Too short-staffed to support a home-birth. WWYD?

[blinder]

Well I'm 36 weeks pregnant, looking forward to a home-birth, and I've bought my lovely pool-in-a-box! But my local midwifery unit says they are unlikely to have enough staff on the day that I go into labour. They say I will probably need to go in to the birthing centre.

I REALLY would prefer not to have to do this for lots of reasons (although it goes without saying that if I needed medical care I would obviously gladly accept it).

So I have a meeting on Tuesday with the head of practice to talk about it.

Should I insist? Beg? Write to my local paper? MP? I don't want to be any trouble but I know a home-birth is best for me and my baby (assuming a normal labour ).

What would you say / do?

But they can employ bank MWs, some of whom are Indy MWs, I believe.

They also have the option of sending out one MW as they used to do not so long ago. I believe one MW is always on call for BBAs anyway in some Trusts. So even now, one midwife attends Home Births in some circs.

I know of at least one Trust who has had to hire IM due to failure of provision for HBs. It was an extra ordinary situation but they were forced to do so by the RCM.

So, if they have to, they can.

True HH - although a hospital birth would bring back some hellish difficult memories for me, which I would prefer not to contend with on the day unless absolutely necessary.

Ah great link Mears - thank you!

I get the feeling the midwives want me to take it further, although they can't recommend it. They look pretty much up to their necks. They need more funding if anything, and they've been having to fight to keep their centre open for years .

Must remember it's not my fault, it's not my fault!

Contacting the LSAMO can help the midwives blinder.

You tell them a HB is your right and that is what you are having.

They will find a midwife for you when they have to - they wouldn't risk the litigation.

It is all about us changing the system by refusing to roll over and comply whenever funds/policy get in the way.

Good luck on a fabulous homebirth

Hi,

Two thought here, what happens now and what happens on the day.

Currently I would follow all the advice given re kicking up a fuss.

However, maybe you want to start (privately) preparing yourself not to get the home birth you want.

If on the day there really is a terrible shortage (based on a combinations of problems now and potential swine flu increases) I can understand that having 1:1 care for homebirths might jeopidise the 1:2 or 1:3 care in hospital. i.e. if everyone wanting a homebirth had one then the hospital may not be able to cope.

Good luck though and I sincerely hope it works out for you (and get letter writing!)

I think you should find out what they mean by "unlikely".

I was initally told that there are only two midwives on duty for home births in my area at any one time. I was warned that if they were with someone when I went into labour I would need to go to the hospital.

When I questioned further, I discovered that there were only two other home births booked in around my due date, one two weeks before and one two weeks after. Obviously there is a possibility that either could clash with my labour (if they were either early or late) but that would be very unlucky and statistically unlikely!

As far as litigation is concerned you wouldn't have a cause of action in negligence if they have already warned you in advance that a home birth may not be possible. Failure to provide a home birth is, sadly, not considered negligence in law and the NHS is unlikely to take such threats seriously.

Hope that the meeting goes well and you are able to negotiate a solution.

Thanks very much for all the replies.

I think that's a good point LG - I need to know exactly how unlikely it is. In your scenario, I would feel much more relaxed about it. I'll be sure to ask that question!

Re litigation - I think ILoveBeingaMummy means that they couldn't legally refuse to attend my birth, which is true as far as I have read.

Although my ideal scenario is that the practice manager of the unit is given the go-ahead from her managers, in advance to fund and support my home birth. This has got to be better than holding them over a barrel on the day.

I was told on the day to go into hospital after I had planned a homebirth. I refused outright, said see you soon, then hung up.

I had a call 5 minutes later saying they were on their way.

I knew someone who faked advanced labour to get a mw to her after being told she couldn't have a hb. So really it depends how bloody minded you are/ how much you really want a hb.

In both our cases we could not have faced going to hospital (unless for medical reasons). Our Mws were very supportive of us btw and were cross we had to go through that kind of stress. But the sad fact is you'll only get a hb if you fight your corner.

Just updating for those who are interested...

The meeting went well today with the practice manager who is a very pro-homebirth midwife.

Without guaranteeing me a homebirth (who can?!), she said that she and her team would 'bust a gut' to make sure I had one, that she hasn't had to refuse a homebirth in five years for staffing reasons (although they may have been 'discouraged' like me) and that, although she would much prefer not to have an emergency situation, if I refused to come in for whatever reason, a midwife would be sent out to me. She offered that information herself, god bless her.

The worst case scenario is that her unit will have 3 simultaneous labouring mums, plus the only other homebirth going into labour on the same day as me. Given that the other homebirther is due 4 weeks before me (ie NOW) that is unlikely in the extreme and pretty much unheard of. She also said that she and her team LOVE homebirths and would look forward to doing it.

Well, you can't say fairer than that.

It looks like I'll be using the pool-in-a-box after all !

Thank you all for your input which was very helpful in the meeting. I pretty much believed I was entitled to a home-birth when I went in, and it was clear I was well informed. This probably helped quite a lot. Many thanks MNers!

Yippeee!

There is a birthing pool for sale on mumsnet!