can I be refused a homebirth if iron levels low?

[jumblies]

I just had a call from one of my midwives who said that my iron levels are below ten by one point and I need to get them up above ten by next friday and they will then do my booking in for a homebirth. I am due on boxing day and am getting really stressed as they said I will be refused one if my level is not 10 or above.

Can they refuse to let me birth at home...it seems like such a stupid reason to refuse a homebirth. Are low iron levels dangerous in childbirth

I have had one homebirth already so would hate to have to go into hospital for this one!

It's not a stupid reason to refuse a home birth.

Blood loss during or after child birth can be very sudden and serious, and you need to have a good level of haemoglobin to be able to cope with this, otherwise the consequences can be serious.

To give you an idea, my hb just before birth was 13.5.

I had the perfect home water birth. Until about an hour after the birth when I suddenly bled very heavily. The midwives were still there and dealt with with immediately, but even so my hb had gone down to 8 and I felt dreadful for weeks afterwards.

From 13.5 to 8 due to child birth, and I'm very glad that my hb had been 13.5 to begin with.

Iron tablets need to be taken with vitamin C for best absorption - orange juice for example.

Milk, tea and coffee can all hinder the absorption of iron.

Look up iron rich foods.

Supplements such as floradix can help but iron tablets will work faster.

No way would I have an home birth if I had a low hb at the end of pregnancy.

I too have been told this - whilst they can't refuse to attend you if you insist on staying at home, as Belgo says there is a very good reason why they say you need a good iron level.

That said - if you take the iron tablets (or two or four sachets of spa tone a day!) you should easily be able to get your level above 10 given you are only a fraction under it. I got my level up by 0.4 in under two weeks by taking two sachets of spa tone a day

The doctor can prescribe lactulose if you become constipated from the iron tablets.

I used spa tone too - worked really well for me.

I think Belgo's right - the need for higher levels is because of the risk of postpartum bleeding. But if you look on homebirth.org it has some info on being told your haemoglobin levels are too love for a HB here.

So time to bring out the big guns and try and get your iron levels up! - iron tablets washed down with OJ as well as lots of iron rich food (spinach, beef, wholemeal bread & cereals, eggs etc) while keeping tea/coffee down. You can try spatone or floradix too, added to OJ you can't taste them.

You're just below the threshold of "normal" so you should (fingers crossed) be able to get your levels back up by next week.

meant too low there of course

I can't see that they can 'refuse' a HB based on Iron levels as you don't HAVE to have them taken in the first place. I agree with the above guys tho, it's a good idea to have all the info as you have the opportunity to increase your iron intake prior to the big day.

You might find this page useful.

Have they given you the full blood count results? I would be loathe to start pouring ferrous sulphate down my throat until I knew more details of iron levels than Hb in isolation. I would also be asking the MWs for the research that supports their position that a Hb of 10 g/dL (especially in the absence of other iron related problems) represents a cut-off point in terms of safety.

Ah, didn't think about the blood loss implications. Makes sense of course, I guess I am a little complacent as my last homebirth didn't have any complications that I forget what can go wrong!

When I had a similar prblem, my MW said it would always be my choice at the end of the day, but they would advise against HB wth an HB under 10. I got mine up pretty quickly eating fortified cereals, dried apricots, green veg, and taking ferrous gluconate(from drs) with spatone in OJ each day. Got mine to 12.6 pre-birth and have felt fine since. Good luck

That's interesting pootle. Of course midwives cannot force anyone to do anything, they can only advise following their own protocols of of course their own experiences.

Even one of my midwives who herself had ten children, and 20 years experience of home birth in Europe and Africa was very definite about making sure that a pregnant woman had a hb of above 10 before giving birth.

BTW, I had absolutely no risk factors in pregnancy and a totally normal drug and intervention free first birth, second and third births but it seems I have a blood vessel that doesn't close very well after giving birth leading to bleeding. Bleeding is one of the most common problems.

Wishing you a successful home birth!

Should have said that my iron was only ever 10.4 so I didn't have so far to get it up.

Belgo my MW was v v v pro HB but was also v clear that there was a reason why they set a limit of 10 on it, so she wasn't encouraging me to flout the rules!

I just wish they hadn't left me 3 1/2 weeks between midwife appts at this stage as I should have had blood taken earlier and then I would have had a longer period of time to increase my iron levels. Thanks for all the advice, I'll have a look at the links in a min.

I was in the exact same position a year ago, in that my HB levels were just below 10. I also had a very short time to increase them. So me being me, i decided to cut to the chase and got iron injections in the GPs. Bingo, HB increased in time for birth (had about a week to increase them over the 10) and definitely felt better for it. I am unable to take Galfer etc and I was told by a clinical nutritionist that Spatone would not work in time.
Might be worth a go?

Crikey we all get such different advice! My consultant told me that Ferrious sulphate takes about 4-6 weeks to effectively raise iron levels.
Post birth my hb was in my boots. The mw told me to bin the tablets and gave me Spatone. I can't rate it highly enough. My hb shot up from 8.5 to over 11 in less than 3 weeks. All the health professionals I've spoken to about it say it works almost immediately, usually having a noticable effect within 3 days.
Hope this helps, good luck with the birth!

Peanut - iron tablets start working immediately, but the main problem with them is constipation which was never a problem for me, but I think can be a problem for most women, and I think that's why spatone and floradix are so popular.

BTW to whoever said you can't taste floradix in orange juice - not true ! I found it disgusting stuff, so I bought the tablets instead and they were fine.

I've never heard of iron injections.

I've never heard of iron injections either. On the constipation front I am just going to eat prunes and the apricots should help as well. If not I have stool softener at the ready

I'm going to get some spatone as well today. It might be overkill but it's all worth a try isn't it.

thanks everyone

I would def. not have a HB with low iron - I had one planned with DD - was advised (agree they can't REFUSE you a HB) to go to hospital and thank God I went because I had a massive PPH, lost loads of blood and I dread to think what would have happened if i had stayed at home.

Good luck with getting your iron levels up - the only thing that helped me (post-birth) was a transfusion but mine were really low (about 6 IIRC) so spinach and spatone were probably never going to do it...

I have been resolutely taking ferrous sulphate for last 4 weeks to get over 10 and eating prunes and dried apricots to counteract the effects (no coffee, tea of course).

Am now 10.8 with quite a lot of work. Wish I had seen this earlier! Spatone sounds so much better and easier.

I struggled to get mine to 10.2 so I could have a homebirth.

In the event I had to transfer into hospital during my 2nd stage.

My iron levels post birth were 6. A difficult delivery can cause an already lowish level to plummet to dangerous levels in some cases.

I too recommend spatone.

hi
just reading this as i need to build mine up - other half away to chemist with shopping list now!!
did you get your iron levels up jumblies?

bump

I too was refused a homebirth for iron levels 1 point below 'normal'3 weeks before my due date ,I was told that I would be likely to bleed heavily after birth and that I could be risking my own and my babies life , the midwife could not answer my questions as to why this might be so with just 1 point less of iron! I contacted the Independent Midwives Association who pointed to research that if my 'body iron stores' were normal then this means that I would be in the same position as any other woman if I bled after birth and not at an increased risk of it occouring either, the NHS protocol is inflexible so I went to a private midwife and had the most amazing home birth in less than 3 hours from first contraction . I was so confident in her abilities and mine! Ask questions, get the birth you want by any means if you can - the midwife we chose was worth every penny and nothing is more important than the birth of your child, for me I just knew that a homebirth was where I needed to be !