Home birth for first time mums

[Viletta]

Hi all, can I please have your opinions on home birth for new mums. Did you feel safe? did you end up transferring to the hospital? Were you happy with the home birth experience?

I watched hipnobirthing video pack and asked midwife about home birth. She said it was a great idea to kick start the labour and I can always change my mind and be transferred if needed.

Then I had NCT course that mentioned the Oxford study where outcomes for the baby were significantly worse for first time mothers delivering at home and transfer rate was 48% (only 10% for non-first mothers). This really worries me.

I wanted to have a chance to talk to the home birthing team before making up my mind but it seems that the only option to see them is being transferred under their care.

I also don't want to be in maternity unit on my own without DH for the first part of the labour and not being able to have a birth pool due to covid. These choices really confuse me as I don't know what to expect and I'm in the process of being transferred to a home birthing unit and haven't spoken to a person who could give me a good idea about all 3 options... sorry for the long rant, really confused here. I want my labour to be as natural as possible but monitored so if anything goes wrong it'll be picked up and the right care would be given. I'd do it in the hospital but the interventions rate is almost 50% for obstetrician unit birth..

I haven’t read the Oxford study, and wasn’t aware of those stats when I asked for a HB with my first. I didn’t get one due to complications, however I did feel that the midwifery team just didn’t feel confident I could deliver vaginally for my first. Once they saw me get through that labour with minimal intervention they were really enthusiastic about my having a HB for my second.

I’ve had 2 home births, both babies delivered safely and I was happy with the births and outcomes. 2 midwives arrive in vans very well equipped, what you don’t see is the equipment they bring with them. They also clean everything up, both times were on cream carpet.

My labours were short, I woke up around 4ish and delivered at 9.31 and 9.37. I was calm in my bedroom. At a certain point during labour my husband was told to get me some food.

I delivered my placenta on the loo with an inco mat covering it. I wasn’t going to have the jab but I did as both times it was taking too long and I was getting cold and baby needed to feed. I don’t midwives like to leave you too long.

During my second delivery the mid wife noticed baby had cord wrapped around his neck, she held her hands around him to stop his head going back in, with the next contraction she turned him and he was fully delivered. She did it so well I didn’t tear. I have no idea if that would have been done in hospital.

Both times I didn’t have any internal examinations, I was left, I used gravity, walking around and using the ball, and delivered on all 4’s.

The best part is that you are at home in your own space, we are mammals and they go to quiet dark places!

I had acupuncture from 36 weeks to ensure I didn’t go over due. I am certain my quick deliveries were down to this.

I had a homebirth for my first and transferred in after the delivery. The reason for those stats is because the midwives take an extremely risk averse approach. A second pregnancy with a first birth under your belt is a lot different to a first time. I would consider the distance and time it would take to transfer to hospital as my main consideration as worst case you get to labour at home and transfer in instead of doing the whole thing at the hospital. We used to have one to one midwives in our area so homebirths were extremely popular, I know loads of first timers who have had them with no issues at all, good luck!

I wanted a home birth with my first, the midwife discouraged it and I had a hospital birth. If I'd have been at home I would not be here today. I had a bleed and ended up in itu.
Think carefully about your options the thing that caused my bleed was not picked up on any scans and only discovered when I'd struggled with last stage of labour and by this point it was to late to stop it occurring.

Ftm here due next week and going for home birth. Everyone around me Thinks i’m mad to do it except my midwives which is good. Tbh they all had Hb’s for first babies so know it can be done. All the studies are mainly around transfer into hospital due to pain management rather than adverse effects and Being a medic myself, i have read a lot!
I am however open to whatever is best for baby and if anything happens i’ll go into the local mat unit which is a 15 min drive away. I just want to be where i am comfy and feel safe and that’s at home with my OH

Home birth with my first and it was the worst decision I've ever made. I'm lucky DD is alive and I paid a huge price physically myself.

I'm about to have my third baby and have had 2 very straight forward births previously, but I wouldn't have a home birth.

The transfer rate is quite high but mainly due to ladies wanting more pain relief, so they go in for Pethadine/epidurals etc, not because of emergencies. Good luck

I wouldn't, because there are some (rare) complications that need immediate c-section (acute placental abruption , cord prolapse).

If i had had a homebirth with DD2 she wouldn't be alive... (severe and sudden placental abruption in birthing pool) they got her out in about 3 mins by GA/section.

(I didn't have any risk factors for this, v low risk 2nd pregnancy)

Had a planned HB with first. Would have had one either way as she didn't hang around and DH delivered her.
I really loved being at home in my own environment and being able to get straight in my bed after.

To offer the converse argument... If my DD1 had been a home birth, her birth would have been attended by medical professionals and I wouldn't have been left alone in a hospital room as they didn't think birth was imminent (not UK NHS, a private hospital abroad). Whereas my HB with DD2 in UK I wasn't left alone, there was always one of the three midwives in the room.

But it's all a complete unknown. You never know how a birth is going to go. My HB for DD2 was recommended due to previous history of quick births. There were blood pressure problems in the lead up which potentially meant I would need a hospital birth- so they were planning on sending a midwife plus ambulance when I went into labour (we lived 45 mins from hospital on country lanes) but then switched back to HB when my blood pressure dropped again. They were checking for potential complications all the time.

All in all, you need to feel safe when giving birth. It's easier to change to hospital birth from home birth than it is home birth to hospital birth. Do what makes you feel safest.

I've just had my first in hospital and from my personal experience would not recommend a home birth for your first. Of the 5 other new mums I am friends with, 4 needed intervention (CS or forceps) to deliver safely, and I had complications afterwards that required surgery. You don't yet know how your body will handle the process and I think it's safer for you and baby to have the full medical options available should something happen.

I had a homebirth for my 4th baby. It was lovely. My previous labours were all easy too so in retrospect I could have had homebirth a for them too. I've just had my 5th. It was horrendous for me although the midwives all seemed to think it was a straightforward birth. I'm very glad I decided to be in hospital (and I was only there as I had read about risk of ppl in multiparous women). Have your first in a hospital if possible. I do remember feeling I could t cope with my first as I didn't know what to expect. I delivered very soon after so was fully able to cope but didn't realise it was so imminent.

I’m another whose ds wouldn’t be here today if I’d opted for a home birth. Ds got stuck in the birth canal and then his heart rate dropped off the scale.

Like pp’s have said you just don’t know the outcome. However it is proven if you’re relaxed the out come is different and birth is quicker.

Do more reading and go with what you feel most comfortable with.

Hi OP, I'm in a similar position to you, first pregnancy and considering a HB. I have also been transferred to the caseload/HB team for my hospital, although in my case this was a route to getting caseload care, which they only offer to those women considering HBs. However I was assured that I didn't need to commit one way or another this early on, and if I decide on a hospital birth later, I won't be "kicked off the team" so to speak, and they will still handle my postnatal care.

I'll have to look up the study you mention - I've only looked at the Birthplace one (quite old by now) which showed no increased risk to the mothers and only very slight increased risk for the baby, for first births. The transfer rate is quite high, but as others have mentioned, it's due to midwives having a very low threshold for transfer, the mother wanting pain relief, or, as I've read in many places, maternal exhaustion. I think key for me will be conserving my energy and not thinking "oh I'll just clean the kitchen/make a cake/tidy these drawers to distract me" while I'm in early labour.

I will say I'm confused that so many people with no personal experience of HB comment on these threads when they appear, simply to dissuade. I understand wanting to present a balanced view but they seem based on the belief that a labour will always progress in the same way, and need the same interventions, even if the external circumstances were different, which isn't always the case.

Like you, I'm undecided but strongly considering it. My baby is due in the winter and with the current situation and a likely second wave, I'm not keen on being in the hospital.

I’m a FTM considering a home birth. My midwife has been really supportive and positive. I’m going to decide nearer the time but I’ve had a totally healthy and happy pregnancy so far so if things continue this way I think I will go for it.

Mumsnet always has scary stories from women who say they would have died if having a home birth, but it’s important to remember that this is not reflected in statistics; for FTMs the risk of complications is only slightly higher for a home birth than a hospital birth. For subsequent births, the risk is the same or lower. Midwives take a very risk-averse approach to home births and will suggest transfer as soon as they consider there might be a complication. You also have the undivided attention of two midwives, which is much more than you get in hospital. Potential complications are therefore often identified earlier in a home birth than a hospital birth.

For women who require urgent intervention in hospital, it’s very rarely the case that the complication arises from nowhere; in the overwhelming majority of cases, had they been labouring at home they would have been transferred to hospital long before the point at which it was an emergency.

Every woman has the right to decide what is right for her own birth. For some women, even the slight possibility of something going wrong at home is a risk they don’t feel comfortable with. That is absolutely fine, and completely their choice. That choice should be respected and adhered to.

But for some women, the advantages of a home birth outweigh this slightly increased risk. That is also a valid choice which should be respected. And yet you see so much pejorative language directed at FTMs who choose a home birth. I’ve seen it said that such women are playing god with their baby’s life, that they’re prioritising their birth experience over the wellbeing of their baby, that they are naive or stupid, that they don’t understands science, that it will be their fault if their baby dies. These allegations are all completely untrue, hurtful, and unhelpful.

There are loads of excellent resources about home birth online, and your midwife will be an invaluable source of information. Do your research, make the decision that is right for you, and don’t let anecdotes be the deciding factor.

Thank you everyone for taking time to reply! Luckily we live 5-10 min away from the hospital. I will speak to midwives and decide later on I think. I feel at home I can carry on with the labour rather than having to go to the midwife unit and back. My initial choice was between maternity ward and HB rather than hospital vs HB. Don't want to be around the hospital during a pandemic if I don't need to.

So true that everyone thinks I'm crazy and if something happens I'd be blamed. My main reason for natural birth is that I am a bit biased on forceps and ventouse. I worked with gyn/obs who fed me horror stories about brain damage that they can cause, mind you she saw this in her student years ages ago but it just stuck with me. So I do want what's best for the baby and not just for myself.

Duchess.... what a thoughtful and informative reply.

I haven't experienced this OP but I did read 'Give Birth Like a Feminist' by Milli Hill and it went into the science behind the research on home births (amongst many other things), and it was really interesting! It went into a lot of detail on birth plans and feeling empowered with whatever choice you make! So I'd 100% recommend it if you want something to read. There's loads of info in there and it's all about managing to work towards a decision that puts the baby AND you as the priority.

The problem with statistics and comparing adverse outcomes from home birth vs hospital, is that the two populations are completely different. Hospitals, particularly tertiary centres, deal with complex births and women with complex medical histories, therefore by definition are likely to have “more complications” than home births, which are reserved for the fit and well/uncomplicated. They therefore need to be interpreted with caution.

What I would say is, even 5-10mins is a long time in the world of delivery, and a birth is only “normal” retrospectively. Lots of ladies have positive home births, but for the few that have disasters (baby or maternal), there is always the chance that outcomes at the hospital would have been different. That is something you have to have thought about and considered the consequences of.

Many labour suites have a MLC as part of the unit, and the rooms are really “homely” and not at all clinical.

I wanted a home birth and read the statistics from my trusts (we are between two) and the midwives actively encouraged home births.
I changed my mind as the time got closer as I started getting very health anxious and liked the thought of having a doctor on hand if needed.
And not to scaremonger but If I had a home birth my little boy would have died HOWEVER... that’s due to my location! If I lived closer to a hospital or paramedic services it would have been different, I live over an hour from the nearest hospital!

Thank you everyone for your thoughts, it's really interesting to read albeit didn't make my decision easier. I decided to talk to midwives about serious complications such as baby stuck and his heartbeat drops or placenta abruption to see how they manage these scenarios in HB and whether they can predict them in advance for a transfer. I will report back after I have spoken to them if anyone is interested.