Consultant said no to homebirth *updated 21/10/11*

[hippylittlej]

As some of you may know most of the midwives I have seen have been very supportive of me having a homebirth and just one horrid one questioning my height (4ft 9") as being an issue. She without my knowledge referred me to a consultant today at 38+4. The main consultant I saw was fine and didn;t see my height being an issue as such but needed to ask the senior consultant.
The senior said i present a higher risk and so she would not recommend, although she appreciated I live near the hospital etc it is just that as the midwife has asked the question she has to err on side of caution and her advice would be to come to hospital in case of a problem.

I explained that nobody else has questioned it and I reached this far, she said she understood this but now someone has asked the question she has to answer it.

So now my notes read HOMEBIRTH NOT RECOMMENDED. I asked if I can ignore this and she said I can but it would go against medical advise and that the community wife would have to still be on board and the head of the community team isn't on board.

I do not know what to do now. I have done my hypnobirthing classes, I have my birth plan, the pool is all ready and now this.

 

[Blah11]

You just tell them you're having this baby at home. The consultantcan recommend what he wants but its your decision. Don't let them bully you.

 

[Samantha675]

If the while reasoning behind the no is because your height then that's just not good enough in my opinion. Fight for your birth!!!

 

[hippylittlej]

I have just checked homebirth.org.uk and if my pelvis is too small then my labour would not progress and it isn't an emergency. They also state that if i went to hospital and labour wasn't progressing they could cause more issues by trying to start labour before they spot a problem.

 

[Pielette]

Your height actually isn't an indication of the size of your pelvis. It's a nonsense reason to use for not recommending a homebirth. Fine, if it doesn't progress at home, if it stalls, baby's in distress and you need medical intervention you can go to hospital, but in that case you would need medical intervention wherever you happen to be anyway. You could be in hospital and you would still need a c-section.
You are entitled to try labour and birthing wherever you want to be, and bottom line is you will be more comfortable at home, which would encourage your labour to progress. You had clearly already made the decision and you're now disappointed - they are NOT allowed to make you come into hospital. They can tell you their thoughts, which they have done, but you can make your own mind up. They have no idea of the size of your pelvis and how it will open during birth and it's simply guesswork.
If you are happy with your own research and your opinions, you need to tell them you respect their advice but you are going ahead with a homebirth with your eyes open. They legally HAVE to attend you, this business about so-and-so needing to be on board is rubbish.

 

[chuck]

All of the above LOL.

Say thank you for your time but I'm having a homebirth thanks.

 

[hippylittlej]

Thanks ladies. My hubby and I have decided we are going ahead with homebirth and if I need medical intervention then we can go to hospital without an issue, but that we have to go ahead as planned. There is no indication I will have an issue, no family background showing it might be an issue. My mum is going to come to my next community midwife appointment with me (if baby hasn't arrived by then) to back me up. Hubby can't get any more time off unfortunately, but he is behind me 100%.

 

[Whitbit22]

You go girl. We have to trust our bodies beyond all else, and I agree with everything the others said. You will be way more comfortable at home and it will encourage you to progress! Glad you stood up for yourself!!

 

[Jims_Girl]

Good for you! Keep us updated...

 

[Rebaby]

Sorry to hear you're facing such negativity so close to giving birth but i absolutely agree with what has been said above already- it remains your choice whether the consultant recommends it or not, and i'm so glad to hear you're prepared to fight for your homebirth (even though i'm sad that you have to- if that makes sense?!) and it's great you're so well supported by your husband and Mum

 

[ljo1984]

its still totally your choice and they have to attand your birth if its recomended or not! i was talking to my boss about hb (she used to be a mw) she wanted to have one with her first and they said no because she was tiny and her pelvis would be small (were talking 20 odd years ago as well here) due to her hight, she said it turned out they couldnt be further away from the truth! she's had 4 children all natural delivery with no issues re: her pelvis size!! xx

 

[lynnikins]

just to point out my mother is only 5ft5 and has had 2 10lb+babies at home with no problems

 

[NuKe]

tbh i think they may be just covering their backs, if your height puts u at a very slightly higher risk!

 

[aliss]

just to point out my mother is only 5ft5 and has had 2 10lb+babies at home with no problems

Mine too - except she is 4'10 on a GOOD day My youngest sister was 11lbs. All home births, and she had an artificial hip. If my itty bitty 4'10 mom can deliver multiple 8-11lb babies at home with a metal hip, any normal shortie can

You are already well prepared - you will be fine, I'm sure. If you had gestational diabetes and an abnormal fetal size due to that (not just "big baby" but abnormal for the gestation from GD) then yes, I could see the issue - but your size alone should not present a problem.

 

[steph.]

I think the consultant is covering her a**. IF anything went wrong, and she had given you the green light, she might be held accountable. So this way she's not responsible because she gave you a big fat no and its written in the notes.

Good for you for going ahead with it! My granny is absolutely tiny and had 10 straightforward homebirths

 

[hippylittlej]

Today the midwife called me to say she was still concerned as the babies shoulders could get stuck and that this is fatal and that I would have no time to get to hospital, she really was like a dog with a bone. I argued my corner and in the end she relented but it left me very shaken and upset.
I now have this fear that if I deliver at home I am risking killing my baby (I know this is unlikely) which has spoilt how I was feeling about the birth.
I am also a great believer in everything happens for a reason and now I am wondering why I keep getting this midwife and why she keeps on at me about this.
I am now thinking much to my own disappointment that I may go ahead and get the midwife to come out for a homebirth, explain my fears and what this other midwife has said to me and ask her if I get scared if I could go to hospital at 8/9am dilated. My fear is that now when I reach 10cm all that will be going through my head is her words about my baby getting stuck and dying.

 

[chuck]

What a terrible thing to say without actually going through all the risks properly or the plus points to HB.

IF the babies shoulder get stuck its shoulder dystocia and the risk is around 1 in 200 births, roughly the same risk as a uterine rupture.

Here is what the RCOG (Royal College of Obstetricians and Gynaecologists say about it..(I've italicised what they do in event of SD and look nothing that cant be done at home.

https://www.rcog.org.uk/womens-health/clinical-guidance/difficult-birth-what-shoulder-dystocia

How common is shoulder dystocia?
Shoulder dystocia occurs in about one in 200 (0.5%) of births.

Can shoulder dystocia be anticipated?
At every birth there is a small risk of shoulder dystocia. In most instances, it is not possible to identify who it will happen to or why it occurs.

Some factors may indicate when a difficult birth might occur. These are:

large babies (over 4.5 kg)
diabetes in pregnancy
previous shoulder dystocia
induction of labour
slow progress in labour.
Shoulder dystocia has been linked to the birth of large babies. However, most large babies (over 4.5 kg) do not have a difficult birth. In addition:

ultrasound scanning is not an accurate predictor of birth weight towards the end of pregnancy, particularly in large babies
at least half of all the babies who have shoulder dystocia weigh less than 4 kg.
Your obstetrician and midwife will be aware that in every birth there is a small possibility of shoulder dystocia.



Can shoulder dystocia be prevented?
In most instances, shoulder dystocia cannot be prevented because it cannot be predicted.

What happens if a baby has shoulder dystocia?
When shoulder dystocia is suspected during the birth, it can be very frightening for the mother and birthing partner. It is an emergency and therefore minutes matter.

The obstetrician or midwife will:

ask the mother to stop pushing
reposition the mother to allow the baby maximum room inside the birth canal to be born. The woman may be asked to lie on her back and her legs will be pushed towards the abdomen (known as McRoberts’ manoeuvre)
press on the mother’s abdomen just above the pelvic bone to try to release the baby’s shoulder
consider making a cut (episiotomy) to enlarge the vaginal opening
try to move the baby within the birth canal to free the shoulders so that the baby’s body can be born.
These are specific manouveures to help to release the baby’s shoulder and allow a safe birth. All obstetricians and midwives who attend the birth are familiar with these manoeuvres. In most maternity units the manoeuvres are practised regularly.

 

[chuck]

Just to add I wouldnt go back and see her again - I'd also write a letter of complaint to the head of midwifery stating that your MW was trying to use scare tactics adn didnt give you all of the information you need to make an informed choice about your birth.

 

[hippylittlej]

She told me that the midwife that attends would not be able to deal with it if it happened. I read that after I spoke to her and I am not being told baby is large at all. The problem is she has now scared me quite a bit. I am hoping that the midwife that comes out to the birth will put my mind at rest.
I can't choose who I see, when I attend the community midwife I get whomever is on that day unfortunately.

 

[aliss]

In addition to chuck's great info, keep in mind that out of the 1/200 dystocia babies, only a small percentage of those come out with injury. And then out of those, it's rare to have anything fatal or permanent. Mine was born with a broken collarbone, which is the most common of the injuries - while I admit it sucked, it was not permanent in any way and was rare enough. If I had to do it all over again, I would have done the home birth in the first place. All those unnecessary interventions that take place in a hospital can contribute to shoulder dystocia.

Keep in mind that they only remedy that a midwife at home cannot do, is the zavanelli C-section, but that is really a last resort option and extremely rare (and does not have a 100% success rate). All other remedies can be performed by a midwife (ie. Gaskin maneuver).

I couldn't push mine out properly due to the epidural... I can guarantee this kid would have been out a lot easier if I had birthed him at home rather than strapped to a hospital bed without feeling in my legs.