# homebirths refused due to staffing issues



## milkmachine

have just heard of two families in my area that have been refused their homebirth due to staffing issues in the last few days..... i have a feeling i could be stamping my feet if i do actually call labour ward when im in labour and they insist i go in


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## subaru555

Let them insist away!! :flower:


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## snagglepat

Yey for foot stomping! :) I'm amazed that this is still happening, but I have absolute confidence that they'll miraculously find a midwife for your home birth once you've said your piece. :)

G. x


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## trumpetbum

They can insist all they like. They have had plenty of notice and frankly, there is no shortage of midwives just no funds being released to employ them so while they can rely on women giving in and going into hospital they can get away with retaining the status quo at the expense of patient choice.


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## Tulip

I've heard a lot of this happening on the Yahoo homebirth group. They're legally obliged to send someone to attend you - you have no legal obligation to attend their noisy, brightly-lit, bacteria-ridden production line. It would be a shame to have to have this argument with them on the day, though. Worth sending a letter to the SOM stating that you do not expect to have to assert your rights while in labour?


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## lozzy21

If this happens to me they will be getting told that while not having enough staff is unfortunate its not my problem and will expect so see some one whithin the hour.


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## snagglepat

A friend of mine, when faced with this issue, said 'No problem, I'll just call out an independent midwife and send you the bill'. They found someone soon enough then. :)

Gina.


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## milkmachine

snagglepat said:


> A friend of mine, when faced with this issue, said 'No problem, I'll just call out an independent midwife and send you the bill'. They found someone soon enough then. :)
> 
> Gina.

this is how i got a private midwife with my daughters birth- hospital was so busy they had to call someone.:happydance:


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## milkmachine

its a tricky one, you have to consider the over stretched tired midwives when you do your feet stamping. This is very likely my last baby and i am totally terrified of the hospital. we shall see what happens!


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## KandyKinz

oh no! I'm worried about a similar thing... I live in a rural area with just a small level 1 hospital with two obs and if there is ever a time when both ob's are off call at the same time or their is no anesthetists available the midwives are not allowed by hospital policy to do homebirths... And all women having their first babies are sent two hours away to the next closest hospital... But get this.... mothers like myself who are having their second or subsequent babies are still allowed to stay at the hospital while being attended by the midwives... Just not at home!!!!

Anyways, here the ob on call and anesthesia schedule is available a month in advance so I'll be aware of the no homebirth days... And if I do happen to go into labour on one of those no homebirth days I do plan (probably gonna get alot of ridicule for this) to trick the midwife into coming to my home to check whether I am in labour or not (common practice even if you're planning a hospital birth) and then I'll just refuse to leave.... Here midwives are not allowed by law to abandon a women in labour so once she's here and I'm in labour she's stuck here........ Anyways, the reality of it is there is very little difference at all between me being at home with the midwives and me being in a level one hospital with no obs or anesthesia coverage!

But if it turns out they can't come cause of simultaneous births I guess I'll be SOL :(

Hopefully it'll all work out for you!


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## snagglepat

Wishing you the best of luck with it all Milkmachine. We're about to go away until next weekend so I'll be offline until then. If baby arrives before then I hope that you do manage to get a refreshed, happy midwife and the beautiful home birth you're planning. Sending you tons of positive birthing vibes from here.

Gina. x


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## trumpetbum

milkmachine said:


> its a tricky one, you have to consider the over stretched tired midwives when you do your feet stamping. This is very likely my last baby and i am totally terrified of the hospital. we shall see what happens!

That's true, but I always feel that the over stretched tired midwives benefit more from the powers that be having their hand forced into funding sufficient staffing.


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## lozzy21

Im sure though if they have to pull some one off the ward (allthough i thought that it was your community midwifes that attend homebirths not the ones based in a hospital) im sure they would rather attend your homebirth where they only have you to look after than stay on the ward rushed of there feet looking after 4 women at the same time


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## milkmachine

snagglepat said:


> Wishing you the best of luck with it all Milkmachine. We're about to go away until next weekend so I'll be offline until then. If baby arrives before then I hope that you do manage to get a refreshed, happy midwife and the beautiful home birth you're planning. Sending you tons of positive birthing vibes from here.
> 
> Gina. x

Thank you sweets


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## milkmachine

lozzy21 said:


> Im sure though if they have to pull some one off the ward (allthough i thought that it was your community midwifes that attend homebirths not the ones based in a hospital) im sure they would rather attend your homebirth where they only have you to look after than stay on the ward rushed of there feet looking after 4 women at the same time

Where i live it is all community midwives no one is based at the hospital as such.


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## milkmachine

trumpetbum said:


> milkmachine said:
> 
> 
> its a tricky one, you have to consider the over stretched tired midwives when you do your feet stamping. This is very likely my last baby and i am totally terrified of the hospital. we shall see what happens!
> 
> That's true, but I always feel that the over stretched tired midwives benefit more from the powers that be having their hand forced into funding sufficient staffing.Click to expand...

Yes def, the fact is staffing shouldn't be this much of an issue. my friend had the 'there are no staff' line EIGHT years ago for her homebirth, you would have thought they would have pulled their fingers out by now.... i appreciate that the birthing rate has gone up and i do live in an area where we have a birth rate comparable to some of london with a 10/12bed delivery ward.... we need a dedicated birth centre really.


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## Sam292

My midwife has told me that this could be an issue in my area - I asked are they not legally required to send someone and she told me that they do have to send someone but it may be an ambulance to take you to hospital rather than a midwife. I will be so annoyed if after all my planning i have to go in just because of staffing issues. I hope it doesn't happen for you and you get the nice calm home birth that you are hoping for. You could always labor at home as long as possible first, you might be ready to deliver when the paramedics eventually turn up and not have to go in after all. Good luck and keep us updated xx


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## milkmachine

i am fully prepared to give birth unassisted if it comes to it


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## trumpetbum

milkmachine said:


> trumpetbum said:
> 
> 
> 
> 
> 
> milkmachine said:
> 
> 
> its a tricky one, you have to consider the over stretched tired midwives when you do your feet stamping. This is very likely my last baby and i am totally terrified of the hospital. we shall see what happens!
> 
> That's true, but I always feel that the over stretched tired midwives benefit more from the powers that be having their hand forced into funding sufficient staffing.Click to expand...
> 
> Yes def, the fact is staffing shouldn't be this much of an issue. my friend had the 'there are no staff' line EIGHT years ago for her homebirth, you would have thought they would have pulled their fingers out by now.... i appreciate that the birthing rate has gone up and i do live in an area where we have a birth rate comparable to some of london with a 10/12bed delivery ward.... we need a dedicated birth centre really.Click to expand...

Absolutely.


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## emmi26

i was offered a home birth at 8 weeks i havn't totally decided yet but there are 4 community midwives on call for home births at all times our area is in the topn 3 areas for maternity care in the country so im lucky. it all happened because they totally changed the way maternity services were used our nearest hospital is now entirely midwife led care and consultnt care is at the next hospital we have a midwife centre and there are drs on call if necessary. it was terrible here untill they switched it all round now its working great x 
its awful that there just arent enough staff for home birth where you are but i totally agree as someone said if you ring and say yr in labour and not moving from yr house they will send someone they are in serious trouble if they don't x


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## milkmachine

emmi26 said:


> i was offered a home birth at 8 weeks i havn't totally decided yet but there are 4 community midwives on call for home births at all times our area is in the topn 3 areas for maternity care in the country so im lucky. it all happened because they totally changed the way maternity services were used our nearest hospital is now entirely midwife led care and consultnt care is at the next hospital we have a midwife centre and there are drs on call if necessary. it was terrible here untill they switched it all round now its working great x
> its awful that there just arent enough staff for home birth where you are but i totally agree as someone said if you ring and say yr in labour and not moving from yr house they will send someone they are in serious trouble if they don't x

if you stomp your feet and refuse to move it doesnt mean that you will instantly get a midwife, my friend tried that and she got sent a midwife followed by an ambulance because the midwife couldnt stay due to the hosp being busy.


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## KandyKinz

milkmachine said:


> emmi26 said:
> 
> 
> i was offered a home birth at 8 weeks i havn't totally decided yet but there are 4 community midwives on call for home births at all times our area is in the topn 3 areas for maternity care in the country so im lucky. it all happened because they totally changed the way maternity services were used our nearest hospital is now entirely midwife led care and consultnt care is at the next hospital we have a midwife centre and there are drs on call if necessary. it was terrible here untill they switched it all round now its working great x
> its awful that there just arent enough staff for home birth where you are but i totally agree as someone said if you ring and say yr in labour and not moving from yr house they will send someone they are in serious trouble if they don't x
> 
> if you stomp your feet and refuse to move it doesnt mean that you will instantly get a midwife, my friend tried that and she got sent a midwife followed by an ambulance because the midwife couldnt stay due to the hosp being busy.Click to expand...

But legally can the midwife leave you if you refuse the ambulance??? Here in Canada midwives have to stay with you regardless of where you are until baby is born. They can call an ambulance to transport you BUT if you refuse they are obliged to stay put.


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## milkmachine

KandyKinz said:


> milkmachine said:
> 
> 
> 
> 
> 
> emmi26 said:
> 
> 
> i was offered a home birth at 8 weeks i havn't totally decided yet but there are 4 community midwives on call for home births at all times our area is in the topn 3 areas for maternity care in the country so im lucky. it all happened because they totally changed the way maternity services were used our nearest hospital is now entirely midwife led care and consultnt care is at the next hospital we have a midwife centre and there are drs on call if necessary. it was terrible here untill they switched it all round now its working great x
> its awful that there just arent enough staff for home birth where you are but i totally agree as someone said if you ring and say yr in labour and not moving from yr house they will send someone they are in serious trouble if they don't x
> 
> if you stomp your feet and refuse to move it doesnt mean that you will instantly get a midwife, my friend tried that and she got sent a midwife followed by an ambulance because the midwife couldnt stay due to the hosp being busy.Click to expand...
> 
> But legally can the midwife leave you if you refuse the ambulance??? Here in Canada midwives have to stay with you regardless of where you are until baby is born. They can call an ambulance to transport you BUT if you refuse they are obliged to stay put.Click to expand...

from what i gather the ambulance crew will deliver the baby and then take you in to be checked over :wacko:


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## trumpetbum

The legal situation has changed since my last baby where it was a given that a midwife _had to_ attend. The good thing is though is that when it comes to the crunch the trust would have to show that IT made reasonable attempt to provide adequate staffing where notice was given that a woman intended to labour and birth at home. If you have someone who can make it clear on the phone that there has been reasonable notice given and a midwife is expected to attend AND that you will not accept a paramedic as they are not trained birth professionals nor will you transfer in an ambulance, you are very unlikely not to be attended. There's an interesting page on staffing on the homebirth resource website I've linked below (see bottom of page as to what the advice is if your trust uses these tactics). This situation makes me very sad, it really shouldn't be like this, I know I was delighted to see that my trust had made changes to stop this kind of carry on but it's so sad to see these tactics still being used against women. I really hope you get your homebirth without the last minute fight :hug:

https://www.homebirth.org.uk/homebirthuk.htm


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## KandyKinz

Gotta love how birth turns into a test to see how truly assertive you really are!


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## milkmachine

bonkers huh! WELL my midwife came today and baby is so lo she couldnt feel his head so hopefully it wont be long. if im still pregnant next thurs she will come and give me a sweep and send me for monitoring (previous still birth) so fingers xxeds its sooner rather than later


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## trumpetbum

fx'd for you.


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## Tulip

FXd MM! Hoping for a speedy, gentle arrival at home x


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## milkmachine

thanks guys :)


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## Dream.A.Dream

When I was on the labour ward for rehydration once they were heaving and women were being left alone for ages because they had a lot of MWs out on homebirths. So I guess in my area they do try and attend them as much as possible. Hope you get yours xx


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## goddess25

Its tough but I also understand it from the other side... When you are there working and 5 midwives phone in sick and you only have 3 midwifes to do whatever on call... and no one is going to cover its really hard and sometimes no matter what you want its not safe to attend home births.. if you need 2 at one birth and there are only 3 to cover a service then how is it possible. Unfortunately the health service is at breaking point and I think everyone needs to understand that at the same time...i don't mean this in a bad way as I am hoping for a home birth myself but i guess i just understand how things work and how bad the system is. Yes your birth is important but sometimes you need to consider more than one person.

I hope that when your time comes everything happens as you want it too.


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## KandyKinz

goddess25 said:


> Its tough but I also understand it from the other side... When you are there working and 5 midwives phone in sick and you only have 3 midwifes to do whatever on call... and no one is going to cover its really hard and sometimes no matter what you want its not safe to attend home births.. if you need 2 at one birth and there are only 3 to cover a service then how is it possible. Unfortunately the health service is at breaking point and I think everyone needs to understand that at the same time...i don't mean this in a bad way as I am hoping for a home birth myself but i guess i just understand how things work and how bad the system is. Yes your birth is important but sometimes you need to consider more than one person.
> 
> I hope that when your time comes everything happens as you want it too.

LOL don't you know midwives are not allowed to get sick! :dohh:


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## milkmachine

i considered other people over my own health for my last delivery and it wont be happening this time around.. this is my last chance.


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## Aidan's Mummy

Haven't read the whole thread 
Xx 

If they are short on staff them I would go in they wouldn't make it am issue unless they were really short. If a Mw has to go out to a home birth because a woman refuses to come in. Then the ward could be left seriously under staffed as a reasult women qill have to be left longer which puts mothers and babies at risk especially if a women has trouble delivering and mws have tp step in

I know you have your heart set on a Homebirth hun and I'm sorry
X


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## trumpetbum

It's so hard from a personal POV when you know there is understaffing, but although I have sympathy for the midwives on the ward/labour suite I don't think just going in helps them at all. The situation in some areas has changed from being dire to working extremely well in a few short years because the powers that be were forced to make changes. In many areas they will work with as few staff as possible to save money, where actually changing the way that they work would be more cost effective and promote choice in the long term. When necessary, wards will book bank staff to accomodate number of expected births, they will fill out incident forms and things will change because bank staff cost more money and incident forms can't be easily ignored. There are qualifying midwives desperate for jobs right now and no positions available for them, because some trusts are working with skeleton staff. The midwieves are there to fill those gaps, it's up to the trusts to employ them as necessary, not labouring women to toe the line and labour in an understaffed ward which she doesn't feel is the safest place for her. I would always say that we need to have realistic expectations of what the NHS can provide, but in this case it is misallocation, mismanagement and poor use of resources in some areas rather than funding which is the issue.
8 years ago my trust was exactly the same, yet today they have a dedicated homebirth team. The trust that is highlighted on birth choice UK as an example of poor care has changed dramatically with only a few small changes. If women just accept poor care, it continues.


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## trumpetbum

KandyKinz said:


> goddess25 said:
> 
> 
> Its tough but I also understand it from the other side... When you are there working and 5 midwives phone in sick and you only have 3 midwifes to do whatever on call... and no one is going to cover its really hard and sometimes no matter what you want its not safe to attend home births.. if you need 2 at one birth and there are only 3 to cover a service then how is it possible. Unfortunately the health service is at breaking point and I think everyone needs to understand that at the same time...i don't mean this in a bad way as I am hoping for a home birth myself but i guess i just understand how things work and how bad the system is. Yes your birth is important but sometimes you need to consider more than one person.
> 
> I hope that when your time comes everything happens as you want it too.
> 
> LOL don't you know midwives are not allowed to get sick! :dohh:Click to expand...

Of course they are, as long as it coincides with their annual leave. Them's the rules :lol:


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## milkmachine

my mat ward is run on mainly agency staff :-/


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## goddess25

One of the reasons I left the NHS and moved to Canada the system is in such a poor state and failing so many people... its pretty much on the verge of collapse so at the moment appreciate that its still there. Not many countries in the world with free health care...its got to fall at some point.


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## trumpetbum

I don't agree that the NHS is on the verge of collapse. There are some serious overhauls being put in place to maintain the service between now and 2020 and further which if the current govt commits to will help to provide a better service. The issue of birth choice is important within the NHS because there are inequalities due to bad administration in some trusts rather than because the NHS is in a mess. homebirth managed well can be very cost effective and the benefits are evidence based so accepting a lower standard of service is unnecessary imo.


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## Jody R

I'm curious about anyone wanting a homebirth because the very thought of it frightens me. 

Why is it that you want one? 

And if you are worried that you won't have an NHS midwife with you at home, could you hire one yourself privately or even hire a Doula? That way, you would still have a professional with you so you wouldn't be alone, you'd know for certain that you were getting your home birth and if for any reason you did need to transfer to the hospital you would have someone with you who knew when to make that decision.


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## milkmachine

Jody R said:


> I'm curious about anyone wanting a homebirth because the very thought of it frightens me.
> 
> Why is it that you want one?
> 
> And if you are worried that you won't have an NHS midwife with you at home, could you hire one yourself privately or even hire a Doula? That way, you would still have a professional with you so you wouldn't be alone, you'd know for certain that you were getting your home birth and if for any reason you did need to transfer to the hospital you would have someone with you who knew when to make that decision.

because i was treated really awfully during labour with my daughter and i had a still birth at the hospital where i was too treated appallingly.
private midwives cost about 4k which isnt an option and doulas have no clinical standing they are prof birth partners not midwives. i would rather give birth alone than set foot in my local hospital to have another baby.


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## Jody R

milkmachine said:


> Jody R said:
> 
> 
> I'm curious about anyone wanting a homebirth because the very thought of it frightens me.
> 
> Why is it that you want one?
> 
> And if you are worried that you won't have an NHS midwife with you at home, could you hire one yourself privately or even hire a Doula? That way, you would still have a professional with you so you wouldn't be alone, you'd know for certain that you were getting your home birth and if for any reason you did need to transfer to the hospital you would have someone with you who knew when to make that decision.
> 
> because i was treated really awfully during labour with my daughter and i had a still birth at the hospital where i was too treated appallingly.
> private midwives cost about 4k which isnt an option and doulas have no clinical standing they are prof birth partners not midwives. i would rather give birth alone than set foot in my local hospital to have another baby.Click to expand...

That's so awful. :hugs: When Ally was stillborn I was looked after really well and when we went on to lose Elisabeth they were very good again. It was hard to be back in the same room, with all the memories of losing Ally and knowing Elisabeth would also die but I can't really fault the care they gave me. I was relieved to be in a different room for Joseph's birth though. We had so many complications and needs for his birth that I wouldn't have been able to give birth at home even if I'd wanted to, but being in a different room made me feel a lot better.

I hadn't realised it cost so much to get a private midwife and I thought doula's had some professional training in the same vein as midwives.

I can understand why your bad experiences have put you off the local hospital. Could you travel to a different one or are they all too far away?


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## milkmachine

too far away it was something i briefly looked into. i also had a botched d+c at the same hospital going there unless its absolutely ness just isnt an option.


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## KandyKinz

Jody R said:


> I'm curious about anyone wanting a homebirth because the very thought of it frightens me.
> 
> Why is it that you want one?
> 
> And if you are worried that you won't have an NHS midwife with you at home, could you hire one yourself privately or even hire a Doula? That way, you would still have a professional with you so you wouldn't be alone, you'd know for certain that you were getting your home birth and if for any reason you did need to transfer to the hospital you would have someone with you who knew when to make that decision.


Studies show there are several benefits to having a homebirth. Women who plan to have homebirths are less likely to require interventions such as augmentations (labours are less likely to slow down or stall at home), pharmacological pain relief (women tend to cope better at home), episiotomies, instrumental deliveries, cesareans, etc etc. Women and their babies who are born at home are also less likely to develop infections in the postpartum in comparison to women who deliver in hospital. Maternal satsifaction in regards to the birth tends to be much much higher among women who have homebirths. They get to remain in the comforts of their own space, wear their own clothes, they don't have to deal with hospital policy restrictions regarding visiting hours, videotaping/photographing the birth, having children present, being able to eat or drink, etc etc.


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## rachiedata

KandyKinz said:


> Studies show there are several benefits to having a homebirth. Women who plan to have homebirths are less likely to require interventions such as augmentations (labours are less likely to slow down or stall at home), pharmacological pain relief (women tend to cope better at home), episiotomies, instrumental deliveries, cesareans, etc etc. Women and their babies who are born at home are also less likely to develop infections in the postpartum in comparison to women who deliver in hospital. Maternal satsifaction in regards to the birth tends to be much much higher among women who have homebirths. They get to remain in the comforts of their own space, wear their own clothes, they don't have to deal with hospital policy restrictions regarding visiting hours, videotaping/photographing the birth, having children present, being able to eat or drink, etc etc.

My reasons exactly... the frightening things about childbirth, for me personally, are the medical things. Forceps/ventouse, IV augmentation, episiotomies. PPH was the one thing that I was mortally afraid of, before I got pregnant. By staying at home (even if, in the end, I have to go to hospital) I am dramatically reducing the risk of having those. Another reason is because I can't think of anything more horrible for my partner to go through than to say, at hospital "Here's your beautiful new baby son, and the woman you love! Now go home and wait for 8 hours before coming back" - how cruel!! He's done as much as I have during this pregnancy (almost!) and I want that bliss of curling up in our own bed afterwards, with a glass of champagne and a cup of tea, patting ourselves on the back for our new creation.

The actual giving birth part, knowing when to push and what to do, how I will cope with the pain, the availbility or otherwise of a midwife or doctor, don't frighten or bother me at all really.


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## special_kala

My area only has 2 MW available for homebirths at any time so if someone else is in in labour im afraid i luck out. Someone on BnB actually lives in the same town as me and is due the same day so things could get interesting :haha:

If i am told that they cant send anyone due to staffing issues i will try and wait as long as i can and call again but im not going to stamp my feet and demand someone come see me as if i drag a MW away from the hospital im taking them away from 2-4 other pregnant women and i dont think that the birth i want is any more important then the safety of those women and babies.


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## rachiedata

My opinion is that if they're so short staffed, I _definitely_ don't want to be in the hospital!


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## Aidan's Mummy

I can see both sides. I completely understand the importance of a woman's wishes when it comes to birthing etc. And they are many reasons why homebirths are great for mothers and babies 

BUT staff shortages are a real issue within the NHS and I have personally experienced this as a student nurse to the point of it verging on dangerous due to be short staffed. And it isn't the MW's fault they don't decide how many registered midwives they can employ I am sure they will be trying their best. So if they really are short staffed, dangerously so then other mums in labour may be put at risk if they loose a midwife to a homebirth. 

Like I said at the beginning I completkey understand and empathise with a lady wanting a homebirth and that wish being threatned. But staff shortages are a huge issue and the staff can only do their best :hugs: x


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## Mervs Mum

I agree it's a tough job when you are understaffed but a woman in labour has a MUCH harder job. Unless women stand their ground then how can the trusts respond to the need? if we go in then it will look on the surface of it that everyone's needs are being met when they are not. If there are not enough teachers in school do the kids get sent home?! No they get supply teachers in and suck up the costs. There are 'bank' MWs and IMWs that they can use they just dont want to pay for them as they are stretched financially. It's not about women, it's about money. And as Rachiedata says if it's too busy on labour ward or in the community to send a MW to a labouring woman then heaven help the poor women giving birth in the hospital - they are in the real danger. If that's the case then they need to get a bank or independent MW to either labour ward or the home birth.


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## Aidan's Mummy

Bank staff are a godsend. But again it's getting past all the red tape and people above you. I have already had a heated discussion with the matron on charge of our ears about staffing and supplying bank staff her reply was " you don't need any" even though we were full to capacity and more coming through the door. I totally agree that the mother is at the centre of care when labouring and every need should be met for a MW to fulfil her duty of care and I'm sure any good MW would agree with that. It's just trying to get past those above us to give the extra support. So many professionals within the NHS are saying every day "we are under staffed we need more help" and we get one reply " funding will not allow it" It is so frustrating and I have come home so many times literally fuming because patient care is suffering. Something needs to be done but I wouldn't know where to start or who to talk to. 

It is shocking how much patient care isnt fulfilled but the MW's on the ground can only give what they have. The people away from the 'front line' high up need to be addressed but like I said o wouldn't even know where to start.

Having head a pretty horrible birth experience in a hospital I can see excatly why women prefer a home birth and why they havens more positive birth experience. So women should maybe start a campaign of some sort? To make it clear that there isn't enough midwives being employed and patient care is suffering as a result of this. But again I would have no idea how to go about this. But I can garuntee the good MW's will be frustated with the situation like all of you. And I hope you all get your homebirths because labour should be a positive experience :thumbup: x


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## naturalgirl

If you must have a hospital birth, you could look into getting a doula. They are great about helping you learn how to advocate for yourself if you want natural birth in the hospital. Plus, the doula will stay by your side for the entire birth, do special comfort measure cares (like the double hip squeeze to take pressure off of your tailbone) and can help you even if you end up getting an epi or c-section.

Just a thought. :)


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## Mervs Mum

There are lots of campaigns like AIMS https://www.aims.org.uk/
Or local campaigners like Airedale Mums. https://www.airedalemums.co.uk/

This isn't a new issue and no one is suggesting for a minute that the MWs aren't doing their very best but the only way for something to change is if women and their families consistently demand that their needs are met. Every time a woman abandons her home birth plans and heads to the hospital she puts pressure on the hospital MWs and sends the very managers you're talking about a message that the needs of the WHOLE community, be they home or hospital birthing women, are being met when they are not.


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## KandyKinz

I think due to the nature of birth and the unpredictability of it sometimes issues regarding understaffing for homebirths just can't be avoided.


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## MadMummy06

More a question than a reply sorry but i thought you couldnt be refused a homebirth due to staffing? My situation is slightly different because we have a team of 5 dedicated homebirth midwives which means someone will always be able to come but my first midwife gave the impression that once you tell smeone your in abour they are obliged to come to you?
xx sorry if any of that is wrong?


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## GeorgeyGal

MadMummy06 said:


> More a question than a reply sorry but i thought you couldnt be refused a homebirth due to staffing? My situation is slightly different because we have a team of 5 dedicated homebirth midwives which means someone will always be able to come but my first midwife gave the impression that once you tell smeone your in abour they are obliged to come to you?
> xx sorry if any of that is wrong?

Thats what I heard as well, if your having a home birth and call for a midwife they have to send one out to you, no one can force you to go into the hospital, if you stand your ground they will send someone out, they have to.


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## KandyKinz

I think it ultimately depends on where you are and if they have staff available to attend you. I live in a very rural area and there's only one midwife here who does homebirths so if she's at another birth what other option is there but to go to hospital :shrug: And I've been apart of bigger practices in which there are 3 or 4 midwives all on call at the same time but then they'll be a crazy weekend where 4 or 5 women will go into labour at the same time. It's just one of those things and it's really difficult to avoid due to the fact that labour is so unpredictable. Term is a 5 week window and unless one midwife is going to remain uncall 24/7 for that entire 5 weeks (which still doesn't gaurantee anything and would make for a terrible life for that midwife) two midwives would always have to be allocated to one client and one client alone. It's just not practical and it would result in even more women having to turn to the hospital because they couldn't get midwifery care to begin with.

But then again it's a different system here as while the midwives do work both at home and hospital for their clients the hospital staff (Obs/consultants and nurses) ONLY work in hospital...


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## GeorgeyGal

From www.homebirth.org.uk

What about staffing shortages?
Women planning a home birth are sometimes told that the local health authority may not be able to provide a midwife on the day, because of staffing problems. If you hold out for a home birth in these circumstances, you may feel guilty that you would be taking midwives away from other women who need them on the labour ward. This is an understandable concern, but it is important to remember that staffing levels are the health authority's responsibility, not yours. You may sympathise with their problems, but remember that where there's a will, there's a way. Trusts which are fully supportive of home birth find a way around this problem; so can yours.

While sympathising with the health authority's staffing problems, you can ask what they are doing to resolve their staffing problems. Advertising vacancies is insufficient - perhaps providing their midwives with more autonomy and job satisfaction, for example with the opportunity to attend births at home, would improve their retention of midwives. 

If women are persuaded to abandon their home birth plans on the grounds of staff shortages, the health authority will have no incentive to improve its services for other women - so by holding out for a home birth you are helping to improve choice in your area, and helping to make midwives' jobs more interesting - and you are also saving money for the NHS (see below). 

Every health authority has access to what are called 'bank midwives', and most use them regularly when they have staffing problems in the hospital. These are midwives who work on a temporary basis, sometimes for just one shift at a time (a bit like supply teachers). Some will be midwives who are employed by the same health authority, who are taking on extra work - doing overtime - and others will be midwives who want to work part-time but who have not obtained a permanent part-time job, or midwives who are currently taking a career break to look after their own children, but will work occasional shifts, or semi-retired midwives. All 'bank midwives' are all fully-qualified midwives. If there was a genuine shortage of midwives on the labour ward then the health authority should always be able to arrange cover on the ward from a bank midwife, thus freeing up a community midwife to attend home births.

In some areas, independent midwives work as 'bank midwives' when they are not needed by their own clients. On occasion, independent midwives have attended home births on behalf of health authorities who could not arrange cover from their own employees. Sometimes such arrangements are made in advance - when people talk of arranging an 'extra-contractual referral' to an independent midwife, they mean that an independent midwife would be booked to attend you, but would be paid directly by the health authority. 

See 'Home Birth Bullying' from AIMS for suggestions on dealing with this situation, and also 'Home Birth Alert' for a sample letter to send to your health authority. If you still have difficulty in arranging your home birth, please contact Beverley Beech of AIMS - she is very experienced in supporting women in this situation, and would far rather that people contacted her, than fought on alone.


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## Rebecca_B

Hi ladies,

I wanted to ask your opinion on what i went through last labour (8 months ago) and my labour this time see what you advise....

I requested a homebirth last yr with charlie. We were all set to go and i went into labour on Fathers day and rang labour ward to let them know contraction times and told them it was a home birth.

They said they would ring the homebirth team and let them know and they would ring me back.

They rang to say they were attending another labour and would release one of the midwifes to come to me as soon as her baby was born.

I progressed quickly and my contractions were back to back within the hour and i knew i was close to 10 cms.

Labour ward was rang and said to mum that home birth team hadn't delivered baby so i would have to transfer.

I went to hospital and on examination was 9 cms.

Had baby on all fours 20 mins later. Was home once all paperwork was done (3 hrs later)

I so want this baby at home this time, it would have been the perfect homebirth but how can i be sure i will have a midwife to see to me??????????????


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