them had anything mentioned to them about shock risks to their DC.

Am sure someone with more experience will be along soon !

Oh and sorry your first birth was so traumatic (but could the trauma have contributed to your DS heartrate being low ? In which case a more relaxed setting would only benefit baby)

I think the midwife is right. I know lots of people who have had home births recommended to them when they haven't ever considered it before because they had their previous baby so quickly.

Out of interest how long did it take to get from 3cm to pushing?

I haven't spoken to the midwife yet, will ask her.

It took me an hour and a half to get from 3cm to pushing

I think that Consultants are generally worriers as they only see the more difficult births.

I agree with the midwife. I think you will probably be more relaxed at home. I had DS2 at home becuase I knew my labour would be quick.

I'd go with the midwife, the consultant will have been involved far more "at risks" births than average ones IYSWIM which is probably skewering his perceptions.

Also if you're not induced it may well not be quite as intense and you may be calmer etc.

I went from 8cm to fully delivered in 3 contractions last time, yes dd was a bit "stunned" but she still had an agpar of 9 on delivery. The more relaxed and in control you feel the better you will cope etc.

I have 4 dc and they were all induced, the time when I was relaxed about it all rather than stressed etc it was easy peasy to cope with the pain and I didn't once even consider asking for an epidural having screamed for them the previous times.

Will you have another opportunity to speak to the consultant about this?

Might a second delivery be slower, if you werent being induced?

I know someone who had a very very quick delivery with her first child who was admitted for induction at 38 weeks with her second to ensure that the baby was born in hospital. Im not sure how happy I would have felt with that, but she was delighted to know that her baby would be born in hospital.

Could the induction have caused shock for the baby? You might not be as quick next time, my sister had an induction with DS1 and dilated from 1 - 10cm in 2hrs her second DS she had at home but the labour was 7hrs in total.

I've had two HBs and can vouch for them making you feel nice and relaxed

I had a fast first delivery, went in at 1cm was told nothing was happening despite having really strong contractions and screaming for pain relief. I was told I could lie in a bed with the gas and air until morning, wasn't until I started making pushing noises that they took any notice and I was 10cms and pushing. That birth was 4h20m from waters to baby.

Second birth was a homebirth, the consultant tried to put me off telling me I could be home in 6 hours etc but the MWs say he does this with everyone and that he only gets to see the high risk cases and doesn't see any straightforward vaginal deliveries.

I had DD2 at home in 2h30m, despite being 3lbs heavier than DD1 I had no stitches. I had gas and air and could have had morphine if I had wanted it.

DD3 was 1h35m at home as well, all 3 had Apgars of 9 when born, fed straight away and had no problems unlike DD1. My MWs were aware of my fast labours and 2 of them came straight away and stayed with me throughout, you would not get that level of care in hospital. Also let your MW know that at nay point should she wish you to transfer you will go no questions asked.

op on my first birth like you was left on ward I was checked and told was 2cm after about 22 hours 45 mins later ds was born his heart rate never dropped due to quickness I had been strapped to bed for most of the labor so I am certain of this. Nothing mentioned about shock.

My second labor was similar after 10 hrs mw checked I was 6cm then dd born 3mins later again as far as I know no drop in heart rate however was not hooked to belt this time so cant be 100% on that. Nothing said about shock.

There was some concern over my cervix tearing on dd as the mw thought I may have pushed her out at 6cm so a senior consultant came in and both consultant and mw strongly advised me to go for a home birth if I have a third because of the quickness of transition and pushing. Are you sure he recommended hospital birth because of the quick second stage and not something else I would double check.

Although will warn you on dd I went into shock and collapsed and was vomiting everywhere due to the quickness of the birth it was okay once they got me in bed but I panicked and got scared by this so thought I would warn you so that if this happens to you (which apparently is not often)you know it is nothing serious.
If I have a third I will have a homebirth.
Hope this helps you decide.

Precipitous births very rarely damage the baby. You decide what you want and tell them to support you - that's their job!

I seem to take a while to get going then whoosh.

I have never heard of a consultant recommending a homebirth. Never, ever. So even if you'd had the world's perfect birth first time around it's pretty likely your consultant would still be angling to get you into hospital.

The answer to your question is that you're the best person to decide, but you need to take lots of advice and information from both sides before you can make your decision. You also need to understand the whole process of your last birth - knowing how a led to b led to c etc has been immensely helpful in my decision to gun for a home birth (after traumatic birth last time). So I highly recommend it for all women having subsequent babies.

Best of luck.

How far away from the hospital are you? Would it take ages if you needed to transfer from home to hospital in ambulance?

I would agree that consultants tend to see only the difficult cases - I never even saw mine throughout my 2 pregnancies, they leave actually meeting women to the junior doctors and registrars!

I had a hospital birth with DS1 as DH refused to consider homebirth. Labour started well then I got scared and asked for epidural and everything slowed down. Needed to have ventouse in the end and stayed for 4 days (didn't realise how hard it is to get out of hospital sometimes!).

Because I had a really bad bleed (nearly transfused) I was told I needed a hospital birth the second time, and that as soon as labour was established they would hook me up to a drip etc etc...However DS2 had other ideas and made his entrance on my sitting room floor 2hr 25 mins after 1st contraction!! No problems whatsoever - Apgar of 10, fed immediately, did bleed a bit but midwives sorted it all out. Then they made me breakfast (DH too shellshocked to do anything useful!) and helped me into my shower. 2 hours after the birth, DS2 and I were asleep in bed and the midwives had gone.

I think it's very unlikely I will have a third but if I do I will most certainly be having a homebirth.

Go with your midwife - she knows what she is talking about.

And good luck!

Thankyou ladies all.

My single biggest fear is that I have to be induced again. That would send me into such stress that I don't think I could have a good birth whatever else happened.

I am also worried about the baby being born at home without it being planned, i.e. just being too quick.

I completely take on the point about consultants seing the "problem" births, so being more inclined to see problems, but its hard to go against someone saying "it could be dangerous for your child"

Its been really helpful to hear what you all have to say. I will talk to my midwife when I see her next, attend the "home birth evening" and decide where I go from here.

You have to remember EVERY birth has a risk, it is a risky process for baby & Mum alike.

You can book & plan for a homebirth and just go in when it happens if you wish.

Book a homebirth, and see how you feel and transfer in (accompanied by either a mw or paramedic) if you feel like it or it is needed.

Trauma to a baby is more likely to be caused by interference in the birthing process for a low risk birth.

I too had a very quick and what I felt was traumatic first birth. I went from 0-10cm in roughly an hour.

Every midwife I spoke to recommended a homebirth for the next one.

As it happened I didn't feel confident in having another NHS birth and booked with Independent Midwives. Part of their antenatal care is to spend one antenatal visit talking about BBAs (births before arrival of midwife) and transfers into hospital. The advice given for BBAs is to get on your hands and knees (good birthing position and means there isn't a long way for baby to fall if you didn't manage to catch), try not to let baby fall and to then wrap both of you up in warm towels. I was told to call them if it started to happen fast but that if I felt it was going to fast or I was scared/worried they wouldn't get there on time to ring 999.

FWIW it might not be a faster labour. My second labour was a back-to-back labour and was 19 hours (I ended up in hospital with an epidural but it was a much much better experience)

OP, read as much as you can about anything to empower you during labour and birth. That way, no matter what happens you will feel SO much more at ease than you do at the moment.

I highly recommend Ina May Gaskin's 'Spiritual Midwifery' - a fab hippy book, just read the stories in the first half.

Also try a hypno CD - the NCT do some, I believe.

How strange. Both my births have been very quick, my second extremely so. Nobody mentioned that the baby could be in shock. He did pass meconium so they wanted him in for 24hrs, but was absolutely fine.

i agree with your midwife!

precipitous, or very fast, labours are usually very straightforward. they're quick becuase baby is ready and there are no probs

i had my third 45 minutes after waking up due to a massive contraction lol. he was absoltuely fine

also, i had a fairly long and traumatic birth with my first.

the 2nd and 3rd were both born at home with no pain relief and were much, much, much nicer than my first (on my back, epidural!)