Home birth & low gestational weight

Torz

Mummy to 2 DS & pregnant
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Hi, I'm after a little advise on my 2nd home birth.

I planned a home birth with my first & I had slight raised blood pressure at the time & I changed my mind. I decided I wanted a hospital birth. I had a text book birth, had pethadine which did nothing, had gas & air which was wonderful. My boy was born within a few pushes, screaming his head off. I had a slight graze & everything was perfect.

My boy was born weighing 7lb 2oz & at 38+6 though I don't believe my dates were correct. He has absolutely no vernix on him what so ever & every dry skin. Apart from the slightly realised blood pressure towards the end I had perfect text book pregnancy.

My second birth, home water birth! There is a link to my birth story in my signature. Basically, again, labour progressed well. I ended up with an unassisted home birth because the hospital midwifes refused to believe I was in labour. I panicked during transition & while pushing. I ended up with a second degree tear.

My boy was born weighing 6lb 6oz at 40+2 & perfect. Pregnancy wise I measured ok on charts, roughly round the 50 centile. One measurement put me between 50 & 10 centile & due to reduced movement one day I had an emergency scan. Baby was fine & weight ok.

This pregnancy I am now under consultant led care as I'm told my second son's birth weight was on 7th centile.

The first time I saw my consultant after my first growth scan I mentioned home birth & was told a flat out no. This immediately got my back up as I wasn't asking permission, I was mealy stating where I would be giving birth. I told her I wasn't asking permission & that she can only advise me on birth options. I basically got told that no midwife would come out to me to deliver my baby as they would be putting their career on the line.

After that appointment things went spiralling down hill. This baby does not move as much as my two boys did. I think it's normal for this baby & the position they are in. His/her back is down my belly & they are kicking into my back. All the movement I can feel are very subtle & low down. I'm having regular monitoring, Doppler & growth scans. Everything so far is perfect, baby is plotting on 10th centile & monitoring has been fine. Both myself & the midwifes can hear baby move on the monitor but I can't always feel it. As days go on I am feeling more movement & stronger movement. I'm happy to continue with monitoring just to keep an eye on things. I've been given two steroid injections just in case.

I know I'm still quite early at almost 31 weeks but should I keep on mentioning home birth to the both the midwife & consultant?

I'm quite happy if I get to full term & all growth & Doppler scans come back fine. My baby is currently following the 10th centile curve. I'm quite happy with this. I think I just produce genetically small babies. I was born at 6lb 6oz at a week over due. My partner was a small baby & we are both quite small people in height & weight. It shows especially with my DS2 who is still small height wise for his age, at 4 year old he is still in age 2-3 clothes on the bottom & has just moved in to age 3-4 on top.

What are the risks of having a small baby at home?

The consultant told me that my baby would need to be closely monitored during birth, why? Why can't the same to be done at home?

I'm starting to dread the birth now. I'm thinking that they want me in hospital, on my back, monitors on etc. I've never birthed that way & don't want to start now. I feel like a fight is on my hands but at the same time I don't want to put my baby at risk.
 
Hi, my first was 2580g (5lb 11) at just over 38, my daughter born at a similar gestation was 2720 (6lb) born at home, it was never a concern during my second pregnancy that I would have another 'small baby' it wasn't even mentioned, I had no extra scans or seen by a dr because of it, at the end of the day there are babies that need to be on the 10th centile just as on the 90th.

Where I work a referral to be seen by a consultant/ extra scans if is a previous baby is <2.5kg so I'm unsure why you were made 'high risk' in the first place.

So on the homebirth issue, it's your choice on what you ultimately decide, a midwife will attend (they legally have to) and anyone that tells you otherwise is wrong, if you have any problems with this ask to speak to a supervisor of midwife, they can make a plan with you. Your consultant will keep saying the safest option for you is deliver in a hospital, that's their job, by monitoring they would want continuous ctg but this would only be indicated for a baby on or below the 5th centile by scans.

The risks would be that a small for dates baby would not tolerate labour.

It's a hard one but only you know what will best for yourself and baby. Wishing you all the best x
 
Baby on the 10th percentile still puts him on track for being 2.7=2.9kg (6-6lbs5oz) depending on gestation at birth. Totally normal, especially with your history having had babies on the small side,having been small babies yourselves and both of you being smaller adults. Thats one thing /I really hate about growth charts - they put you in a one size fits all box and dont take into account family history and genetics. A friend of mine is English and had her baby in Japan where the growth charts they use are obviously tailored to smaller babies and the drs were all freaking out about her baby measuring off the charts .
Some babies have to be on the poles of the growth charts, thats just a fact and not concerning. (on its own) If a baby was measuring in negative percentiles or was consistently dropping percentiles (ie 40 to 30 to 20) that would be one thing. But small parents who have had smaller than average babies having another small baby would ot concern or surprise me at all if that was the only factor.
 

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