# 40% of first time home birthers end up transferring to hospital? can it be true?



## Jayneypops

Hi,

I have been reading a lot of stuff online about homebirths and have read a stat that concerns me :wacko:

According to one home birth website I was on, 40% of all first time moms, who opt for home birth end up going into hospital anyway (for various reasons).

Can this be true? I hope not! I know it still means that 60% stay at home but it is concerning. Our local hospital has a Norovirus outbreak and we were sent away when we arrived for our tour of the maternity ward last week so Im now even more anxious than I was before about being transferred.


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## lozzy21

I think it's that high because they are not progressing as fast as the midwifes like and bug them to transfer rather than because of an actual issue.


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## Mervs Mum

It's not mostly for emergency reasons. It's generally for more pain relief or due to policies as Lozzy said. Obviously I don't work with the kind of numbers used in a proper trial but as a doula my transfer rate is less than half that for 1st time mums. Being well prepared and informed on the types of things they might want to transfer for in advance will help you avoid an unnecessary transfer


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## amjon

I planned a birth center (basically home away from home) birth, but ended up having to transfer to be induced for my stillborn. The center doesn't do transfers for pain, you have to make a commitment for no pain meds as they will NOT transfer for pain only. They only transfer for the health of either baby or mother.


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## NaturalMomma

It is usually for the use of pain medications. Where I live I think the transfers are low, somewhere like 10-20%, and I believe only 4% are for emergencies and the rest is for pain meds.


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## Jayneypops

Thanks for your replies. My MW has said that although I have a home birth planned (which she is very supportive of) I can change my mind at any point during the labour and decide to transfer to hospital. I think maybe because many women have this option it may seem like the best thing to do if time is dragging on, fatigue is kicking in etc.

Hopefully I can remain energised enough to see it through!
I may try to find out the figures for my local area.......


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## Mervs Mum

Jayneypops said:


> Thanks for your replies. My MW has said that although I have a home birth planned (which she is very supportive of) *I can change my mind at any point during the labour and decide to transfer to hospital. *I think maybe because many women have this option it may seem like the best thing to do if time is dragging on, fatigue is kicking in etc.
> 
> Hopefully I can remain energised enough to see it through!
> I may try to find out the figures for my local area.......

this is absolutely true and one of the things I say to clients who aren't sure if they want to be at home or hospital. You have your dedicated mws who will transfer in with you at any point if you feel more comfortable at the hospital. However if you plan to be at the hospital and then when you're there wished you were at home, the mws won't come with you ;)


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## ChrissiK

If it's a UK study there is also a difference in transfers from NHS midwives vs IM. NHS midwives have many more guidelines to follow and are often not as educated in home births and natural pain relief / position options as IM or doulas.


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## ChrissiK

I should add that there are fabulous NHS midwives and not everybody can afford a doula or IM!
Ultimately you pain threshold (and preparation) will play a big role in a successful home birth. With your first baby this is a big unknown!
I am wondering what the transfer rate of second time (or more) mothers is, who know their pain threshold and usually progress faster...


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## Mervs Mum

ChrissiK said:


> I should add that there are fabulous NHS midwives and not everybody can afford a doula or IM!
> Ultimately you pain threshold (and preparation) will play a big role in a successful home birth. With your first baby this is a big unknown!
> I am wondering what the transfer rate of second time (or more) mothers is, who know their pain threshold and usually progress faster...


Not everyone can afford a doula which is why there is a doula for everyone via the Doula UK Access Fund! Anyone on a low income can apply and will have a doula for free - NO WOMAN who wants a doula is excluded on financial basis alone. They will often skill swap too so if you or you're hubby are a web designer, decorator, photographer or perhaps teacher there maybe a deal to be struck without any money changing hands ;)


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## aliss

This whole pain part sort of scares me, I know it was practically impossible last time but I was strapped to a bed and pumped with pitocin for 24+ hours straight and artificial membranes ruptured (induction), how on earth does natural pains compare??? I won't be transfering to a hospital for pain relief, they don't do that here.


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## NaturalMomma

Pain is different for everyone. I had ds2 at home, and the pain wasn't really pain. It was intense because the contractions were one after another, but I wouldn't call it pain. It was also only at the end before pushing and not very long. It is best to stay on your feet and move with your body and the contractions. For me, the pain associated with chldbirth is not scary and not something that should be feared or numbed.


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## aliss

Thanks naturalmamma I have heard this from others too. I also tore an ab muscle in labour so I think that was part of it. That's why I want to be at home, if I'm going to go on a bed it would rather be my own! Preferably squatting, LOL


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## Blah11

I dont think overall that transfer rate is very high. if you follow the hopeful thread the vast majority of women achieve a homebirth. A few need to be transferred but its usually after the LO is born for placenta, meconium issues or to be stitched up.


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## lozzy21

I dident find labour painful, it was uncomfortable but I wouldent say it was painful. But I dident know I was in labour so my body's natural painkillers had chance to build up.


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## Blah11

Aliss - roman was back to back and I found the pain barable. Lots of breathing through it and PMA helped. I also stayed very active and was walking about until I was ready to push him out and I pushed him out on my knees leaning over my couch so still upright. Helped with the pain in my back and also sped things up a lot. 
When i was in labour, I thought I was only about 5-6cm from the level of pain and because I had just vomitted but I was actually 8-9 and 25 minutes after that he had been born. I really enjoyed my labour so please don't fear it. This time you wont be induced so your body will have time to get used to it and make lots of lovely natural homegrown painkillers! Labour doesn't need to be a very painful experience.


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## ljo1984

40% is more than I thought it would be but yeh I guess the majority are not emergency situations. I had to transfer for meconium in waters but on this part of forum it's only a tiny minority who transfer in and I look at it that way rather than them stats.


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## LittleOnes

Seems very possible, as at my birthing center about 25-30% are tansferred. Main reason is failure to progress, and midwife said recently the failures to progress transfers had nearly all been 'face up' babies - she advised me to get on a birthing ball early, get on all fours, not be in reclined seating position always, and so on to try to avoid face up baby and thus a possible transfer due to failure to progress.


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## Jayneypops

Thank you so much for your responses. The stat I found was from https://www.homebirth.org.uk/

and having looked at it again, it was a study in the Netherlands.
it quotes:
Amongst women having their first babies, 39.3% transferred to hospital; amongst women having subsequent children, 10.3% transferred.

I guess this reinforces the pain relief theory or failure to progress, as only roughly 1 in 10 2nd time moms transfer. 

I will be trying to do all I can to prepare myself, my DH is also doing lots of reading at the moment, and watching youtube clips so that he understands each stage of pregnancy etc. He is so supportive, Im sure I will feel looked after and relaxed - I hope!


x


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## Mum2b_Claire

That was the statistic of transfers from the birth centre I had Ruby in. But like others have said, it was mostly for epidurals. 

I obviously didn't find labour with my second very painful because I'd only bothered to call the midwife about 20 mins before I was actually having to push!


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## Mervs Mum

The 40% is first timers transferring


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## MrsMac5

I have learned so much recently since finding this section! I'm due in a couple of weeks and while a home birth doesnt appeal to me for different reasons, I have the option of a midwife led birthing unit. My concern is that if I stay locally and go to the unit then the transfer time to the nearest hospital is 2 hours. My other option is to head straight for the hospital as soon as labour starts or earlier and stay close to the hospital. I'm trying to keep thinking positively but at the back of my mind I can't help thinking what is something goes wrong and I'm a full 2 hours away from help. If the transfer time was greatly reduced then my decision would be much easier. Does anyone think this would affect their decision for home/ birthing centre delivery?


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## Jayneypops

MrsMac5 - I think time/distance from the nearest hospital is a concern, is the 2 hours allowing for normal traffic conditions? If it is, bear in mind that if you were in an ambulance with blue lights (i.e being transferred because the baby was in distress etc) this time would be significantly reduced as you would go through traffic lights and past other cars etc. 

Our nearest hospital is 16 miles away and in the car takes us just over 30 mins, but our MW says with blue lights it usually takes 15 mins from our area to the hospital by ambulance. Also, when you're at home the MWs have an ambulance on standby for you who are aware of your location etc so it take a minimal time for them to arrive to collect you (I assume this is the same at a birthing centre)

Ask your MW for some advice about journey times. 

Ultimately, the mosty important thing is the safety of you and your baby, and although we may have idealistic ideas of how birth will be for us, I am keeping an open mind as when it comes down to it, I wont care what has to be done or where I end up giving birth as long as my babys ok. 

You will know what feels right for you Im sure when the time comes. Remember, you can change your mind at the last minute if you choose home/birthing centre and go into hospital, but if you go straight to hospital you are less likely to be able to then go to the birthing centre instead.

Good Luck  x


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## Mervs Mum

Don't forget that the mws caring for you at home or in a MLU know the transfer times and factor that in their reactions to different situations. Most issues don't come bam out of the blue. There's signs and warnings in advance so just as mws at home births are way mor cautious than hospital mws so will the MLU mws be. If it was truly 'dangerous' for that stand alone unit to be that particular distance from a full obstetric unit, it would have had enough bad outcomes to close it. Birth in the UK is safe where ever it takes place and the people in each local area know what's important in their particular scenario iykwim. :)


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## MrsMac5

There would be an ambulance on site to transfer but taking into account the location I would say the minimum time to get to hospital would be 1hr 30 mins. What you are saying about the warning signs makes sense and I hadn't thought about that. If I do decide to head to the main hospital myself I am glad I read this section. I truly believe my last birth didn't go to plan due to so much intervention ie induction with drip leading to epi resulting in no lower body feeling so no pushing urge resulting in forcep delivery. All worked out in the end but I'm determined to be strong minded and not just do what I'm told this time.


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## Jayneypops

That's the most important thing is ensuring you get the experience you want. Obviously this is my first so I cannot go on previous experience, however I am very stubborn and am determined not to feel. Persuaded or pressured into changing my plans to suit others. The only thing that should change things for you is the health of you and your baby. If there are no high risk circumstances I would go for whichever type of birth is your ideal.


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## Mervs Mum

Understanding why interventions are much more likely in a hospital environment versus a MLU or home and how interventions almost always lead to more is key. Then ensuring you have strong birth support around you who are going to help you advocate when you're not in a position to do so. I've known THE strongest women who campaign for maternity rights etc find themselves and their partners put under such extreme emotional pressure that they agree to things you wouldn't normally dream of them ever agreeing to. We are at our most vulnerable in labour as are our loved ones and when someone starts talking about something happening to you or your baby, it's hard not to cave in. A strongly worded birth plan or 'contract' is something that's helped people who have previously be railroaded. :)


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