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

https://www.facebook.com/share/1HzuU89LEZ/

That makes it a bit different, if the pain wasn't just recovery from a rushed c section done when you've already laboured and are knackered, but the spinal. I imagine getting the spinal in when contracting and under time pressure makes it far harder though.

The scholiosis night be something to discuss though, but it might be if it is known about, it won't hurt as much . I believe they can examine your spine, perhaps do an ultrasound if it before hand so they can better give the needle in. Or maybe give extra of the numbing injections first, as you shouldn't really feel the big needle - only the little ones along the area.

A planned section should, and usually is pretty pain free though, even if the recovery isn't. Even if it's half an hour of pain, then at least there's zero labour 🤷.

Have you had a debrief re the second birth? Reading between the lines a bit I wonder if there may have been a bit more to it than you remember/understand about it. Re. the anaesthetic side of things you could ask for anaesthetic clinic appointment to plan for this time - some women really do have surprise scolioses but sometimes it’s a function of the amount of pain & just that it’s hard to sit in a good position. A failed epidural doesn’t necessarily mean it’d happen again, but does increase the chance above baseline (baseline quote is that about 1:10 epidurals is a bit naff). A spinal for an elective is often easier than in an emergency, but no two emergencies are ever the same so a second go in an emergency might be easier. However, if they managed to get the spinal in/get the epidural working I. The first 2 it’d probably be ok a 3rd time. For a labour ward delivery it might be worth asking about remifentanil for pain relief if you didn’t want another epidural (they may say it’s not a great idea with more info about your history, but it’s worth asking the question if you do end up choosing a LW delivery again). Couple of other thoughts in no particular order… Monitoring in labour during attempted vbac is important because occasionally the baby rather than the mother gives the first clues that there’s a scar problem. If the blood loss wasn’t bad last time even though they were worried enough to not delay cord clamping then they probably did a good job of keeping you safe (it’s not just the total volume of bleeding that matters but the rate of bleeding….if it looks like your hosing even for a minute or two that has to be treated like an emergency). It may be worth going through the whole thing with someone at a debrief to help understand where problems arose/what could happen again/what might be done to prevent problems this time round so you’re making a well informed choice.

Yes - Facebook blog IS in fact the most reliable source of medical information. Not the UK medical guidelines - or similar governing bodies in other developed countries....

The assumption that medial professionals who specialise on childbirth are intent on doing unnecessary interventions - while the woman who is giving birth (for the 1st or 2nd time in her life) knows better is mindboggling to me.

I had an IM homebirth with my third after two awful hospital births. I regret not having all three of them at home, but my first husband was a control freak.
One of the best days of my life and certainly the most empowering.

I considered a home birth with my second after a very difficult first birth. I ended up going to a midwife led unit (with birthing pools) at my local hospital. And I’m ETERNALLY glad I did as I had a severe and sudden placental abruption and needed a category 1 c section under general anaesthetic and a lot of medications to stop haemorrhaging and blood transfusions etc. We both would have died if we’d not been in surgery literally in under 5 minutes. The point of the midwife realising what was going on to by baby’s birth was under 5 mins.

I had none of the risk factors for placental abruption.

I didn’t live that far from the hospital, but we’d both still be dead, even timid an ambulance had been fairly quick (which is not guaranteed). My baby is now a healthy, bright 7 year old.

I know a lady locally who had a similar emergency and action wasn’t taken quickly enough and her baby died full term.

I really wouldn’t have a home birth in your shoes. It’s just not worth the risk.

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 would say it’s complete and utter insanity.

@Ezra123 I'm pretty sure the second birth was vaginal.
Cadcade of interventions probably a factor in both, often avoided with a home birth.

@Sashya Are you suggesting all consultants will say a home birth is unsafe under any circumstance?! I think not.

Thank you.
This is absolutely the case. I never had any actual complications, baby was never in distress, I was never at risk. I just wasn't fast enough. Every bad thing that happened was actively done by somebody to me. All my pregnancies have been low risk, just long. My labours uneventful, just slow.

I don't believe I am unable to give birth. I believe their need to stick to a set timeline has put me and my babies at risk.

I think we will try for a homebirth but go straight to a c section if any interventions are required. And DH will just have to stay home with the kids in that case.

@Mumtotornadoes Have you considered home birth with an IM? I can thoroughly recommend it. So very different to anything I've ever experienced with the NHS. I really felt listened to. The birth took ages and that was absolutely fine; there was no rush. I didn't need to labour quickly in order to leave the room as the ward was busy (unecessary cascade of interventions as a result).

I've had a home birth after a CS

I had to be incredibly stubborn to make it happen.The consultants were not happy. The midwvies were more tolerant, but even there I got very mixed opinions. My CS was due to a breech baby and I had had an uncomplicated vaginal delivery before the CS, so my only real risk factor was the previous CS.

It all worked out perfectly for me - but that's anecdote not data. I do understand a lot of what you're saying. In a different era my breech could have been delivered vaginally, but I was almost forced into the CS becuae they kept telling me they didn't have anyone experienced or comfortable with breech delivery (even in the hospital). I was so angry for a very long time. I'd gone into labour, my body knew what I was doing, there were no signs of distress.

Even with all that, I'm not sure what choice I'd make in your circumstances, depsite being a home birth advocate.

OP Homebirth is a polarising topic on here.

I think yes, Homebirth could be wonderful for you but you need a plan that gets the children out of the house, especially if you have worries that things might not be completely easy going.

When I had a home birth with a 2 yo in the house he didn’t want his grandma, he only wanted me or his dad, he knew something was up and it was really bloody annoying. In this end his grandma drove him round in the car for hours just to get him out of the house so me and DH could focus on the birth. I gave birth within about 30 minutes of him leaving.

I’m pregnant again now and hoping for my third Homebirth. Both of the current children are going to be sent out of the house. I need to be able to focus on the labour and the birth and not have to worry about them.

Let them have a sleep over or 2 with your mum asap. You have some time.

"My name is Kirsten Small. I am a retired specialist obstetrician and gynaecologist, and I work as an educator, writer, and researcher."

The lady I posted is one of the leading OBGYNs in fetal monitoring. She trains professionals in fetal monitoring. She just shares information in a way many women can access it because she is a feminist.

Based on what statistics? Can you give us some numbers so we can see how you perceive risk?

I personally don’t like the idea of home birth, especially if you’ve needed intervention previously.

I don’t really understand why the Doppler is considered an issue for you. I had it constantly on with both of mine so they could monitor the heart rate. Why is that a problem? To me, that seems like something that should help.

Also, with the epidural, of course they refused if you wanted to move around.

I understand that you want a home birth, but if you choose to go to the hospital, you have to follow their procedures and rules rather than expect it to be exactly how you would want it at home. I know a lot of people have had bad experiences in hospitals, but for me, being surrounded by professionals provides a lot of reassurance.

This was what I did - aim for Homebirth but if anything changed, straight to section. I would not consider the labour ward, MLU, induction or anything at all. Simply Homebirth or c-section.

similar to you, I had a first birth with unnecessary intervention after unnecessary intervention… it was relentless and broke me.

my homebirth was wonderful.

This was what I did - aim for Homebirth but if anything changed, straight to section. I would not consider the labour ward, MLU, induction or anything at all. Simply Homebirth or c-section.

similar to you, I had a first birth with unnecessary intervention after unnecessary intervention… it was relentless and broke me.

my homebirth was wonderful.

In your shoes I’d probably want a homebirth too. It’s not recommended because of the previous CS, but you’ve also had a vaginal birth since then, so you will probably have a straightforward time of it.

What sort of statistics are you looking for exactly ?

Im not sure there will be any statistics in the public domain about my own personal perception of risk.

Could you just look the stats you want up yourself ?

I do know the stats of uterine rupture after VBAC, they are very low in my eyes. That is why I wanted you to quote the stats and then justify how they could be seen as high.

This seems like a really sensible plan. I had a home birth with my second child after a very difficult first birth with the classic cascade of interventions. My home birth baby is now in her late teens and I still remember her birth with joy and wonder. It was fast (three hours) and easy. She was in a complex presentation (hand up by her ear with elbow pushed up too) and I think if I'd been in hospital it may have been a C-section. I think that it was a quick and straightforward birth because I was relaxed and had a midwife one to one.
Wishing you a happy birthday whatever you decide OP.

I had no issues with the Doppler. I had an issue with every 15 minutes being told to get out the pool and lay on my back because that was the only position she knew how to do it. And I had an issue that they brought a Doppler that didn't have any batteries so DH had to go fishing through draws looking for some for them

@Mumtotornadoes My IM checked in with a doppler about every hour to half hour and I stayed in the water as she did so (specialist doppler).
For all my pre-labour checks she used a pinnard as it's far more gentle on baby (yes, babies can absolutely hear a doppler even if muffled!)
Apart from that she was pretty much hands-off; I absolutely did not want unecessary internal checks and the like.

I think the plan c thing being easy is a myth. It’s second c’s which are easy.

I went for two Cs, both planned. First really fucking hurt and long recovery. Second a doddle.