Birth wwyd- mummies help me out

[Sleeplessem]

So I’m 29 weeks and have just had the news that the home birth service at my trust has been withdrawn due to staffing issues.

Reasons for wanting a home birth:

1. childcare for Dd who is 2 ( our family and friend options are less than ideal and flaky)
2. concern about labouring alone, based on my previous birth I can really see how women are mistreated and coerced into things that they don’t want.
3. awful experience on the maternity ward post delivery- doubt very much this culture has changed.
4. all trusts in my area are very similar so home birth seemed to be the best option.

I think given the state of the nhs it’s very unlikely that home births will start back up. The midwife today said that they are dangerously underfunded to the extent that even the midwife led unit has been closed at certain points due to staffing issues. I asked her to check with some colleagues at the other local trust to me and it’s a similarly sad story there.

So my question ladies, what would you do?
This matter is compounded by the fact I’m ‘medium’ risk due to a previous SGA baby so will be having growth scans at 32,35 and 38 weeks, so far baby is on track, DD at this stage was already measuring small.

I’ve looked so far at private midwives for home birth - it’s really expensive, not absolutely out of price range but would need to be a considered and measured decision as it seems like gas and air etc they charge you for additionally.
A doula and a comprehensive birth plan - seems ok but I think I’d still feel very much alone in this scenario, although I’d definitely want someone to advocate for me.
Childcare wise- is a nanny or childminder even an option for spontaneous labour? I don’t even know how that would work? Any one know?
Family- my mother, strained relationship as she’s a very difficult woman and was quite abusive to me growing up. She’d never touch my daughter but still I’m not entirely sure I trust her. She also lives 2 hours away and is unreliable, dawdles and I think would hold this over my head for the rest of her life.
MIL- lives 20 minutes away, but cannot speak English. She watches DD whilst DH and I wfh but as she can’t speak English she’s never been truly alone with her (we’ve always been a bit hesitant as in the case of emergency she can’t communicate to anyone). DD is ok with her ish… she doesn’t particularly enjoy being around MIL. Basically I’m not sure I’d trust mil with her either.
I have a friend who has a daughter 2 years older and she might be able to watch dd at our house, might as it would interfere with her work. I also think she’d have to come around to ours as DD, if it was night might struggle to sleep in a strange house without her parents. We’d stay home as long as possible, ideally be able to put DD to bed so she can just sleep. But who can plan this sort of thing.
Early discharge after delivery if possible but I’ve heard you need to stay at least 6 hours… 🤷‍♀️ But I can’t put into words ho low awful that maternity ward was.

My first was an induction of labour, god only knows what I’d do there?

So mummies, thanks for reading this far if you have. What would you do? Am I maybe missing something? I know it’s a bit early but I’m a bit of a planner and having some sort of game plan helps me feel relaxed

If you want a home birth can you see if any other trusts cover your area? Where I live two trusts cover me.
If not could going to the MLU be an option if it is open? You wouldn't be on your own, plus if no issues you won't have to go on the labour ward or delivery suite. If there are issues you would have the same issues with a home birth anyway so the outcome would be the same.

@mummyh2016 the staffing is so poor in the one other hospital that covers my area, they’re pulling people from the MLU too and their home birth team has been withdrawn.

It’s the big IF it’s open, I think it would be alone if I wasn’t in ‘established’ labour. All options seem crappy at this point xx

With my 2nd and 3rd I was much more assertive about my expectations. Also worth speaking to the consultant to discuss your concerns and to be clear about what you expect to be minimum standards of care.

Even with a home birth you need reliable care on hand in case you have to go to hospital. Friends?

Perhaps you need to have a pragmatic think about whether it's best to spend your pennies on a homebirth or on 3/4 weeks of childcare?

I think that you don't need the most ideal, best babysitter ever for this. Safety is important and as much comfort for DD as you can get, but it'll be for a fairly short period of time and with everyone waiting for news it won't be a normal day anyway.

Also I think you don't have to pick one. What about recruiting the friend for if it's in the day, and MIL for if it's night? And keeping in mind that it could end up being a mixture of both depending on how things work out? Then you know your daughter won't be stuck with MIL for hours and hours, but you're also not asking too much of your friend.

You'd then need to sort something out for comms with MIL, which would probably just mean making sure your partner keeps an eye on his phone in case of emergency.

The only option you will have in that case then is go on the labour ward, unless you travel to a hospital who has an MLU that is open. At my MLU your birthing partner can be with you the whole time whereas it's only once you're in established labour on the normal labour ward/delivery suite.

@mummyh2016

The only option you will have in that case then is go on the labour ward, unless you travel to a hospital who has an MLU that is open. At my MLU your birthing partner can be with you the whole time whereas it's only once you're in established labour on the normal labour ward/delivery suite.

I don’t have a birthing partner, that was my point about being alone. In either scenario labour ward or MLU 😢

@RosesAndHellebores my daughter is already in nursery 3 days a week, so if it happened then it wouldn’t be too bad, so if DH was with my he’d still need to pick her up, give her dinner and put her to bed. We couldn’t trust MIL to do that.

@SweetPeaGirl my MIL apparently can’t even dial a phone that’s my real hesitancy with her, even if something happened she couldn’t call my husband. Granted the chances of something happening are low and DH would put DD to bed, but still.

Do we think there could be any sort of childcare outside of family, like a nanny agency or something that could watch DD?
I don’t know what to do 😢

@Sleeplessem but if both of your local trusts have stopped home births then a home birth isn't an option so you would only have the labour ward or MLU as a choice.
I don't know how it will work with a private midwife, I would've thought you would have to switch to private maternity care for the rest of your pregnancy as if you just have a private midwife for the birth won't you end up going into hospital anyway for you and baby to be checked? Or are you planning on calling an ambulance? Do you live anywhere near anywhere that offers private maternity care that you could ask for advice, and is paying private an option for you?

@Sleeplessem could you ask the staff at the nursery if they could offer childcare out of hours? A friend of mine did it for her wedding recently, the member of staff was known to the child and was happy to earn some extra money.

Sounds an awful situation to be in and I know I wouldn't labour very well if I were worrying about DD so in your shoes I think I would leave DH with your toddler and hire someone to support you on the labour ward, rather than having DH with you and finding someone suitable to look after DD. You're going to have to hire someone for some aspect of it and I think, although I'd hate for DP to miss the birth, in this situation where you can't predict timings of anything it would be less worry to be paying for someone that is exactly geared up for the uncertainty of when the call will come such as a doula.

The only other way is to coach your MIL as much as possible and cross your fingers as at least it sounds like she has some familiarity with things and is nearby. Either teaching her how to phone, or prepping a neighbour that if she knocks on the door there's a problem of some sort even if she can't get across what it is- I'd do that for a neighbour even if it wasn't one where I'd be prepared to watch their child myself.

Personally I’d drop an email to PALs and ask them to liaise with the Head of Midwifery to see what the plan is going forward with this service, they may well have plans or a timeframe when they expect to be up and running again.

I’m not saying your midwife isn’t knowledgeable but I’d look for a more strategic view of the service before starting to make any other plans.

[quote mummyh2016]@Sleeplessem but if both of your local trusts have stopped home births then a home birth isn't an option so you would only have the labour ward or MLU as a choice.
I don't know how it will work with a private midwife, I would've thought you would have to switch to private maternity care for the rest of your pregnancy as if you just have a private midwife for the birth won't you end up going into hospital anyway for you and baby to be checked? Or are you planning on calling an ambulance? Do you live anywhere near anywhere that offers private maternity care that you could ask for advice, and is paying private an option for you? [/quote]
For a private midwife, you can basically have a hybrid card model. I think with a private midwife for a home birth they’d do all the post birth checks that you’d need and after that tbh I’m not sure. They only reason to call an ambulance would be if the labour wasn’t progressing and then the private midwife would go with you to the hospital for the rest of the birth. Paying private is incredibly expensive, not prohibitively so but it’s around £3 for the birth alone and then if you want gas and air you pay for that additionally. So I’m hesitant to pay that much as you can only spend it once, but I’ve yet to even have my first growth scan so I don’t even know which way babies growth is going 😭😭

I’m not sure we could coach my MIL into using a phone (dh has shown her repeatedly) or acting sensibly in a crisis, even though it’s incredibly unlikely that there’d be one. With her, it’s tricky to explain unless you know her, but sometimes she just does really daft things, which is infuriating when we’re at home but we’re there, for instance, sometimes she’ll go upstairs, take DD and just leave her in the hallway with the stair gate open. So the only instance I’d be ok with her being alone with DD would be when DD is asleep. DH would have to put her to bed and give her breakfast

Ah ok so that rules her out then too I guess.

So you've either got to find incredibly flexible childcare that your trust for DD or someone to accompany you. Or (and I'm crossing my fingers for you here) a way of getting that home birth that would resolve most of those issues, unless you ended up needing to go into hospital.

I still think I'd be leaving DD with DH so i wasn't worrying about anything other than myself and the new baby but I get that's not a good solution either!

I think getting a doula in any situation is a good idea, if your DH has to leave at any point you have someone to advocate for you.

Talk to the friend about care for DD during the day, and her nursery staff if they are allowed to. Even if not, talk to the manager and explain the situation. Someone dd knows and you can trust.

The nursery worker is a good idea, she loves her key carer, only thing is they might not be allowed to, the nursery are super strict on boundaries like not being able to friend staff on social media (not that I would but it’s in the contract.

MIL would be an option solely for night, but I guess that could work too.

A doubla is just shy of £1k still pricey. There is a volunteer network I know but you’d obviously be reliant on IF a volunteer is available.

It’s just a shit situation. The state of maternity care is at an all time low

I think you are conflating the issues.
Your childcare is solvable as you have a friend who can have DD . It is only for a few hours,?your DH can come and pick her up. If she doesn't sleep properly it is just one of those things. I don't fully understand the issue with your mil as surely she has raised children herself already and knows what to do?To me , either of those options should be ok.
As far as distrust of tf the hospital service is concerned I would think clearly about your issues and discuss them with your consultant. If you are not convinced by their replies and you don't think your DH will be able to support you adequately I would have a doula in the case of a potentially risky pregnancy rather than a home birth. As said above the home birth scenario doesn't obviate the need for proper childcare so the issues are separate.

The reality is that even with a home birth you need to have a childcare option for you DD in place in case you need to go to the hospital.

I would definitely check out nursery staff as an option but I know mine don't (I'm due end of November with my second so asked as my parents are three hours away).

Otherwise best option to me seems for you to hire a doula (soon so you can form a bond with them) and leave your OH with your daughter. Next best seems a combination of friend during the day and MIL at night - at the end of the day it is only a short period of time, your daughter will cope. Otherwise speak to other local parents and get the names of reputable childminders and start ringing round and see if anyone seems like a good fit and then enjoy a few nights out whilst your daughter gets used to them!

In that worst case scenario for home birth where you get rushed into hospital I would have gone alone, although not great i didnt feel too bad about it as I’d have been with my midwife (she’s done all my antenatals and would have been at the birth thus far). So DH would have been the childcare here.

@yikesanotherbooboo MIL had children in another country (where DH was born) so speaks the language fluently. She also lived, until DH was 7/8 in an extended family setting so she’s never really been alone with a toddler. We’ve had a few issues with her not respecting some very simple parenting choices particularly around food before and she just does silly things that defy explanation, compounded by the language issue in case emergency, that mean both DH and I don’t feel like she’d be a viable option for that day time.

I don’t really see a consultant, I’m just down at consultant led due to a previously small baby. That could change if this baby measured small, then all bets for a MLU birth would be off and they’d push induction. Fingers crossed we don’t get there. I’ve articulated my previous experiences and I really don’t get the ‘vibe’ anything has changed- which is scary

@T0rt0ise

The reality is that even with a home birth you need to have a childcare option for you DD in place in case you need to go to the hospital.

I would definitely check out nursery staff as an option but I know mine don't (I'm due end of November with my second so asked as my parents are three hours away).

Otherwise best option to me seems for you to hire a doula (soon so you can form a bond with them) and leave your OH with your daughter. Next best seems a combination of friend during the day and MIL at night - at the end of the day it is only a short period of time, your daughter will cope. Otherwise speak to other local parents and get the names of reputable childminders and start ringing round and see if anyone seems like a good fit and then enjoy a few nights out whilst your daughter gets used to them!

We’re due around the same time!

I think I’ll call around childminders and see if any are available for this sort of thing. The nursery would be lovely but I think they might have rules against it, they’re really tight on security and boundaries. But nothing ventured.

I’ll know more from my 32 week scan any way. But waaaa.

Has anyone birthed with a doula and no partner? Xx

I had the same situation, with my 2nd and 3rd children. I just went in alone. We had no one to help with the kids, so my husband had to stay with them. The 3rd child in particular was an incredibly lonely birth, the midwives were barely in the room and left ASAP after the birth despite the PPH risk, which then happened and I was alone holding a baby, quickly going in to shock trying to reach the call button for help. It also took over an hour to get the gas and air as the midwives kept leaving and not coming back for ages. I was only in labour for 5 hours though and texted/called my husband regularly for support.
It is do able and wasn't as bad as I expected it was going to be. I just pushed to go home as quickly as possible after.

You might find an induction helps matters in some ways OP (I am due an 'early' induction with second SGA baby we're just waiting to see how many weeks we're allowed to get to). Our MLU is closed for staffing reasons so it's labour ward for all anyway.

We will get a date for starting induction, my mum (soon your case the friend or nursery person or similar) will have DD when DP is at hospital with me which we will keep to a minimum as we know last time there were says of sitting round. He will have to go home at night when there's nothing happening (so your MIL is an option then) and then just get called in for the birth itself once my waters go or the drip goes in or whatever.

I was dreading it but the more we've talked about it that little bit of predictability will help us as we won't be calling anyone out in the middle of the night and waiting etc. I wouldn't have chosen another induction but once I learned MLU was off the table it became slightly more acceptable to me!

I don't get how you don't have a birthing partner and you don't have childcare? Surely your husband can do one of them? Sorry if it's been answered I couldn't see it.

@cactijones

I don't get how you don't have a birthing partner and you don't have childcare? Surely your husband can do one of them? Sorry if it's been answered I couldn't see it.

It’s an either or… either DH is my birth partner or he looks after ds x

@Mynotsoperfectlittlefamily that’s what sort of worries me, that very lonely labour. I think it would really affect me. From my experience with DD I can very easily see how mistreatment happens, especially at this hospital, seems a bit of pot luck as to if you get a good midwife/ doc or not.

@8dpwoah I really really hope I dont have another induction because I’d have really struggled alone with that and I feel like as a result of my induction a lot of my birth preferences weren’t respected. So I’m praying hard this baby measures on track and then at least we have a shot at the MLU, it’s only been closed once thus far so I’m hoping it was just a really shit day. Delivery unit staff are hit and miss but all the MLU midwives are lovely and so caring, even if I was ‘alone’ with one of them it wouldn’t be as bad, still not preferable though x