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 ☺️

I would say home birth is the right option only if you truly want one, not for any other reason. The benefits of a home birth are relaxation and feelings of safety, so unless the thought of a home birth relaxes you, it's not going to be your best option!

A low risk woman who feels calm and confident at home is statistically likely to have a safe birth with little need for intervention, whereas panicking at home would be scary, slow down labour and will likely result in complications/hospital transfer.

I'm pregnant with my first and would love a home birth, but my husband's nerves about it are enough to "contaminate" the environment I would want. I hope a calm delivery in a midwife centre will be enough to swing him my way for any future births.

I've been present at 2 home births and they were wonderful, but that was because the mother was certain. Please don't feel "pushed" by anyone but yourself.

@bobbots Obstetric doctors are naturally going to draw upon their experiences of only being present during high risk births, usually with mothers who would never have considered a home birth in the first place. Adam Kay is the worst example; every time he writes about babies that "he" delivers I cringe for the mother he disempowers. He even mentions holding one up like Simba from the Lion King after a c-section, no thought for the mother. Total god complex. Midwives deliver far more babies than obstetric doctors and are overwhelmingly pro-home birth for low risk mums.

I wouldn't for your first, second yes maybe. I did like the idea first time, but I was totally naive about what birth involved and I needed help to deliver my baby. I am so glad I was in the hospital.

[quote Historytoo]@MayorGoodwaysChicken he was an anaesthetist not an obstetrician, there is a difference... And the midwife was there to help the birth.[/quote]
Yes of course, I’m aware of the difference! But all medical students are required to have some experience of assisting a birth during their degree, regardless of eventual specialism. And particularly given his specialism I’d say he’s pretty well placed to help in an emergency compared to most partners. Much as I adore my DH the sight of him preparing the hot towels wouldn’t aid my levels of relaxation

Obviously this is a contentious issue with strong feelings on both sides of the debate. I just think it’s worth highlighting that the OP was asking about her FIRST birth which I think everyone is pretty much in agreement is significantly riskier then a second birth. Some posters are getting upset and feeling criticised about choices they made for a second birth which is a different situation.

I can see the appeal of a home birth but I wouldn't personally have one - I feel like I would be too anxious incase something went wrong. Labour is so unpredictable, I would rather be in a hospital knowing the right help is there.

An acquaintance had her first baby at home - all planned - and thought it was wonderful. She was relaxed in her own home with 1:1 and then 2:1 care from midwives. I believe that if she went on to have another and no issues picked up during pregnancy she'd have another home birth.

No way would I have one, never mind any perceived/actual increase in risk, giving birth is a messy experience and I'd rather that was left in the hospital!! I started off in the MLU with DS and ended up in theatre so I think it was a good thing I wasn't at home.

@Bobbots

Adam Kay talks about home births in his book “this is going to hurt”. He says he thinks they are madness. The fact that obstetric doctors aren’t keen on them speaks volumes.

Paradoxically, obstetricians are some of the worst people to talk to about normal, intervention-free births because once they have finished training they simply don’t see them. In the UK at least, low-risk births are entirely handled by midwives and by definition if an obstetrician is involved then something is not quite going to plan. It’s inevitable that this will skew their perception.

I’d have loved a home birth - I hate hospitals and they make me very anxious, I enjoyed labour, I had a smooth pregnancy, I felt empowered during labour and everything went well. I even remember thinking ‘i should totally have opted for home’ at one point.

Except then it went from ‘going well’ to ‘category one emergency csection’ in approximately five minutes. I’m not exaggerating how quickly things flipped - it was shockingly fast. I am profoundly glad, now, that I had medical intervention
right there when I needed it.

Having had this experience, I can still definitely see the appeal of homebirth, as i loved labour and suspect i’d have enjoyed it even more in the comfort of my home. But there is no way I’d do it for a first delivery. You just don’t know how your body will respond in labour, and to be blunt, that’s not something you want to fuck about with.

Sometimes though objections to home birth are based on misconceptions. Like the idea that you need to be in hospital for the baby to have any needed intervention. Many interventions can be done safely at home, and even if babies do need intervention when born it is not always a huge life threatening rush to do things that can only be done in hospital. I had this with DS2 (born in hospital) - his breathing wasn't quite right but they still left him on my chest for 30 mins for a cuddle before taking him for oxygen and he was then transferred to NICU, which was at another hospital.

Or the idea that in hospital you could be in theatre within 30 seconds if needed - not the case - OK, my 20-30 mins estimate was out of date, but it could still take up to 15 mins if you're in hospital, so being (less than) 15 mins to the hospital would make no difference. Although possibly more risky if you're further away, it's a question worth asking and traffic/routes worth considering.

And the idea that anything unexpected is incredibly urgent, as I understand it, this is not necessarily the case as there are often things that can be done to stabilise the situation to allow for a delay in needed personnel/equipment (or transporting the patient). And the vast vast majority of transfers for home birth are happening for non-urgent reasons.

I hear a lot of "Me and/or my baby would have died if we weren't in hospital" but this never takes into account:

Whether the complications were caused by some aspect of the hospital environment or policy anyway

Whether the concerns started earlier and would have caused you to be "risked out" of a home birth much earlier on (NB even if they seemed to come out of nowhere from your perspective, sometimes the midwives are aware and keeping an eye, but don't mention this to you in case it worries you)

Whether the intervention that you had could have been done at home

Whether you could have been kept stable and transferred for the hospital intervention

I'm sure there are some very tragic cases where deaths or adverse events happen at home that wouldn't have happened in hospital, and these should be investigated and recommendations changed if necessary.

There are probably also cases where deaths or adverse events happen in hospital that would not have happened at home. I would hope that these are also investigated and recommendations changed too, not necessarily towards home birth, but certainly towards a lower intervention approach or whatever aspect would have made a difference.

For context to the above - i was in a midwife led unit attached to a hospital, so was very relaxed throughout labour and had one on one care. I found this a good middle ground as I was relaxed and in charge but it was good to have a surgeon down the hall when i needed one!

I had an easy, two hour labour with my first. Then I had retained products and a massive haemorrhage. Thank goodness I was in hospital. I didn't see my baby for ten hours.

@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.

Absolutely this. There is zero chance you can get blue lighted in faster then we can set up a theatre.

I would personally never have a home birth myself. Ever. I know there's some pros, but there's the overwhelming con that I've seen the results of enough horror stories to not even want to entertain the idea.

I can maybe understand having a home birth when you've already given birth at least once before. Especially if it was precipitous. You have a clue at least about how your body reacts and how you best cope with labour pains. As a first timer, you're going in blind. You never know how baby is going to react to labour, no matter what number you're on.

I was desperate for one with dd3. So much so I ended up being 16 days late to try to keep my dream!! Ended up being induced but it was fine.

I’m now pg with dc4. I keep dreaming it’s fast and I end up giving birth on the bedroom floor! I’m not bothered either way.

If your not 100% for a home birth, don’t have one. I think you do really have to want one x

After a horrible first birth where unnecessary medical intervention was accelerated, I had two home births. The home births were relaxed and fairly easy. I have very lovely memories of those births. Maybe I was lucky but I'm sure that it was a positive not to be in a harsh medical environment and not to have people around who just wanted to speed things up for their own schedules. Having said that as PPs have said, I'd still want to be close to a hospital if I was having a home birth.

I was seriously considering a home birth with my first, then had some stuff appear that made me a higher risk pregnancy. I elected to birth my second in hospital as I had a rough ride postpartum with my first and might need extra medical care.

My advice is... don't make a rational decision. I don't think it is a rational decision. And I think labour goes better if you're in a good place emotionally. So go with your gut. What would make you FEEL better?

For my first, I would have FELT better to never be looking at my watch wondering if it was time to go to hospital or not, and whether we should go now in case the taxi ride would be unbearable later or whatever we should leave it to make sure we weren't sent home. I had faith in the midwives ability to monitor problems adequately at home and the ambulance's ability to get me there in minutes. Didn't happen for me, but that's how I FELT about the different potential stressors.

But then for my second, it actually FELT better to travel to hospital and just know I'd be there for the aftermath. Even though in that event there was no aftermath and we went home that evening.

I'm now pregnant again and while not planning a home birth, I am considering the real possibility of an unplanned homebirth (I go from 4cm to "somebody catch that baby!" REALLY fast) and am going to educate myself about it. I'll FEEL better if we can get to hospital but I'll also FEEL better knowing it's not an automatic disaster if we don't!

If you are at home because you feel pushed into it and are worried about what will happen if there are any complications, go to hospital. If you are scared of being in hospital and will be more comfortable at home, be at home. Just decide what will feel less stressful to you, then own it.

If I hadn’t been in the hospital with my first (and only) there is a good chance that either DD or/and I wouldn’t have made it. Things did not go to plan, but luckily I was in the place I needed to be and could receive the help needed ASAP. It is of course up to you and it’s your personal choice, but just wanted to let you know my experience.

Have name changed for this three words

No fucking way

Another three;

Hypoxic ischemic encephalopathy
or
Spastic cerebral palsy

I worked in NICU for a total of 5 years, the worst outcomes in term babies were either home births gone wrong or transfers in from midwifery led units.

I wanted full obstertric and neonatal crash team on site.

My infants neurological outcome was more important than wanting to control the birthing enviroment.

I really don't think a HCP should be suggesting this to you, especially for a first.

If it's not a personal dream, don't.

@custardbear

First - no chance

Also the ambulance situation - for hone birth complications - it takes an ambulance off the road for that time period so in effect someone may suffer due to choices of home birth

If an ambulance is required for a home birth, it's not 'off the road', it's attending an incident it needs to be at.

OP it's a very personal choice, and if you are unsure I would encourage you to write down what questions/concerns you have and speak with your midwife. There is actually nothing around home births being more risky, and many midwives opt for them- they can be amazing. But I would caveat that with if it's what you genuinely want and are comfortable with, there's nought wrong with wanting to be in hospital from the get go and resisting them pushing HB on you.

Lots of different opinions here OP.
I think what has been mentioned is that if you feel its right for you, then go for it. This is a very personal decision and needs to be the right decision for you.
I had planned a home birth with DC3- ended up backing out in labour because I wanted a pool, and didn't have where to put one at home. The midwives were really chilled and told me its a decision I can make in labour and they'll be fine with whatever I decide to do.
With regards to some of the emergency scenarios listed here, I was worried about these things and my midwife reassured me that with a home birth, they will decide to transfer if there are any signs of things not being right. Meaning that in a hospital, the midwife might observe signs but not say anything to you- preferring to wait and see, whereas at home, they will transfer at the first sign- even if it turns out to be unnecessary. Midwives also carry some emergency drugs with them, and ambulances carry drugs to stop haemorrhage.
I am currently pregnant with DC4 and planning a home birth again. I have moved to a larger house from my previous small flat so now have room for a pool. With the Covid situation, there's no way i'm going to give birth in a hospital, potentially without my husband or birth partner (because I do have quick births).
Good luck with your decision OP!

I had all homebirths, they were beautifully straightforward and I loved being able to get straight into my own bed with baby and DH and a cup of tea afterwards. It was a calculated risk as things also go wrong in hospital that might not in a different setting; I get massively anxious in medical environments so knew I wanted to avoid that if at all possible. It was right for me but I appreciate it isn't the right thing for plenty of people. It certainly wasn't done recklessly or irresponsibly though.

I can’t see why anyone would but I like hospitals and feel comfortable and reassured in them. Go to hospital well into labour and leave as soon as baby check done if you don’t like hospital and all is straightforward.

Discussing home births on MN always gets heated because people usually feel quite strongly one way or the other.

For me, as I said before, the thought of a home birth was not appealing at all. I wanted the medical assistance. For me, the labour and birth wasn’t something to be cherished and empower me. It was a means to an end to seeing my babies. I didn’t care if my birth plan wasn’t followed. I didn’t feel violated or traumatised by not getting what I wanted. In the moment, I just wanted my babies born safely.

I understand that everyone is different though so I don’t judge anyone for wanting something different to me.

OP, if you want a home birth, research it and make your own decision. If you don’t, then don’t have one.

The thing is that there are not really any huge potential negative consequences of a hospital birth. Yes you might not feel as comfortable or as empowered but personally I think those two factors, whilst important, are secondary to baby’s safety. There are no negative consequences for baby’s safety of having a hospital birth. Some people argue that medical intervention is given when it is not necessary and sometimes this may turn out to be the case but that is often when there is no way of knowing for sure whether the intervention IS necessary at the time and so it is given to be on the safe side.

But there is a massive potential negative consequence of a home birth as other pps have pointed out. Yes they may be rare but there is a small risk and anything you can do to minimise that risk is surely a good thing.

There is also the confidence that you have with your decision and whether it would come back to haunt you. A friend had a home birth for her first baby and baby contracted group B strep which wasn’t picked up until day 2. He was in intensive care and they had to wait several months to find out whether there had been any long term consequences- fortunately there had not. However she said that if there had been she would have always wondered if she could have prevented it by being in hospital as it may have got picked up quicker before being discharged home and then she would have always blamed herself.