Home births- how do they work?

[lisianthus]

If you have a home birth, how do you arrange it? I had a hospital birth last time, so just did all my MW appts at the hospital and then went there when in labour.

If you want a HB, who do you call to arrange it? Are you forced to have the MWs from your closest hospital, or can you have them from any hospital (ie.do you get a choice?) My closest hospital has a horrible reputation and is a really unpleasant place, so I chose to go to another hospital, but it turned out that the hospital I chose shunted all my post birth care back to my closest hospital, so I wound up there anyway.

Ideally, I'd like a home birth for my next baby with a MW I have at least met before and so have built a certain level of trust with, and then have my aftercare with her as well. Is that even possible, or am I being too difficult?

Thanks very much to anyone who can give me any info or guidance on this!

It really depends where you live, as the way things are organised varies greatly from one health authority to another. Your midwife will be able to give you all the info and advice. You should also look through all the useful info on www.homebirth.org.uk/

fwiw where I live the health board recently set up a dedicated home birth team run by two midwives. You are allocated to one of them and see them for all your antenatal appointments - they come to your home. Then one of them comes to you in labour supported by a second midwife who arrives right at the end, just as you are about to give birth. The second on-call midwives are hospital midwives who agree to be on the home birth on-call rota.

I know if differs greatly from area to area so you are best off asking your midwife how things work where you are.

Good luck!

MrsC

My community mw, attached to the gp's surgery, organised my homebirth. She was fantastic, I had to be booked in for a home delivery around about my due date. I thought this was bizarre as so few babies actually arrive on their due date, but the mw explained that they were only allowed to have a certain number in any one month. In my area hb are only allowed to go ahead if you are btw 38 and 41 weeks. I had a final prep visit at around 37 weeks when she brought a bag of sterile equip. to the house. When I went into labour she arrived about 1 hour later, she rang a colleague so I had two qualified community midwives there and it was fantastic. I hope it works for you too, it was the best experience ever. As soon as I was ready my ds and dd1 came up to see their new baby sister, and I was home, safe, clean and relaxed.

Where I am it has to be the hospital that covers your area - just like the post birth care gets sent back to the local hospital as well. If you have all the antenatal care from the community midwifes its likely that you'll know the one who comes went you have the baby.

Where I live it is all done by the community midwives. You have all your appointments at the doctors surgery with your community midwives no matter where you are giving birth. The the community midwives do home borths but if you go into hospital you get whoever is on duty there at the time.

I had a home birth. I just made it clear that I was not going to go to hispital under any circumstances, no matter how much they tried to ersuade me with horror stories and how much safer it is for first baby etc...

Pah, it's rubbish. It's your baby and as long as everything ir normal then you can have it where you like!

I had to see the consultant, he tried to talk me out of home birth, but I wasn't persuaded.

I didn't know who the MW would be as it rather depends who is on duty, how many other people are giving birth etc. I was given a bag a couple of weeks before the event, and had to have a further scan quite late on to ensure position was correct etc.

You need to have two midwives as one is there to care for you and the other to care for the baby.

In my case I phoned for the MW in the morning, said I thought it would be today... They didn't rush on over as being first time mother it would be ages (haha). Rang them again an hour later saying I really thought they should come quite soon. Live in a rural area so 30 mins from midwife centre, hour away from hospital. Midwife arrived and immediately called for second midwife, who arrived as ds did! Lucky it was a home birth as I would never have got to the hospital in time! 2nd midwife told me after that she had desparately needed the loo when she arrived but wasn't able to as baby was arriving too!

Best decision I ever made was to have home birth!

Just to add to everything else, you will need to tell your MW at c 24 or 28 week appointment at the latest really that you would like a HB. Then things jsut get organised from there. Only difference (for me) was that there is an appointment at your home to check its suitability and then the last couple of appointments (39 -40 weeks) are at your home rather than clinic or hospital.

Following that box of tricks is delivered and then when you are ready you ring the MW who come to you rather than you ringing the hospital and going to them.

Good luck!

You can decide to have a HB at any point in your pregnancy - from before you conceive to when you're in labour. Some PCTs (or individual HCPs) make it very hard for you to express your wish until very late on (>30 weeks) - if you're generous, it avoids them doing lots of paperwork for women who will subsequently change their mind. I would say its courteous to give them a bit more than 5 minutes notice. It also makes it harder for them to say they are understaffed and can't support you at home as you will have given them time to plan. Around here, HBs are supported by the combined forces of the local PCTs CMW teams - our CMW said we'd be unlikely to get her for the birth (although by that stage that was a good thing ).

Ask your MW how things work in your area - but be prepared that in many areas the only way to know for sure that you will be familiar with the MW who attends the birth is to contract the services of an IM.

We wound up transferring to IMs at 36 weeks with DD1 - and it was the best thing we ever did. The level of care (both ante- and post-natally) far exceeded that provided by the NHS and I believe that the level of trust I had in my MWs made it very easy for me to relax into DD1s birth.

Thanks very much everyone - this is really helpful. It sounds as if I would need to get sorted and get a MW first, before I ask for a home birth.

The independent MW idea sounds terrific too. The continuity of care is really attractive to me.

You know I would never have considered a home birth before DD was born as I would have been worried about the lack of pain relief, but all your stories make it sound a much more comforting alternative to a hospital birth.

Great link, MrsCurly!

An independent MW can cost £2000-4500, so it's not a cheap option, but you do get continuity of care.

I'm planning for a home birth - my area supports them. We'll have 2 midwives from the community team come out to us, but I probably won't know them as there are 26 in the team!

If you have community midwives, they will have to be the community midwives from your own PCT.

The site www.homebirth.org.uk] is great btw.

I would have liked an independant midwife but the cost was a bit too steep. So I chose the next best thing - a trusted friend who'd had children herself.

Here on the South Coast the midwives encourage home births but when it comes down to it there are never enough midwives available and they tell you to come into hospital.

If you really want your home birth to go without a hitch, check out the homebirth website other posters have mentioned, particularly the bit about refusing to go in. My best mate just kept saying "No, we're not coming in. Please send a midwife." until they got the message! Thankfully, she did this out of my earshot so I was none the wiser! I'm convinced if it had just been me and DP at home, he'd have loaded me in the car and rushed me straight there!