Homebirth for first baby

[Oceanbeautiful]

I am a first time mum and looking into home birth . Up until pregnancy, I hadn’t considered home birth at all, however, losing my Dad quite recently and trauma associated with hospitals (in particular heart rate monitoring device’s sounds) has made me want to avoid hospitals through fear that the stress would stall my labour and lead to a cascade of interventions.
With that said, i’m conscious there is a slight increase in risks for home births with first timers.

I’m curious to hear your experiences with home birth, particularly if there were complications. How was this dealt with? Did you feel safe? What were the outcomes?

I’d most like to hear from 1st time mums where the risk is slightly elevated.

Thank you xx

I had a home birth with DD1. This was several years ago, before ambulance waiting times were in the news as much, so I'm not sure if they were as much of a concern. I also lived literally a 4 minute walk from the hospital, about a 30 second drive from our door to the A&E ambulance bay, which was next to the maternity department entrance. The midwife suggested a home birth to me at my 32 week appointment.
I did haemorrhage after DD was born, and did need an ambulance. The paramedics gave me something to stop the bleeding which I think they said they'd only recently been able to use on postpartum women (transexamic acid?) and I didn't need a transfusion.
They weren't sure but said the bleed was possibly due to the placenta taking a while to come, and a 2nd degree tear (this would have been stitched by the midwives at home if I hadn't bled). I had whatever injections they give to help the placenta come, and it did come on its own in the end, just took a bit longer than they'd like. But not to the point where they were suggesting I'd need to go in to hospital for it, which I assume would have happened had it reached a certain point.

For DD2, I was referred for a consultant appointment - nothing to do with the haemorrhage, but because I was a low weight pre-pregnancy. The haemorrhage came up and I asked about birth options because I assumed the MLU might be out and I'd have to be on the labour ward, and she said MLU was fine and actually she'd be fine for me to have another home birth (provided the additional growth scan I needed due to my weight was fine) which I was very surprised by! With DD2 my waters broke at 34 weeks so was induced at 37 on the labour ward anyway - no haemorrhage.

Jesus. I can assure you op that the most common reason for transferring to hospital is NOT pain relief.

They are:

-Issues with the progression of labour eg baby getting stuck
-Baby in distress
-Postpartum bleeding
-Baby having breathing issues

I don't want to incite fear or be accused of scare mongering but sometimes maybe the people who reply on home birth threads are those for whom it has gone well.
I wanted a home birth also, due to fear of hospitals and not wanting all the interventions etc. I had practiced hypnobirthing, felt confident etc. Now I can't tell if my birth would have gone the same way if I had gotten to have him at home, I didn't because they didn't want me to go any longer over due so he got induced. My birth ended with forceps and 3rd degree tearing but I was losing a huge amount of blood and required 3 transfusions and emergency trip to theatre where I got sewn back up (badly). If my birth had gone that way at home I would most likely have died. Bit maybe at home without intervention and with correct midwife support it would have been so different.. I'll never know but I'm just glad to be here to raise my son. I'm going for planned section on my second which is something I NEVER thought I would opt for but that's mainly to due with suffering from a subsequent prolapse and the difficulty I had in recovering from the tearing (incontinence unfortunately).

Again not to scare you but to offer another side to the difficulties which can arise, particularly with first time birth.

IOL bashing is dangerous. It's there for a reason, maybe overused sometimes but it isn't an evil. I know 3 people who had IOL and straightforward uncomplicated vaginal births. I had no IOL, baby stuck, failed forceps, EMCS. I know another that refused IOL, 48 hours later reduced movements and EMCS with very sick baby, placental failure. Would she have needed EMCS if she'd been induced? Possibly. But that baby wasn't being born alive naturally. IOL is used to attempt to avoid EMCS, and usually used in occasions where the risk of needing one is higher anyway. Not everyone goes into labour naturally before baby becomes unwell or distressed.

I had a homebirth with my first. I was 37. We lived a few minutes away from a major hospital. I had independent midwives, as the NHS couldn't guarantee a homebirth.

Baby took a while to come out, midwives decided to call for an ambulance, they were there in about three minutes. Just as DD emerged 😁 She was born with meconium in my waters and the cord around her neck, but all was fine. Paediatric medics didn't even open their bags.

You'll hear stories about home births. But you'll also hear stories about hospital births and midwife led unit births. I decided that home would work for us, and it did.

My first would be dead. So would I. Uncomplicated pregnancy. Everything went smoothly. Wouldn't have been able to foresee it. Everything was fine up until the moment they said it wasn't. Was in surgery within 5 mins and we survived.

There's a reason that infant mortality rates changed drastically from the early 80's onwards. Modern healthcare is amazing.
I just couldn't do it. The risk is so high. I don't want to frighten you but please look at all options. Perhaps a birthing centre? Much more relaxed & not at all like a hospital ward.m but a full team there if they are needed.

Another one whose first baby would have died if it's had a home birth.

Ultimately, no one else's experience matters, good or bad. Your pregnancy can't predict your labour. You need to accept the possibility that there could be a very urgent, last minute emergency situation during labour and then decide whether you are willing to take this risk in order to have a home birth.

@MariaVT65 I've been a midwife for 25 years and I've never known a woman to go post dates and just...never go into labour. I've just asked a break room full of midwives and obstetricians and nobody else has either. All women labour, when their babies are ready. The baby doesn't know what date it is on the outside world. You weren't even 42 weeks yet!

The risk of stillbirth post 42 weeks is always trotted out by consultants but it's massively overstated. 'The risk doubles' is often heard. The risk is absolutely tiny. Tiny. Infact the most recent MBRRACE report (2023 I think) shows the risk of stillbirth actually decreased after 40 weeks gestation. This is a hot topic in obstetrics right now. Dr Sarah Wickham has fantastic books on the topic and all of the research is very clearly presented.

Women should be presented with accurate information and to make an informed decision. If the information is biased and presented in a way designed to frighten you and sway your decision because doctors are scared... that's coercion.

A section isn't just the mode of delivery for one baby, it also dramatically increases the risk for all future pregnancies. I think that's something people often forget

We are constantly having these discussions between colleagues op. We are seeing every day the damage we are doing but are trapped having to work within guidance that is not based on strong evidence. We are interfearing too much and leaving women traumatised thinking that their bodies have failed them... when it's the system that's failed them. Most midwives I know birth at home, and I think that says it all.

Wishing you the very best of luck with your birth!

I absolutely agree.

IOL is amazing and necessary... when the risks of continuing a pregnancy are higher than the risks of induction.

Sadly, the risks of IOL are very rarely fully explained to women before the IOL is commenced. There is almost never a thorough discussion where the risks are listed and explained. Once the process is started it's too late really to stop.

My experience of homebirth is that I got a lot more careful, nurturing attention than I did in hospital. Midwife was with me for the whole thing, regularly checking everything: heart rate, blood pressure, post ion of baby etc etc. I took no drugs to complicate bodily procedures and I honestly believe that any problem would have been spotted well in advance of it being an emergency.
Whereas in hospital they basically leave you to your own devices until you're ready to deliver or cracking with the pain and / or fear. Just pop their head around the door every hour. I got no "care" at all, apart from physical.

My sister nearly died during a homebirth.
More recently a younger friend would be dead if she had been at home.
Please don't do this.

And I have a friend whose baby would have survived (still birth) if she had been born at home... And I know dozens of women who would have had far less traumatic births/ unnecessary interventions if they'd been at home. But that doesn't mean home birth is right for everyone.

Individual anecdotes really aren't very helpful. And as the midwife PP says, even the actual 'data' isn't presented in an unbiased way.

OP, this is a decision only you can make. Do your due diligence (read the research, talk to the homebirth groups, talk to your mw) and you will know what is the right decision for you.

Quite a few mothers plan to give birth at home and then something changes (low lying placenta, breech position etc) and a hospital delivery becomes necessary

Birth is unpredictable. Even if everything is going fine a problem can occur and you or baby could need help very quickly.

On the other hand being at home with full on attention from one or two midwives could be the best experience ever.

Good luck with your decision.

I've planned to have two home births but sadly did not get to have them in the end due to medical issues. Got up to a week before the due date both times then ended up being told I needed to be induced.
I do not regret planning them though. I have a fear of hospitals due to trauma as well. I was under perinatal mental health team who supported my idea to have home births.
My friend had a successful home birth with her first and second births and she could not speak highly enough of the experience.
I think you should be prepared that many homebirths with a first baby end up transferring to hospital as first births have a tendency to be long.. nhs midwives attending a homebirth will only let you labour for so long before suggesting a move to hospital. They are very cautious.
I say go ahead and plan one if you are low risk. If there's any concerns along the way your midwives will discuss it with you. If they are happy to support you in homebirth then go for it!

I considered one with my first but looking back very glad i didn't

I've been a midwife for 15 years, worked on community, labour ward and midwife led units. I live 45 minutes from my nearest hospital. I'm currently pregnant with my first baby and planning a home birth, as I'm low risk and know I'll feel safter and therefore will labour better in my own home.
Look into things and birth wherever you feel most comfortable :)

The rate of transfer cited by some people here was never the experience in my area. If I recall correctly, my midwife said about 10% of her first time mothers ended up transferring. I do wonder what the reasons for transfer were? Do some midwives have time limits others don't in their practice? My labours were longer than typical hospital limits would have allowed. Most transfers were not emergencies. My own transfer was a dire emergency, but I know a lot of women who have birthed at home, including myself multiple times, and I'm the only one out of my group that ever transferred. I know of one baby who died, but that baby would have died anyway as it was due to a birth defect that made it inevitable (and the baby was alive on arrival at hospital where it was determined that the baby couldn't live).

A home birth midwife should be willing to discuss her personal statistics on transfers and other policies with you. You should ask what safety equipment they carry to cope with emergencies. They should also be willing to help you weigh up your own situation, because we're all different, to decide if home birth is right for you. There has to be an understanding that birth is not risk free wherever you are, but most of the time, it's fine.

I know someone who wouldn't certainly died if she'd have had her first at home (doctors own words) and she was in her twenties and very low risk. She had a severe postpartum haemorrhage out of the blue and even though she was In hospital they only just got the blood to her in time. Sorry to be doom and gloom but the risks of home birth do need to be considered. It's easy to think it's 'safe' if you're low risk but the reality is it's always a risk.

Would've not wouldn't!

There are a lot of politics around birth and doctors do have their own biases. I had a massive bleed at home with a good few units of blood afterwards. If it had happened in hospital I'm sure I'd have been told the same and I would probably have believed it too. Birth has inherent risks. If you're keen on a home birth and concerned about them, talk about them with your midwife, how they can handle them, how transfer would work. Then you can weigh it up, together with a professional, and decide what you are comfortable with.

This thread is taking me back to when I planned my home births 18 & 15 years ago - I eventually stopped discussing them with anyone other than DH and my midwife as so many people seemed to have a negative opinion which was never a based in fact. Childbirth is such a personal thing that people can’t help but reference their own experience or that of someone they know/have heard about but it’s not helpful.

Here’s what I would say:

First time home births are statistically more likely to be transferred to hospital. That doesn’t mean that you shouldn’t opt for it but mentally prepare yourself that it might happen, think through how it might feel and keep an open mind - if you go to hospital it’ll be for good reason.

Despite the number of people who say “if I’d been at home the baby/I/we both would have died” there’s statistically no evidence of higher mortality/negative outcomes for mothers and babies having a hospital birth vs. home birth - if there was then home birth wouldn’t be offered as an option. With a home birth you’re closely
monitored as it’s only you the midwife (and then second midwife closer to the point of giving birth) is looking after and they’re never going to risk something going wrong - if they think things are heading in a potentially risky direction they’ll get you transferred. It’s tragic when something goes wrong but it can happen in either situation.

I also think you being so close to the hospital is a big comfort (I was the same) although I’ve also had friends opt for a home birth for 2nd/3rd births for opposite reasons - they were so far from the hospital that they were worried they wouldn’t make it after earlier labours being pretty quick and they were all right!

Best of luck with whatever you decide and I agree with others - seek out supportive spaces such as dedicated homebirth groups where you’ll get some great advice.

This is great advice.

Well it obviously wasn’t fine. Your daughter was clearly distressed and it wasn’t picked up. You were lucky but it didn’t go swimmingly well.

As for me, I had 2 high risk hospital inductions so cannot offer personal experience. Had I been low risk, I would’ve chosen MLU for the first baby, and possibly home birth for subsequents if the first birth went wells there were no further risk factors. Oh and if I was a maximum 10 minute drive from hospital.

However I have heard some very sad outcomes to home births lately. I will add these women were high risk and chose home birth against medical advice. All resulted in the death of the baby and an injured mum. One was a shoulder dystocia, one was heart rate deceleration which was so rapid the transfer and caesarean didn’t happen quickly enough. Really heart breaking.

I just couldn’t ever recommend a home birth for a first birth unless perhaps the mum herself was an experienced midwife or doctor. So many things can go wrong. I had a 3rd degree tear, there was a true knot in the cord which could have tightened and cut off blood to baby, and without monitoring you wouldn’t have known, the cord snapped and the placenta was retained (it turns out that I have a shelf structure in my uterus and when the placenta attaches there it sticks), they put me on a drip to get the final stage going properly after 12 hours and babies heart rate struggling , even if the birth went well I could easily have lost too much blood at home, I needed to take iron for a long time afterwards, but also there were so many chances there for the unthinkable to happen for baby, and that was a low risk first birth from a healthy mum. (I 100% would have needed a transfer asap to the hospital to get the placenta out and to sew me up.)