Thoughts on Home Birth

[Analysethat]

Hi all,

So I’m 36 weeks and just come back from my midwife appointment(for clarity I’m in Scotland)

Anyway the midwives are really pushing home births, not sure if this is a new thing or if they have always done it. However I’m really open to the idea but partner and my mum are very wary as it’s my first.

Has anyone else had Home birth for their first and how did you find it? Is it quite dangerous or should I really just go to hospital?

Thanks in advance ☺️

It depends what you are comfortable with.
If you've had a complication free pregnancy the chances are you could have a good home birth.
Problems are your pain relief will be limited. If there are unforseen complications you will have to get transferred to a hospital and as you have no experience of birth you never know what will happen.

I've had all mine in hospital, 1st was induced due to high bp and the rest I was classed as high risk for a variety of reasons. I am expected to get to hospital early this time as I had an elcs with breech twins last time too due to risk of scar rupture.

Obviously personal choice but particularly for a first baby I think it’s insanity and highly irresponsible. Others will disagree but for me, even a possibility of the baby being harmed in some way as a result of that decision was enough to immediately discount it as an option. How would anyone live with themselves if the delay in getting medical help resulted in harm or worse to the baby? I was offered it, as well as a midwife-led birth centre away from hospital. They told me ambulance transfer to hospital from there would be 15 minutes if needed. I declined in favour of setting up camp under the same roof as the doctors and the drugs. On the postnatal ward after I had my baby the lady in the bed next to me had started off at the separate birth centre and had a two hour wait for an ambulance when it was needed. Luckily she and baby were fine but she seemed a bit traumatised.

We are so lucky to have the medical care that we do in this country. Why on earth anyone would voluntarily decline that is beyond me. Yes everything might all be great but it also might not and this really isn’t a situation in which to take unnecessary chances.

How close are you to hospital?

You might be interested in this study which looked at different birth settings including home birth in the UK.
Outcomes are reported including by subgroups for first/subsequent birth:
www.npeu.ox.ac.uk/birthplace/results

I used to think home births were far too risky but actually I'd love one with my second. Having a baby at home where you're comfortable and relaxed, what could be better!

I had all home births and would thoroughly recommend it, as long as you are in easy reach of the hospital if you need it. I was told beforehand, that most mothers who end up being moved to hospital partway through labour, are moved because the mother is exhausted and wants intervention, not due to emergencies.
I found it as 'relaxing' as a birth can be, in the comfort and familiarity of my own home. Also you have the undivided attention of the midwife who attends you.

I considered it. Researched it. And came to the conclusion that i wasn't willing to do it for my first (despite being 6 minutes away from hospital and having a completely straightforward pregnancy). But depending on how this one goes (40w4 now) i might have home birth for future babies.

That being said, i don't think anyone but YOU will know what's best for you.

I totally get everyone’s views, initially I thought it was insanity but the midwife told me that more and more women are doing it, especially now with Covid creeping about.

@Fyredraca I’m a 13 minute drive from the hospital. That part does give me the fear that what if we needed to get to hospital and there were no ambulances available.

Just really wanted to weight up the pros and cons I suppose.

If you are not too far from a maternity unit and can be taken there quickly if necessary I would go for it. As long as there are no complications you will be fine, I'd go as far as to say, probably better than being in hospital because you have more freedom to move around during labour, etc. The midwives carry Pethidine, gas and air etc, know how to do an episiotomy and stitch should you need any of those, and you will be comfortable in your own home with your own bathroom.

I often wish I had had a home birth, having said that mine was straightforward and my hospital stay very short. My baby and I were discharged to the care of the District Midwife and I would have loved her to deliver me at home, she was very senior and experienced and ran the ante-natal classes husband and I attended.

Make sure you are confident in your midwife or midwifery team and that you like them. It's important to be comfortable with them.

Good luck.

The above linked research states:

‘For women having a first baby, a planned home birth increases the risk for the baby

For nulliparous women, there were 9.3 adverse perinatal outcome events per 1000 planned home births compared with 5.3 per 1000 births for births planned in obstetric units, and this finding was statistically significant.’

You probably need to discuss further with your midwives. Ask them to be realistic about what happens in an emergency. What is the priority system?

How far away are you from hospital if you needed to get in quickly and it was rush hour? Can your partner drive, for example if there wasn't an ambulance available?

If less than 30 minutes then I'd definitely consider home birth - there are lots of benefits which you can't replicate in hospital. In reality they tend to be pretty cautious about transferring you in at the first sign of any problems, so it's not hugely risky to be at home, and if there was a genuinely urgent emergency, it actually takes around 20-30 minutes to get theatre prepped, anaesthetists called etc even if you're already in hospital, so if you're no further away than this then it's no increase in time, as they'd start prepping all this stuff while you were on the way.

You also get the benefit of 1:1 midwife care, 2:1 near the end and the psychological benefits of being in your own space which should not be waved away, as your mental state during childbirth can really affect the course of it.

Ummm. In a real emergency we aim to deliver the baby within 15mins of the emergency being called. And the obstetrics theatre and anaesthetists are already prepped for this.

It’s so strange, midwives pushing home births the problem is when this feels like a quota-driven objective more than a “because we believe it’s the right thing for you” exercise. I was also heavily pushed to have a home birth (in uk) with my second.

Thank the good lord I didn’t. I did agree to a birthing centre (The Rosie in addenbrookes), the labour did indeed all go horribly wrong and I was taken to theatre nearby (three floors up) for emergency surgery. I had a very smooth first pregnancy and delivery.

I don’t like to think about if I’d agreed to a home birth.

But to be absolutely frank about it, the thought of a home birth was so unappealing - I wanted to be let rest afterwards and not have child #1 asking for stuff, I wanted the house to not be affected by labour and mess... I wanted to be handed a cup of tea by anybody but me after it all.... it’s the little things

Oh OK perhaps it has changed. This is what I was told when I was planning a home birth, but thinking about it this was 13 years ago now.

My midwives were pushing for homebirths too.
I decided to go for it. Was a little worried because I lived in a rural village at the time but was told that's no issue it's all fine.

Well, I was on gas and air all day from5am to 5pm when they realised they didn't have any more canisters. They had to organise two midwives to come to the house to let the midwife with the official van away to go to another town and get more cannisters which took 2hrs and just as she left the house my gas and air ran out and I can tell you it was hell. When she got back they realised a piece of the cannister was missing and we're trying to fashion valves out of rubber gloves. It wasn't working and I was on so much pain I lost my shit and asked for an ambulance. Finally got gas and air in the ambulance then I also asked for an epidural and the anaesthetist was waiting for me on arrival thank god. And I will never think about home birth again. I want an epidural.
Home birth/natural birth is not the lovely cosy painless birth you think you will have. It's painful and worrying and if something does go wrong you are wasting time with the travel etc. There's a reason why births moved to hospitals in the first place! They push home births because it saves on costs.

I wouldn’t. I was low risk but each baby needed instant intervention on arrival. I think it’s mad but people say it’s more relaxing at home which is important of course. I don’t think home birth would be relaxing at all for me but each to their own. I think a lot are transferred to hospital which makes the whole ‘relax at home’ idea void imo. I could relax better in hospital knowing I’m in the place I need to be already. The drive to hospital was the worst part of labour for me and that I did that in early labour without signs of distress in the baby. I can’t imagine the stress of being transferred in an emergency state, never mind waiting for the ambulance.

@Cyclingforcake

Ummm. In a real emergency we aim to deliver the baby within 15mins of the emergency being called. And the obstetrics theatre and anaesthetists are already prepped for this.

This is exactly why I’ll go going into an alongside MLU for this baby (no2). DC1 heart rate dropped from 140 to 52 and within 3 minutes I’d had an injection to stop contractions, stripped of my clothes and was being wheeled into theatre just down the hall. They got verbal consent for GA and C section because the HB kept dropping, one beat at a time, as we all looked on powerless.

The midwife held my hand as I shook on the table because my DP wasn’t allowed in. Then it climbed on its own, thankfully he must have grabbed the cord or something they suggested. There’s just no way of knowing how labour will turn out. 13 minutes from hospital sounds close but there’s always a ‘what if’ I think that’s why most go to MLU/labour ward.

Positives: Research suggests that planned home birth is equally safe for the mother compared to hospital births. Significantly less likely to have interventions such as forceps or caesarean section.

Negatives: For a first baby, home birth is statistically significantly more likely to have "adverse outcomes" although the numbers are still low. You are also quite likely to be transferred to hospital, although for most this is due to needing pain relief or "just in case" rather than emergency ambulance dash. (Women transferred to hospital are still counted as a "planned home birth" in the research)

People will have horror stories of home births, but people will also have horror stories of hospital births which are somehow seen as more acceptable.

I would recommend reading research rather than anecdotes. The birthplace study is a good place to start www.npeu.ox.ac.uk/birthplace

Im having one -hopefully- for my first in June. While I’m aware of the risks , I’m also aware of how unbelievably stressed I get at that thought of a hospital birth . Obviously calm and positive won’t be the answer to everything - but it will help me cope with everything better . My birth partner doesn’t drive which is also a factor - I just don’t feel like I want to flaff about trying to get a taxi to my rural village in mid-contraction! And I have had some impressive reactions to most of the pain management on offer in the past , so regardless of where I am for the labour or how I feel about it in the moment , I’ve just had to come to terms with the fact it’ll be natural!

I’ve been offered extra scans (33 and 36 weeks) to ensure everything is progressing as it should- and any indication that there might be complications, I’ll be changing my plans.

I could relax better in hospital knowing I’m in the place I need to be already
This is why it is such a personal choice. I felt much safer at home with DD2 as I hate hospital, whereas others feel safe at hospital as they know help is readily available.

They push home births because it saves on costs.
Saves costs because you're less likely to need costly drugs, interventions and c sections. A good thing surely.

Personally I wouldn't, I had a textbook pregnancy and a fairly good birth in a MLU for DC1 but I was pushing for ages was threatened with forceps! DC2 I was imagining would be a breeze and would just 'pop' out and unfortunately that wasn't the case and I ended up with ventouse cup.

I'm FTM and it's a no from me.

Health/emergency risks aside I honestly just think it will stress me out even more like the thought of the mess to clean up after, the constant fear of 'what if' I need to get to the hospital, the not knowing how I'll cope with the pain. Yes I know you can transfer to the hospital if you end up opting for an epidural but I'd rather not have that stressful experience of the transfer. I guess I'm a bit of a control freak and hate having plans changed last minute and having to travel in a horrible state etc. It will just panic me more.

I'll be setting up camp hopefully calmly in the MLU and knowing that any extra staff or urgent facilities needed are just one floor away.

I do think home births are rather hyped up to be this amazing calm experience but logistically I'm not sure they often are. The one benefit that I'd consider with a home birth is that if you have your heart set on a birthing pool then you're guaranteed one as you hire it yourself. I really want one but it's down to availability at the time in my MLU so I just have to keep fingers crossed for one really.

I would have hated to be anywhere but where the professionals are in case something happened.