Home birth for first child?

[tacosplease]

I’ve been reading this thread and it’s completely freaked me out:

www.mumsnet.com/Talk/am_i_being_unreasonable/3750574-to-still-be-pissed-off-how-i-and-so-many-other-women-are-treated-before-after-birth

Giving birth in hospital sounds utterly horrendous!

I’m now wondering whether a home birth is the way to go - surrounded by the comfort of your own things, with a lovely private bedroom and bathroom. It sounds so much more relaxing.

On the other hand I worry what will happen if there are complications or things go wrong.

I’m mid-30s and it’ll be my first child. What do you think?

You're always going to hear more negative than positive birth stories, it's just the way it is. And especially on a thread like that.

I have had a positive birth in an attached mlu. No drugs, just tens and in the water. The stay in the main hospital afterwards wasn't enjoyable and in hindsight, I could have discharged myself as there was nothing wrong with either of us. I wish I'd known that. But then again, when is a hospital stay every enjoyable? They fed me, checked up on me and changed my DC when I was too conked out to do so.

My second birth was a planned homebirth and it was just as positive as my first, only with the added benefit of being in my own bed afterwards. There is a dedicated homebirth team in my city, I transferred my care to them and they were amazing. Their transfer rates into hospital are lower than the national average, significantly so for 2nd timers.

I recommend the positive birth company digital pack, which is a series of hypnobirthing videos that fully inform you of the process of birth. It also gives you access to a private Facebook group full of positive birth stories, in a variety of settings and scenarios.

I booked a home birth for my first baby and ended up transferring in due to tiredness and lack of progress. It wasn't an emergency and though it was upsetting, it wasn't the end of the world. I had a nice experience and I put that down to having started out as a home birth.

I agree there are a lot of stories of people who think they "would have died" at home, but seem to miss key information that would have been present in a home birth management. For example a PP referred to induction, but you would never be induced at home, you'd be in hospital for that. There are other things that would result in transfer as well much before.

I opted for a hospital birth for my second because we were living in a flat and I felt it would be unfair on our neighbours, also that trying to manoeuvre out and down all the floors would potentially be distressing, plus the hospital was a good 20 minutes away and longer in traffic.

However I have heard of a couple of bad experiences - one woman I know who had a straightforward birth for her first DC had a home birth for her second with an independent midwife and she was really reluctant to let her transfer into hospital and it got quite dicey because she left it too late. Ultimately everyone ok. But a concerning experience. The other was a friend who had twins - so fairly high risk anyway - and one suffered oxygen deprivation at birth and ultimately was disabled by it. Could have happened in hospital too, but it happened at home, so they had to deal with their feelings regarding that.

DS2 the one I had totally in hospital suffered distress and needed oxygen and to spend time in nicu. Whereas DS1 with half the labour at home did not. I'm not drawing any conclusions from that at all btw! They think DS2 took in some meconium before the birth, so it would have happened anywhere.

I agree with the advice to look at hospital and think about home and just think in terms of the moment, what would be the best thing/place right now? If the balance shifts that hospital would be better you go in, just a practical decision, nothing value based on it, no failure.

Giving birth in a hospital is not horrendous. It’s incredibly reassuring to know that you are in the very best place if anything goes wrong. And things can go wrong very quickly. 30 mins from hospital is a long time.

Have you visited the birth unit at your local hospital? If you have no complications in your pregnancy then you can be in a midwife led birth centre which really feels nothing like a hospital.

Most of the time prenatal care is great but where I found it lacking was postnatal care, so I would recommend seriously educating yourself on things like best feeding practices (whether breast or bottle feeding) as you might not have anyone advocating for you like I found. Also just be prepared to stand your ground and advocate for yourself and baby if you need something or feel something isn't right.

Op I had a horrible experience in hospital. Midwife didn't even recognise I was in labour and kept making snarky comments. Spent most of it in a toilet thinking I was dying. Anywho I'd still opt for a hospital just in case something goes wrong.

I think it’s a very reasonably option for second and subsequent pregnancies. Personally and professionally I think that home births for first time mothers are ill advised, when compared to labouring in a MLU within a hospital.

Ultimately it comes down to you being comfortable with your choices though. Should the worst happen, either in hospital or at home, would the differing geographical location change how you felt about it and affect how much blame you might place on yourself.

Realistically some primigravidas make an informed decision to attempt a home birth. A significant proportion of those end up being transferred to hospital and have a successful birth there - many women are happy that they spent as long as possible at home and still see it as a positive experience. A tiny percentage of mothers require really urgent transfer, because in the vast majority of cases it’s clear that things aren’t going smoothly from relatively early on and a good midwife will make the call to transfer early.

Most of the bad outcomes I’ve seen have been due to either catastrophic complications such as placental abruption or where transfer has been delayed due to lack of ambulance availability.

Even if you live 5 minutes from the hospital, depending on where you live and how stretched the ambulance services are, you could be waiting upwards of an hour for an ambulance.

Lots of super helpful replies, thanks everyone! I will keep thinking...

I'm not anti home birth for other people, but it's not something I would choose for myself. I'm very risk averse, have had eight rounds of IVF to get pregnant, three miscarriages and two (so far) complicated pregnancies. I imagine it can be a wonderful experience for some.

Due to the nature of my pregnancy I was consultant led and gave birth to my DS in an obstetric unit. Was induced. It was a really good experience. Wonderful care, I felt safe and reapected at all times and my overriding memory of childbirth (apart from the pain) is laughing loads and loads. Midwife was hilarious. Spent a few hours on post natal and then came home. So not everyone has a poor hospital experience- that thread is a self selecting group, so don't read too much into it.

Should also add I was one of the people who transferred in after my DC3 was born at home.
The birth itself was very straightforward and uncomplicated. But around 40 mins after DC was born, she required a little extra help so we made the decision to transfer in and received wonderful care in the hospital’s NICU for 24hrs.
According to a recent report, it’s not my local hospital as a whole that is failing in all areas....just their maternity services. There was a damning report released in our local press this week and I honestly wasn’t surprised considering the horrible care I received during DC1’s birth there.

There was a damning report released in our local press this week

Both my local hospitals have been rated as "needs improvement" by the CQC

Seems like since I had DC1 there (in the Labour Ward), more women have become more and more vocal about crap care and have actually been submitting formal complaints which has made the CCG aware of the issues. A friend of mine took the hospital to court in a medical malpractice suit and won after she and her baby almost died due to shocking care there.
But on the flip side, I’ve heard stories of wonderful care in the same hospital’s MLU! So something is apparently going wrong inbetween the Labour award and MLU

It's things like this that make me

• had a problem free pregnancy, spent 40 hours labouring in a hospital room with a midwife beside me, when they lost the foetal heartbeat. 1 min 45 seconds later and with the help of a surgeon & crash team of 5, ds was born pink and wailing.*

You do realise that they don't leave women labouring at home without suggesting transfer for monitoring? So assuming you followed medical advice the outcome would have been identical 🤷🏻‍♀️.

OP it's up to you, my experience is that you are looked after much better at home. I had a homebirth for my second. With my first I'd have ended up transferring. I think you have to be flexible and not set your heart on it. I hated the postnatal ward - and for those saying 'can't you put up with it for a short time' I would say why go to hospital if I'm healthy and don't need to? I think the hospital default for births is a bit strange. in fact hospital has risks, including infections.

You always have the people who start talking about stats in danger from 1940 when there were no scans so women bled to death as they didn't know where the placenta was or that the baby was breech/ was actually triplets etc.

Base decisions on medical advice you are personally given I reckon.

My midwife seems very pro home-births, which surprised me. I'm not sure why - I just assumed that they would automatically encourage you to go into hospital for your first. I will speak to her further about it.

I had a hospital birth for my DD which was absolutely horrific in a variety of ways. But I would likely have died if I had had a home birth due to severe complications immediately after delivery. And there was no indication in advance that that would be the case.

Lots and lots of people say that too. You quite simply don't know. The number of women who have PPHs in hospital who would have died at home but no woman has actually died from a PPH after home birth in the UK in modern times. It baffles me BUT if you personally feel safer in hospital then ultimately go there and you are the norm aren't you?

www.npeu.ox.ac.uk/birthplace :)

I've just remembered that a friend of mine, an obstetrician, had her baby at home based on her knowledge of the statistics. She was given a pretty hard time about it by her colleagues etc etc. But she did say if she was having a second she'd have it n hospital with an epidural! She hadn't appreciated how painful it would be! That was over 20 years ago and I like to think it's made her a much better doctor.

@tacosplease I am planning a home birth with my first. We are 15 mins from nearest hospital / MLU but I want my home comforts as pp have mentioned. Highly recommend you read the Positive birth book by Milli Hill and cut down your time on MN - I find the negativity on here really unnecessary. You do you.

I’m hoping for a home birth for number 2. I live 10/15 minutes from hospital with a labour ward and birth centre. With number one if was considering home birth but decided against it. My waters went and I went into be induced. The hospital was busy and I almost had a free birth in hospital. No one would believe I was labour. I was refused any pain relief even gas and air. No one checked baby’s heart beat at all. If something would have happened to baby no one would have known.

This time I’m want to have a home birth as I feel it is more likely I will get a midwife and some medical care!

I had my first at home with NHS midwives without any doulas or independent midwives. It was fine. I was ten minutes drive from the hospital, less time that it take to prep the theatre. So it felt like the risk was moderated.

Tbh, I don't feel like being at home made the actual labour any harder or easier (I had my other 2 children at the mlu) as I have quick labours and am too quick from 0 - to - pain to give a shit about the ambiance or environment or which way is up. But post-birth it made all the difference. I was able to eat the food I like straight away, take a bath in my own bath, didn't have all the noise of a busy ward outside my door - it was very zen.

I had my other two in the MLU. I just couldn't take the risk that I might have to be transferred in the middle of labour leaving them worried and confused and I didn't want them having to be jettisoned from their beds in the middle of the night to have the house to myself. The pregnancies and labours were as uncomplicated as the first but I still think it was the best decision in the circumstances.

I planned a home water birth. Started off well, phoned the midwife when I felt ready. 3 turned up, it was like having a girls night in, in my lounge! If only I could have had some wine
Also the gas and air gets delivered a regular taxi driver which we thought was hilarious!
After a few hours I felt like I wasn’t progressing, they agreed, so I decided to transfer.
They called me an ambulance and it arrived really quick (the paramedic said “ladies in labour come first!”)
Spent another two days on an induction drop before deciding an a c section.
Now, I think I had a c-section. My notes said I had an emergency c section....between deciding to go for a c section & going into theatre was over 2 hours!!
If I had continued at home & then decided on a c section....there was plenty of time to get there!!
Also, at home I had 3 midwives all to myself!

The thing to remember is, whatever you plan you can always change your mind. The best thing I found was being in control.

The thing is, according to the latest research, women with a complication free pregnancy are more likely to have a better birth experience at home (with trained midwives) or MLU than in the hospital where their low risk means midwives don’t give them as much attention.

For high risk women like me a hospital birth will always be better as I will get the attention I need

Whilst I agree high risk women need to be in hospital, I disagree that you get more attention there. I had a midwife and student with me the entire time at home and a second midwife who arrived for delivery. That’s 3-1. They saw every contraction, every movement I made, consistency of the same midwife etc.

@GeorgieTheGorgeousGoat I think that's the point though, you got plenty of attention at home, but as a low risk patient, probably wouldn't in hospital...

For high risk women like me a hospital birth will always be better as I will get the attention I need

I was high risk and, since they insisted I wasn't in labour until I was well into pushing, got very little attention...