Home birth - first baby

[yevans]

Hi all,

Seriously considering a home birth for my first. I live 15 mins from the hospital (7 mins ish if blue lighted), low risk pregnancy and love the idea of being in my own space. I'm very open to the fact that I may have to get transferred in and that's okay but I would love to hear tips about preparation, what I need, any questions I should be asking the midwife etc.

Thank you!!

I planned a home birth for my first baby. Similar distance to hospital as you. Great experience even though ended up transferring for EMCS. Be utterly ready to listen to midwives telling you it’s time to transfer - mine were very supportive so when they said we need to go I was “yup, right away!”. Was then in hospital with a woman who had got so focused on a home birth that she had persevered through some very obvious danger signs (heart rate issues and meconium in waters) and ended up with a brain damaged baby. The point of that story being that you really really have to trust in and believe the professionals. Would highly highly recommend it but if you are successful in birthing at home - which you probably will be (my issue was a face/brow presentation so I was unlucky) - be prepared for mess!! Don’t think you can get away with a few towels - full plastic sheeting is the way to go. Go for it - I did all the hard boring bit at home and sat in the bath and watched tv and was fully dilated at transfer but was massively less stressed than I would have been in hospital.

There will be loads of positive messages on here and I don't want to freak you out but...

If I'd have had my first child at home she probably wouldn't be here -I'm 20 mins from the hospital, very healthy pregnancy but her heart rate dropped to such an extent that they whisked me off for a GA and EC section.

They only knew her heart rate had dropped because of the hospital monitoring-now I've no idea if they can now do this with a home birth but without the specialist support of the hospital I don't think she'd be here

There’s always someone who comes onto these threads saying if I’d had my baby at home they’d be dead - but the horizon program that came out in 2012 showed that actually many babies die in hospital because they aren’t closely monitored enough. Sorry but it drives me up the wall- you can’t guarantee anything when it comes to birthing, so much is down to luck on the day and you have to weigh up the pros and cons for yourself.

I had both mine at home - my choice was based on having a very supportive community midwife team, being a similar distance as you to hospital, feeling utterly safe and reassured they would whisk me in at the first sign of anything not going 100% to plan and especially a bad experience on the ADU when I was 20weeks and the midwife shortage was terrible - one midwife to 7/8 mothers, I went in because I had abdominal pain and the midwife was exhausted and rushed off her feet, kept forgetting to write my measurements down, left the sonography gunk on my tummy and the floor when a doctor whisked her away - I felt at risk in the hospital and decided two midwives focussed totally on me in my own home made me feel a lot safer.

I couldn’t give a damn where anyone chooses to give birth but having the choice is so important so you can at least aim to be where you feel safe to give yourself the best head start - if that’s at home, brilliant, if that’s in hospital surrounded by men in white coats then you should be able to have that too.

My experiences were wonderful, truly. The only thing I’d say is prepare yourself for the possibility of induction - I’d prepared for transfer but when I went 10days over and induction was looming it really freaked me out I wouldn’t even be able to begin at home, so I’d just mentally prepare for all eventualities.

What about if you live further from the local hospital? We live about half an hour away (40-45 mins in traffic) from our nearest maternity ward but like you I'd really like to give birth at home - one short visit to that hospital was enough to set my anxiety off We're in Wales so I expect things might work differently here, but wouldn't be surprised if midwife shortage was as bad or worse here than it is in England.

Go fir it if it's safe to do so! I had my first at home, encouraged by my midwife. I had severe SPD and was on morphine for it in the later weeks although managed to get off it a couple of weeks before the birth. I gave birth with just gas and air and a tens machine with my own midwife and a student midwife. It was so far removed from what you see of hospital births. Dd2 was an undiagnosed breech so I had to have a section and was blue lighted in as was already in labour when they figured it out. That was horrendous. Ds was a planned home vbac. I live about 5 mins from the hospital of blue lighted and saw the head of midwifery to discuss the home vbac. You live close and if no known complications then I highly recommend it. Good luck

All mine were early btw. Dd1 was 8 days early as was dd2 and ds was 2.5 weeks early. Severe SPD and crutches with all. Ds was just gas and air too. God bless has and air. They were both back to back the horrors.

Thanks all! I will chat to my midwife at the next appointment and see where it goes from there. I figure that I can try it and if I decide I'm needing more pain relief or don't like the feeling of being at home I can always go in! I'm well aware that as much as you plan things, baby might have other ideas haha!

I had 2/3 of my babies at home. Was the most amazing experience ever! I had a midwife who monitored and kept on top of of everything and obviously woild have gone to hospital if needed

Hi op. I had a home birth for my first baby. I was low risk and I am terrified of hospitals and I knew I would panic and end up with intervention if I went in. I was due to be induced and declined it and on that day went into labour. It was wonderful, so chilled, baby all good, showered in my own shower, slept in my own bed. Only you know what risk you are comfortable with taking but I was 10-15 minutes away from the hospital and felt I could cope with that.

Things to have are:

Birthing pool if you want one (you can hire them online)
Shower curtains for extra coverage (cheap and covers large surface area)
Puppy pads
Towels (not new and fluffy and black like I did 🤦🏻‍♀️)
Food like apricots, dextrose tablets, lucozade sport to keep you going. (Extra tip: toast and honey tastes amazing after!)
A nightie to stick on afterwards

Bear in mind that sometimes it can be too late to get pain relief or for it to kick in. I know several people who had to have emergency c-sections / stitches for third degree tears. A planned risk based birth is always better and for your first I would suggest you plan it in the hospital or attached midwife unit (you could have a water birth there even if you book early enough); then if there aren’t real complications you could consider it for your second.

Emergency c-sections / stitches without any pain relief

As you are so close to hospital if you want one and understand the positives and the negatives then why not. Bear in mind though 7 minutes blue lighted doesn't account for the wait for an ambulance; even as a high category emergency it can be longer. The midwives should be able to be cautious enough to transfer you at first inclination it may be needed, mine didn't though. Not trying to put you off, many people have a straightforward and amazing experience, but please do be aware of the (small but serious) risks.

Personally I wouldnt, not in a million years knowing what I know now.

@teddybear45 I really don't think they do emergency C sections without pain relief?!

Three babies, three homebirths here. Somebody has touched on it above but I’d just like to say to OP and anyone else reading this that a lot of the time when people say ‘I/baby wouldn’t be here if we weren’t in hospital we wouldn’t have made it’ or suchlike, it’s a bit of a false conflation. Yes you will probably end up with continuous monitoring in hospital, one way or another, but you’re also very likely to be left to your own devices for long stretches of time without anyone checking the trace. At a homebirth you have two midwives, focusing their attention solely on you and baby, and still listening to baby’s heartbeat at very regular intervals (which are actually recommended in NICE guidelines/best practice over the continuous monitoring). It’s probable that the much closer care and attention will actually allow any issues to be picked up early on, before they reach the critical stage they sometimes get to in hospitals due to understaffing meaning long gaps between checks.
The other correlation/causation issue here is that standard practices in hospital don’t generally lend themselves to particularly successful births. Not enough options to move around/try different positions in labour, the huge prevalence of continuous monitoring, some staff wanting to make life easier for themselves rather than a labouring mother...whatever the reason, the relative lack of freedom and high chance of ending up on your back in labour in a hospital can actually end up causing problems that would never have arisen at home. Look up the cascade of intervention.

I’m not militant at all about homebirths - they’re not a good idea for some people, either for personal or medical reasons; everyone should give birth in the best place for them. And lots of hospitals are brilliant at getting women up and about in labour, etc. But I do think there’s a lot of myths around them. OP, I had a similar set up to you for my first baby/first homebirth - low risk, close to hospital, etc. My thinking was that they’ll only tell you to stay at home as long as possible when you’re in labour, so I’d give it a go at home and if I had to go in, I was no worse off than if I’d planned to go in anyway. As it happened I absolutely loved all three of my births and wouldn’t change a thing. Definitely have a chat with your midwife about it all - and sorry for the mammoth post!

If it helps, this is the study where the NHS-cited statistics on birthplace come from.
www.bmj.com/content/343/bmj.d7400

Based on my own experience I wouldn't for a first baby. I had a low risk pregnancy, and was an ideal candidate for a home birth. I didn't want one even though the local midwives pushed me to consider it. Thank goodness I didn't.

My child was born after a significant shoulder dystocia. I had no risk factors for it. If I'd have been at home she'd have been born brain damaged at best, dead at worst. I also had a retained placenta and a huge haemorrhage. Again, life threatening if not in the right place at the right time.

As it is, we're both healthy and well. Thanks only to being in hospital, with an emergency theatre and excellent doctors who saved us both.

I am biased, obviously. But I didn't and I'm glad.

Some rubbish on this thread! They don't do emergency c sections without pain relief. If speed needed they do a general anaesthetic. You can be under in seconds - quicker than the time needed for the surgeons to scrub up. You wouldn't be having a c section at home under any circumstances. Stitches are not an emergency so even less reason to do them without pain relief.
You would be usually quicker to go to hospital in your own car than wait for an ambulance (barring major traffic hold ups), the 7 minutes assumes one will be waiting outside your door! More likely there would be an hour's wait for it round here.
It's hard to compare home birth vs. hospital as some of the life threatening complications are due to the increased stress of being in hospital /being inactive /poor staffing etc so wouldn't have happened in a home birth.
Also although lots of people end up transferring in, it's very rarely a life threatening situation. There are no universal rules - it depends on the quality of your local maternity unit, distance, how much you hate hospitals, your attitude to risk.
Personally I decided against due to excellent local midwife led unit and being a bit too far away from hospital. Did seriously consider it though.

I had a second degree tear with dd1 who was a home birth. Stitched by the midwife with local anaesthetic and gas and air. Was the worst bit until she gave me more local as it hadn't quite worked. Well, apart from crowning which they took the gas away for because I didn't seem able to suck on that and push

I think it must be lovely to have a baby at home, I wish I had, not that I'm complaining about my hospital delivery which was quite straightforward and didn't take long. However it would have been nice after the birth to be at home in my own bed without other new mothers around me.

If I had time over again I'd definitely opt for a home birth.

I had both of my two children at home.

Be prepared that it is different. Dh held a torch shining on my bits so I could be stitched with my first. We did also get an amazing look at the placenta though. They checked his heartbeat after every single contraction.

With my second, the midwife only arrived in time to catch him as I rang her too late.

Luckily it ended well for me and I would make the same decision again.

Knowing what I know now, I wish I’d had my first at home - I likely wouldn’t have been left traumatised by the way I was treated by the people who were supposed to be looking after me! It was a very straightforward birth, nothing exciting to report: no pain relief, very minor tear requiring 5 internal stitches - which could have easily been done at home.
I had my second at home and the entire experience was wonderful
Planning another home birth for DC3 in September. I can honestly say that me or my baby would need to be in serious medical trouble to choose to birth in a hospital again.

@yevans I’m in the same boat, first baby and planned home birth. I’m low risk, MLC. I’ve been for a tour of the labour ward and MLU anyway, in case I decide to go in or if I need a transfer - I told midwife should a transfer be necessary no problem whatsoever, she was relieved apparently a lot of women get so focused on having a home birth they get very upset if it doesn’t go to plan. Better to be chill about any changes that are needed and listen to midwives. Ambulance has been to evaluate access to house! I’ve got plastic sheets ready, a basket full of old towels, stash of biccies and frozen bread for toast, an old duvet for my knees and birthing ball. Just a waiting game now! (39 weeks).
My reasons for home birth are I’m low risk and I love the idea of just relaxing at home. I’ve been doing hypnobirthing videos, I don’t want pethidine or epidural, and if I need transferring I will at least have managed to labour at home for as long as possible

I think the best thing is to speak to the midwives as they are the ones with the most knowledge and experience.
I was really keen on home birth for #2 (although dh was not)
The midwives were very helpful and talked to me about how they monitor and that at the first sign of an issue they send for an ambulance. They never take a risk and as there is 1:1 care at home they tend to pick up on issues faster. Although granted this won't always be the case so you have to weigh up the risks.
I had my first in an MLU which was 20 mins from the hospital. It was a standard water birth but very fast so I ended up with a bad tear. I was taken by ambulance but not blue lights.
I've spent the past few weeks pondering what to do this time but have finally settled with the new MLU at the hospital (the other one has closed otherwise I'd go there)
Due to the speed last time (waters to out within 2hrs) a consultant has recommended the MLU as fast births can increase bleeding risks and if this one is faster, its safer to be there. She did tell me that they'd support a home birth if that's what I wanted though.

Remember that just because you decide on a home birth doesn't mean you have to have one in the end. Our trust (and I presume it's the same elsewhere) assess your home if you request a home birth. Without it, they won't let you birth at home, so if you think you want one, make sure you get the assessment. Just to check access and suitability etc.
When you go into labour, if you've changed your mind, you'd call the hospital/birth centre and say you wanted a home birth but changed your mind and then go in. They won't turn you away.

It really is up to you OP.

As long as you understand all of the risks and have talked them through properly with the doctor then that's all you can do. Only you know what level of risk you are comfortable with.

Interesting anecdote - I have looked at quite a lot of studies into home birth and the results are surprising (I am a data fiend and wanted cold hard evidence for every decision I made regarding my birth lol). Theoretically they are very dangerous, but in practice they pose only a very small increased risk. Perhaps it's all due to mum being relaxed at home? Or maybe it's because they only let women do it if they are very low risk? Who knows.

I have opted for a hospital birth simply because I want an epidural and also I have no fear of hospitals as some people do, so I'm sure I can get very comfortable in there. But if you want a home birth I recommend having a look at some studies on it.