Home birth V hospital. Still on the fence.

[littleraysofsunshine]

Third baby.
Uncomplicated super fast deliveries, I'm currently 31 weeks and thinking about my birth plan. I think it's best to hope I can get to the pool room at MLU, but been told to have things ready at home.

So home jut and hospital bag. What would you advise?

thecakeisalie - That sounds horrible to have little support in hospital - our maternity services have much room for improvement in some places, for hospital- or home-births. The 'experience' comment wasn't meant for you or anyone in particular, more my general experience (pardon the pun) of talking to women I know both before and after labour. If the labour was straightforward, or expected to be straightforward, a lot of people I know talk about the 'experience'. Fair enough, but childbirth is unpredictable - my second labour was mostly a good experience until things went quickly wrong at the end / afterwards with no warning.

Rosebud - I can understand your viewpoint. I probably said to people in my second pregnancy that I wanted birth to be 'a good experience', but I didn't really mean it like "wow, I want a nice experience to tell people about". It was more "I want it to be a positive experience and not terrifying and lonely and with nasty after effects". I talked about it in pretty similar language to a friend who had decided to go for an elective section after a tough time first time round. I guess the language we use can be interpreted in different ways. It's such a personal thing that we sometimes talk at cross purposes. I would totally agree that, on the scale of importance, having a 'nice time' would be way down the list.

I know what you mean Rosebud and I certainly didn't take offense.

I do think for a minority women there is some naivety about labour and it can end up becoming about achieving the perfect birth experience, in a way though sometimes I wish I was less aware of all the things that could go wrong as they say ignorance is bliss. I've said all along to the HCP's that I will listen to advice to transfer and I won't hold on to the idea of a home birth in the face of increasing risks. I think staying open minded can only help, at the end of the day there's no guarantee baby will even be in the right position.

On another note has anyone else found people in real life are quick to be judgmental about home birth? I find it odd when people openly pass judgement on my choice and almost imply I'm taking a gamble with the life of my baby.

It seems for first time mums it is a lot more risky
www.telegraph.co.uk/health/healthnews/8912237/First-time-mothers-warned-over-home-birth-risks.html

Poops comment aout setting birthing pool up in kitchen sent shuddes down my spine, IMO can't imagine anything worse/les hygienic! have been shown birthing pool suites at my local hospital and they are relaxed, calming but knowing 100% sterile and hygienic with all help - human and technology to hand immediately, totally won me over.

Jemima - I am afraid, like so much of what is reported in the press around birth (and health more generally) that is sensationalist reporting that doesn't convey the actual findings of the report fairly. Press particularly love multiples, and they haven't talked about how risks are defined properly. If you are interested, the full study is on the internet and there were lots of threads on here at the time it was published.

In summary, there is a tiny increase in risk in absolute terms for first time mothers. But all options were considered safe for those assessed as low risk.

I think every mother should choose to birth where she feels is best for her, but it's wrong to think that homebirth pools are not just as hygienic as those in hospital. And actually, being close to technology doesn't actually seem to change outcomes much (probably, although I'm not aware of any studies, basically because it breeds complacency and a lack of action at an early stage, whereas homebirth midwives are very attentive to any developing problem). This argument is supported by the fact that birthing in a stand alone midwife unit (with no emergency section facilities, etc, etc) is just as safe as hospital birth even for first time mothers - it's obviously not the technology that improves outcomes there are they don't really have any that homebirth midwives don't carry.

As I said, every woman should choose for herself, but I agree with Cake that people (not you specifically, just to be clear) can be very scaremongering and judgemental about homebirth in a way they aren't about other birth locations.

Cake I definitely find that people look at me like I am crazy when I tell them we are planning a home birth for our first child. It is what we feel most comfortable with though. I think a lot of people just don't know much about it and presume it is risky when the data says otherwise.

DP is dead against hb where can I get some evidence regarding the risks?
His only reason is that if things should go wrong, the 20 mins/ half hour to get to hospital are risking mine and babies life, whereas in hospital they can have you in theatre in ,5 mins should the need arise.
I would love a hb, but when he puts it like that I feel selfish that I'd risk our lives to be at home...

Well, the vast majority of sections are not a question of being in theatre in 5 minutes. In the majority of cases where you would transfer for a section, the time taken to get you to the hospital is also used to prepare theatre (if necessary waiting for it to be free), etc, so very little time is lost in travel time. I presume therefore that he's talking about crash sections? (I think it's officially called something like category one? There was a post about it recently).

The first thing to say is that that is very rare. So when balancing something very rare but incredibly serious, it's also absolutely legitimate to weigh in the balance far more common but far less serious complications. That's what clinicians do all the time. It's not as simple as saying 'hospital is better because you are better off in the very unlikely event of a catestrophic and wholly unpredictable crash emergency'. For example, planning a homebirth means you are far less likely to have an instrumental delivery (with the problems that can cause for long term maternal health in particular) or a section (and before he says 'that's because they don't do those at home, they include people who transferred in for those procedures after planning a homebirth), and less likely to have a 3rd/4th degree tear.

In terms of resources:

Homebirth UK has links to lots of resources.

And this is the key findings release from the birth place study. The website it comes from has the full study, etc and that is here. The key thing for you as a second time mum is that the study found that it was just as safe as hospital. There is a hypothesis that the benefit of being close to life saving technology is cancelled out by lower levels of 1-2-1 care, and later detection of trouble brewing, plus perhaps a false sense of security from the technology on tap, though I'm not aware of any studies that test that hypothesis. It is also worth saying that the study is about low risk women (it's not that the hospital figures are skewed by the high risk, but equally the study isn't much use to you in assessing your own position if you are not low risk).

HTH

What about if you tear? Will they mend at home or transfer? My last two I had 2nd degree.

I now have SPd so would that make for a difficult labour? I just still worry about timing with setting a pool up

Don't know about SPD.

Second degree they will happily stitch at home (I had a 2nd degree). They carry local anaesthetic and full suture kit. They do like a good bright lamp though in case they are doing it at night. Cheap angle poise from argos ideal and can be used elsewhere afterwards!

Sorry, meant to say, I think serious tears they will transfer for. 3rd degree and worse.

Anyone managed to set up a birth pool in a fast labour.?

yes I posted earlier in the thread about filling the pool quickly.

my labour with ds3 was 48 mins from waking up to holding a baby.

we managed to inflate and fill the pool in time for me to get in and have him.

I had a home water birth with my first, it went absolutely fine. Five hours from waking up with contractions to holding a baby, the MW's were present but still juggling paperwork and unloading the car while I gave birth in the pool and caught DD myself. Had a natural third stage with no issues there either.

I did however tear. I don't know the degree, but it was probably relatively bad as they had to call in the senior midwife to come and stitch me back up. She arrived within about ten minutes and I was sewn back together while lying on my back on the kitchen floor, with lots of people looking on to study the technique and a huge torch lighting the area. Glamorous.

We had a solid frame pool that we hired. We're doing the same again this time around. I felt a bit more comfortable with a rigid frame and fortunately we had enough room in the conservatory to keep it set up, so it was just a case of filling it at the time.

Where did you all give birth if not in a pool?

Bump

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