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!!)

Fear mostly. Having the doctors and medical interventions there to hand you’d need to wait to get into hospital.

But when you think of the lower amount needing said intervention at home due to the relaxed environment I think that we’ll outweighs the ‘chance’ you might need it.

I’ve had two home births, could not recommend it highly enough. I didn’t need any pain relief and it was lovely to curl up in my own bed with baby after. Currently six months pregnant and this one will be a home birth also.

Yes there are two. One constant and one to assist. And they are there for you and you only

Am I correct in thinking there are two midwives present during a home birth? Think I read this somewhere but not sure?

It depends. Sometimes they are too busy and unable to come out at all. So you give birth unaccompanied.

Am I correct in thinking there are two midwives present during a home birth?

I had two community midwives at mine. One came out within half an hour of being called in the middle of the night, then she called the second midwife a few hours later when the birth was clearly imminent. The second one arrived about an hour before DS was born - and I was delighted to see her as she proved to be amazing at giving lovely, firm, pain relieving lower back rubs.

I'd never met either of them before (my usual midwife was out sick, unfortunately) but they were wonderful & 22 years on I can still remember their names.

Two midwives, I think it is also for their protection, and for accountability.

Are you intending to scare women @orangezog?
Yes, there are two midwives at a home birth. The first will stay with the woman once she is in established labour and will call the second ilto the home when she judges labour is progressing towards pushing. Once baby is born midwife will stay for a few hours to write up notes, check all is well etc. Mine sat and drank tea with us, though she very much stayed in the background. I had an independent midwife because I was unhappy with the community antenatal care that I'd had with first DC and had no intention at all of allowing that midwife anywhere near the birth. So just one independent midwife plus DH with me when DD was born, and that was fine, all went quickly and easily and it was a fabulous birth. DH had been a bit of a rabbit in a headlights at DD1's birth in hospital, but he was amazing support at home.
And the birthplace study of 2011 is an excellent place to look if you want the facts. One of the things it lists is that home birth is the cheapest option for the NHS, despite the fact that the woman has one to one care through labour. Some more forward thinking areas have a dedicated home birth team.

@Sewingbea no, I’m being honest. A home birth works wonderfully for some women but it’s a sad fact that you are not guaranteed to have two midwives and it’s irresponsible to say otherwise. It’s the same as when people say it’s ok that an ambulance can get you to hospital in a certain amount of time but that’s no good if there aren’t ambulances are available at the time you need them. There are also shortages and delays in hospital. Even if you go privately, they won’t have emergency and neonatal facilities that might be required afterwards.

canyousew that surprises me - as mine kept disappearing off I assumed it was more likely to be expensive to have 2 to yourself.

“Fear mostly. Having the doctors and medical interventions there to hand you’d need to wait to get into hospital.

But when you think of the lower amount needing said intervention at home due to the relaxed environment I think that we’ll outweighs the ‘chance’ you might need it.”

I find comments like this quite unfair and unrealistic about why many women don’t have home births

I had two midwives at my home birth, one came straight away, the other arrived a bit later as she went to the hospital to pick up the gas & air. Both stayed the whole time, and for over an hour afterwards while they wrote up paperwork. We were really well looked after.

@converseandjeans below is copied from the NHS site, following a BBC article on this issue is 2012. The difference in cost is really marked, although I'm not sure it takes risk factors into account. However as discussed upthread there's the issue around whether giving birth in hospital might lead to additional intervention because of the environment and how the whole system is set up to deal with risks etc in there.

Researchers found that the average cost for a home birth was lowest, at £1,066. The most expensive were hospital births, at £1,631 on average, while midwife-led births came in at around £1,450.

I guess with a hospital birth it's also the bed/room, porters, cleaners, post natal ward bed space, nurses, auxiliaries, consultants and anaesthetists who are there on standby, theatres that need to be available and staffed. Catering. There are a lot of costs beyond the midwife associated with being in hospital.

I’m pregnant with my first and would absolutely love to have a home birth, as I really dislike hospitals and find them such stressful places. Plus both my local hospitals in London have been rated as “requires improvement” by the CQC - which doesn’t exactly fill me with confidence However, I’m just too nervous to stay at home in case something does go wrong and I can’t get to hospital quick enough for help.

I had pre eclampsia with my first. When I had my second, with my history I wanted the safety of a hospital birthday. If I had had a third a home birth would have been considered as things were so much better the second time round.

@OrangeZog If they are too busy then they tell you to come in, they don't just go 'Tough, give birth alone'.

I did actually give birth without a midwife for DC2 as my contractions suddenly sped up in the space of about 5 minutes. The midwife was on the way but didn't make it in time. DH delivered DC2, called an ambulance as instructed and they appeared within 5 minutes and took care of me while we waited for the midwife. Midwife came and checked us over and then left as we were all absolutely fine.

I actually had four midwives at one of my home births. All for me!