Limited options in places to birth due to Covid/staff shortages etc

[PlantMummy87]

Feeling a bit low after a home visit with midwife for discussion on home birth. Not really sure what I'm looking for from this post, if anything, maybe just a vent is needed.

I'm 35 weeks and from early on in first trimester I knew I wanted to avoid a hospital birth if possible due to a range of personal reasons, including genuinely being really frightened of hosp environments.

I did a lot of research and found a birthing centre nearby, but there are no maternity led units unless we travel 1.5hr +. At the time I hadn't considered a home birth as felt our circumstances of living in a terrace house would mean it wasn't possible due to noise, even though I'd love one. Anyway I got in touch with the birthing centre early on in my pregnancy and they said they'd been closed through the pandemic for births, but they'd hopefully be open by autumn for births there and to call back when I was 32 weeks. I called back and found out they are still closed and unlikely going to be reopened by the time I go into labour. They mentioned their sister site birthing centre is open for births but that is around a 1.5hr (often more due to bad traffic) drive away from us, so not really an option.

In-between the callback to the BC I started considering home birth as an option. I did a home birth antenatal class, have been doing the positive birthing company course and spoken to various midwives about home birth to get as much info as possible and it seemed like it would be something that was not only possible but something I'd really, really like. So I've been planning up until this point to have a home birth if all stays well with this pregnancy and baby, with the intention that if I had to go into hosp for birth for a medical reason this was fine because it was for a medical reason and I want to do what is right for the baby.

When the midwife visited today she said that where I live only around 50% of families that have planned a home birth are actually able to have one currently due to staff shortages and ambulance shortages (even though if I had to transfer to hosp we have a car and could drive they have to insist you go by ambulance.) She listened to my concerns about hosp births but I wasn't very reassured at all by her responses, and for some of my worries her responses actually made me even more worried.

Now this is obviously a glass half full/empty situation, and nothing I can do about it at all, but I'm now feeling really low that it now feels unlikely I'll be able to have a home birth. I'm completely sympathetic of the situation midwives are in and it's not their fault so don't want to seem like I am blaming anyone. But I am feeling upset that it feels like all my options have been taken away. The idea of a hospital birth really frightens me and although I know the rate for FTMs that try at home and then transfer into hosp is pretty high but I really wanted to give it a go and if I transferred then it wouldn't have been through lack or trying and would likely have been my choice to have transferred. I am so frightened that a hosp birth is going to lead time pressures to hit a certain point in labour progression at their prescribed times, and that is will lead to procedures and interventions that I don't want in an environment that I know I will struggle to relax in and therefore this will impact the labour progressing.
Part of me is also worried that as I'm feeling nervous about them putting time pressures on that I'll labour at home for as long as possible and end up having the baby with just my partner present, because I'll have wanted to only go in when I knew it was absolutely happening to avoid going into hosp and labour stalling and interventions then happening.

I absolutely know no birth ever goes to plan and wasn't expecting everything to just be perfect and go exactly as I wished, but I'm now feeling like I've gone from being excited about this really happy and special event in our lives to dreading having to make that call to the midwives to say I'm in labour and them saying unfortunately it's not possible to have a home birth on that day and to go into hosp. I can't even visit the hosp due to Covid to help relax some of my fears about the hosp and to try and make it a more familiar place 😢

Has anyone else been in a similar situation and ended up with a hosp birth when you hadn't planned to but been surprised at how positive the experience was?

Sorry to hear you may not be able to have the home birth you wanted. I’m in a similar boat (second pregnancy) really wanted a home birth because didn’t fancy being in an understaffed hospital during a pandemic but due to some complications I have to give birth in hospital now to be monitored. I had a natural birth with no painkillers or interventions in a MLU first time so really gutted!

I’ve just done a hynobirthing class to try and learn some techniques to ‘zone out’ regardless of my surroundings..this might be something to consider. I’m going for noise cancelling headphones and those eye masks so I can just properly go inside myself and pretend I’m on a beach in thailand and not a clinical hospital room in yorkshire ...it’s a pain but usually even in a hospital you can still have an active labour, get into different positions etc unless you have an epidural.

One thing the hynobirthing teacher said was for any intervention either ask or get your birth partner to ask / agree in advance - is it an emergency? What other options are there? Do we have to decide right now or can we have 5 mins to think about it? What if we do nothing? This will help you ascertain whether intervention is totally necessary if you’re worried about being rushed etc.

Another thing to consider Is contacting a private midwife to enquire about a home birth if you can afford it? They might have the same limitations though due to ambulance shortages etc I’m not sure.

Good luck! Rubbish time to be having babies isn’t it but hopefully we won’t care once baby is here

Ok so this was before Covid. Wanted a water birth but was deemed high risk due to multiple losses ect so no birthing center for me.

I really didn't want to go into hospital but baby had other plans (reduced fetal movement shortly followed by a induction) and I can tell you one thing. When in labour you do not care. The things you care about amount to getting the baby out ASAP. I was grateful as the hospital had whole range of drugs and during induction I changed my mind on the whole no drugs birth plan. The hospital were able to accommodate and flex faster to my needs, if I had been at birthing centre if I wanted pain relief I would have had to have waited until ambulance was free and chances are would have had to have gone drug free anyway.

Birth is scary no matter how many times you do it as it's so changeable. If your hospital has a fb page for its maternity unit look at the reviews what mums have said. Look at what people say about the hospital your considering online, gather as much information as you need to make a balanced choice.

Try to remain flexible on you birth plan, some very lovely women have suffered ptsd because their birth didn't marry up to what they pictured in their head.

Good luck op xxx

Thanks for the reassurance and kind words, exactly what I needed.

@Annabelle780909 sorry you've had to go down a different route to what you envisioned too, wishing you all the best with your second little one. Will definitely will be trying to draw on hypnobirthing techniques too wherever the birth happens and will try and make it homely if I end up in hospital with some battery lights/candles etc. Visualisations of being on a lovely beach in Thailand also sounds just what I will need to do! I've heard of the BRAIN technique for deciding what to do, if there is time, which sounds really similar to what you are saying so will definitely use that too!

@candlelightsatdawn thanks you are absolutely right, as I have never experienced labour it is very hard to know exactly what it will be like and having access to a range of options in terms of pain relief etc is not bad if I change my mind. You are also absolutely right I do need to be more flexible in terms of the 'plan' and see it more as preferences. Hoping as I've got a few weeks until baby's arrival it will give me the time to come to accept things will not go to plan and that whatever birth I have it will still be beautiful.

Had a good research into the local hospitals last night and decided on one that seems more what I'd want so that feels like at least there is a choice if I have to go down that route.

Thanks again both of your for your support xxx

@PlantMummy87 I'm hoping your birth goes well and I have heard loads of people say hypobirthing really worked for them.

Please don't let my story of induction throw you off. Being induced is a very different birth experience to natural labour and had I been able to go into natural labour I'm pretty super I wouldn't have needed access to the drugs (or maybe I would who knows!) My MW said fear is the enemy of labour, something that effects the birthing hormones, so make sure where ever you are your happy and feel safe.

Remember there's no medal for birth (no matter which way you go) but the best present at the end will always be your baby.

Good luck and if it helps you do completely forget the pain after a few months. It's like your brain just wipes it out ! I'm crossing my fingers for you lovely 💐

I sympathise with you, I too want a home birth and because of this I have researched a lot to ensure this happens. I’m at the point now where I don’t care if a midwife is present. Women are made to birth in power and often birth is medicalised when it does not need to be in most cases. For example, Women should given birth in a calm environment which hospital certainly is not. Oxytocin often stops at the point of entering hospital as there is nothing at all natural about it. Birth should actually be orgasmic. and being at home where you are safe and loved is safer for you and baby. There is a wealth of information out there about this, help far beyond medical convention. Ricki Lake even did a documentary about it called the Business of giving Birth, it’s on Prime, and it offers fascinating insight into the medicalisation of birth and the high rate intervention, called the cascade of interventions, in a hospital setting. That being said you have to go with your instinct, in the end only you know what is right for you and baby. However, a lack of staff should not prevent you from having the birth you want and deserve.

OP, I really feel for you.
My sister in law is in a really similar position, where she has been told that a home birth is just not likely due to staff shortages.
She had read lots of things on here about how you can just insist and they are obliged to send 2 midwives to your home, but when she told them what she had read, they basically laughed and said if only it was that simple
If they don't have midwives, they don't have midwives.

A couple of tips from me...

Read 'Give birth like a feminist' by Milly Hill. It is brilliant at outlining the various questions to ask at different stages, how to write a plan, and how to work with the confines of the hospital policies/your risk profile/whatever else. Very positive and empowering book and very easy to read

Have you had a tour of the hospital maternity unit? It would be really helpful for you, partly so it's not a totally unfamiliar environment, and also partly because you might find its really not as bad as you expect.

Also, look at the route to and from the ward.. In my hospital, you can either go into the main reception and into the lift - with all the bright lights and hospital smells and other patients.
Or there is a stairwell from the car park, and you can go from corridor straight onto the ward. This means you don't get that 'stepping into a big hospital' feeling.
It would be worth asking the staff if they have any similar back routes you can take to keep things calmer.

Keep an open mind...The views from @Sydneyb3 are... a view, but really not the experience of the vast majority of women. It sounds like you are being totally realistic, but birth isn't 'supposed' to be orgasmic or really anything other than a way of getting the baby out into the world as safely and calmly as possible for mum and baby.
And what counts as calm will be yours to decide

Good luck

Great post from @tenbob and I totally agree, I was a bit gutted I didn't get 'the dream' trip to the MLU (I wouldn't have a home birth if you paid me but that's personal preference) first time round because of medical needs but I'm so glad I was in the right environment for what my baby and I needed in the end. This time round I'll take whatever I get but it's very easy to say that having been through what's portrayed as the less than ideal and found it to be absolutely fine, I know I'm coming at it from a totally different place.

I did just want to say I've read a few posts on here just today where people have genuinely suffered from building up birth to be this one big spiritual experience and then it not working out like that for them. It always makes me sad when I see that the increasing industry- don't be deceived about it being anything other than that, I imagine Ricki Lake is talking about American medicalisation and profiteering, so the opposite- that's built around 'natural' childbirth has contributed to this for at least some of them.

But you sound like you've thought about that and I can understand not wanting to be in hospital, I'd never stayed in one before my week in having DD and the fear of the unknown is really strong but when the shit hit the fan I was really glad I'd ended up with access to what was needed.

Just wanted to share really that even a textbook 'horrible' birth doesn't have to have a horrible recovery or taint things for you, I felt ok after 24 hours, pretty good after a few days and normal after about a fortnight when my stitches bogged off. I was able to enjoy the final stage of pushing and can vividly remember those first few hours in spite of (or maybe because of) the medical situation I was in, and I never in a million years expected that after all the talk of 'cascade of intervention'. That cascade for me was precipitated by a baby that had stopped growing so had no option but to go, each step in the cascade potentially saved our lives or at least prevented harm. Just a different slant on it I guess.

Just gonna jump in and say people saying "Birth should actually be orgasmic" can do a lot of damage to women who truly do all in their power to have a birth like that and it just not happen because nature takes it course or intervention has to happen to save both mum and/or babies life. This is the lead cause for PND

I'm sure there are women who would describe labour like this but I haven't encountered any in RL. Holding your baby in your arms - absolutely. Nothing better but labour I'm sorry I think this is a dangerous thing to say to a mum to be.

I had a hospital birth and epidural with my first and a water home birth with my second. I actually was someone who was told they didn't have enough midwives but after dh pushed a bit they ended up sending 2 plus a student midwife. I'm hoping for the same again but I'm aware it might not happen.

Think about how you could make the hospital room as close to your ideal birth space as possible- have music ready loaded that you like, take blankets or cushions from home, have comfort things in your hospital bag that remind you of home etc. Remember that a hospital birth doesn't mean lying on your back in a bed, you can move around, position yourself how is comfortable, have a birth ball etc.

Don't be put off by the midwife saying a home birth probably won't happen, you're entitled to request the birth you want. Just keep in mind a hospital birth might be necessary and consider how you can make it work for you.

Oh, and my water home birth definitely wasn't "orgasmic"! Agree that narrative can put a lot of pressure on women to relish the birth when most just want it over with and to meet their baby!

Have you made it clear to your midwife just quite how frightened you are? As opposed to “oh, well, all first time mums are a bit scared”? As in, you are so scared you think you might end up having an unscheduled home birth because of your feelings about hospitals? Because if they know how scared you are, ie that this crosses over into a mental health need rather than a nice to have, they may be able to arrange a tour for you.

I say that as somebody who was terrified both times and first time round would not have been able to articulate it. I was terrified of a hospital birth, ended up with an induction, which failed, an emergency CS and feeding problems. And I can tell you that in the moment, I didn’t care about fairy lights and stuff but I did care about how I was treated and what was happening and being done to me. And I ended up with post-natal PTSD.

Second time round I had an elective CS. And what made the biggest difference was that the staff knew how scared I was and did everything they could to help, including a tour of the theatres at my pre-op (and again on the day) so I was mentally primed for what everything would look like. This helped hugely as although I was scared and upset, I wasn’t as overwhelmed as I would have been otherwise.

I also recommend the Positive Birth book by Milli Hill. But most of all, I recommend articulating your fears and getting your birth partner to be able to do so on your behalf.

I would also say, brief your partner on what interventions you are ok with and which you really don't want unless totally necessary so he can advocate for you- my dh was amazing and did loads of discussion around interventions while I was in hospital, e.g. they wanted to put in a cannula but I hate having my blood taken and a cannula would have made me feel sick so he questioned if it was necessary (I wasn't really in a state to argue with them) and they conceded it wasn't, they could just take blood as needed so that really helped

I'm sorry you won't get the birth you wanted, it's a really crap time to be pregnant at the moment.

I will say though, it definitely helps to stop thinking about birth as a "journey" or an "experience" or some other instagrammable shite, and starting thinking about it as a necessary evil in order to get your baby delivered. Labour is hard and painful and scary for the most part. It's best to recognise that from the beginning and to realise that experiencing it as such, and not really enjoying the "journey" isn't some kind of failure on your part

Yes I planned a home birth for ds and ended up with an emcs as he was too big to exit. So my first birth wasn’t great.
Booked a cs for second ended up with a VBAC in hospital it was painful but not scary. Anyway the midwives said I’d i had a third I’d be an ideal candidate for a home birth. I thought no if I have another I’m coming back here! I was on the labour ward so no nice big room or anything.

Thank you everyone for the really kind words of support and advice, I really appreciate it 💐

I have read a few of the books suggested already like The Positive Birthing Book and Give Birth Like A Feminist and will dip back into them over the next few weeks for sure.

I'm definitely going to speak to my midwife again at my next appointment about this as writing up my birth preferences on my badger notes this morning the question about how I'm feel about my birth plans really triggered me, as a I truly am dreading ringing maternity up in a few weeks to say I'm in labour and fully expecting them to say home birth isn't running that day/is too busy etc. which isn't going to be beneficial for labour either way if it is at home or in hospital. I definitely don't think the midwife took how I scared I am seriously and saw it more as first time mum nerves, which I'm sure is contributing to things a little, but it's not the actual birth I'm afraid of so need to make sure I articulate this well.

Unfortunately I can't visit the local hospitals for a visit, although I've asked. Due to not only Covid but also because prior to Covid they stopped visits as it wasn't the nicest for labouring people to have visitors wandering around when they were in nighties etc which I completely understand. Unfortunately I have been told that although I can have a preference of what hospital I go to, it does depend on the day whether they have space, so feel like this is yet another option being taken from me as spent some time the last few days really researching the local hospitals and feeling like at least I had a choice of them if the worst case was I had to go into hospital.

Luckily my partner is very supportive and knows how I'm feeling and think he will be the best at advocating what I need when I'm in labour, but will continue to have these conversations leading up to it so he feels able to as well.

Thanks again everyone for your advice and personal experiences, it has really helped me.

I know this was a while ago now, but I just wondered how your birth went and whether you got to try for a homebirth in the end?

Staffing is still an issue in maternity unfortunately. I had my baby a few weeks ago and desperately wanted a homebirth. When I called up on the day I was told I couldn't due to staff shortage, so the exact problem you had been worried about. Even the midwife led unit was closed due to staffing levels, so I had to go straight to the labour ward. It was so far removed from what I'd envisioned and mentally prepared for. I'm still trying to process it really and it makes me so sad I wasn't even allowed to try for it.

Lol at birth should be orgasmic. What a load of toss.