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

Thank you all for your thoughts, some very good points and suggestions.

I think we will try for a homebirth and go straight to c section if there's a problem. Maybe counter intuitive but I feel like midwives may be less rash to suggest transfer if they know it would be straight to a section rather than just a transfer to continue labour.

I think my last midwives just didn't want to be there. They were complaining about how how they'd had to drive as soon as they got to us and were just so impatient. It was 11pm when they got to us and I was in bed trying to get some rest but they said I had to get up and get walking about to speed things up. So 12 hours later when I'd had no sleep and had been made to break out of "the zone" every 15 minutes to lay on my back with a back to back labour which was torture. And they said I hadn't progressed enough and had to transfer I didn't really have any fight left in me. First thing they suggested when I got to hospital was to lie down and try to get some sleep.

I've spoken to a friend who has kids the same age as mine who has incredibly generously said she will have the kids any time for us. I won't take the piss because I know she has her own responsibilities but I trust her to manage with them and keep them safe without having a breakdown at their chaos. And I know that she would have the initiative to look through my cupboards if she needs something or nip to the shop rather than disturbing us. So I'm massively thankful for that. Shes capable of taking them out of they get restless and they'll have the entertainment of their friends.

We aren't far from the hospital at all, 7 minutes at my driving pace in normal daytime traffic and we're not in a poorly serviced area so I know there is an increased risk if there is a major emergency but the chances of those happening are very rare. And I don't have any risk factors bar a section 5 years ago that I've since had a vaginal. I've even had scans on my scar because of the issues I had and it's apparently very well done. I had a nerve problem where my nerves essentially didn't stop signalling the cut, alot of people have a dead 2 inches around their scar they can't feel anything because of the nerve damage, mine instead just kept screaming. I actually had a similar thing on a small surgery I had on my hand which caused years of pain too. I'm neaurodivergent and have hypersensitivity aswell as imune issues and hyper mobility so I think it's probably a me problem and is likely to be repeated if I had another section. But if something is wrong I would still choose that over an induction.

I feel better having a plan in place and not being at someone else's mercy.

That’s crazy! They can use a Doppler on you in the pool, they also just used it in whatever position I was in, I was never asked to change positions for it.

I’m sorry OP 😔

That's what I thought would happen. They didn't bring the waterproof one despite being told we were having a pool birth. I mean they didn't even bring batteries so that's not surprising.
It was horrible. So traumatic. I honestly get a bit panicky and upset just writing about it because I'd been so firm about my choices and boundaries right up until the labour and then they just trampled all over me and I didn't even try to stand up for myself. And it was DHs first time so he wasn't confident either and was scared and didnt know what to do for the best.

Every time they made me move to get on my back it would trigger the most painful contractions, every single time. I was so angry at them but I just had no strength left and was just broken.

I could have birthed him alone at home and they made it such a trauma. I am so angry about it.

I wish we could have an IM but we just don't have that kind of money for, essentially, my comfort for one day.

@Mumtotornadoes Ours was cheaper than we thought - all of the care (height of Covid) was £4k all in. I used savings (know I am fortunate enough to have) and we went without holidays for a good number of years after that.
Originally we'd booked NHS but they cancelled all homebirths last minute due to the pandemic.
I would have done anything to avoid another traumatic hospital birth.
If you want "hands off" as much as possible you have every right to that.
I went for a lovely nap just before the pushing stage - it was total bliss!!

There's a brilliant fb group called homebirth UK, so many women who have been through it with the best advice.
Ive Just had my second HB, 4th baby.

Check home births are definitely available in your area (a few have been stopped due to staffing) you usually need to tell them
before 37 weeks you want that so they can come and do a home environment risk assessment. Usually home births are 2:1 care and the midwives tend to be very experienced. Alternatively you could book private midwife’s (usually about £8k) and get a doula aswell but it’s a bit last minute xx good luck ❤️❤️❤️

I kinda wish they’d call it a birthing preference rather than a plan because sometimes when things go off the rails it can feel a bit like failure. Whatever plan you make I would suggest you don’t hold
onto it too tight, as long as you and baby both make it through in one piece it is already a success. Trying to put pressure on yourself by telling yourself this is your last chance to ‘get it right’, is not going to help you if your plan has to change because baby or circumstances aren’t playing ball.

One of my babies had a NICU and then ICU stay, it was all diagnosed during pregnancy on the 20 week scan and I’m not suggesting that you’ll have similar. The only reason I mention it is because for the first while I grieved the ‘normal’ experience I was hoping for which is totally reasonable. On the other hand being with others who had really really ill babies also put it all into perspective that however traumatic it all was, those of us who got to take our babies home really have won the jackpot.

I do wish you all the best for your delivery and hope both you and the baby stay safe and well.

Where do you live?? Vaginal births and home births after c section can absolutely done well with midwives in the UK, unless the last c section was in the last two years there’s no need to be classed as high risk unless complexities she’s already aware of.

My local midwife team are very supportive of a home birth. But so we're my last local team but the midwives I got sent were from somewhere else and one was I'm sure a student or very newly qualified and neither were experienced in home birth and one particularly not supportive.

So I need to really talk to them about making sure the midwives I get are local, I'm sure she said about making sure she would be on call as they're aware I've had bad experiences.

I lived in a different area that had really weird boundaries so technically fell under the care of of people on the other side of a river which really pissed alot of my "care" off.

The only online private midwives that serve our area are 8k just for the birth. That's like double our bathroom budget.

Ah right, well unfortunately I don’t take orders from randoms on the internet. Sorry!

Ok so we can be sure your opinions are baseless.

Having a home birth is always at someone’s mercy! You often cannot choose who is on duty and who you get. You cannot expect an ambulance or an immediate Caesarian. You simply cannot plan much at all. You can ask and hope there are not too many babies being born in the hospital unit so they can spare a midwife for you. Why not ask for the Caesarian or an epidural and bs more relaxed about it all? If you are too rigid in your demands you will always be disappointed.

Have not read the whole thread and you may have already come to a decision but asking for advice for this could just confuse you even more. Without magic powers and a crystal ball it's all just speculation. I feel in order for a homebirth to be successful you need to have absolute confidence in your body and a good strong birth partner who will advocate for you if you are unable to speak for yourself (highly likely at the height of labour). I wish you well and hope you a positive birth experience whatever you decide.

HBAC (home birth after C section) right here! Cascade of intervention ending in EMCS with my first. Ended up making me feel sooo unsafe and terrified of (unnecessary) intervention the idea of birthing second time round in hospital. My home birth was honestly the most incredible experience of my life! I would do it again in a heartbeat!!! I never knew birth could feel this way and I feel so grateful I got to experience it. Also- risk of uterine rupture with VBAC is 0.5%. That’s a 99.5% chance it won’t happen. You have more chance of being struck by lightning twice, to put it into perspective.

Erm, no. You can’t.

What you can be sure of is that I’m not going to be ordered about on Mumsnet into providing mystery statistics, that you claim to have anyway, so don’t actually need from me.

If you wish to extrapolate to the far end of a fart from that then please yourself ☺️🙏

1 in 200 is a much, much higher probability than someone’s chances of being hit by lightning twice! So that’s misleading.

Op it sounds like you have made up your mind. Just be aware there will be a selection bias on this thread of people who have been lucky with home birth. And luck is a huge factor.

As I have mentioned, no amount of planning, midwife attentiveness or even proximity to the hospital would have saved me or my baby had I opted for a home birth.

I do hope you will research the real risks if something were to go suddenly and seriously wrong, and be aware that the Facebook group mentioned above will be avidly one sided in support of home births at any cost. As I have said, I had no risk factors whatsoever when it happened to me and my friend was not so lucky (delay in getting into theatre and baby stillborn at 41 weeks, she also had no risk factors). I’m not saying this to frighten you, I just think people need to be aware and not be too starry eyed about home birthing and the risks it may involve.

before anyone starts, I am not saying that hospital births are without risk

@Ezra123 The fact of the matter is that for low-risk, subsequent pregnancies, home birth is just as safe as in hospital.
And with very obvious advantages. For a start, 1-1 care at at times, increasing to 2-1 in established labour. That of course doesn't happen in NHS hospitals.
"For women and birthing parents who have given birth vaginally before, it is as safe for the baby to be born at home as it is in hospital." (NCT)

And as I have explained there are also disadvantages

@Ezra123 Of course. But the fact remains that for women who have given birth vaginally before (as is the case for the OP), it is as safe for the baby to be born at home as it is in hospital.
I had two hospital births and one home birth - the two hospital births were nowhere near as safe due to insufficient staffing. Incorrect procedure followed by a student midwife meant that my second son has some degree of permanent hearing loss.

Is there not a birthing centre attached to a hospital near you, midwife led and peaceful. They will need to monitor though, home or in hospital, for the sake of your health and your unborn child checking everything is ok is essential including the Doppler

@hahabahbag No - a doppler isn't essential and checks can be declined. VEs are definitely not and increase risk of infection.

But the fact remains that for women who have given birth vaginally before (as is the case for the OP), it is as safe for the baby to be born at home as it is in hospital

not in my case

@Ezra123 You cannot say, with any certainty, that your baby wouldn't have made it had you not been in hospital. That isn't possible as there will always be a specific and unique set of factors.

There's a big difference between it statistically making no difference, on a population level, and on an individual level, a particular mother and child who would have died.

Given your natural birth and the blood lost, plus the needing to let people know ahead of time a planned section might be the best option. Ive had 2 emergencies and a planned a d the recovery from the planned section was so much easier. The planned section it self seemed more at ease as well. Planning on having a 4th baby so that will probably be planned as well