Home birth after difficult previous births, or plan a caesarean instead?

[Mumtotornadoes]

I am 34 weeks with my third baby. I noticed at a random growth scan I had yesterday while seeing the consultant that my PI is high and baby's size is small. Neither outside of the "norm" but not far off. They didn't say anything, they're not concerned but have booked another growth scan for in 4 weeks.

I just noticed and it got me thinking about having a plan for if something goes wrong. I have been fully expecting baby to be very late as both my others were and labour to be very long. I want a home birth and essentially to be left the hell alone. But I think I'm being a bit naive and overly positive.

My first was an induction and emcs. It was fucking hell. I will not have another induction. The recovery from the c section was incredibly hard, like over a year of pain, unable to wear most clothes level hard.

Second was a natural labour but the midwives were absolutely hell. Constant Doppler despite no issues and vaginal checks despite the fact I'd said none all of which they could only do on my back so I'd get comfortable and in the zone and they'd make me move to my back. Baby was back to back so it was so hard. Failed epidural that they denied even as I was walking myself to the toilet and squatting to push. They told me when to push, I pushed for an hour then said "oh you weren't actually fully dilated , there was a lip but you are now, but you've been pushing an hour so it's a c section. While they prepped I pushed and got him nearly out which DH had to force them to even check. But consultant still wanted to do a suction even though he hadn't been stuck or delayed. I said no, she said yes and cut me. Wouldn't let me delay cord clamping because I was bleeding so much but nobody was concerned about the blood loss and it's not recorded on my notes as being much at all. Then turned to her student and said "well that's good, now you've seen a ventous delivery "

SO I don't have good experiences.

I want a home birth. With supportive competent midwives and I want to birth my own child without panic.

But 1. I'm scared if that if we try for that then it goes wrong we'll end up with another hellish experience.
And 2. We have very limited and unreliable childcare options. Our eldest had a different dad who happened to have him that weekend but we also lived near alot of family so had alot of options for childcare with number 2.

Neither of my kids have ever spent the night with anyone but me or their dad. My youngest has never been in anyone else's care ever, not a single hour of babysitting for an anniversary dinner, birthday drinks, nothing. He's 2 in a few weeks.

We have a few not super close friends that I'm sure would help for a few hours if arranged in advanced, but not be on calls to drop everything and spend two days at your house level friendships but they are lovely people and would come in and emergency. And my mum who thinks she's super helpful but just adds so much work. The plan was for her to come and look after the kids while I'm in labour at home but it is constantly asking for stuff, asking how to work stuff, she comes to ours to see the kids sometimes and it is just like having another kid. They're up later at night then up earlier in the morning and need more from us to settle. It's just like having their friends over for a playdate. I worry that she'll just make it more stressful then the kids will be put in a situation where I'm suddenly leaving for longer and it'll be so much harder on them and me. And she gets stressed with them easily.

I could schedule a c section and have either a friend or my mum take him out for the day, on one of the weekends eldest is at his dad's. He would be best if he could go somewhere. Or he might handle it better an a weekend his big brother IS here so he has someone he knows well with him. Then DH can go get him and have him the night then they can come to hospital in the morning to get me. I would hate being alone at the hospital. And I am scared of the recovery from a c section again. But I think maybe a scheduled rather than emergency and being with a very supportive loving H rather than the abusive POS I was with the first time would change that?

I WANT a peaceful home birth. But it's such a gamble, is it worth it?

Oh this is likely my last birth. So last chance to get it right but also c section won't impact future births

I wouldn't say it's a gamble to be honest. You're much more likely to end up with an intervention in hospital which seems like more of a gamble to me. In a standard low risk pregnancy it's just as safe, if not safer to plan a home birth especially for second/third time mothers.

Studies also show that planned home births which end in a transfer to hospital have a more positive experience in hospital than if you were to plan the whole thing at hospital, if that makes sense?!

I would have a listen to some of the episodes of Midwives Cauldron or Better Birth podcasts. Also read 'why home birth matters' which is a very quick read but may alleviate some of your fears. E.g. planning a home birth doesn't mean you'll stay at home no matter what, risking the health of you or your baby. Midwives are trained to spot things early on and will recommend transfer before anything turns into an 'emergency'. For DD1 I transferred in after being in active labour for for over 12 hours and only going from 3-6cm in that time. It wasn't an emergency but I was absolutely exhausted and needed an epidural to give me some rest. Had I been in hospital the cascade of intervention would have started much sooner and I suspect I would have ended up with forceps or similar.

I am SO pro home birth. I have read everything. I've wanted a home birth for every birth. And been pressured and given in each time. For DS1 it was because he was overdue and measuring big. For DS2 it was because he was overdue, I was progressing slowly and I'd had a c section.

This is the most supportive any medical professional has been, it is probably my best chance at a home birth. And I really thing a c section will massively impact my mental health.

But if I try a homebirth and we have a repeat of last time it will really impact our kids and we don't have reliable enough, competent enough childcare options to be there for them imo.

Recovery from a planned C section is generally far smoother than an emergency one. You haven't spent hours in labour and become exhausted for a start.

I had one very traumatic, shoulder dystocia birth (and it was lucky we were in hospital or it's uncertain whether DS would have survived), followed by two planned CS. Both of which were great experiences and recovery was fine, but I did have to be sensible about not overdoing things, (e.g not lifting anything heavier than the baby for the full six weeks), and accepting offers of help. Also good being able to arrange child care in advance as you mentioned!

I wouldn't even contemplate a home birth personally, having been in an emergency situation, but the person I know who had one went into it knowing that they were a 5 minute drive to the hospital if required.

Good luck, whichever you decide.

If this was 'just' about this baby then I would go home delivery with competent support who you are comfortable.

However, the older kids add complexity to this situation, especially with the 2yr.

I think the worry about what to do with the other kids could impact your decision if the home birth isn't going quite to plan.
Like an earlier poster said, she transferred to hospital before it became an emergency.
If you were in the same position, would the lack of childcare and the (understandable) reluctance to go to hospital on your own impact on your decision on when to transfer, if needed?

@Mumtotornadoes - I understand your desire for home birth, and sorry you had bad experiences with your previous deliveries.
HOWEVER - you had 2 C-sections. Setting aside your previous experience here - you need to think rationally, and you must make the decision not on emotions, but on medical grounds of safety for you and the baby.

And medically - you must know that natural birth after 2 C-sections is risky.

Not impossible, just much more risky than regular natural birth. And it must be carried our under medical supervision - with an obstetrician, NOT a midwife . Why would you want to subject yourself to a risk of rupture and bleeding, that are impossible to deal with in a house???? Any complications would affect not just you alone, but your existing children and new baby.

If you had two regular uneventful births - home birth would not be an issue. But with 2 deliveries that did not go smoothly and ended up with C-sections - planning a home delivery is irresponsible, in my opinion .

I understand that you are emotional and scarred by how it all went before. I'd try to talk to my doctor and plan for scenarios. And just remember - in the end what matters is that the baby comes our healthy, and that you are OK. Even if it doesn't quite go the way you wanted it to go - hospital vs home, for eg - main thing that you and baby are OK.
Good luck

I'm pro home birth in the right circumstances and had one myself.

In your shoes I would 100% go for a C section- far too many risks and complexities given your history. A planned section is peaceful and you'll be able to make plans for your other children so that will be off your mind.

I’m going to be honest, I’m TERRIBLE at giving birth. I can get pregnant easily, have generally smooth pregnancies, and could probably single-handedly provide milk for a small village but my body did not get the memo about how to give birth.
I’m not anti home birth at all but it’s not really meant for someone like me who just has complex deliveries with all manner of things going wrong. I think when you are weighing it up, just be really brutally honest with yourself around whether the previous complications were all simply the fault of the midwives and hospital, or whether you might just not be good at giving birth, regardless of where you are…. In which case, home won’t be the best place.

I get it, I really wanted to be good at giving birth but I just want. I had a 5hr surgery after one of my births to try control a PPH without resorting to hysterectomy, but my birth notes still describe my bloodloss as minimal, so the lack of notes about your bleeding are not necessarily evidence it was all fine….

I had 2 inductions, followed by an emergency C section. Falling pregnant with another year later really wasn't planned, and the Doctor wouldn't even let me attempt an induction as it was so soon after my last section (there was 20 months between the kids). As it turned out, it was wise advice because during my planned section, they discovered I'd got masses of surgical adhesions from the 1st section and it took some time for them to cut through all this to deliver the baby. I was told after not to get pregnant again because the risks would be too high.

You also have to consider that calling and getting an ambulance out to you these days is a high risk strategy. Those minutes between getting you from home into a theatre really could be life or death for you and your baby.

I’ve had 2 home births and am pro home birth (one with shoulder dystocia) but, unless medical opinion has massively changed, I wouldn’t attempt it after a c-section.

Childbirth is risky and the most important thing is for you both to survive it.

fwiw, my first child was 16 days late, my second was 10 days late but my third was the day after his due date! He took us all a bit by surprise

There's no way, following 2 deliveries that required intervention I'd even be considering a home birth. I understand that the 2nd birth intervention may not have been necessary from your standpoint, but you ultimately did have interventions and haven't given birth without them.

Schedule the section. Honestly its so calm for a scheduled section than a emergency one. Literally couldn't be more different.

I think some women are better at giving birth than others. I turned to not be much good at it (perfectly fine at the other parts though) and ended up with 2 EMCS. My oldest was back to back and a face presentation, it turned out once they got in there she was absolutely stuck and a lot of tugging needed to get her out. They'd tried to move things along with a drip but 36 hours after arriving at the maternity unit there wasn't any significant progress and she was showing signs of being in distress. Once out, she was too exhausted to cry with a bruised face and black eye, poor little mite. I was shattered too. Without the C section I dread to think what could have happened. With my second DD they didn't let it go on for so long before intervening. Your history seems similar. I think you'd be a fool to do anything other than book an ELCS with this one. A home birth for your 3rd baby with your history would be crazy. The ELCS would also neatly sort out your finding childcare cover as it's a set time and day. A VBAC should only be attempted in a medical setting in case it goes horribly wrong and major intervention is needed, I think the risk to you and your unborn child is just too much to consider a home birth. I know this baby has a different father to your others and that might make a difference, but you've got the 2 previous c sections to factor in and I just think it's too much of a risk. The end goal is mother and baby both alive and well, not the birth experience itself and I think it's easy to lose sight of that, well I know I did for many years and kept beating myself up for being a failure because I couldn't manage to give birth naturally.

I had a home birth with my third, but I was considered to be low risk due to my history of two previous straightforward vaginal births and no risk markers during pregnancy. I wouldn't have even considered it otherwise. It was actually my midwife who suggested it.

OP, you've had two difficult births resulting in c-sections. In your case I really, really wouldn't try for the home birth. Your safety and that of the baby is what's important. How the baby comes into the world doesn't ultimately matter a bit. I think you should take the advice of the medical professionals looking after you and go for the safest, least risky option for your particular situation.

I think there's a little confusion about my second birth, it was a suction, a ventous. Not a section. But also not without intervention. But the consultant does think a natural birth is low risk.

But yes both ended in interventions. ALOT of interventions. My issue is that I don't think any of it was warranted. There was nothing wrong with me or my babies. At no point was anyone at any risk. And I'm so angry about that, I feel so let down that these people ignored me and grabbed at me and cut me without my consent and with out good reason. Just because their estimate of when I should give birth and their idea of how long it should take to give birth.

Both children had to have constant growth scans. The first because he was "too big" the second because he was "too small" there was 3oz between them and neither were "abnormal" weights. But they've all spent my whole pregnancies and labours telling me I'm doing it wrong and I just want to do it how I KNOW I can.

But if it goes the wrong way then it impacts my current kids and causes them distress. And yes, as a pp asked I absolutely would be reluctant to go to hospital if midwives suggested it.

But I am also really concerned about how a c section would impact my mental health. The idea that I will never properly birth my baby really hurts me, and being in that pain again would be devastating.

To add in I'm due in court 5 weeks after my due date against my highly abusive ex over my eldest DS.

Try to let go of the fixation on 'properly birthing' your child. Women and babies frequently died in childbirth in years gone by, and there are reasons for medical professionals to want to intervene that you not agree with, but they are trained and know exactly what the consequences could be if they don't act.

Healthy baby and mother with a safe delivery is all that matters. There is no 'right ' way to achieve this and to feel like you are failing and it affecting your mental health is very sad. You have no guarantee that you will ever achieve this perfect birth, so why not plan an ELCS and control the factors around that to make it a good experience? It really is a calm and peaceful experience. Stop putting pressure on yourself and just enjoy your babies, regardless of how they get here. There is far more to being a mother than the birth process and it will soon be a distant memory.

I think there is a third way here - to plan for a home birth, but if baby is late or you need to be induced to go to section instead. Also any issues with labour, have a low threshold for section.

I had both of mine by planned section, and they were pretty much painless. Less pain than I get for my averageish period. Pretty much back to normal within a week. So my default would be to shout out the benefits of c sections.

But experiences and recoveries do vary, and even though yours was an emergency, that was a very long recovery.

I’d definitely try to challenge your ideals around giving birth ‘properly’. You might just not be a person who does birth particularly well. I found it hard to accept, I have no idea WHY my body is so uncooperative, it just is. I’d also challenge the idea that you can do it…. You might be able to, but also, you might just be someone who isn’t great at giving birth. I haven’t found any rhyme or reason to why some women find it so comparatively easy, and it just doesn’t work like it should for others. Some of my friends who I assumed would have an easy time of it due to things like athleticism and all the calm birthing courses in the world have needed interventions, and others had a very easy time of it. It’s not a reflection of who you are as a person, so I’d just focus on trying to find a care provider you are happy with.

I have had 2 CS.

One EMCS and one planned.
Neither births were as bad as what you have gone through

Even after my emergency CS (Back to back and found out I had a tilted pelvis) I was fine and driving (automatic car) after 2 weeks.

The planned one was a lot easier. Out on the road after 10 days. No pain from scar.
Turned up to hospital, epidural and then CS

Very chilled and laid back. Hosted a Barbecue in the garden 48 hours later.

I think if you are comfortable with a home birth then I would go with what you feel comfortable with. But I have experienced back to back labour just for a short while before the epidural kicked in and I know if I was told that baby was back to back quite close to their due date I would go for the planned CS.
Even though I only experienced 2 contractions in DD’s birth before the epidural started to take the edge off I can say I couldn’t cope with the pain and would be signing for the planned CS

I actually think this might be the way forward. I can't go through a long birth alone if we have to transfer to hospital mid home birth. And we don't have anyone to look after the kids that long.

But we could say that if we have to transfer to hospital it is straight to a section and DH stay home with the kids. It's giving us a chance but still falling back to what we would be choosing as if I did schedule a section I would still be hospital alone while DH went home to the kids. We could see if our childcare is able to do a couple hours just so he can come see baby be born and then go back if things are well.

It's essentially giving it a shot but taking the "easy" route at the first bump.

Uterine rupture can pretty quickly result in dead baby and mum. A home birth after a section is madness.

OP - with respect - birthing a child is NOT about whether your idea of "birth" is fulfilled. I get it that you are hormonal now and things seem to be very important. But try to find whatever rational thinking you may hidden under the emotions.
You don't need to prove to yourself - or anyone - that you can give birth in some particular way. Also - there is NO way for you to know that you can give birth without any interventions. No one can know this.

As to your consultant saying that natural birth is a low risk after a C-section. Yes, it is - however, it does not mean natural birth AT HOME. No consultant in the UK will tell you that it's safe for you to do that, simply because it is against UK medical guidelines:

"According to UK clinical guidelines, a doctor does not need to be physically in the room holding your hand while you push, but the birth must take place in a consultant-led hospital obstetric unit where doctors are immediately available on-site"

You must ask yourself - what makes you so intent on knowingly putting your and your baby's life at risk,

Have a boring planned section. You'll be able to get organised and go into it having slept properly.

I would definitely do planned c section, no way would I risk a home birth after a c section. I had one and recovery was fine.

One thing I want to flag though is most hospitals won't do a planned c section on a weekend. So you will need to find a care plan for your oldest regardless, but at least this gives you the ability to plan as you'll have a set date.

https://birthsmalltalk.com/my-publications/

I'd get some information from this site.

It is pretty awesome meeting your baby having slept, and pain free!

A c section wasn't pain free for me though.
And the anaesthetist at the last one said I have scholiosis. Both times they have massively struggled to get the epidural in. Like half an hour of me screaming while being stabbed in the spine level pain. So I don't want a repeat of that and I don't want a general