Why is the home birth rate so low?

[RainMinusBow]

It's just 3% in my area and I think that's about typical, if not higher than the average?

I know for first-time mums home birth slightly increases the risk of problems but this is my third, low-risk pregnancy.

Having done lots of research, I'm very much hoping for a home birth this time around after two not great previous hospital births. My midwife has been great about discussing this with me.

My fiancé (his first baby) just assumed from the get-go I'd be going to hospital to deliver but he's supportive of my wishes (unlike my ex-husband was!!)

I know quite a few people who have had lovely home births.

For me - with DS1 our flat was tiny and not really suitable, no bath, no room for birthing pool etc. As it happens I’m glad we were in hospital as DS1 had unexpected complications.

With DS2 I wanted to be very close to the hospital because of DS1’s complications. Again, the house wasn’t great for a home birth and still not adequate space for birthing pool etc without lots of hassle.

DS2 was born in the MLU at the hospital while the midwife was filling the pool though. Never got my birthing pool anyway!

I wouldn't choose a home birth as I'm quite risk averse. I had a perfect pregnancy, no complications etc, but giving birth can be totally unpredictable. I wanted the security of hospital facilities.

My local hospital is doing lots of work to promote home birth as an option and I'd have loved one. At booking my midwife did present it as a viable option if I had a preference or wanted any more information. What would stop me in fear of something going wrong and not knowing how I'd cope for the first time. I know the midwives would be monitoring but something unexpected like shoulder dystocia was a real fear for me. And knowing how stretched the ambulance service is, I wouldn't like to assume they'd be able to be with me quickly for transfer.

I do think if I decided to have one, lots of family and friends would have tried to dissuade me.

I would consider it for a second DC.

For me it was logistics.

My house was in one London borough, my GP surgery 100m down the road was in another. Hospital 20 mins walk away was in GP borough, hospital in my home borough was 45 mins on 3 tubes, with no option to drive.

If i wanted a home birth I’d have had to transfer all my pre natal care to my home hospital. All scans, m/w appts etc. In an emergency I’d have been transferred to that hospital.

I stuck with a hospital birth as it was far easier to see the m/w and antenatal teams locally, plus I did need emergency c-section so i am very very glad it was a 5min trip and not tubes and taxis!

I wanted a home birth with dd3. Dh was against. Thank God. Shoulder dysocia.

Perception of risk is a funny thing.
My first birth was hospital. I gave birth alone with no one else in the room. Nearest person was DH just outside the room who had ran to find help after pressing emergency button. I had been left alone as birth was not considered to be immenient- midwife was gone 5 minutes

Second birth. I believe my home birth was a lot safer. There was a high possibility of another quick birth. I lived 45 minutes from nearest hospital on country lanes (not including level crossings which could be closed for 5+ minutes). The safety assessment was homebirth or ambulance to hospital. On the day I went into labour, during heavy snowfall, the nearest maternity unit was full- if I hadn't been booked for a Home birth, it would have been 90 minute transfer. Instead I had two community midwives plus a student midwife, who never left my side at home. DD2 was delivered safely. My toddler had cuddles at an hour old. There was no mess to clean up, midwives took the old sheets etc with them. It was lovely.

I'm pro home births if that's what the women chooses, but surely it's obvious the many reasons people would prefer a hospital birth. Access to pain relief, no need to transfer if it's not going well, medical staff on hand just in case, no mess to clean up.

I personally just didn't want one. I couldn't wait to go to hospital as soon as I was in labour. I felt safer and more comfortable being there than at home.

Many places, like mine, only it offer it to the lowest risk women (ie those who have a history of low risk birth) and first time mums don’t make the cut unless they are under 30.

I wanted a hospital birth . It felt safer to me , however by the time of birth home birth wouldn’t of been an option

I had a home birth with my 1st age 24 and I was so blasé about it all! I'm not sure I would the second time round. But I did have the guarantee of a birthing pool and I had 2 midwives and a student midwife! I also lived pretty close to the hospital should anything have gone wrong. They estimated 4mins with blue lights.

I think the reason I wanted a home birth so bad was because I was so scared of being in hospital at any point without my partner. The best bit ever was going to bed with my new baby afterwards. I would do it again but I think I'd be way more nervous.

Fear. I'll have a hospital birth because I faint at blood so I'm scared

Has anyone read This is going to hurt but Adam Kay? That planted the seed of doubt in my mind although I had a wonderfully amazing experience.

I am booked in with the home birth team. I know that some people need help during birth from doctors, but I feel confitthat I live close to a hospital if I need one. And whilst at home I hope to benefit from reduced intervention, a lower risk of tearing and 1:1 care all while saving the NHS money!

Most women will plan for their birth to be as low risk as possible, and statistically, that means giving birth where their are medical staff as close by as possible to intervene quickly if necessary. Some women will also consider the physical mess that a home birth could create (a friend I know had to replace all her downstairs carpets and sofa after her home birth 😬) You also have to be considered a low risk to even be given the agreed option of a home birth, which is hard to categorise when there are so many minute factors which can make you "high risk". For the huge majority of women, giving birth in hospital just makes sense, or is their only option, not many people will live close enough to the hopsital to consider giving birth and home, and getting there quickly if things go wrong. I would not have wanted to give birth at home as I was terrified and wanted to be in the safest place possible. Luckily I was in hospital with my first as my baby got stuck in the birth canal, her heart rate plummeted and I got rushed in to theatre to get her out before she was starved of oxygen. If I'd have been at home, things could have ended completely differently. Home births are a great option for some, but not for most.

I'm a 38yo FTM. I mentioned a home birth at my booking-in appt thinking my midwife would immediately dismiss the idea but she surprisingly didn't. I suspect I'll end up at the local hospital in the end but I would like to be able to stay at home for as long as possible. (Most FTMs here go to the larger, regional hospital 100 miles away, but I want to avoid that if at all possible).

It just sounded like a lot of faff to me tbh (sorry!). There was talk of having to hire your own birthing pool and using your own towels and all I could think of was the mess and the clearing up afterwards (!). Also I live in a terraced house and I'm a loud birther 🙈 . So it was a no from me. The birthing centre was a good compromise .

I think it would be lovely to have a home birth, and I think they’re supposed to be a lot more relaxing as you’re in your own familiar space thus have a chance of lowering the chance for intervention. Hence why they like you to labour at home for as long as possible.
However saying that, I think what puts most people off having a home birth is if you did need intervention, especially emergency, then you would have to wait to be transferred to hospital and that wait could have make a massive difference.
I gave birth in a birthing centre which was like a really nice fancy hotel, so almost like a second home and knowing help was right next door really put me at ease.

Because a normal birth is a retrospective diagnosis.

@GrumpyHoonMain you can have a home birth whether you're considered "high risk" or not, it's your choice, no matter where you live. No one can force you to do anything, so all that stuff about not making the cut is just rubbish!

Hmm aliensprig while yes, that is absolutely true, and no one should be told otherwise, if like me you would opt for a home birth but having weighed up personal risk factors feel that the MLU is the best option it does rather feel like being told you are letting the side down

Well our house is rented so do I mention my plans to the landlord?!!

From what I understand it's actually a myth that, unless a FTM, giving birth in hospital is safer?

I thought everyone knew that? At a population level. But individual posters here are responding according to their own circumstances, which is a very different matter

@rainminusbow it’s such a personal subject I think it’s the done thing in western culture to try be as prepared as possible and medicalise everything. I did hypnobirthing and wanted as natural a delivery as possible, considered home birth too but chickened out due to fear of complications. I had a hospital birth which needed forceps after 36 hours of labour, baby came out hypoxic and needed to be resuscitated. Could the stress of hospital birth have caused the delay in delivery? Probably not, I had a single room, just me and my husband, calming music, relatively pleasant experience until he came out blue.

Would I consider a home birth? Probably not just because if it happened again I’d blame myself for not having all available help nearby. I’d rather if anything went wrong I had someone else to blame 😂