Lack of support for home birth rant!

[Ijustneedsomespace]

So I'm 13 weeks pregnant with my 2nd child, and would like to have a home birth. I had a hospital birth with ds. I have read the 'planned place of birth' study and found that reassuring, as they found that for women that are not having their first child the safety levels for the baby are the same for home births and hospital births. This is a large study of nearly 80,000 women.

Anyway, as part of the home birth scheme here in Ireland you have to register with the maternity hospital anyway. So I had my first appt today. Well they asked all their questions, did their tests and concluded that I was a low risk patient. I said to the jnr doctor that I was planning a home birth. She quickly left the room and came back with the consultant.

The consultant rushed into the room and told me she would not permit me to have a hb and that instead what I'd do is go into the hospital have the baby and then go straight home. I said no, I was a low risk patient, fulfill all the criteria listed by the health service as being eligible for a hb. She went on at length about how that may be the case but that I could end up with a dead baby. I refered to the 'planned place of birth study' and their findings on safety. She said she hadn't heard of it, that she has no time to read reports. She then said that the findings would not apply to Ireland. She went on about risks, I said I accept and understand the risks but as there is no medical reason to rule me out of the scheme that I will continue with my plan for a hb. She then said if I chose to have a hb and was transferred in she would refuse to treat me. I said ok (although I'm sure she couldn't do this anyway). I said if she'd prefer I can request another consultant. She said no. Then I left.

I'm fuming . Should I change consultant? Is there any point? I'm nervous as now she'll be watching me like a hawk trying to look for any reason to stop me being eligible for the scheme.

May I suggest that you look at the AIMS(Association for the Improvement of Midwifery Services) website? They have some superb standard letters that you can send to your local health authority.
I used this route when we moved areas and I was told I could only have a HB if enough midwives were available (they only have two on at any time).
I sent my letter and within 24hrs was contacted by the head of midwifery services, offering to have additional teams on standby and she would come out if they were not available!!
It's in a HA interest to promote HB as it's actually much more cost effective.
HTH!

That is really quite shocking about her reaction!

I don't know why the study wouldn't apply to women in Ireland. Does it make any difference in terms of risks etc that you live in Ireland? What if you were from the uk and moved to Ireland, would that be ok? What a stupid thing to say!

I'd be making a complaint, changing consultant and sticking with your plan. And there's no way she could refuse to treat you if you went into hospital, how ridiculous.

Is there a reason a consultant would need to be involved at all? Surely if you're low risk you'd never need to see a consultant. And if you had a HB and ending up back in hospital there's no guarantee when's be the consultant treating you anyway.

I would have considered a HB myself but I know DP wouldn't cope well with it. When my mw asked where I'd like my place of birth to be I mentioned that, and she said I should talk to him about it and she would 100% support me. I still don't think I'd do it but it was lovely to know she was so on side about it.

Anyway, I'll stop waffling now. I hope you get something sorted and no one finds a reason to stop you having your HB. Good luck.

Thanks Mischief, I'll look them up. I assume that's a UK organisation, I wonder would that type of thing work over here in Ireland.

Last one - Over here on your first appointment you always see a junior doctor, then if you are low risk you only see midwives after that even in a hospital. The consultant was only called in because I said I wanted a hb, otherwise I would have never seen her.

I did laugh at one point and flippantly said I am English! (I am)

Perhaps I should make a complaint, after all if the health service offer a hb service to low risk women they must support the idea. I will definately ask to transfer consultant.

I think she was just trying to scare me saying she wouldn't treat me in that instance. She wouldn't be allowed not to treat me. Anyway, any consultant could be on duty if I was transferred in.

Bloody hell COMPLAIN! Switch consultants. This person sounds massively unprofessional.

So it's likely you'll never see a consultant again anyway so it probably doesn't matter who your consultant is. You still need to complain though!

OP, you are legally entitled to give birth wherever you want - hospital, home, local park, it's up to you, and your hospital are legally obliged to get a midwife to you. This is in England but, as you say, I can't see why it would be any different in Ireland, it's still the NHS isn't it? They try to put you off, but if they don't have enough midwives rota'd on at that point then they have to call in more or send you a private one that they foot the bill for.

I too am considering a homebirth, for my first, and my midwife tried to put me off with scare stories of "we may not be able to get anyone to you" but we are looking into doulas (birthing companion who helps you (and DP) through the experience) and we interviewed 2 and they both said this was bollocks (is 5:30 a.m. too early to say "bollocks"? ).

One recommended a book called "am I allowed" which apparently tells you all about what you can and can't do (mainly what you CAN do, by the sounds of it) with regards to homebirth. She also said that either that book or AIMS (can't remember which, sorry) has a script that you can read out down the phone if you phone the hospital, when labour starts, to request a midwife for a homebirth and they try to say no. She recommended looking into local home birth support groups as well, as they are a wealth of information and experience.

I am determined to go for a homebirth as it doesn't seem like rocket science to me that the more relaxed I am, the easier and quicker the birth will be, and I will be more relaxed at home instead of in a hospital or birthing centre.

I think it would be worth sending the letter suggested by mischiefmummy but also including a paragraph about how terribly your consultant treated you, as that is appalling!

I asked my midwife about a home birth at my very first appointment. I was concerned that I might not be 'allowed' because of my age (I am nearly 40). She was very positive about the whole thing. I might have to 'clear it' with a consultant, but even if I am advised against a home birth for any reason it will still be my decision.

I live in the south west of England, so not sure if I am what I am saying applies to Ireland, but my midwife said that she has a duty of care to me that overrides any recommendations she might make. Even if she warned me that I home birth would be risky for any reason (she didn't), she cannot refuse to treat me. She said that even if you start with a home birth and it is then recommended that you go to hospital, "nobody can make you get in the ambulance" (her words).

Good luck, and I do hope that you get the birth experience you want.

Remember that Ireland is a completely separate country- unless the OP means Northern Ireland (Ulster)- so what applies in England is no more likely to apply in Ireland than in Germany or Italy.

Ireland does not have the NHS- that is a Uk thing and Ireland is not in the UK.

Have you contacted the Home Birth Association of Ireland?
www.homebirth.ie/
sure they can help you :)

I had a HB with my first child and can't recommend it highly enough!

RichMan sorry, my mistake, thanks for the correction. I am pretty sure that you are still entitled to have a homebirth wherever you are though.

Not everywhere no, in some countries (and IIRC some states in the US) it is illegal, in others it would not be covered by the state or health insurance so you can only HB with a private practitioner.
You might be interested in this campaign www.oneworldbirth.net/

Zorra, I am planning to contact the hb association. I'm not so angry now, but I will still pass on this info to the hb association and see what they recommend.

We don't have the nhs here. Also the uk is a very liberal country whereas Ireland is very conservative by comparison. It's only in the last few years the state will cover homebirths. Until then you had to arrange it privately. When I was pregnant with ds (he is 5 now) I would have had to pay between 3k and 5k for a homebirth. So I had ds in hospital. Now it is paid for by the state, so that is why we are able to do it this time.

Yomping- No, unfortunately not the case. Pretty sure you cant have one in Germany in fact. I live in Hong Kong and here you can theoretically have one if you can afford a private midwife to support you, but they actively discourage it, and it is a bureaucratic nightmare to register your baby's birth if you have one- involves you, your DH and the midwife separately going to the registry to testify that the child was born as you say, and not just smuggled in (this is the reason they dont allow them- people adopting illegally from the mainland and passing the baby off as their biological child).

OP: which HSE are you under? I think in Dublin there's a domino scheme you can apply to but around the rest of the country you may be out of luck. Apart from that, I would look to change consultant (speak to your GP if going public). I would also complain the consultant- I think HIQA is the way to go there. You can also look up www.hse.ie and check your hospitals policies to arm yourself with more info on homebirth.

I'm fairly sure a homebirth is not an entitlement here in Ireland though (prob down to bad ambulance availability/transit times as much as anything else - eg if you're in Cahersiveen you're probably 90 mins from Tralee at the best of times) so be 100% sure before you go back. Like I said, your GP is probably the best source of information.

Just to say I think you should absolutely be able to have the homebirth you want, but, just so you're making an informed choice, the place of birth study will only be partially representative of your risk if you're not in the NHs. The experience of midwives at home birthing impacts on its safety, so being in a country that doesn't support it or have the infrastructure to readily promote will make a difference. I doubt it's a huge difference, especially with a second, but I just don't want you to think it tells the full story if you're not operating under the NHs.