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

It was picked up. That is why the medics were called. Nothing to do with luck, just good midwives. And a knowledge that a major hospital was five minutes away. As was planned, and I stated in my post.

I too would have died myself if I’d ended up having the home birth I wanted. Up until q weeks before she was due, it was a planned HB, but she turned and was breech, so I was advised to have her in hospital. Which I did. She had turned again by the time I went into Labour and was born very quickly. All well and good, but I then had a PPH 2 hours after she was born (in the middle of the night), ended up in theatre within minutes of discovering I was bleeding profusely. Following much drama and worry, and any week stay in hospital, I eventually recovered. Had I been at home when it happened, I fear I may not have survived.

You will hear lots of anecdotal stories either way. Instead look at the birth place study if you haven't already, the risk for low risk mothers of a homebirth (even first timers) are the same in hospital or at home.
The risk to baby is increased for a first time baby but still very small.
Birth overall is very safe.

Going to hospital isn't a neutral action, and isn't necessarily the safest place for everyone. It has its own risks.

I wanted a homebirth with my first but due to covid wasn't allowed (I ended up with an accidental homebirth anyway, but it wasnt the calm experience i envisioned for this reason!). Homebirth with number 2 was divine, I'd recommend it every day.
The midwives are exceptional, and I had great continuity of care meaning that I had already met the midwife who assisted at the birth.

Transfer rate is fairly high for FTMs but mostly these are often non emergency reasons and after the birth, eg stitches. It's also testament to the low safety bar, and how closely the midwives monitor and advise transfer if necessary.

Curious how you know this?
my midwives told me majority of people are transferred for non emergency reasons

Here are the stats for hospital transfer.

•	Stalled/slow labour - 5.1% to 9.8%


•	foetal distress - 1% to 3.6%


•	postpartum haemorrhage 0% to 0.2%


•	infant respiratory problems 0.3% to 1.4%


•	emergency transfers 0% to 5.4%

Majority are non emergency reasons. And remember that things like foetal distress are usually picked up early in routine monitoring.

It just depends

Fit me I was the perfect candidate for home birth. Midwife pushed me for it. My husband told me he was happy and I wasn't bothered either way so said no. Thank god I did because if I had a home birth both me and my baby would be dead and or my baby would be severely disabled. Not a risk I'm willing to take again

I had home births with both my DC, and I'm very glad I did. Both births were around 4 hours from first contraction to baby arriving. Everything went smoothly, just very fast! I went from 2cm dilated to 10cm dilated in roughly 15 minutes.

Unlike all the women who are sure they and/or their child would have died if they'd not gone to hospital, I have no idea what would have happened if I hadn't had a home birth.

I suspect that the first time, if we'd have gone to the hospital, we'd have been sent away and told to come back later. Then DD1 would likely have been born on the side of the road. And unless we'd had an ambulance arrive quickly, or some good Samaritans rush over to assist, it probably would have been without help - because my DH is likely to have fainted at the sight of blood!

I was a low risk pregnancy so cleared for a home birth early on. I prepared two birthing plans each time - one for if everything went as expected at home, and one for if the midwives decided I needed to transfer to hospital. I also had a hospital bag packed and ready to go, just in case.

If your medical care team is happy for you to have a home birth, and you are comfortable with the idea of a home birth, then I would suggest you go for it. Midwives are amazing, and in a homebirth they are not having their attention divided to other labouring women so can focus entirely on you. They can deal with a lot of situations themselves, but they also know when they can't and a transfer is needed.

I'm also planning a home birth with my first, due to arrive in the next few weeks! The more I read/listened to about physiological birth and how much labour can be halted due to the hospital environment leading to the increased likelihood of complications, the more confident I felt about homebirth. I really recommend the birth Ed podcast. My advice is ask the team what their stats are for transfer etc. My hospital has an amazing home birth team and they publish all their stats. Most of the reasons for transfer aren't serious eg. Woman wanted more pain relief, tear needed stitching. Also, ask them about what medication/equipment they stock and their protocols for dealing with emergencies, all of that should reassure you 😊

The statistics don't really mean that much, because they can't tell you what will happen during your own labour. You just have to decide whether you are willing to run the risk of something emergent happening at very short notice, and the possible outcomes of that. Then weigh that up against having a home birth.

Nobody can predict what will happen. This is true in hospital or at home. The point is that whilst transfer rates are fairly high, the majority are for less serious, practical reasons and the poster has provided statistics to back that up. I see this as hugely positive, and it breaks down the often cited and untrue implication that large numbers of hospital transfers were for serious issues arising as a result from being at home. Those cases are of course sad to hear, but they are not helpful when trying to assess the bigger picture.
It's really a shame that so few people hear from a homebirth midwife about how they deal with various complications, because it's very reassuring!

The current maternal mortality rate in my region is all in hospital. It is incorrect to suggest that deaths are occurring in home births. You are, statistically, much more likely to die with a hospital birth, but I'll add that that's because it's usually the high risk women, and often that's why they are high risk (but not always). Same for babies, the overwhelming majority of baby deaths are in hospital.

Home birth is safe, generally as safe as hospital birth. I work in the NHS in maternity (not a midwife) and midwives are highly trained professionals who will in nearly all cases identify potential issues long before they occur, and transfer you into hospital in good time. It's extremely rare for something to go wrong that they didn't see coming in time to deal with it, and there is a huge amount they can deal with in your home.

People who wouldn't choose home birth aren't generally best placed to give opinions on it because I've never met a non professional who birthed in hospital who knows enough about it.

I had both of mine at home, am considered high risk (though that is debatable in my opinion) and had no issues at all.

Everyone should choose the birth that works for them and their baby.

I was on the fence (and DH was more apprehensive). What decided it for us was comparing the stats between hospital, birthing centre and home birth, both nationally and from our hospital.

I was low-risk, so may have chosen differently if there were risk factors. Like you I have hospital anxiety (not noise-induced though), so that was a big factor for me.

I’ll also add that my midwife told me that any transfer from home birth will be blue-lighted, regardless of urgency, even if it’s just for slow progression. It’s just precautionary.

Also (at the time at least), there had to be a certain provision available from the ambulance team in order to allow home births. They were super busy a couple of weeks before I gave birth, so cancelled all home births that week.

There’s also nothing wrong with planning for a home birth and then deciding you want to go in when you get to the fact. You’ll have a hospital bag ready anyway in case you need to be transferred during or after.

Sorry HNRTFT but I personally think that a homebirth is a huge risk. If anything goes wrong even calling 999 is not a guarantee that you would get to hospital in time.Just not worth it IMHO.

I had a home birth with my first. I had to transfer in as baby got stuck and I also ran out of gas and air (got through 2 whole canisters, which shocked my midwives!!). It took me a while to come to terms with not getting my dream birth, but I still believe it was the absolute best thing for me and I don't regret it at all.

I don't think my oxytocin levels would have been as high in hospital and I don't think I'd have managed the pain as well. I was making jokes in the ambulance between contractions, had an instant latch from baby for breastfeeding and felt SO in control and empowered throughout labour. Also had minimal blood loss despite the odds saying I should have lost more. I was low-ish end of iron (but not anemic or in the danger zone) and baby was crowning for a LONG time.

The worst thing was waiting for the ambulance and then being triaged by a new midwife and surgeon before being given ANY pain relief. Felt like torture and some of the hospital staff were incredibly rude. Glad I had minimal time there.
I was 25mins from the hospital, so being closer I guess that's less of a worry for you.

Aromatherapy was my friend and definitely felt it slowed the contractions when needed (I think it was frankincense, but I'd need to check). Also had Shepherd's purse on hand in case of blood loss.

Follow your instincts but be prepared for the worst would be my advice. Really hope it goes to plan for you!!

Surely a joke post

As another poster has said, I also had continuity of care when planning my home birth. I knew my primary midwife well and trusted her. She knew my preferences amr what I cared about, which also made me feel safe.

Giving birth at hospital is safer for baby and yourself. Choosing a home birth you are taking a risk for some comfort. You have to decide what more important for you. For me safety of my baby was more important so I chose hospital birth. And it was the right decision as well as I ended up needing assisted delivery with forceps. Everyone hopes for a perfect birth but it is often not the case, especially with the first baby.

Chances are the interventions in hospital were what led to the need for forceps. That was my experience, hence having the rest at home.

First babies are by far the most likely to need assisted delivery, subsequent babies are much less likely to need it. So it probably wasn’t that hospital = forceps and home = no forceps, just that you had your first at the hospital therefore was more likely to need assisted delivery anyway.

Home births are not allowed in my country or I would have had one…and probably my baby would have died. Textbook pregnancy and delivery. Baby developed sepsis shortly after delivery. I wouldn’t have realised til it was too late. It was a nurse that realised there was an issue and intervened. 10 days in NICU. Terrifying.

Actually it was the result of a bad attempt to speed up labour, forcing me to be on my back, setting a time limit on labour, which led to forceps. The cascade of intervention is a real and well known thing.

So you could have delivered at home and transferred to hospital when you needed to. My midwife did daily checks to make sure all was going well.

You don’t know that. I’ve had forceps after induction, you can take a guess but the truth is we never know for certain why some babies pop out and others won’t. Had you stayed at home with no time limit the baby could’ve gone into distress as is the case in many prolonged labours.

I know that the transfer rate for first time births is about 50%, so you’d need to be prepared for a likely trip to hospital anyway.

I've had three home labours lasting well over 30 hours with babies well monitored. No, we can't know what will happen in different settings because we don't get the chance to experience them, but I feel safer at home, so that's where I should be. A woman should always be where she is most comfortable, assuming no compelling reason to birth in hospital is anticipated.