Now no home births - options?

[RainMinusBow]

So my hb midwife informed me earlier a home births are suspended in my area. From the moment I was pg I decided on a hb for many reasons so this isn't just a knee-jerk decision.

I am not going into hospital for many reasons - a significant one of which is I refuse to put my baby and myself at unecessary risk of becoming infected with Covid-19.

Does anybody know what other choices are available to me? I have heard of freebirthing but don't know much about it?

Islay No one has been judgmental about the idea of a home birth in principle. But the fact is, the OP cannot have a home birth under the NHS, because these are dangerous times. Free birthing is excessively dangerous.

I've sought advice from an independent midwife. The whole ambulance thing is, in essence, not a valid excuse for denying women home birth.

You are correct on the current ambulance shortage and delayed turn-around due to the current situation. Even in emergencies nothing to do with pregnancy ambulances are at a shortage and taking longer to be sent out. Even before this situation it is often the case.

Ultimately, in the very unlikely event of a true emergency situation it would be quicker for me to be driven to hospital by my partner if need arose. Clearly also roads are less busy too at this current time.

I am further exploring IM options. She gave superb advice.

Ultimately I believe it is safer with the curent situation to birth at home. I respect the fact that others may not agree - this is solely my personal opinion. Going forwards I will be seeking support from midwifery services (and this may well not be NHS) to facilitate me in doing so.

In your other posts (which you mention) you've also said how tight money is, how you've had to keep wearing shoes with holes etc because you can't afford new ones. Think very carefully before spending several thousand pounds that you clearly haven't got on an IM. If your previous births haven't been straightforward, what makes you think you'll be so low risk re transfer anyway. The reason homebirths are safe is because the midwives have a very low bar for transfer to hospital. The idea of you being driven in your car, if having complications is crazy, and with Covid, the ambulance might not get there in time.

Under ordinary circumstances, go for a homebirth, great, but at the moment the safest thing for you and your baby is the hospital. I'm sorry you may not get the homebirth you want.

Ps: your consent is EVERYTHING, so if you give birth in hospital you can just decline interventions, examinations etc. Obviously this may carry risks, but you don't have to do what they say just because you're in hospital.

I've sought advice from an independent midwife. The whole ambulance thing is, in essence, not a valid excuse for denying women home birth.

There is a global pandemic, plenty of people are heartbroken by having their treatment stopped, or operations delayed that could save their lives (such as cancer patients). You do have the chance to access a hospital and medical professionals, so I am afraid that it is a valid 'excuse', to protect the midwives and health service battling with shortages. Please bare in mind that independent probably isn't actually wildly independent, there is money involved by convincing people they need to pay for a service. It's obviously up to you and not minimising your fear or reservations, but please think carefully.

You seem set on what you’re going to do, and I do understand your worries on going into a hospital at the moment but I really do want you to reconsider free birthing.
I’m not going to bore you with all the details but my second was an accidental home birth and it was just horrendous for me. Really scary and upsetting for everyone. Ds is fine and I’m fine but I’m still traumatised.
I know if you plan a home birth obviously it’s very different, but I just don’t think this is the right time to be doing it, when there aren’t the right numbers of staff/ambulances on hand to help you if god forbid something happens.

The Hospital will be clean and sterile. You and baby will be looked after, and you can decline vaginal examinations if you wish although personally the thought of declining the midwife knowing what’s going on and detecting an issue makes me very nervous.

@RainMinusBow I would gently suggest trying to have a conversation with your consultant or head of midwifery to share the experience you had last time and to examine your options this time.

In the same hospital I had one glorious birth and one awful. It is not a given that what happened to you the last time will repeat. I am COMPLETELY sympathetic to your position, I honestly am and would examine independent organisations like NCT and Daisy Birthing etc to see what they say too.

However as @Babyboomtastic mentions, the risk appetite for home births is LOW and I would respectfully suggest even lower with an independent midwife; they have they lit professional reputation to think of and THEY don’t want to be risking anything going wrong either. In the age of COVID-19 that bar is probably even lower.

If I were advising you I would suggest you start coming to terms with a hospital birth and you and DH read up on partner advocacy and assertiveness in labour.

After what happened to you last time it’s highly likely they’ll be desperate for you to make all the decisions.

I'm a big fan of homebirths but would be concerned in this setup about the lack of ambulance availability too. It's not necessarily as simple as your partner being able to take you - what if you were unconscious? An ambulance has the equipment and man power to stretcher you if necessary, plus other lifesaving equipment and medications that your husband won't so they are not just different modes of transportation.

It sounds like this is very important to you, which is understandable. Could you perhaps make a written list of scenarios of varying levels of severity and plan how you could get go hospital in each one. The most serious may mean that you would find it nigh on impossible and would be stuck waiting for an ambulance for a long time. You need to decide if you are prepared to take that risk and balance it against the risks that you feel are present when going for a planned hospital birth. Don't let emotions lead you in this stressful time - get in all down on paper and make the decision making process as methodical and logical as possible. Good luck

Thanks all. I have made the decision to home birth, hopefully with an IM.

@daisypond I agree, free birthing is completely way too risky, I would never do it or advise it. But the OP has said time and again she is going to engage an independent midwife (IM) (paid for by her) so my posts were based on this. It doesn't look like she is considering free birthing anymore. It just seems some people may have missed that and there are many people being very judgmental about her preference for a home birth given the current climate - which, to be frank, I can understand - but we do not know the OP's intimate circumstances... there are many reasons why people need/want home births... and I don't think that someone's personal reasons, if very strong for them, should be completely invalidated due to COVID. I just think the OP is being sensible looking into an IM and so wanted to point that out and give her some support. I do agree that due to the current situation, the lack of ambulance availability is an issue. But we are not the OP, and she needs to weigh this up with her reasons for needing a home birth.

@PaulHollywoodsSexGut I agree it would also be a good idea to prepare as back up for a hospital birth, just in case, and do some research into assertiveness and make a birth plan etc. The POsitive Birth book is great for this; Expecting Better very good too.
Good luck OP! Try to be open to the different situations that might unfold, stay positive, be prepared, get a good IM if you do it at home, ensure you have support for saying what you do/don't want should you go to hospital, and hopefully all will be well. Good luck for your birth x

Presumably an independent midwife would attempt to access an ambulance or whatever if needed though, no? In all likelihood you will not need one, but there is more support usually for home births than the 2 midwives in your home. Anyway, good luck with whatever you decide.

@Marieo Only in case of serious emergency. If the case that I needed to go in I would go in partner's car as I'd get there far quicker that way. She said in 12 years on the job she'd only called out an ambulance once.

in the very unlikely event of a true emergency situation it would be quicker for me to be driven to hospital by my partner if need arose

With 2 straightforward deliveries behind you, the odds are on your side, OP, and I hope it works out for you.

But you are deluding yourself if you think your partner could drive you to the hospital if you had shoulder dystocia or a good going PPH. And what happens if both you and the baby are get into difficulties? There is a reason HBs usually have 2 MWs for the actual delivery. Please make a sensible back up plan for emergencies.

Please make a sensible back up plan for emergencies

Just have that chat with the hospital, even though you don’t plan to use them and on balance of what you’ve said won’t need them.

All info is good info.

They'd be two midwives at an IM birth too.

I gave birth in an MLU. DP and I were taken to the delivery room and left to do what we wanted. The midwife came in at regular intervals to listen to baby's heart beat and check my blood pressure and that was it. I was asked if I wanted vaginal examinations and I said no, you don't have to have them. As long as your blood pressure and baby's heart beat are okay they just leave you to it.

Out of interest how much would the IM charge for her and another midwife to attend a home birth?

She quoted around £2000-£2500. Obviously at 31 weeks already not much more antenatal care left to do.

Apologies for referring to your earlier thread, but since you mentioned your DP being unwell, I think you need to acknowledge that he has just had a very serious operation. It's wonderful he may be having the catheter out, that will make a huge difference, but I doubt he will be able to drive a car in the next 9 weeks. He will need weeks of physio to be able to walk again and he should have surrendered his license to the DVLA given the severity of his condition.

I know this will be a huge blow for you to hear, but I think you need to be realistic.

Can you get some legal help to get your DCs back? I think this must be a massive source of anxiety for you and it may not be possible to make any decisions regarding your type of birth until at least this is resolved. There are a couple of knowledgeable posters advising on how to maintain contact arrangements during these difficult times, perhaps if you repost just about that they may be able to help.

@Booboostwo Thankfully he's been given all clear to be driving shortly, probably over next two weeks. Catheter coming out in around a week. It's pleasantly surprised us how quickly he's recovered - he is far less pain than he was before the op. So at least some positive news 😊

My fiancé is also extremely supportive of a home birth as he knows that it would have significant benefit to my mental health. As my partner and having been at my side throughout many of my life traumas, he understands the importance of this more than perhaps anybody.

This is also his first (and last) baby - I'm 39 - so with things as they are we can't guarantee he could be present with a hospital birth. He is of course keen to be there from his own point of view, but mostly because as a partner of someone with severe anxiety he is aware of the importance of being with me.

RainMinusBow whilst your anxiety is entirely understandable and valid, you’re being massively irresponsible in thinking about freebirthing. It’s hugely dangerous, it could well end with catastrophic consequences and you will most likely still need the NHS’s help but in an urgent/emergency situation that would take up more resources than if you were in hospital.

I speak as someone who was very anxious in both my pregnancies and would was under perinatal mental health as a result, so I know you feel you’re right here but you aren’t thinking straight. You need to be in a hospital or have an independent midwife but with things as they are and the NHS under the strain it is the most responsible thing you could do for you and your baby is make a kickass birth plan and go to hospital.

I'm sorry but I think your age automatically puts you in a high risk category. And the words 'hopefully with a I'm' implies you'd go ahead with a home birth without one? But

@AllTheWhoresOfMalta I disagree. The safest place for me to birth, especially with the coronavirus situation, is at home. The IM recommended myself and OH self-isolate the two/three weeks before EDD to further minimise risk.

@PeppaisaBitch Guidance in UK is that 40+ classed as "Increase risk" so at 39 not in that category. And none of the other "Increase risk" factors applicable, meaning I'm classed as Low risk 😊