Home birth

[ZebraMammy17]

I've been binge watching call the midwife since times have changed it seems so odd to have a home birth but the more I think about it it does have some appeal being in your own bedroom. Since me and DH are trying to conceive baby2 it would be nice to see everyone's experience with home births pros and cons

Well, it depends how keen you are to risk your baby’s life, I suppose.
Do you have a paediatric crash team, an obstetric consultant and a fully equipped operating theatre in your spare bedroom?
My second DD would have died if she’d been a home birth, despite a normal pregnancy, normal labour and good full term birth weight. No delivery is “low risk” except in retrospect.

Bloody loved my home birth. I had a pool in the living room. It was so much more relaxed due to the home environment but the real benefits were using my own toilet, shower, bed etc after as the post natal ward with my first was absolutely horrid.

I would say though that you need to be completely comfortable with a home birth as the choice. I think the added relaxedness of it would be cancelled out if there was additional stress due to worries about home birth.

Plenty of people think home birth is irresponsible but, as with many things, it all depends on circumstances. Is your pregnancy text book, how close to hospital are you, what pain relief do you want available etc.

Have had two homebirths, with my first and 2nd babies. Absolutely fantastic experience. I'm a midwife and there was no way I wanted to head to hospital with a low risk pregnancy.

I’m seriously considering a home birth with my second. I had an uncomplicated first birth and it’s actually therefore statistically very slightly safer to have the second at home than in hospital from the reading I have done. My midwife is very keen. For me the main reason is to ensure that I have access to a pool our local MLU only has one and the labour ward has none, all the other local MLUs have been closed due to lack of staff so it’s a total lottery as to whether you will get the pool.
No I don’t have a crash team etc on hand but I will have one to one midwife care and monitoring so hopefully any problems will be identified early rather than being left to get on with things until it turns into an emergency and worst case we are around 12 minutes by blue light from the hospital. I know that means that realistically it’s likely to be 30 mins minimum before they can get me into theatre but it’s all a balance of risks.
You’ll get both views on here stated to the extremes. There was a good thread about it a month or two ago.
Some posters think it’s insanely risky and they’d be dead if they hadn’t been in hospital. Others think that births should rarely need medical intervention and if you are relaxed at home it will all go beautifully- the reality is somewhere in the middle and all about assessing risk. The best person to talk to about it is your midwife as they will have the history from your previous pregnancy and from this one.

I had my 1st at hospital! Hated it! But as it was my 1st i felt safer! But 2nd and 3rd i new i could do it so looked into home birth! Best experience ever! I had the same midwife through out so felt completely confident with her. She delivered my pool 2 weeks before and then i rang her once labour started! 2nd labour was a breeze and loved being at home and my 1st born coming home from nursery and already being home and settled. My 3rd i gave birth while my 2 oldest were upstairs in bed and when they woke in the morning they had the best surprise. 3rd labour was a little harder and placenta wouldn't deliver for a while, was worried incase i had to go hospital but midwife ended up pulling it and all was fine. I'd recommend home births to anyone.

If I have a third child I'm putting my foot down and having a home birth.

We live a long way away from the hospital ( 30 mins even on blue lights and a clear road, an hour in normal circumstances)

I have had two intense and fast labours, both times the hospital have tried to send me home after first examining me, and both times the baby has been born well within the time it would have taken us to get home and back again. A long journey on rural roads in active labour and no pain relief is also not an experience I wish to repeat for a third time.

Plus how nice would it be to get in your own shower and bed after giving birth.

@Babdoc If it’s not too personal and rude of me to ask....can you give a little detail around the circumstances of what happened to you? The reason I ask is I am planning on a Home birth and of course am interested in hearing both sides and all the risks. I’ve read many accounts of how close the mum and / or baby came to dying or being seriously ill in hospital and therefore a home birth would have been catastrophic however no one really ever gives details (I do realise it’s personal and traumatic).
The thing is - the midwives are VERY clear that they are extremely careful with monitoring and they have set protcols for if the birth is not progressing, baby is showing signs of early distress etc - they have been very clear with me on all the possible reasons they will interrupt and advise we go to hospital. It seems they would never let you go anywhere near to being in a catastrophic state, preferring to always err on the side of caution.
So when I see examples given saying “I would have died if I’d been at home” I can’t help but think - but surely the midwife would have taken me into hospital way before getting anywhere near this point?

Hopefully I’m making my question clear? Apologies if it’s too personal to ask, I just want some real life examples of both sides.

For me it was simple.I wanted to give my child the greatest chance of survival, so I had all mine in hospital and went home after a few hours.

I guess it would have been cosier at home;but the safety of the baby outweighed everything. A few minutes lack of oxygen to the brain and you have a disabled child - just not worth the risk, just to satisfy my comfort.

All my DDs had normal pregnancies but finished up with difficult deliveries with which they needed help - which was thankfully on hand.

It's a lovely idea but I just know too many babies and mums who would have died despite low risk pregnancies.

Again, more comments about serious issues arising at hospital - with no mention of when these were picked up. If up until the exact moment there had been zero warning then I understand but if the hospital midwife picked up the problem hours before delivery and was therefore able to prepare accordingly, it’s the same for Home birth - they’d just transfer you in.

I had two home births, my second and third children. I find comments about safety of the baby so I had a hospital birth both rude and patronising. I cared about the safety of my babies, I did my research. Home births in the right circumstances are perfectly safe.

My first home birth was great, second less so as labour was so fast that the mw didn't arrive in time and DH delivered DD. This will have some people believing I should have gone to hospital, but I would not have made it in time. I'm grateful my birth was at home unassisted rather than at the side of a road in the car.

Getting into your own bed afterwards is so lovely.

Happy to share the details, Grumpos. I actually briefly considered a home birth, as DD2 was due at Christmas. Fortunately my lovely old obstetric colleague talked me out of it! I’d had a normal first pregnancy and delivery the previous year, DD2 was again all normal, I had no pain relief or drugs at all in labour, she was a normal delivery weighing 8lbs 5oz.
So there was nothing that would have warned the midwife to transfer me to hospital if I’d been delivering at home.
This is my point- no delivery is safe or low risk until it’s over, you can’t predict in advance.
DD2 arrived almost dead with an Apgar score of 1.
She had a barely discernible heartbeat, couldn’t breathe, was completely floppy, hemiplegic, and having multifocal epileptic seizures.
Because I was in hospital, the paediatric crash team burst through the door immediately. DD2 was given intracardiac adrenalin, intubated, ventilated, given three different anticonvulsant drugs before they could stop the fitting, she was x rayed, brain scanned and admitted to paed ITU.
No community midwife is trained to that level of intervention, and doesn’t even carry all the drugs that DD2 required for immediate resuscitation.
DD2 spent a week in hospital. She’d suffered an intracerebral bleed during delivery, and came very close to dying. The paralysis took a week to resolve, and she breathed unaided after 24 hours.

But because I was in hospital, not at home, she survived undamaged and has since graduated uni.

Suggesting women that had home births put their babies at risk is both offensive and inaccurate. Circumstances vary but there are circumstances where there is no more risk to home birth than hospital, which also carries its own, different, risks.

Thank you Babdoc, I’m sorry that you and baby had such an awful time of it, so glad it all turned out well.
This is the sort of example I was after, in this case there was absolutely no way DURING labour to know there was an issue right? Ie baby’s heart rate didn’t dip, your BP didn’t fall, Labour didn’t stall etc. There was no indication at the stage of labour as opposed to pregnancy.
It’s these sorts of examples which are helpful to assess our own risks and concerns, rather than general comments of difficult labours if you see what I mean.
General difficulties in labour are usually picked up as the labour progresses through the monitoring process, so I feel confident transfer would be ok in those cases.
It’s the very rare unidentifiable issues which definitely need to be thought about. Thank you!

@Thegirlinthefireplace you said what I was trying to say so much better.

Mishappening, I’m pretty sure mws bring oxygen and a mask to HBs.

I also hate the suggestion that women who have HBs care more about being ‘cosy’ than the health and safety of their baby. If you really think that women make this decision based on such frivolous factors, then I have to tell you you’re wrong about that (and insulting).

My community midwife was very encouraging when I chose a HB, as was the head MW who showed me round the antenatal dept at my local hospital! She was justifiably very proud of their facilities and good reputation, but said she would choose a HB in my situation.

I did a lot of reading and research. I knew that I could be blue lighted to hospital very quickly. I can drive to it in 7 mins at night time, and within 15 during the day, so I was confident an ambulance would have got me in swiftly if needed.

A homebirth for my first was recommended to me by the midwives at my booking appointment. They also came and did a home assessment at 36 weeks and I had to meet the criteria (full term, no complications etc).

They said we’d have to transfer in at the first sign of any trouble and we’re about an 8 minute normal ride from the hospital.

Everything was fine and my son was born at home in a pool. I had one midwife with me from 6cm, and another for the last few hours.

I did a load of reading and research, and it’s true that there is a very slightly higher risk with a first, but

Bah.

Continuing: but there are plenty of risks associated with hospital births too.

I think you have to look into all your options and decide what’s best for you, taking into account medical advice and where you’ll be most comfortable.

With my first DC there was shoulder dystocia which is fairly rare statistically but evidently my body loves being a part of the minority (!). I had to be rushed down for an emergency forceps delivery to save his life.

With DC2 the actual labour was a breeze, I only went to hospital at 9cm dilated and she was born half an hour later. But the placenta retained and I had a huge haemorrhage, I lost 4 pints of blood and had to be rushed to theatre to remove the placenta and attempt to stem the bleed. It was all very rapid and I would have been blue lighted for sure had I been at home. Worth noting no one should rely on ambulances to turn up very quickly anymore, I thought I was in pre term labour a few weeks ago so dialled 999. Ambulance took an hour to arrive.

I had a missed miscarriage last year and chose medical management which led to a massive haemorrhage and emergency surgery again. All of this has made me incredibly aware of my own mortality and I definitely feel safest at hospital. I’m having a consultant led delivery this time and I’m glad, it makes me feel as though I’ll achieve the safest outcome for both the baby and I.

Current evidence states that the safest place to birth for second time mums without additional risk factors is at home. No pregnant woman who opts for a home birth does so without doing her research, so it is both wrong and rude to suggest they are risking the health of their baby.

Our bodies successfully grow these babies with very little medical intervention, yet society has taught us that we need a highly medicalised birth to get them safely into the world. Birth is only possible with the hormone oxytocin, the love hormone, the same hormone produced when we see loved ones, when we kiss, cuddle, have sex, laugh and dance. We do all these activities in calm, quiet, personal spaces. It seems odd that we expect this hormone to be able to keep flowing in a bright, sterile, unfamiliar place full of strangers and loud noises which is essentially what a hospital is.

Reading wise I would recommend the NICE guidelines on birth. AIMS website. The positive birth book by Milli Hill and The positive birth company do an online hypnobirthing course which is excellent.

I was told at NCT that a home birth is actually safer than a hospital birth if you have a normal low risk pregnancy. You have 2 midwives and there is more chance of an easier stress fee birth and much less chance of infection for mum and baby. The midwives will transfer you to labour ward long before anything could go wrong as they are monitoring you constantly. I'd love to have one but am too high risk this pregnancy.

I’ve not heard of any evidence that home birth is SAFER than hospital birth even for a second or later baby so if anyone can point me towards whatever study/papers the NCT is basing this on I’d be interested to read it.

My understanding is that home birth for a second or later baby in a low risk pregnancy carries a similar risk to hospital delivery or maybe very fractionally higher.

Yes, the midwives monitor you closely and will transfer you to hospital if there is any risk. My worry would be those complications that happen very suddenly without warning and there may not be enough time for an ambulance to arrive and get me to hospital e.g. cord prolapse, placental abruption, shoulder dystocia or post-partum haemorrhage. These are relatively rare but I feel safer going to the MLU that’s adjacent to the labour ward at my local hospital knowing that I can have a doctor/C section/neonatal resus team there within minutes if the worst happens.

I don’t think it’s fair to say homebirth is irresponsible but I do think it’s important to consider the risks as well as the benefits and make an informed decision.

@Darkstar4855

www.bmj.com/content/343/bmj.d7400

Link to birthplace study; main UK evidence currently available on birth place outcomes.

The recent(ish) very well respected one is the Birth Place Study. It shows that for second or subsequent births home birth is no more risky than hospital birth, and even for first timers the risk is not very much higher.

I believe it also shows that statistically simply by planning a homebirth, whether you transfer in or not your overall chances of intervention are lower - which might be where the NCT line comes from that it's "safer" as opposed to just as safe - I suppose it depends what you're counting - only deaths/serious adverse outcomes or also the fact that outcomes such as c-section carry risks as well.

I think for me it also comes down to the environment of the home and distance to hospital. I planned a home birth with my first, transferred in due to exhaustion/long latent stage and was very happy with the overall outcome and experience but I have not planned a home birth with this baby. Partly because I actually had a positive experience in hospital and don't feel as anxious about the thought, but mainly because the first time around I lived in a house literally around the corner from the hospital with only my partner, and this time I live in a flat on the fourth floor, at least 15 minutes' drive from the nearest hospital without traffic and I have DS1 who is 9 and for me I don't think it would work to have him around during labour - I know some people do have their older DC around/involved but I think I wouldn't focus and it would bother me.