Eeeek, I may be able to have a HB, lots of questions!

[Sazaroo]

Hello Lovely ladies!

So I had all sorts of problems with my last birth. My daughter had IUGR due to placenta probs so I was induced at 38 weeks and it all turned into a bit of an emergency - babys heart rate dropped dramatically, i had emergency episiotomy and she was rushed away as she was shocked and need extra care as she had glucose issues etc etc.

Anyway, I am so desperate for a more controlled birth this time and would love a home birth, I have some growth scans coming up to find out if this baby has IUGR also. If he doesnt my consultant is ok with me having a HB.

My main questions are - what happens if I need an episiotomy again, can the midwives do this? What if the babies heart rate goes down and he needs to be got out quick, can the midwives do this or is it an ambulance job? What if the baby needs extra care again after its born - do they have equipment with them for this? etc etc.

I just reeeeeally want to birth my baby naturally, in a birthing pool, and hold him straight after and delay cord clamping etc etc.... all the things I never got the chance to do with my DD.

Thank you in advance, im super excited but terrified at the same time!
Ps. I am doing pregnancy yoga and natal hypnotherapy too x

 

[berniegroves]

I think it will depend what stage you are at in the labour as to what happens if there are complications.
As far as I'm aware midwifes at home births don't do epistiomys or interventions like forceps etc. so if those were needed an ambulance would be called.
But I do believe they have resuscitation equipment with them to use on the baby if needed.

I might be wrong but this is my understanding. But generally the need for intervention is much lower in home births anyway.

 

[MindUtopia]

Nope, midwives don't do episiotomies, but really, there's no medical 'reason' for one unless your OB can't maneuver the forceps in otherwise. It's just tends to be something that's done to speed up the process (usually because OBs get tired of waiting for you to birth naturally or they don't have the experience to advise you how to position your body so that your baby comes out easier). If you're having an otherwise uncomplicated home birth, you won't 'need' an episiotomy. If your body needs to it will tear, but it's not a big deal (I didn't even feel it, wasn't painful) and most tears can be stitched up at home while you rest on your bed or sofa.

Home birth midwives in my experience was much more cautious than hospital-based midwives and they take into account the time needed to transfer (in the unlikely instance that might happen) into their clinical decision making. I know for the community midwife team who attended my birth, their protocol is to transfer in any time they detect any unusual heart rate pattern. So if it happens one time, they'll talk about transferring. But usually babies born at home (and who aren't induced - induction is actually the reason most babies go into distress because they don't cope well with the escalation of contractions or the use of syntocinon itself) don't have the heart rate issues that hospital birth babies do. You'll be more relaxed (especially since you're using NH), so your heart rate and BP will be lower, meaning your baby will fair much better. And you won't have been induced, so you'll be cutting out a massive source of risk from the very start. But if anything unusual does happen, they are very quick to discuss transfer.

As for dealing with anything that might happen after the birth, yes, they have most things that you would have in hospital. They don't have all the big fancy machines, but most of the key post-birth interventions are really simple things that don't require a lot of technology. Like oxygen for you and baby if needed or syntocinon for a stubborn placenta or postpartum hemorrhage. If anyone needs more care that that, they can transfer you in when you're ready, but they can deal with almost any emergency you can think of right there.

But you are so much less likely to need any of that if you're at home. You'll be more relaxed, more likely to be upright and mobile, and can avoid some of the meddling that goes too often in hospitals that causes problems with birth for too many women.

I had my first baby at home (used natal hypnotherapy as well - it's awesome!) and it was the best decision I could have made. I was so comfortable and it was so manageable. And so much easier than I thought it would be. Everyone really respected my wishes and treated me wonderfully. I actually can't wait to do it again one day.

 

[BunnyN]

I had a wonderful HB experience. It was a very long labour and I feel sure they would want to speed thongs up if I was in hospital. The babies heartbeat never suffered though and was very stready throughout. I feel sure speeding things up would have been harder on her and on me and may have lead to more intervention. The MW had with her most of what would be available at hospital in an emergency and I think you often get more attentive one to one care at home so a real problem may be spotted earlier.