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 😊

Sorry but I just wouldn't. There's too many potential risks involved and in the current climate with potential lack of ambulances etc, 20 minutes is a long time to get to the hospital if there's a real emergency.

I wouldn't be risking my baby's and my own life for the sake of wanting to be more comfortable and being able to go back to my own bed.

@Luckyelephant1 Home birth is definitely about much, much more than that. The benefits are huge for a lot of women (esp for subsequent births).

@Nicknamegoeshere I don't doubt that but it seemed to be what OP was most concerned about.

@Russell19, OP deflexion - back to back with the head tipped back.

For all those saying "it was important I had 1:1 with the midwife"

Plenty of hospitals offer this

Hi OP, I had a lovely successful first time home birth. I did live 5/10 mins from the hospital and have now moved so I can see it from my window!

I’m planning one for baby no2. Midwives have discussed how fast labours are usually v straightforward and if there are problems it usually results in a slower labour, also with home births they’re much more cautious and transfer in far ahead of time.

I live in an area with low COVID and my hospital has at no point been stretched, maybe look at the data and talk to the home birth team to help you make a final decision as I suppose if my hospital had recently closed A&E or been queuing ambulances that might change my decision

I should add- similar to a pp my first labour was so fast I was advised to prepare for a home birth anyway and have everything in I might want.

I'm planning a home birth for my first baby OP. This is because, so far based on my research but accept I may change my mind if things change) the risks and benefits of it lead me to the conclusion that I would cope better with the control at home.

Our MLU is closed and all labours are now on the delivery ward. I have done a FOI request from the Trust and there are loads of complaints compared to 2 years ago. Also lots of comments on the reviews about maternal neglect, not being checked regularly enough and therefore being denied partner in when already in established labour, more frequent intervention and medical management due to the environment etc. If I feel powerless I'll feel worse and less able to cope.

I love the thought of home births but unfortunately I couldn't for a few reasons.
I had a hospital birth with gas and air and spent most of the time on a birthing ball.
I do agree with a few of the previous posters re yes for home births with your second and not your first. Although your low risk no one ever knows how you will react the labour and it doesn't always go as planned.
I do admire people who feel comfortable enough for a home birth.

I'm a very aware of risks I think it's the nurse in me!
At the mo in a pandemic I waited 2.5 hours with a lady who was waiting for an emergency ambulance who had very low oxygen levels (the only way I would have been able to upgrade it would have been if she stopped breathing) therefore I wouldn't be bagging that your only 20mins for the hospital if there was an emergency.

Hi OP, I'm also seriously thinking about a home birth for my first.

There are a few scary comments on here 'if I had had my birth at home I would have died' but the complications that arise in hospital are way less likely to happen at home in the first place. I would highly recommend the Positive Birth Book which describes the physiological process of birth and how much the environment matters (i.e. mammals don't give birth strapped to a table under bright lights surrounded by strangers!)
Secondly, emergencies don't tend to happen in the space of 5 minutes (like it seems on one born every minute). If there is even a hint that things aren't going smoothly, or baby might need help, bad position etc the midwife will suggest going to hospital. I think its something like 45% of first time home births are transferred, and most of those are a non-emergency e.g. slow labour or mum is exhausted/wants an epidural.

Anyway good luck with your decision :)

@lcdododo

For all those saying "it was important I had 1:1 with the midwife"

Plenty of hospitals offer this

I like knowing though that the approach of the midwifes who are part of a dedicated Homebirth team share the same approach to birth as i do.

For example, everything is so woman centred. They won’t do checks to see how dilated my cervix is to find out how far along I am, they’ll go off the cues im giving out and will only check if I ask them to.

If any of the labour stages are longer than average they won’t rush to interventions if I’m generally coping well.

You don’t have to fit into their policies they tailor their approach to you.

People saying emergencies don’t happen without warning, they’ll work on the side of caution and transfer you in earlier..etc... a fetal bradycardia can occur without warning and you don’t have long to deliver the baby. About 15 mins max.This is an emergency scenario where immediate access to theatre is vital to save the baby’s life. It doesn’t happen often of course and I’m not trying to scare anyone, but people need to know both sides. Yes midwives will be cautious and transfer in early but unpredictable events occur which need immediate obstetric intervention.
(Saying this as someone who had a homebirth- it just worries me seeing people saying risks can be predicted)

@PinkPlantCase

But there are also plenty of hospitals that offer this approach.

You don't have to stay too local, you can look at others and find one that is tailored to you

My home birth was also a non-NHS one. I am not for one second putting down the NHS here - they do a remarkable job under very difficult circumstances - but they do tend to be routine-led a little to much IMO. And certainly having had two hospital births I've definitely felt like I'm on a conveyor belt - I imagine this may be felt even more keenly under current circumstances.
The thing is, you have a right to ultimately birth in whatever way you choose. I had a baby last May at home. I opted for a very minimal hands-on approach from mw, definitely no internals, physiological third stage (so cord not cut until turned white, I delivered the placenta naturally without injection etc), and no injection of Vit K (opted for baby to have orally). Heel prick not done on Day 1. For me it was about making the entry to the world as calm for my baby as possible.
Of course I was very fortunate in that my birth went relatively smoothly, and a lot of this In think was down to fact I felt so well supported.

I think absolutely talk about it with your midwife but don't get too invested in the idea until you have, especially at the moment. My trust reinstated home births quite some time ago and I was planning on one for my second DC, due in a couple of weeks, but when we got to the home birth planning visit the midwife ended up advising against it, saying that they would have absolutely supported me planning a home birth under normal circumstances but the current situation with ambulances meant they were advising against with even the smallest of red flags (I had a retained placenta with DC1). I strongly suspect the advice would have been similar for a first birth, given the transfer rates. I am quite sad about it - I didn't have a great experience of hospital first time round and had got my hopes up for a home birth, especially as they'd previously actively recommended it to me - but it's such a fluid and changeable situation at the moment that I think it's great to explore all possibilities but you also have to be prepared that possibly not everything that would normally be available be.

As lost of previous posters have recommended, I wouldn't for your first baby.

I was low risk the whole way through and did a lot of birth preparation, hypnobirthing etc and was of the view that lots of complications are caused by women not understanding the physiology of labour etc.

Unfortunately labour ended up being very complicated and ds might not be here if he hadn't been born in hospital. As pp have said, there are many scenarios (even if rare) where very urgent action is needed.

This isn't intended to scare you, but I actively avoided any negative birth stories when pregnant, believing in the power of positive thinking, and unfortunately for us it wasn't to be.

Hope all goes smoothly whatever you decide.

My sister had a massive post partum haemorrhage. Totally unexpected and she needed almost her whole blood volume replacing. She would have died at home. No warning whatsoever. It really was touch and go.

When things go well a home birth is great, but the unexpected can be deadly.

Lots of people seem to assume that a postpartum haemorrhage would be a death sentence at home - PPH does happen in home births and of course it's an emergency but it is managed and deaths are incredibly rare. Home births are just as safe for the mother statistically.

PPH is also a good example of how people assume that hospital is risk-free, but it isn't - research has shown that women are significantly less likely to have one in the first place in a home birth, even when they controlled for known risk factors and so compared women who were otherwise of the same risk: bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/1471-2393-12-1

You always get lots of women on home birth threads saying they had a PPH and so 'would have died' at home; not only is this very unlikely to be the case, but actually they may well not have had it all.

I personally wouldn't with a first born as you don't know what to expect our how your body will cope. If you need ambulance transfer you could be waiting hours and if you haemorrhage the drugs a previous poster mentioned paramedic carrying can't be given if you haemorrhage prior to giving birth as there would be a high chance that they could cause significant damage or death to your baby. I know it's a lot of what ifs at this point though.

If go into your appointment with your midwife and write out all your questions about hospital Vs home and make a plan from there.

Home births are just as safe for the mother statistically.

And for the baby?

Can you supply data?

From the NHS website:

For women having their second or subsequent baby, a planned home birth is as safe as having your baby in hospital or a midwife-led unit.

I dont know where the evidence second delivers are safe comes from, maybe someone could link.

My first was a drug free birth pool home-birth. No issues at all. Done and dusted in 7 hours. Sat showered and eating toast in my living room two hours after birth.

My second was birth centre. Much faster delivery. Haemorrhaged. Blue lighted to hospital, where i spent a week. Nearly died. Lots of follow up care needed.

See above.

Had both mine at home in 2011 and 2016. I had a pool and gas and air. Wonderful experiences. They weren't small babies either! 8lb 5 and 9lb 8.
I completely trusted my midwife team and we were 5/10 mins away from hospital if blue lights were needed. Ask your midwife, she won't put you or baby at any risk. Good luck!

@lcdododo

Home births are just as safe for the mother statistically.

And for the baby?

Can you supply data?

Of course I can, do you think I made it up? For second and subsequent births home births are as safe for the baby and beneficial for the mother. For first births there's an increased risk to the baby (it almost doubles, though that's from one very low level to another) and a very high rate of transfer:

www.npeu.ox.ac.uk/birthplace/results

For those reasons I personally didn't and wouldn't consider a home birth for a first birth. However, it simply isn't true that women and babies die in huge numbers in home births as is always implied on these threads where lots of women insist (and I'm sure genuinely believe) that they 'would have died' in a home birth, which just doesn't fit with the reality of how likely that is to happen and often seems to be based on the idea that a home birth is the same thing as giving birth with no medical intervention, support or resources at all.