First time home births?

[ftm87]

Hi there, I'm 34 weeks tomorrow and my trust have just reinstated home births after having to stop this service for a while. I'm not going to lie - I'm a bit of a wimp with a fairly low pain threshold but I can't help wondering if this could be worth exploring as an option? The idea of having my husband with me throughout (not having to wait until I'm in established labour), being in my home and able to just sleep in my own bed sounds wonderful. Whilst of course I'm anxious about labour, I'm similarly anxious about being in hospital during a pandemic and especially being without my husband when I need him. I'm 33 and low risk, with no problems throughout pregnancy so far. Just curious to know if any first time mums had a positive experience of home birth, especially if like me you're not necessarily the toughest of cookies! My hospital is a 20 min drive away so I wouldn't be too far if I did need to transfer. Thank you 😊

Wouldn't consider it for a minute. placental abruption and an oxygen starved baby. Madness but I am biased.
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If my friend had done this she'd have died 100%. She was 28 with a low-risk first pregnancy and no problems but without warning had significant post partum bleeding and needed an emergency blood transfusion. Even with being in hospital it was touch and go with how quickly they could get the transfusion into her. I'm not saying definitely don't do it but I'm just trying to raise awareness that there are (admittedly low) risks. I really hope u don't mind me saying this and it comes from a good place.

My experience isn't a home birth but a very bad one - I would never ever recommend a home birth to anyone

I know lots of women who have had home births point out that they had 1-2-1 care for all of their active labour as a bonus, but this seems to be standard for my trust for hospital births as well.

For both mine, in different hospitals, I had MWs who stayed the whole time and another came in just in time for me actually giving birth.

If this matters to you (it would for me!), can you check what your local hospitals policy is?

I had dc 1 and then 2 at home and they were fantastic experiences. I had dc3 in hospital and it was not. At home I felt more comfortable, coped with pain better, moved about easier, went to the loo, ate and drank when and what I wanted etc. We all got more rest after and my husband was completely included.

I did a lot of reading and prep including hypnobirth and relaxation podcasts and they all helped.

I had brilliant midwives who were so so attentive and gave me every confidence that if I needed to be transferred they would pick it up early and arrange a transfer quickly.

If not,rest reassured that your body will do the job,you just need right mindset as sometimes

What a dangerous and stupid comment to make.

Honestly would not recommend home births for first time mums.

You have NO idea how your body will handle the situation and what to expect and then there are so many other risks with baby, what if you need emergency assistance? And even though they have reinstated Home births I think now is particularly a risky time to even contemplate it with services so impacted (ambulance etc)

Lack of ambulances is what made my trust stop home births for the time being

Your husband can be with you at any point of labour in hospital, and if your birth is straight forward there is no reason why you wont be discharged and at home quickly

My friend gave birth last week at 5 am and was home by 4pm. ( second baby but straight forward birth)

When I had my first baby, the NHS advice was that home birth was just as safe for first pregnancies as it was subsequent. With that reassurance, I had the most wonderful, safe and empowering birth using a birth pool. Gas and air was available, but I didn't like it.

Two years later the advice had changed; the NHS advice was that first time pregnancies were slightly more risky at home, but there was no increased risk for subsequent births. I remember thinking that I am glad I didn't know that at the time because I might have had made a different decision. Second pregnancy was 'high risk', but my midwifes (the same as with my first birth) supported my decision for another home birth, which was again 'text book'.

There are risks associated with every birth. I would advise you to talk to your midwife, identify the risks vs benefits and decide accordingly. Good luck whatever you decide!

A couple of things stood out in your post to me. Firstly, even if you had a hospital birth you would have your husband with you throughout as you wouldn't go in before being in active labour - they wouldn't admit you, so you'd be together at home until then. Secondly, 20 minutes isn't particularly close to a hospital, esp in an emergency. I know people who have had wonderful homebirths but personally I think for a first labour it's too unknown. A pp mentioned a homebirths then night on the labour ward which confirmed why she hadn't wanted to be in hospital. The labour ward is nothing like the delivery suite, which is calm and private. I had an excellent delivery experience but agree the ward is rubbish and will do my best to get discharged straight home this time around.

I'm pro home birth in the right circumstances and had my third baby at home with no problems whatsoever.

However, I don't support home birth for first babies as you have no track record for how it will go.

Also, very importantly, I think being twenty minutes away from a hospital is too far, even in normal times. I was ten minutes away at most, but after two previous deliveries I was deemed to be very low risk. If I'd been further away from the hospital I would not have had my planned home birth. Just too risky.

I’m planning a home birth with my first pregnancy, my trust has a dedicated team and I have every confidence in them.

The 50% transfer rate is mostly made up of people who decide they want more pain relief. The vast majority of the people who transfer to hospital are not doing so in an emergency situation. That’s partly the job of the midwifes to use their judgement and experience to keep you safe. They act so far as possible before a situation becomes close to an emergency.

I’ve had lots of conversions with them about what happens if xyz goes wrong. In particular about big hemorrhages - they carry the same drugs as a midwife led unit to stop bleeding, paramedics also carry the next level up of drugs. I think the birthplace study found that outcomes for women even for first births are better at home than in hospital, it’s outcomes for baby that is worse by a very small percentage for first babies.

I’m grateful to have the chance to give birth in my own home. I’ve had a few hospital stays in the past and have never felt particularly well observed or cared for if I’m honest. Rarely the fault of health care professionals they are just often too stretched to be able to deliver suitable care.

Having 1 midwife 1:1 throughout labour and an extra one for the birth is a big comfort to me, and the fact they stay with you for 3 hours afterwards. After which time DH can keep an eye on me too which he wouldn’t be able to in hospital with covid at the minute.

Look at the stats - nearly 50% of first time mums attempting home births get transferred to hospital. If that doesn’t put you off then go for it, but I felt the transfer would be more stressful and in the end I was high risk anyway.

I personally think with the current climate it may well be safer to birth even your first baby at home.
I had a home birth last May after two hospital births. It was amazing and the care I got was exceptional. My OH was with me the whole time supporting me. I felt listened to at all times and took everything at my own pace. It felt so incredibly empowering. I felt safe and cared for. The complete opposite to my hospital births basically!

@FudgeSundae But as a previous poster has said these include women who hsve felt they needed more pain relief.

I felt like that myself after seven hours of hard labour but I am soooooo glad I stayed at home!

You will be sent home in early labour so there’s no “being alone until you’re 4cm” as you should be at home at that stage anyway if all is well and you’re low risk.
I’d be very cautious due to the nearly 50% transfer rate and lack of ambulances- in my area I’ve know a long wait for an ambulance due to shortages and that could be life or death

Towards the end of my pregnancy I regretted not organising a home birth. However, despite being low risk and managing to have an unassisted vaginal delivery in hospital I had a retained placenta and was rushed to theatre to have it manually removed. Baby was strangled by a very tight cord around her neck on the way out and needed help to breathe.
These events were completed unpredictable and had I been at home I think it would have been quite traumatic being transferred in as an emergency.
If you have a straightforward first birth I believe home birth is statistically the safest option for second and subsequent births. Personally I would have the first in the MLU and try for home birth next time if all is well.

Oh and I’m very pro homebirth- I had one myself, but would take careful consideration as a first time mum with potentially no ambulance available

Hi OP

Congratulations! I didn't go go hospital until I was in established labour. I waited at home as long as possible.

I had a tens machine (hired via boots) which helped with pain

Hospitals are the best place to be. You have everything you need in case of emergency

It does sound so tempting to be in your comfortable home and go to your own bed, but I’ve been in a medical situation where I needed morphine before and gas and air did nothing for me. I couldn’t withstand that pain for so long. If you think you can then go for it.

Quite a few people mentioned that most getting transferred to hospital weren’t emergencies but that’s still a negative point to home birth. Imagine you’re in so much pain you want to go to hospital well since you’re not an emergency you’re not a priority and so how long is the ambulance going to take to get to you? Just now we’re seeing queues outside hospitals so even though you’re only 20 minutes away the ambulance could be significantly delayed. I’d find that stressful. Plus you have the hassle of the ambulance drive and then going through the hospital when you’re further on.

For me the low risks of something going wrong still outweigh the extra comfort.

I wanted a home birth - so I fortunately had a presentation scan - turns out I had low fluid, breech baby and low birth weight - ended up with a planned section.
My friend has had 3 home births - all great.
Lady on my road had one and the baby came so fast with the cord around her neck and it wasn’t a good outcome.
I’d be very cautious with your first. You don’t know how you labour or birth. Midwife led unit an option? You can stay home as long as you want. 20 minutes is a long time and ambulances aren’t in abundance at the moment. Is that risk worth it?

Hi OP, I planned a home birth for my 1st. I had started having contractions at home at 10pm after my waters breaking at 9am that morning, let my midwife know and a few hours later she was in my living room filling up the birthing pool which was lovely. I loved the chilled out vibes, had lights, photographs around etc. To cut a long story short my baby was back to back and it was taking a long time to progress. 19 hours after my contractions started I was still only at 5cm. It was so tiring and just had gas and air (tbh though I would have carried on if I knew I was closer to pushing)

I decided to go into hospital due to the risks of my waters being broken for more than 24 hours (and I'm sure my midwife had said the water needed emptying and refilling after 24 hours and I couldn't be bothered with the faff of that.) She also said a drip (no idea which drug) would speed up the process. It was my decision, I wasn't forced and my husband drove me in his car so you don't always need an ambulance if it's early.

After 42 hours my baby was born but he had a low body temperature and I had a high body temperature. They suspected sepsis and we both had IV antibiotics for 3 days. I'm guessing if I had given birth at home I would have been transferred after anyway but I really don't regret my decision to try at home. Nothing was traumatic about it.

Labour ward was hell, that's all I'll say.

If you have any other questions feel free to ask.

@Russell19 thanks for sharing a birth story with a hospital transfer x

Hi OP. I planned a home birth having had a healthy, uneventful pregnancy. I laboured beautifully, was fully dilated - but ultimately needed an emergency transfer for a caesarean. Not for pain management or exhaustion; my baby was OP deflexion.

One or two PPs have raised the most pertinent point - ambulance response timeframes at the moment. I don't think I would want to take that risk or add to their pressure at at the moment.

I tried a home birth with both children, and DS2 was born at home.
DS1 just took too long and the midwife called an ambulance. He was born normally in hospital.
First births are usually longer than subsequent ones and less likely to be successful at home, but you can transfer in at any point.

@Sherunswithwolves just out of interest what is OP deflexion?