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 😊

@Hardbackwriter

Ahhh ok, you missed that rather crucial 'second birth' part out of your original post.

So in OPs circumstances, they really aren't just as safe

And it's worth noting that although they did find that increased risk for first births the policy recommendation was that low-risk women should still be offered a choice of setting for a first birth, i.e. that the research did not suggest that the increased risks meant that a home birth should be automatically ruled out on safety grounds for first-time mothers.

[quote lcdododo]@Hardbackwriter

Ahhh ok, you missed that rather crucial 'second birth' part out of your original post.

So in OPs circumstances, they really aren't just as safe[/quote]
I didn't - they're as safe for the mother (the high rate of transfer shouldn't be seen as a risk as such, since the vast majority are non-emergency, though personally I wouldn't want to plan a home birth knowing there was only roughly a 50:50 chance I'd actually deliver at home) but not for the baby.

@Hardbackwriter I like you

@toolazytothinkofausername

I've heard the position of the baby changes how childbirth feels, therefore wanting different pain relief. I would find out what position your baby is in before deciding home vs hospital.

Babies can change position up to and during labour.

Also, pain perception is based on a number of factors, as is the ability to cope with it. Stress is an example of one of those factors. So if you are less stressed at home than in hospital for example and feel better supported, you are likely to be better able to deal with the pain and therefore less likely to request stronger pain relief. Hormones help with this.
Also, the fact that stronger pain relief options is not so readily available at home isn't always a bad thing. Epidurals, for example, do increase risk to both mother and baby.
Look up "Cascade of Intervention" also.

See flow diagram.

My midwife and consultant told me there was no evidence that epidurals increase risk. Correlation not necessarily causation. Makes sense that more risky births also more likely to involve an epidural.

@bourbonne But ateotd it is (quite rightly) down to the person in labour as to whether they request an induction, for example. So they can request one if not "medically" necessary / birth progressing normally.

Some really interesting and informative posts here, thanks all.

Hi OP, I haven't read all the replies but if you're considering this because you are worried your partner won't be able to be with you until you are established labour then there's no need to worry about this. They don't want you in the hospital until you are in established labour either! If you go in and are less than 4cm dilated then they may well send you home.

I had a relatively smooth (but very long!) first labour so would have been considered a good candidate for a home birth second time round. However after my DS was born I haemorrhaged, cue the emergency cord being pulled and the the room filling with people trying to stop me bleeding. It was really traumatic and I dread to think what would have happened had I been at home.

Also I was hooked up to the monitor constantly which showed my DS was in distress so there was a rush for me to get him out. Turned out the cord was tightly wrapped around his neck. I'd definitely check how they monitor the babies during a home birth.

I'm pregnant again and will be firmly in the hospital just in case.

[quote Nicknamegoeshere]@bourbonne But ateotd it is (quite rightly) down to the person in labour as to whether they request an induction, for example. So they can request one if not "medically" necessary / birth progressing normally.[/quote]
Sorry, I'm confused - why are we talking about inductions?

If you meant to write epidural, I'm still not sure of your point. Either epidurals are disproportionately used in complex births (hence the blurring of causation and correlation), or they aren't. I don't have those figures, but the health professionals I mentioned were satisfied that there was no reason to fear that an epidural would put me (low risk, textbook labour) or baby at increased risk.

I'm not sure how one can judge pain relief as "medically necessary" or not. Either the patient wants it or they don't. How else do you judge?

@Hardbackwriter Of course home births are less likely to have a PPH. They are a selected group of very low risk, usually 2nd time mothers.

I would disagree with a severe PPH being managed at home. The placenta is a very large object and if it separates without the blood vessels supplying it clamping down, as happened to my sister, the only life saving management is a blood transfusion. I do not believe midwives carry blood. It is very ignorant and dismissive to say those women saying they would have died following a PPH, are wrong. They know their experience, you don't.

I have had natural births and hated the experience. I would have hated it at home or in a hospital. At least I felt safer in the hospital. Surely the answer is (as in Scandinavian countries) have hospital nice birthing centres with emergency care literally a door away.

@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 😊

I've had a home birth with all three of my kids soon to do it again in august . Homebirths I would say are more personal as the midwife that delivered my first child has delivered all of mine and she will be again delivering my fourth home births you can have the same pain relieve etc at home as u can in a hospital not the epidural but diamorphone dehydrocodine etc so I'd definitely think you'll love the experience and feel great after baby arrives good luck xx

@MotherOfCrocodiles

I think realistically more than half of people having their first baby at home end up rushed to hospital. Much much more likely to be successful with second child.

If it's urgent you would need an ambulance and they are in short supply at the moment.

I think it's a risk

I had a Homebirthing with all of my kids including my first no need for hospital intervention if you listen to your midwife and have a positive attitude and mind set towards it

@bourbonne Apologies, I meant epidural. I do believe they increase risk and also make further interventions more likely. No intervention is without risk realistically.

[quote Nicknamegoeshere]@bourbonne Apologies, I meant epidural. I do believe they increase risk and also make further interventions more likely. No intervention is without risk realistically.[/quote]
Well, you believe that. And I know you're not the only one. But you also know that there is no conclusive evidence either way, right?

I also think the flow diagram you posted is misleading and unnerving for a first time mother. Following the arrows after epidural (which is bundled in with "narcotic drugs" (what are they offering nowadays, heroin? ) as if all forms of pain relief are the same), they all seem to lead to bad outcomes. It seems impossible to trace a path from epidural to normal birth and successful breastfeeding. What a needlessly depressing diagram. I can't imagine a trained midwife would give it the time of day.

And obviously, it's also true that turning down interventions is not without risk.

@bourbonne Why do they routinely use CTG monitoring once epidural has been administered?

I had an epidural for my first labour and regret it personally.

[quote samanthawashington]@Hardbackwriter Of course home births are less likely to have a PPH. They are a selected group of very low risk, usually 2nd time mothers.

I would disagree with a severe PPH being managed at home. The placenta is a very large object and if it separates without the blood vessels supplying it clamping down, as happened to my sister, the only life saving management is a blood transfusion. I do not believe midwives carry blood. It is very ignorant and dismissive to say those women saying they would have died following a PPH, are wrong. They know their experience, you don't.

I have had natural births and hated the experience. I would have hated it at home or in a hospital. At least I felt safer in the hospital. Surely the answer is (as in Scandinavian countries) have hospital nice birthing centres with emergency care literally a door away. [/quote]
You obviously didn't actually read the paper, which was clear on how they controlled for the fact that women having home births are more likely to be low risk - did you really think that didn't occur to the professional medics undertaking the study?!

[quote Nicknamegoeshere]@bourbonne Why do they routinely use CTG monitoring once epidural has been administered?

I had an epidural for my first labour and regret it personally.[/quote]
I don't know, actually. (Though I was quite glad they did - I found it reassuring to see the little graph chugging away!). I just know what they told me (and what I've since read in reputable places) - that there is no proof of increased risk. Perhaps the monitoring is factored in? Don't know.

Sorry to hear you had a bad experience.

@Nicknamegoeshere

See flow diagram.

That’s the most irritating birth diagram I’ve ever seen.

Not every single person has issues BFing if they have c-section.

Epidural doesn’t equal forceps or c-section.

As an aside: that’s talking about induced labour not spontaneous labour.

Just to add to this- after my gorgeous spontaneous home birth my baby was very jaundiced and I didn’t get breastfeeding off the ground.

A home birth doesn’t equal certain death as some would have you believe, it also isn’t a guarantee for everything else progressing ‘naturally’ or whatever that means.

The whole tone of this thread has really shifted, if reminds me of how people used to talk about breast vs formula about 10 years ago

CTG is routinely done (NHS) after an epidural although of course the mother has the right to refuse this (I was never asked for consent, however). It monitors the heart rate of the baby and changes during contractions. If there was no greater risk to baby from an epidural, I'm unsure as to why they would do this additional monitoring?
CTG can often increase anxiety and is restrictive so best positions for labour are often difficult to achieve.