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 had a home birth with my second and it was fantastic; I am very pro. HOWEVER, given your medical and birth history, the odds against you birthing naturally and safely this time are pretty low. I think it would be irresponsible to try for a homebirth.

I am actually surprised your medical team are entertaining the idea to be honest and curious to know if they''d be allowed to refuse to attend if they felt attempting a homebirth would put you and baby at risk. It puts them in a very difficult position in any case. Homebirths are usually planned for people who are likely to have a straightforward labour and sadly, the odds are stacked against you.

Also re your two year old - you need to make a sensible plan which you're happy with as I think worrying about him could affect your ability to birth effectively.

"HOWEVER, given your medical and birth history, the odds against you birthing naturally and safely this time are pretty low."

She's had one caesarean and one assisted birth after that. What statistics do you have that show women like her are unlikely to have further vaginal births?

"I am actually surprised your medical team are entertaining the idea to be honest and curious to know if they''d be allowed to refuse to attend if they felt attempting a homebirth would put you and baby at risk"

No that is illegal in this country.

If a home birth is outside of guidelines the medical team write up a plan that is agreed and signed off and the homebirth is then attended.

Tbh given the OP has already had a VBAC this vaginal birth is more likely to be like a second vaginal birth with a much lower chance of intervention than her first vaginal brith. That probably why her medical team consider it low risk.

The chance of being struck by lightening in a whole lifetime is about 1:15000. The chance of a uterine rupture after a c-section is about 1:200. Absolutely fine if that feels like an acceptable risk, but it is important to understand that in the time it takes an ambulance to arrive to a home it might be too late to prevent catastrophe.

1:200 is not a ‘rare’ risk - it’s more of an ‘uncommon’ risk. Those of us who work on labour wards do see them…(my last was last night - good outcome though because they were already in hospital when it started).

Yes apologies I’m not sure why I was told about comparing the risk of rupture to lightening risk as I can see the stats are quite different! Of the ruptures that do occur in the 0.5%, a percentage of those are life threatening. So if you do have a rupture it doesn’t automatically mean catastrophic. (I can’t remember the figures on that).
For me, due to my first birth and the cascade of intervention resulting in a traumatic birth, the idea of birthing in hospital became terrifying to me. I was willing to accept the 1 in 200 risk. 99.5% chance it WON’T happen! That’s pretty good odds IMO. Also worth noting the research on rupture in VBACs is that a lot of the women were augmented.

@ Notellinganyone Totally agree with you. Would choose IMs again in a heartbeat. Yes we had to make financial sacrifices e.g. no holidays for a good few years, but it was absolutely worth it. The experience was so far removed from my two NHS births, and I felt listened to and ultimately very empowered. Life changer.
My husband was also very present for the birth of his first and last baby in a way that simply wouldn't have been possible in hospital.
In fact, during Covid the NHS Trust was insisting on an unecessary VE (with all of the risks that has) before husbands/partners could be allowed to be there. Not a chance.
My husband had a vasectomy soon after the birth of our daughter so we won't be having any more, but if we'd have been lucky enough to I would have been straight on the phone booking in the same IMs!

The chance of UR after a successful VB is about half that of a UR in the subsequent pregnancy following C/s.

So if the chance was 1/200 for her 2nd pregnancy, it is now about 1/400.

@FunPartyIdeas - I had the same midwife for DCs 2 and 3 and that was particularly great !