Has anyone had a homebirth in a block of flats?

[cheddar21]

Hi I am 30wks and had initially planned to give birth in a midwife led unit. Unfortunately my home circumstances have changed and it is looking like my partner will now be recovering from major surgery at home just as I am due.

I'd really like him to be present at the birth and it is increasingly looking like a home birth might be the only way to make this happen as it would allow him to rest for as long as possible but also be there (if that makes sense).

I've just started looking into it, weighing up the pros and cons. A big worry for me is the number of stairs I may need to get down in the event of an emergency. I am on the second floor and there is no lift.

Does anyone have experience of a home birth in a flat up several flights? Is it possible? Or should I just get the idea out of my head?

I had 2 home births in a third floor flat. No lift. They were fine. The midwife came and did a home assessment and wasn’t particularly worried about access if things became an emergency.

Only thing you might want to consider is if you want a home birthing pool and whether your floor can support.

Logistically, it's not ideal.
If anything were to happen to you in labour or if you had delivered and you and/or baby had complications an ambulance would have to be called, and contrary to belief, midwives do not 'have them on standby' - they would have to go through the 9s like anyone else.

Then there is the issue of getting down the stairs. It's walk or tight carry chair (which is less than ideal for obvious reasons).
No lying down until you get on the ambulance.

Take into consideration of exceptional weather (worth thinking about for a winter delivery) which would also delay an ambulance getting to you.

For the sake of a day or two at most, have your baby in hospital.
It's the safest place.

@mintbiscuit

I had 2 home births in a third floor flat. No lift. They were fine. The midwife came and did a home assessment and wasn’t particularly worried about access if things became an emergency.

Only thing you might want to consider is if you want a home birthing pool and whether your floor can support.

Thanks @mintbiscuit it is helpful to know it isn't likely to be an immediate no so it is worth investigating further, but still a lot to think about.

Was there anything else logistically about a home birth in a flat I should think about?

I would be a little concerned about the neighbours? Is the noise insulation good? You could potentially be very noisy for several hours in the middle of the night... it might be quite annoying for them!

@FrankiesKnuckle

Logistically, it's not ideal. If anything were to happen to you in labour or if you had delivered and you and/or baby had complications an ambulance would have to be called, and contrary to belief, midwives do not 'have them on standby' - they would have to go through the 9s like anyone else.

Then there is the issue of getting down the stairs. It's walk or tight carry chair (which is less than ideal for obvious reasons).
No lying down until you get on the ambulance.

Take into consideration of exceptional weather (worth thinking about for a winter delivery) which would also delay an ambulance getting to you.

For the sake of a day or two at most, have your baby in hospital.
It's the safest place.

Thanks @FrankiesKnuckle an important reality check! It will be a winter baby so that is something else to think about.

One of the things I find so hard about this is looking online is that Mums who have had a home birth tend to rate them really highly and others who haven't wouldn't touch them with a barge poll. One website says it is risky, another says the extra risk is very small if everything else in the pregnancy has gone well.

It is a tricky one but very helpful to hear views.

I had a planned home birth but ended up getting transferred in. My husband drove me i didn't have to have an ambulance because it wasn't an emergency.

I'm sure the midwife told me you can only have birthing pools on a ground floor due to the weight. Do you have a bath you could use the warm water in for pain relief? Just remember at home all you can have is gas and air.

I'm in a flat (well, a maisonette technically but there's a property below me, and one on each side) with an external stair up to my front door, and I'm planning one. I'm only 28 weeks but my midwife has already been to my home and deemed it perfectly fine - I'd been concerned about access, like you, but she said not to worry at all. I can have a birth pool as the subfloors are concrete in my block, but it's good to check that.

This year being what is was, I have (unfortunately) seen a couple of my neighbours carried down these external stairs on stretchers when ill, so it's not impossible if it came to that. But remember that the vast majority of transfers into hospital for HBs are not emergencies, happen in good time and you could likely just walk down.

The noise is another concern and I have seen people on these boards being embarrassed, worrying about neighbours etc. I've just decided not to care - birth shouldn't be embarrassing and it's not like I'm going to be doing it every other week!

I'm supposed to be having one any day now if this baby gets its act together.

Second floor flat, and not always parking directly outside. If your floor can hold 8-10 people it can take a birth pool. You can put it in the corner of the room for more support if you're worried.

There are a lot of benefits to a home birth, especially in a low risk pregnancy. There are two excellent home birth support groups on Facebook where I've learned a lot.

If this baby makes an appearance soon I will come back and let you know how it went

I had a home birth in a flat albeit it was ground floor so no stairs and was a very quick and easy labour. The main thing I would consider is transfer time, I live very close to a hospital and transfer time to it would have been the same as what the time would be to transfer to a labour suite rather than a midwife led unit for further intervention. As a previous posters said considering the different possibilities of weather could highly impact on transfer time to a hospital. I am a total home birth advocate but it is definitely worth fully researching the pros and cons as unfortunately not all are straight forward and complications can arise. I made sure to discuss worsecase scenario to prepare for this just incase and I'm glad I did as I felt that if anything went wrong I was fully prepared. Good luck in whatever you choose x

I’ve been at loads of homebirths in flats! Third floor with no lift... 10th floor with a lift...

As pp have said. Transfer time to hospital and also what the stairs are like. If it’s a very narrow staircase in a flat conversion where the neighbours hang their bikes off the wall is different to a modern block with decent staircases.

Aside from that, same consideration as any other homebirth.

In the grand scheme of things it won’t take the paramedics much longer to get you down a couple of flights of stairs on a stretcher than it would one flight of stairs in a house. The time spent is waiting for the ambulance, getting put in the stretcher, getting to the hospital. And in reality most hospital transfers aren’t a time critical emergency as midwives will be correctly cautious and transferring in at the first sign of any issues.

Doesn't noise travel in flats ? I was on the labour ward when I was pregnant ( was very unwell ) and the noises were scary for me let alone another child in the flat . If you don't care then fine but it would be my worry that I'd be too noisy !😬🙈

I have.
Inman emergency the ambulance has a wheelchair that easily goes down many flights of stairs if no lifts. No worries there.

What's the sound proofing like? People may still work from home and birth isn't what everyone wants to hear on a Wednesday afternoon... or in the middle on the night.

I had a Homebirth, it really wasn’t noisy, it was very peaceful. A bit of moo-ing but no noisier than sex and certainly quieter than the baby. You can stick a bit of music on if you want to.

I had a homebirth in flats with awkward access up external steps. It was fine, very little noise as was so relaxed being at home, and your unlikely to be transferred in labour. Women that plan to homebirth, even if they change their minds and Labour in hospital, statistically have higher rates of satisfaction and less likely to have intervention, so I'd say go for it! There is nothing to stop you changing your mind if you want too later.

Ambulance crews do not carry people on stretchers down stairs. Doesn't happen.
We have ortho scoops (cold metal) mostly used for spinal injuries but in no way would that be suitable for a heavily pregnant person.
Yes our carry chairs have caterpillar tracks but again, the load is still carried by staff.

Just pointing that out!

To be honest any emergency I’ve been involved with at a home birth the woman has walked herself either down the stairs or out the door to the stretcher thing (the one on wheels which clicks into the ambulance floor, I don’t know the proper word).

This includes for cord prolapses and also a moderate pph. In labour in an emergency women can generally move between contractions and never fail to amaze me how quickly they can move when they realise the urgency of a situation.

Yes, I did. DC2 was born in my second floor flat (no lift, unattractive metal staircase semi sheltered from the elements, above a seedy row of shops).

Midwife who carried out the home birth visit at 36w wasn’t thrilled and was at pains to understand that if I needed to transfer in an emergency nobody would be carrying me down the stairs etc etc, but she was pretty unpleasant throughout my pregnancy really. Midwives who actually turned up on the night were completely unphased.

Both of mine were born at home and really lovely, straightforward, easy and empowering births. I know it’s not for everyone but I’m certainly happy to recommend it based on my experience.

I had an accidental home birth in my flat, I can hear DD crying throughout the building so I know people heard me shouting (it sounded like I was being tortured because I was begging it not to happen like it did ) I'm hoping for a planned home birth this time with a midwife in attendance.

I walked out of the building (loft and then some stairs) after the birth and SIL was in labour and had to walk down the steps from her first or second floor flat I guess and she was in a lot of pain but has never mentioned that bit so probably a blur.

@elfran

I'm in a flat (well, a maisonette technically but there's a property below me, and one on each side) with an external stair up to my front door, and I'm planning one. I'm only 28 weeks but my midwife has already been to my home and deemed it perfectly fine - I'd been concerned about access, like you, but she said not to worry at all. I can have a birth pool as the subfloors are concrete in my block, but it's good to check that.

This year being what is was, I have (unfortunately) seen a couple of my neighbours carried down these external stairs on stretchers when ill, so it's not impossible if it came to that. But remember that the vast majority of transfers into hospital for HBs are not emergencies, happen in good time and you could likely just walk down.

The noise is another concern and I have seen people on these boards being embarrassed, worrying about neighbours etc. I've just decided not to care - birth shouldn't be embarrassing and it's not like I'm going to be doing it every other week!

Thanks @elfran that is a really good point. I wonder what percentage of transfers are actually an emergency situation and how many are led by decisions being taken in good time by good midwifes.

On the noise front that is probably the one thing that isn't worrying me! We only have neighbours below us and they make more than enough noise themselves!

@Iwouldlikesomecake

I’ve been at loads of homebirths in flats! Third floor with no lift... 10th floor with a lift...

As pp have said. Transfer time to hospital and also what the stairs are like. If it’s a very narrow staircase in a flat conversion where the neighbours hang their bikes off the wall is different to a modern block with decent staircases.

Aside from that, same consideration as any other homebirth.

@Iwouldlikesomecake if you don't mind me asking are you a paramedic? Transfer time from my flat to the hospital would be around 10-15min. The staircase is kept clear in a relatively modern block, so I don't think access technically would be an issue although I am just wondering how I might actually get down the stairs if I couldn't walk. Could be a lot of work for the paramedics :/

@addler

I'm supposed to be having one any day now if this baby gets its act together.

Second floor flat, and not always parking directly outside. If your floor can hold 8-10 people it can take a birth pool. You can put it in the corner of the room for more support if you're worried.

There are a lot of benefits to a home birth, especially in a low risk pregnancy. There are two excellent home birth support groups on Facebook where I've learned a lot.

If this baby makes an appearance soon I will come back and let you know how it went

@addler please do let us know how you get on and best of luck!

Hope this isn't too delicate a question, but, in extremis, would two paramedics be able to carry you on a chair? DH had to be carried downstairs by them (he was very unwell) so they can certainly carry adults, but if you are very heavy, that might be a challenge? DH was about 90kg, and it was clearly well within what they could manage.

OP also worth considering pain relief options. Not sure if the rules are the same where you are but you can have gas and air. Everything is delivered to you in advance of birth. From memory I think oxygen is too in case baby needs it. These are highly flammable so need to be kept in safe place and you may have a safety check from local fire service.