home waterbirth

[Jill72]

Reassure me please!! Just been for 30 week midwife appointment. I am 39 and have a higher Bmi ( dress size 18). I announced my wish for a home water birth and while it was not dismissed out of hand the vibes were certainly towards it not being fully supported " think we need a longer chat to go through the risks". NOTHING else is an issue with the pregnancy - all going very well and no Gestational diabetes. Have only put on 10 pounds so far. I feel confident that as things stand now there is no reason to not go for it. Thoughts? Experiences?

As I have just posted in another thread about clexane - I am forever caught between a general suspicion of the motivation of of the medical people versus a dose of healthy common sense. I am finding myself treading the fine line between what is over cautious interference and absolutely needed medical treatment. Therefore I am not convinced that two general indicators are enough to dissuade me from the birth I want. However it is easier said than done when the safety of your unborn is dangled in front of you as almost emotional blackmail!! I know that if things are going pear shaped I can transfer to hospital - and I would - I am just objecting to an out of hand response based on guidelines rather than a reasonable discussion based on me and my history so far. Grrrr!

What is their arguement for not letting you have a homebirth? I know that our local hospital won't let you have a water birth if you have a high bmi but in practice they need you to be able to get out of the pool if necessary so really it is only if your bmi is so high as to incapacitate you.

I don't think they can stop you having a homebirth, so I would listen to their concerns and then determine how you feel about the risks and whether indeed there are any additional risks from you being a higher bmi.

Btw I have a high BMI am a size 18 and 5ft9 and my midwife would have happily allowed me a home birth or water birth had I wished.

Jill,
I am going to say something that you might not want to hear.
Home water births are not necessarily the best plan for everyone. If you are slightly larger, there is the potential that you may be having a bigger baby (GD or not) and there are complications that can arise from a bigger baby that may mean that complcications occur without lots of warning ( bigger babies do not show signs of distress as quickly as smaller babies , increased risk of shoulder dystocia etc). If either of these things happen being at home can be a very difficult place, and transfer to hospital once this have gone wrong can simply never be quick enough.
I am not going to tell you why I know all of this. BUT I will just say that the BEST kind of birth is one where your baby arrives safely into this world. It is in the end, their birth, not ours..
If your MW is cautious I plead with you to really discuss her concerns before and make a really informed decision.
If you decide to go with a HB after all, then I hope that it proceeds smoothly.

I was in the same boat and have had three healthy happy home births but with a supportive midwife, ask her why she is not convinced its a good idea might be a confidence thing with her, good luck xx

Hi, no real advice for you but I wanted to recommend the Home Birth website - www.homebirth.org.uk/
Go with your gut feeling on where is best to deliver your baby. I agree with the previous poster who pointed out that it may be down to the confidence level of the midwife concerned. Might be worth you asking to discuss it with the supervisor of midwives at your local hospital?
Best of luck x

mrsrvc - Thank you for your input, I appreciate hearing all sides. My concerns are that when you look into some of the statistics they don't seem to add up. Here is an example:

There is another small but serious risk to the babies of more mature mothers. More babies die in the uterus right at the end of pregnancy in mothers aged over 40. Figures for 2006 show that the rates of stillbirth were steady at around 5 to 6 babies per 1,000 births for women aged 20 to 39, but increased to just under 9 babies per 1,000 births for women aged 40 and over.

YES - the statistics show an increase but that is only of 2-3 babies per 1,000 births. Is that really statistically significant enough to be telling older women that they are more likely to have a stillborn????? If the increase difference here was significant then fair dos but to me the difference is so minimal that I think it needs to be explicitly pointed out how slight it is. Instead you have older mothers running round imagining swathes of older mums are giving birth to stillborns!!!

Shoulder Dystocia - from the Royal College of Obstetricians and Gynaecologists website and guidelines:

^How common is shoulder dystocia?
Shoulder dystocia occurs in about one in 200 (0.5%) of births. (note that there is no demographic brake down of the 0.5% !!!)

Can shoulder dystocia be anticipated?
At every birth there is a small risk of shoulder dystocia. In most instances, it is not possible to identify who it will happen to or why it occurs.^

So why are older mums / higher BMI being scaremongered that they are at higher risk of this??????

I completely accept that there are higher risks of different things for different women right across the board - what irritates me is the fact that clearly sometimes these risks are VERY small but represented as being MAJOR issues - not fair!!

I think it is an intelligent approach to question and research what you are being told - there are plenty of examples of professionals, (in all kinds of disciplines), getting it wrong or not always behaving in your best interest. I am not going to blindly accept everything I am told or asked to do without good reason.

My midwife told me that a larger baby is easier to deliver, they sit more heavily on the cervix and there is less room for hands or arms to get into the wrong position. She told me that mums prefer smaller babies, doctors prefer larger.

Of course there will be midwives that would disagree with her I imagine, and this is why I think it is so important to look at the evidence and make the decision yourself. And of course, no one can predict what size a baby will be regardless of the size of the mother or father.

Have you thought about a midwife led birthing unit, if you do decide that the risks of a home birth are too much for you?

Jill,
I am sorry that my reply seems to have made you respond so aggressively. I was simply trying to point out that there are often reasons why some proffessionals can be cautious.
I have a personal reason for replying to this exact post. I was a slightly higher BMI mother, aged 33 and no one questioned my decision to have a home birth. No one pointed out to me the risks of larger babies, and how severe shoulder dystocia can be. And I wish that they had.
If they had I may have really considered whether it was that important me to have my baby at home. Sadly, my larger than average baby boy, didn't let us know he was in distress until it was too late (trapping cord, possible gbs), he then suffered a shoulder dystocia and was born with a heart beat but made no effort to breathe. At home there is no oxygen and as such he was on bag and air until an ambulance arrived and got him to hospital, and while we are only 4mins drive from one of the best neonatal units in the country, it was 25mins before he was intubated. We sadly said goodbye to him a week after he was born due to severe brain damage.
Yes, what happened to me was very unusual. Perhaps 1 in 1000, but I promise you, whether you are the 1 in 1000, or 1 in 100, when your baby dies statistics mean nothing. Simply the haunting wonder of whether you should have done something differently.
Perhaps that is why your midwife is "scaremongering". Birth can be a very unpredictable and dangerous thing.
I wish you luck with you birth and hope that it all goes smoothly.

I am truly sorry to hear of your loss. I apologise - my post was in no way meant to be aggressive in responding to you personally. I suppose I should lay off the capitals. It comes from a sense of frustration as I feel that non of the medical professionals seem to want to engage in a discussion with me personally - it feels like a factory conveyer belt, rushed and short appointments, no dialogue with me about my case history so far just constant reference to statistics and policy. I just want them to look deeper than that and speak to me about me and this baby as an individual case rather than a generalised approach. It is such a mine field trying to find a way through what is often conflicting advice and stories ect. I am sorry to have stirred painful memories for you and do take seriously your warning - again please accept my apology for coming across in the wrong manner - truly not intended

Jill, your original post said that your MW has suggested "a longer chat to go through the risks" - surely that is a sensible approach? Have they dismissed it or or they willing to talk about it?

I have tachycardia and my MW wasn't leaping at the idea of a HB but was willing to discuss it. She was concerned at possible risks but in the end said if it was what I wanted they would facilitate it. Like you, I think there is a lot of scaremongering and a lot of unnecessary interference when it comes to pregnancy. However, I thought her approach was very reasonable. In the end I opted for a hospital birth, which was a very positive experience for me. I did most of my labouring at home in the bath. Meant to have a waterbirth at the hospital but baby was imminent when I got there so forgot all about it - think it was too late anyway! I am considering HB again this time, which I think they will support having had a very positive first birth - although I may just stick to the same (similar) as last time - in plan anyway, who knows how things will actually turn out!

A home birth with no oxygen???!!!! Thats crazy i've had three and at every single one my midwife brought tanks of the stuff!!!!!

I was booked for a home waterbirth for DD1, 4 years ago. I was size 18, BMI 34, and 34 years old.

Our local midwifery team went through the risks, but not in a scaremongering way, just giving me information. They said they liked home births :). The only thing they did mention on the paperwork I had (no-one mentioned it out loud!), was that there should be two people (apart from the midwives) available in the house in case I needed lifting out of the pool. This was in case I became unconscious and couldn't pull myself out at all.

I ended up not going into labour, and having a failed induction and an EMCS... :(. We also had oxygen provided, along with a huge crate of other things the midwives would need (and you need to inform your home insurance company that you will have oxygen on the premises).