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..

@TheAquaticDuchess from everywhere I read HB risks are very low, from ~1000 women there were 9 complications (not deadly) for HB, 5 for hospitals and midwifery units. They highlight that in this particular study there were 4 more babies with complications but overall the risk is low.

Hi everyone, thank you again for replying! Can you please let me know if possible what complications you had in the hospital that you think would be fatal in HB so I can ask my midwives how early they can detect this at HB for a hospital transfer. @princesshollysmagicalwand @Bingobongo1 @LockdownLemon @Englishgirl9

@Anaesthetist83 I read midwives are equipped for hemorrhage management that contracts uterus and ambulance will follow up on the way to the hospital so hemorrhage is manageable in HB setting. Isn't this the case you think?

Those of you saying you’re only 5-10 minutes from the hospital, how long can you hold your breath for?

I had a home birth - I am a nurse myself and I wanted a water birth for pain relief and I also wanted a midwife all to myself! I would not be guaranteed the birth pool had I gone to the local hospital and I also wouldn't have a midwife to myself ( 2 in the end ) . Best decision ever, totally chilled birth , baby happy ,healthy and Dad there for the whole thing . I did weigh up the risks , classed as higher risk as had borderline high BP but that settled and also under Dr as hypothyroid . Was healthy throughout the pregnancy tho . The local hospital was only 2 miles from me , which was another factor to consider - should transfer be needed .
It's such a personal choice - you will find good and bad in both . It was right for me and my baby . She is my only child so I have nothing to compare it to !
Good luck

Haemorrhage control - the uterus/placenta has a blood flow of about 700mls a minute. With a total blood volume of 5 litres (ish), this means you can bleed out within 7 minutes.

Yes they will have a limited array of utertonic drugs which may help but surgery is generally what stops bleeding.

[quote Viletta]@TheAquaticDuchess from everywhere I read HB risks are very low, from ~1000 women there were 9 complications (not deadly) for HB, 5 for hospitals and midwifery units. They highlight that in this particular study there were 4 more babies with complications but overall the risk is low.[/quote]
5 vs 9..... yes out of 1000 but that's still Nearly twice the number....

I couldn't do it

As I said earlier. My SIL laboured at home 6 weeks ago until last bit where she was allowed her husband in with her in hospital. She was then out hours later.

If u have no complications (which if you are thinking HB it would need to be the same!) you'll be in and out anyway

@Viletta Well it's not a very nice story, but you did ask.

My baby got stuck. Totally stuck she had a significant shoulder dystocia (where the shoulder wedges behind the pelvic bone, info online).

In a minor SD, a midwife can do manoeuvres to move the baby. Didn't work for me and ended up in theatre with an Obstetric Consultant almost having to break by child's arm to get her out, she was basically born being dragged out by hand. She was left with Erbs Palsy which luckily resolved itself. They cracked my pelvic bone doing it. Then I lost 2.5 litres of blood, massive haemorrhage. Needed two transfusions and went into shock on the table. Followed by a retained placenta which needed surgical removal.

If I'd not been in hospital, my baby wouldn't have survived the trip to hospital (as it is, many babies born after a SD have brain damage because of the lack of oxygen, mine was SO lucky) and I'd have bled to death.

I had no risk factors for a SD, and a low risk pregnancy throughout. She just turned and got stuck and that was it.

Can you guess why I had an ELCS
for my second birth (which incidentally was calm and lovely and I enjoyed every minute of it - bar having the spinal which was a bit grim!)? Still haemorrhaged in the ELCS so I'm obviously prone to it, but was a much smaller one (500ml) and I didn't even notice. They patched me up and sent me on my way with no problems.

@princesshollysmagicalwand 500mls isn’t a haemorrhage.

@Squiffany
It's not about holding your breath - should you be unable to breathe , they would be able to support you mechanically until you got to a hospital. That's why your midwife would have full emergency drugs and airway support .
The distance to the hospital is more about the baby being stuck in the birth canal / shoulder dystocia which would mean they have around 30 -40 mins window to get baby out safely.

I did have a shoulder dystocia at my homebirth and my baby was born with the cord around his neck with a true knot in it. He has to be resuscitated on our dining room table. I had a really fast labour, if I'd been booked for a hospital birth I never would have realised I was that far into labour and without those midwives at my house we would have lost him as there's no way my husband could have delivered him alone.

no one knows which way it will go, and sometimes, the hospital wouldn't be the best choice. You just don't know.

[quote MrsRusselBrand]@Squiffany
It's not about holding your breath - should you be unable to breathe , they would be able to support you mechanically until you got to a hospital. That's why your midwife would have full emergency drugs and airway support .
The distance to the hospital is more about the baby being stuck in the birth canal / shoulder dystocia which would mean they have around 30 -40 mins window to get baby out safely.
[/quote]
I have been an obstetric theatre nurse. I’m not talking about a shoulder dystocia per se, but any problems can mean you have less than a few minutes to safely deliver the baby and hope there is no long lasting damage.

I’ve seen plenty of hospital deliveries go catastrophically wrong that despite being mere feet (let alone ten minutes-plus decision time plus hope the traffic is light and all traffic lights are green time) from an operating theatre and a whole team of hcps have tragic outcomes.

Sorry, my point being that the baby does not have 10 minutes of oxygen reserves.

My community midwife was saying I should have a HB as a FTM because everything was so “normal” and when I went into hospital in labour the midwives in triage said I should go to the midwife-lef unit but I think it was instinct and I said I wanted to go to Labour Ward. I was in Labour Ward for a couple of hours and things were moving on but baby was back to back (had turned) and within a couple of minutes things went very badly wrong. We were both ok in the end but the room was full of staff within seconds of the heartbeat dropping off. Until you’ve seen that red button pressed, it all seems like something that happens to someone else.
You have asked, I’m not saying to scare you! It’s a really tough decision, especially at this time. Pros and cons as with everything...

@TwinkleStars15 That was a typo, it was 900mls. Still, I didn't notice, felt fine and was ok.

But regardless, I am clearly prone to bleeding when giving birth, however I deliver. something which I couldn't possible have known first time round and something which could be and is very dangerous, life threatening even. Now that's not to say that will happen to every woman, of course it won't. Nor will the complications that I've mentioned or some of he other people have mentioned. But they can, and they do and the OP wanted - I think - balanced views.

My personal view, following my own experience is that home births particularly for first time mothers who are not very close to a hospital are unnecessarily risky. I am biased, obviously, because I've had a very dangerous experiences.

OP I hope you've had a good read of the different experiences. Only you can decide what's right for you, and making an educated decision is always best. Ultimately, as long as you all get out if it in one piece then it doesn't really matter where is happens.

I had both of my babies at home. All very straightforward. One of the things that influenced me was that of the people I knew who'd had babies in hospital, a very high proportion had either had planned caesarians or said that they/their baby would have died if they'd birthed at home. Of the ones who'd had home births, some had straightforward births, some had complications which was were sorted out at home, some had complications which meant they needed to transfer to the hospital after the baby was born, and some had to transfer during labour. But I can only think of one person who had the kind of traumatised flashbacks of birth after a homebirth which were very common among my hospital birthing friends.

There was no midwife-led unit at my local hospital, so the options were either home birth, or hospital birth at a consultant led unit with very high rates of intervention. If there had been a nice birth centre, I might have taken that option.

Our local midwife unit encourage home births. I planned one with my first 9 years ago, but due to prolonged pushing at home (2hrs) i was transferred to hospital and had an episiotomy and she just came straight out after that!

My second was a home birth and it went fine.

I’m currently pregnant with my 3rd and plan to have another homebirth if Covid doesn't get in the way of it!

The transfer with first was fine, I was really scared as I’d never been in hospital before, but they were all supportive and my midwife came in the ambulance with me. I just didnt like being on the ward afterward, it was middle of the night, everyone was sleeping and I was left with a screaming baby I didn't know what to do with! Because of the late hour I felt so alone and received no guidance or support. Also, I’m a very private person and sharing a room with several other women just didn’t work for me.

I really hope I can have a home birth again!!

I was told by the midwife, that if complications occurred, we’d be at the hospital by the time they set up the operating theatre. So that put my mind at ease, but we are only 20 mins away.

Having been through a home birth and hospital birth there are pros and cons. I was in hospital with baby for 4 days as she had jaundice. So my experience is different to those that get home after a few hours.

Home birth pros: You’re in your own surroundings, more relaxing, no intervention during labour, can go to your own shower and bed after midwives have left.

Cons - The clean up! We had our own birth pool and it had to be emptied and cleaned next day and it was the last thing I wanted to do. Also had to make meals and still look after the our other child - no time to just chill like in hospital.

Hospital pros: During the day you get to lay and enjoy baby, while you’re brought 3 meals a day!

Cons: Lack of privacy, No sleep at all as theres always a baby crying/someone snoring, sharing one toilet and shower between 8 mums.

I had home births for all three of mine. I heartily recommend it. I had independent midwives for the second and third and wish I had for the first. If you can afford it do it. I know it was the best environment for me and I’m glad I did it that way. I had to fight for the first one as midwives weren’t keen and wouldn’t allow me to give birth in my pool.That was the only birth where I tore.

@Piper100 - I stayed in bed for a week each time. DH cooked and looked after other DC.

Where you are will inform how positive the experience is. Generally even in labour wards of hospitals the maternity suite (where you give birth) tends to be lovely. The problems often begin afterwards when you need to be transferred to the postnatal ward.

I had booked a home birth with my first (I had an uncomplicated pregnancy and midwife was very supportive) and did 31 out of 34 hours of my labour at home; unfortunately, I had meconium in my waters and was transferred for closer monitoring and had a C-Section within 2 hours of arrival at hospital.

Don’t regret opting for a home birth. I did most of the hard work at home, where I felt safest (important to keep those labour hormones pumping!). Like PPs have said, the midwives are very risk averse and don’t like to take any chances.

My labour was back to back and I didn’t take any pain relief (as was coping well with hypnobirthing breathing), which might have contributed to the length of my labour. I wonder now whether, if I’d accepted pain relief, my labour would have been shorter and been a vaginal delivery.

That said, being in hospital would have been very stressful for me, so I imagine that would have impacted negatively on my ability to labour and I would have needed some intervention anyway.

If it was your second or third I'd be volunteering to come round and blow your birthing pool up myself, but I think going with a HB for no. 1 is brave. All very well saying you're only 5-10 minutes from the hospital, but you've to wait on the ambulance arriving, get loaded on, do the drive and then get from the ambulance into theatre or whatever. In an emergency that 5-10 minutes could be more like 20. DSis had to get transferred from an MLU with her first, said it was the worst part of the labour. The last thing you want to do if you're struggling is do a move like that. I would imagine it would be quite hard to keep in the zone with the hypnobirthing with that much distruption.

Staying at home as long as possible on the day and then going into an MLU (ideally attached to a traditionally Maternity Unit) is a good halfway house.

If you're on Instagram check out Victoria Emes's video (instagram telly?) on her birth story. She's very positive about HB but it really is a no-holes barred portrayal of the wonder of birth

[quote Musmerian]@Piper100 - I stayed in bed for a week each time. DH cooked and looked after other DC.[/quote]
@Musmerian That would be bliss! Sadly that wouldn’t happen in my house! After I came out of the hospital with my first, the birth pool at home was still up and I had to help empty and clean it, because my husband “didn’t get a chance to do it” Maybe I demand he take full responsibility of everything this time and leave me to rest

@Musmerian wrong smiley at the end there, meant to be