Not a bunfight please but Home & Hospital births advice for first timer.

[shouldIbecrossaboutthis]

I'm currently 14 weeks pregnant and I know this is early but I like to plan ahead!

I was hoping to have a home birth but reading the recent study (Can't remember the name as on a different laptop, but it was linked to on another thread) and speaking to a DR friend who told me a horror story, I am now doubting my initial thoughts.

Bit of background: I'm 28, exercise for 1 hourish 5 days a week, fit and healthy with (as of yet) nothing out of the ordinary pregnancy wise. I live 1.5 miles away from the hospital. Women in my family (mother, sister, aunts) have a tendency to have 8lb babies within 9-12 hours with their first labours. Not that is means much I know!

Reading the study, am I right in thinking first time mums have the best outcomes at a MLU?

With a home birth my main concern is that the transfer time between my home and the hospital could make the difference between life and death? I know having 1 midwife with you means it?s unlikely to ever be an emergency, but if the midwife didn?t notice we were on a dangerous path would the added transfer time really make the difference between life or death? I?m guessing with your second you kind of have a feel for what is normal and what isn?t and that?s why the outcomes are the same for MLUs and HBs with second labours, you can give the midwife a heads up as such?

Any opinions would be brilliant, either way, as I really am confused.

NB: I'm contemplating a home birth not because I think a birth is something you should necessarily enjoy as such, my main worry is making sure we both live and beyond that anything better is a bonus. I hate hospitals so am just not sure I would be calm in that environment and that is why I am considering home birth

hoping it doesn?t turn into a bun fight

Edless do you have a link for that study? I'd love to have a read. I'm planning a hb. Ds was a hospital birth and I hated it. Went to GP yesterday he was soooooo not supportive. I've told him my decision is made but would like some handy stats to throw at him if he brings it up again.

i wanted a homebirth for much the same reasons as you - the hospitally-ness of going into a medical unit, the transfer in labour!

our hospital is 8 miles of 40mph roads away, and we had to make the trip a few times when i was overdue, an it was hell.
i didn't want to do that in labour.

there's no reason why you shouldn't plan for a home birth. it's so much nicer to do it all in your own environment.

I did it - had to nag for more midwives because they reckoned there wasn't enough cover. funny how when i got my friend who works in another hospital to get a release to attend, i was overflowing with midwives...

I was able to run up and down stairs during contractions (that really helped), have whoever i wanted there, didn't have to worry about having forgotten anything!, ate and drank what i wanted when I wanted to (which was pretty constant, actually), including freshly cooked pizza, and DH played the piano for me

I ended up transferring after DD was born because i had to be stitched quite a bit (ended up with an episiotomy after 2.5 hours of pushing - if we'd been in hospital, i'd have been allowed an hour and then been forced to have forceps/ventouse)
but i wouldn't have it any other way. even in the ambulance (not blue-lighted), i knew i couldn't have done that journey with contractions.
and at least the several hours of sitting around waiting (because remember it should take 14 hours to get from 3cm to 10cm in a first birth), i was with my friends, in my home, not worrying about when i had to leave, not worrying about what to wear, what food to take, etc etc

pain relief wasn't a problem - i had my birth ball (exercise ball from argos), tens machine, bath-if-wanted-it-but-i-didn't-want-to-get-wet, and eventually gas-and-air.

talking of pain relief again - i was amazed by the way the body works - it starts off with small pain. like a period, then ramps up sooooo slowly. I was amazed by the time I was fully dilated, that i knew i was in loads of pain,. but didn't really notice because it built up so slowly.
i was able to measure it by the tens machine - that the next setting felt like it was electrocuting me, but an hour later it was just right to dull the pain.

I'd go for a hospital delivery first time round. The comfort of knowing that if the delivery turns to an emergency you're in the hospital is a huge relief. I couldn't live with myself knowing that if something happened to the baby it might have turned out okay if I was in the hospital.

Second births are a bit different. For instance, you know if you can deliver vaginally. A friend and my sister couldn't because of how their bones are positioned so both needed a cs. You don't know these things until you have given birth at least once. Equally a friend I know gives birth extremely quickly so a home birth is ideal for her.

I was offered a home birth at my booking appointment by my midwife as I was classed as low risk, but as it was my first, I thought I didn't want to disturb the neighbours with my screaming! In the event though I didn't scream or cry!

I decided to go to our local midwife led birthing centre which is actually in the hospital on the floor underneath the normal antenatal and postnatal wards. I really liked the idea of a midwife led unit as I wanted to have a natural birth as possible and the idea of an epidural scared me, so it felt right for me. I decided to go for a water birth after having a look around the midwife led unit and the normal labour wards.

I would definitely go for a water birth again at the same midwife led unit. I found it very relaxing getting into the birthing pool and my midwife was very calm and let me get on with things at my own pace. I'd love the same midwife again, shame you can't choose!

I think for me I didn't want a home birth for fear of the unknown as it was my first and I didn't know what labour felt like and if I would cope or not. I also liked the idea of being so close to the hospital ward so if I needed an emergency c-section it was literally a case of going up one floor in the lift. Also if I had of wanted an epidural I could have been transferred upstairs in no time at all.

I did meet a lady who had a 45 minute birth from waking up to baby being delivered and it was her first, so I think if that was me I'd book a home birth for the second as I would rather give birth at home than give birth on the way to the hospital!

It's really what you feel happy and confident with. I think if you talk it through with your midwife and they will be able to tell you what they would do if you needed to be transferred to the hospital and timescales etc.

I think my mind is set, I'm going to have have another chat with the midwife too just to check a few things.

But I'm going to plan for a home birth and go to the MLU if the pool is free, if it isn't I will stay home and transfer in if needs be.

Thanks everyone for the advice, opinions and suggestions and all wihtout a bun fight!

Yay! shouldIbecrossaboutthis Awesome Your plan is coming together.

smongesmoge

then you will be pleased to hear that the study - even with the heavy correcting factor applied - still found home the safest place for a second or subsequent baby to be born - +0.1% (not actually above level of stat significance to be fair) reduction in adverse outcomes, much lower incidence of neo-natal admission (ie, baby having a hospital stay after birth)

and much safer for you.

here some very large pdfs linked to here... it took me hours (husband very neglected) to chug through it for all the answers i was looking for..

I've not read all the other posts as there as sooo many.

I had planned a home birth as i had done hypnobirthing and i wanted it to be as natural as possible. Baby had other plans. Waters broke and labour didnt start for 25 hours therefore i ended up in labour ward.

Baby was in "foetal distress", heart rate dropping a little with each contraction. Laboured about 11 hours without any pain relief, personal choice managed to get in ""the zone". Turned out that cord was round babys neck twice and needed vantouse/episiotomy/stitches.

I would say only consider a home birth if you and your birthing partner are both 100% sure about it. Otherwise the MLU is probably the best place to be. That way you are very close to the labour ward if it is required. During my 25 hour wait for my labour to starts we were in to our MLU for a check and it was lovely. SO much so that whenever we decide to have DC2 then we will be going there.

Hope all goes well with your pregnancy and birth, it truly is an amazing experience

excellent.

now, you also need to listen to the MW's advice - make sure you try to have 4 weeks before the birth if you work, for relaxing and preparing.
and take iron supplements

my two pieces of advice that i didn't do.

cheeky - my baby's cord was wrapped round neck twice, body once and arm. my episiotomy was because her hand was clamped to her face. my theory was that that was why she wouldn't come out earlier - that it wouldn't have been safe, so she hung on until she was given some help :)
but it was all safely done at home.
(i didn't have the waters breaking thing)

however, OP, i have to add that NICE guidelines give you 96 hours after waters breaking before you need to worry, most PCT will "give" you less than that, but it's to err on the side of caution, you don't have to comply.

Hi shouldIbecross. I had a homebirth with my first. It was great, I spent about 6 hours of contractions sitting in the dark in my bathroom with candles & TENS (because I had been vomiting at the beginning of labour) and the last hour and a half in a birth pool in my kitchen. DD was born with no intervention, no gas and air (and I'm usually a pop-a-pill kind of person so no hero) and just fell on the floor of the pool, I scooped her up and had cuddles, and then got out to deliver the placenta on the sofa.

My hospital is about 1.5 miles away and the ambulance station is just up the hill. We figured that it would be max 15 mins to get to hospital in an ambulance from the midwife making the call, and that's how long it usually takes to assemble a theatre team. Even in hospital the target for "call to cut" for emergency CS is 30 minutes. In the end, I called the midwife out after about 3 hours of intense contractions 3 mins apart and she said I was one cm and went away. We only called her back when I was spontaneously pushing (as we didn't realise I quickly I had progressed) and baby was born within 50 mins of her arrival. If I had planned a hospital birth and had gone in at 1cm I would have been sent home. Then I would have had to make the journey to hospital in the car while pushing which would have been not only uncomfortable but potentially dangerous!

In my city homebirths are popular, there used to be a 10% rate, now it's down to 5%. Of my friends who planned homebirths for their first babies, one transferred in after 15 hours for an epidural, one decided on the day to go to hospital anyway, a third went in for induction at 12 days over (and ended up with emcs) and another transferred in after about 3 days for more pain relief and a rest. Apart from the one with induction they all ended up with vaginal births and no problems. It's definitely worth having the homebirth plan in place like you have decided because then you have all options open on the day.

I'm 27 weeks now with no.2 and really can't see any good reason to plan a hospital birth (for me).

I had an 8lb 8 baby in 12 hours so I obviously take after your family! Seriously, I gave birth in the pool in an MLU and it was lovely - a really, relaxed atmosphere with the reassurance of knowing that epidurals etc were only one floor away if things went tits up.

I had an all but home birth with DD1.23 hrs of contractions inc hours in birth pool. In the end my contractions started to .peeter out and the MWs called an ambulance. Lots of time, no emergency as they were monitoring me closely and had no intention of leaving it too late.

I gave birth about 5 mins after arriving. No pain relief needed.

I'm hoping for 100% hb next time if poss as it was so nice being at home