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

Please don't do it. I had a terribly traumatic first birth, forceps, 1.5l loss of blood, days in HDU.

Second birth is an entirely different story.

Sepsis? Could have been too late.

When people say this they often seem to have very different views of what a compelling reason is. I think out should be a very unusual exception for a pregnancy that isn’t very low risk to be a homebirth, and that in hindsight the mums of dead or injured babies aren’t the most comfortable at home after all.

Exactly the same as my experience. I planned for a home birth and did 24 hours at home before it was strongly recommended I go in to hospital.
Looking back, I had no understanding about labour and birthing and I was naive to think that I (me, specifically) could do it at home.
I haven't had another child, so I haven't really considered what I would plan for, if it was to happen again, but I think I would just plan for a hospital birth.

Of course dead and injured babies never happen in hospital. The only babies I know of that died in home birth had birth defects not compatible with life.

You clearly prefer to birth in hospital and I clearly prefer to birth at home. So that's what we should both do.

That's very distressing for you. Were you induced, did you have an epidural, waters broken, drip up? Interventions increase the risk of what happened to you, Interventions that won't happen at a homebirth.

Sometimes things do just happen though. I had no interventions at all, at home, and a massive PPH with a number of blood transfusions required. While those things can increase the risk, not having them doesn't completely eliminate risk, no matter where and how you birth. It's just the nature of birth. Perfect home births before that.

I had a difficult first delivery in hospital (transferred from MLU to consultant unit in sane maternity centre) because the baby was back to back. If it had been a home birth I would have been transferred to hospital at the same time as I transferred to the labour ward, no urgency. Forceps and the lot were needed in the end. Second time round I had a wonderful home birth. Loved being in my own surroundings knowing I was 5 minutes drive from hospital if needed. It was a really healing experience and I felt safe throughout.

Your post is awful and harmful, like you are accusing me of lying. I find it alarming that you’re a midwife. I hope you’re lying.

FACTS:

-I was induced at 41+5. I was very clearly overdue.
-After 24 hours of contractions, I still only dialated to 3cm
-After a further 24 hours of contractions, I had not progressed beyond 3cm. My baby’s heartbeat was dipping.
-A further 2 hours after having my waters broken, I still had not progressed beyond 3cm. Needed EMCS.
-It was discovered that my placenta was no longer fully functioning because of how overdue I was. You realise that’s a thing right?? My son was really struggling.

My best friend is a midwife, and also dealt with a case with a woman who refused any intervention due to religious reasons. She never went into labour before her unborn baby died.

Guessing you don’t agree with the NiCE guidlines recently updated about not inducing past 41 weeks then, because of proven increased risks beyond that.

Please stop spreading harmful and misleading information.

You seem to be ok with just letting women continue with failing placentas and never have an induction. No wonder maternity care is so crap in this country.

a) My consultant told me this. The fact is, the issues women and babies experience during birth are no different regardless of whether you’re at home or hospital.

b) It’s all over the internet.

I don’t know what this list considers as ‘emergency’ but I would also be very glad to be already in hospital for ‘foetal distress’ as an example.’

I had a cat 1 EMCS because they lost trace of my baby’s heartbeat in an instant.

Yes of course, as a homebirth midwife, I am well aware.

It's just frustrating reading the shocking amount of misinformation on this thread. It's worrying how many women believe they would have died at a homebirth, yet that's actually vanishingly rare. Hospital admission carries massive iatrogenic risk that many people just don't understand sadly.

Eg the baby with sepsis- was it hospital acquired? Was it due to multiple VEs or early ARM in labour? Was it due to too many different people handling the baby, lack of immediate skin to skin (microbiome), golden hour? Admittedly that last one is a stretch, but who knows.

All the PPHs - were they due to induction, epidural, being forced onto your back, lack of nutrition and hydration in labour, augmentation? Instrumental birth? Caeseran birth?

The baby's born distressed - again often due to the above factors.

OF COURSE emergencies can (rarely) happen without any of these risk factors, but midwives are trained to manage emergencies. No birth is risk free, but there is overwhelming evidence to suggest that birthing at home is at least as safe as birthing in hospital - partly due to the significant iatrogenic risks of birthing in hospital.

It is for each woman to decide where is right for her and her baby and all these replies about dying are unhelpful - no one can know that they would have that emergency had they avoided the risk of being in hospital, and no one can know what the outcome would have been anyway.

We should be supporting women, not terrifying them!!

A placenta may start to deteriorate at some point, no one knows when or what it really means. The pp you are quoting isn't saying you weren't over due, they are saying everyone will go into labour eventually if left alone. The most advanced gestation that I have encountered was 43+6.

Most people accept induction or are pushed into it, so we don't really know a lot about what happens beyond 42 weeks.

In my trust, had you declined induction at 41+5, you would have had a thorough fetal assessment scan which would have picked up if the placenta was impacting on fluid levels or blood flow which in your case may have led a recommendation of either elective cesarean birth or induction anyway.

Your baby likely wasn't yet in a great position for birth hence you not labouring, had they had a bit longer in there, that will eventually have changed - hence the pps comments.

I agree with what you have written but my PPH still happened for none of the reasons you listed and it could have ended very differently for me. Also, my midwife really let me down in that moment and did not respond appropriately, which was acknowledged. I'm a very well informed consumer and agree there's a lot of misinformation in this thread, but things do happen out of the blue. It might be rare but, if it happens to you, it's high stakes. I'm pro home birth and had four of them myself, but my experience can't be dismissed because it's doesn't suit the image people want to portray of home births. I think home birth is a safe option but, as they say, sometimes sht happens.

sorry I still think the whole narrative of ‘your body will always go into labour at some point’ is harmful. Note the case I mentioned.

I was induced because I went really overdue and intervention was needed. Yes anything can go wrong at any time with the placenta but don’t tell the risks aren’t increased by going massively overdue.

I mentioned that i never went into labour. It was a fact. The Pp’s response was ridiculous and pointless. This is all about keeping babies safe.

Anyway, only relevant to the OP’s question in terms of being mentally prepared to also give birth in hospital if she sets her heart on a homebirth.

Oh absolutely and I did acknowledge that in my post. It happened to a woman we cared for within our time - thankfully just once so far. We have equipment, drugs and training to manage the situation but ultimately are reliant on getting an ambulance promptly.

It definitely can happen, but it's far more likely to happen in hospital.

It's a fact though, and all women are offered induction so I don't see how it's harmful? No one in an under resourced country where induction isn't offered stays pregnant forever. However the risk to mum and baby is obviously very high eventually.

You didn't labour because your team failed to get you into labour within the time frame open to them once they had intervened - that's not a failing on your part in the slightest. Had you been left to it, you would have laboured eventually - but possibly with catastrophic outcomes for you both.

Attempting induction was likely the right thing in your case (or ELCS).

My midwife also carried all the safety equipment but failed to use it in a timely fashion. In hospital I believe my situation would have ended in c-section if the issues were picked up in time (not sure they would have been), and I'd have bled anyway. I don't think I would have bled as badly in hospital as I do believe they'd have given me medication much sooner (like my midwife should have done, which she acknowledged). They do also have stronger medications in the hospital, which I did receive on arrival. However, I am still here and not actually sorry I delivered that baby at home, though with foreknowledge I would have chosen the hospital because that would have been the better more sensible place to be in that instance.

I'm a fierce supporter of home birth but don't believe stories like mine should be rug swept because they aren't pretty. Three of them were textbook home births.

Not sure if this thread is really giving op what she needs.

I think as you're so close to hospital, home birth is not too bad an option. Personally I'd say midwife led unit is much better happy medium as you're near the machines and theatre etc if you need them. Having been in an ambulance during labour to move from freestanding mlu unit to big hospital delivery suite, I don't recommend that. Goodbye breathing exercises, hello being strapped on your back on a gurney while contracting.

I'd also recognise you have limited control over what happens op - don't build yourself up then get disappointed or feel like you've failed if you need induction, c section, instrumental delivery etc.

Labour is really intense and you might opt for home birth but decide you'd rather go into hospital for more pain relief. First birth I had, I was all built up for it to be like period pain and breathing through it but the contractions were kind of non stop and I freaked out.

Please don't think I don't believe you - I absolutely do and I'm sorry it happened

Thank you. I've felt quite wounded by some of the attitudes to my experience from home birth supporters. I think it's important to acknowledge these things can and do happen, even while being positive about home birth as an option.

I hope the OP is not traumatised by this thread. Given that she stated she has hospital anxiety, it's pretty irresponsible to have let this degrade into a classic homebirth vs hospital slanging match.

OP here. Wow! Firstly, thank you so much to everyone that’s taken the time out of their day to respond to my post - appreciate it a lot.

For those of you who have had positive birth experiences in whichever setting, I’m so pleased for you. For those with difficult births, I am glad that you’re here to respond and your babies too. ❤️ ❤️.

I must say, I perhaps rather naively posted this on here and it has taught me a lesson. This sort of question was only really ever going to invite polarised opinions in the same way Google reviews attract 1 and 5 star reviews. I don’t think I will be posting on mumsnet again. I’ve felt very upset to see the way women responding have really started to lay into/attack one another. I understand how personal and sometimes traumatic birth can be, and it is probably coming from a good place to ‘advise’ one another on perceived judgements or evidence, it just can be delivered in a different way.

I shall be unfollowing my own post from here and wish any other first timers reading through this thread emotional/mental peace. Please don’t follow my example, maybe get off mumsnets and do your own research reading academic papers, asking midwives, asking friends and looking within yourselves for what is right for you. I shall be reverted to this form of research only here on out as opposed to mixing it up with any anecdotal evidence.

I would speak to your homebirth midwife team, they will be able to talk you through the service, the risks etc. There is a slight increase risk to babies and mothers in first pregnancies but second and subsequent pregnancies at home are lower risk than hospital births. There are many factors in play so it is useful to have someone experienced in seeing many births in different settings, to talk these through with you. I think that a significant proportion of women who transfer to hospital do so for pain relief. Take a look at the Facebook home birth group and possibly the place of birth study (Sara Wickham might have written about this... possibly in her what is right for me book). There is no guarantee that all of the hospital birth scenarios described on this thread would have happened had the birth been planned at home. There is a film being screened that could be of interest.. https://vimeo.com/900960730. showing in Trowbridge and Bath towards the end of March.

https://www.nct.org.uk/labour-birth/deciding-where-give-birth/giving-birth-home/home-births-are-they-safe

I have attended 2 home births as a doula and over 20 hospital births (a tiny number compared to midwives!). The experiences are almost incomparable.