home birth with 5th baby

[wiggle]

Hello! I am 5 months pregnant with my 5th baby and after speaking with a midwife and doctor I have been refused a homebirth. They have said that the chances of bleeding with your 5th baby is greater then with the first 4 and think the risk is too high to stay at home. Does anyone know if this is correct. I can't seem to find any info and would like to be informed. Thank you.

 

[SimplyRhi]

There is some info on the Homebirth.org.uk website about it: (have a look at site for more!!)

'Grand Multiparas and Home Birth'

Is a mother who has already had five or more pregnancies at higher risk? Can she still plan a home birth?

The concern in the past has been mainly that grand multiparae (mothers who have given birth five times before) were at higher risk of postpartum haemorrhage and some other complications, because the uterus might lose its elasticity and therefore might not contract down well after the birth.

The latest research and expert opinion suggests that in fact a woman who is healthy and who does not have a history of such complications is no more likely to be at risk simply because she is a grand multipara. Below you will find research abstracts, and a review from a professor of midwifery, which suggest that a woman's previous obstetric history and personal health are more relevant than the fact that she has a large family. The older studies which led to these worries may have been misleading because control groups were not matched for age or for pre-existing health problems such as diabetes or high blood pressure.

 

[mamato2more]

My first and second homebirths were with #4&5..No heavy bleeding...It was fine..I would keep asking

 

[Celesse]

I believe there is an increased risk of bleeding. But like with all risks they cant refuse you a home birth. They can recommend you come into hospital, but if you refuse they have a duty of care to provide a midwife. I would get researching into the risks, how high they are and if you consider that an acceptable risk or not. The home birth site linked above is a good place to start.

 

[mrsmo7]

The concern in the past has been mainly that grand multiparae (mothers who have given birth five times before) were at higher risk of postpartum haemorrhage and some other complications, because the uterus might lose its elasticity and therefore might not contract down well after the birth.

The latest research and expert opinion suggests that in fact a woman who is healthy and who does not have a history of such complications is no more likely to be at risk simply because she is a grand multipara. Below you will find research abstracts, and a review from a professor of midwifery, which suggest that a woman's previous obstetric history and personal health are more relevant than the fact that she has a large family. The older studies which led to these worries may have been misleading because control groups were not matched for age or for pre-existing health problems such as diabetes or high blood pressure.

This is all true the latest research says a grand multipara is no more likely to have a pph than anyone else if she has no history of it! And you are not even a grand multipara yet!

I am expecting my 5th baby and even my consultant put me back into midwife led care because she said i was no higher risk with this one as i have had no trouble before!

I would go back to them and ask again but as people have said they can not say no!

 

[summer rain]

Hi

my mum had her 5th at home in the 80s when home births were thought to be a lot more risky for various other reasons and the fact it was her 5th really wasn't an issue at all. I have seen some hospitals/health authorities don't deal with many home births and they see it as an inconvenience so they will use any excuse under the sun to say you're not allowed one. I wouldn't be surprised if they are telling some women they can't have a hb as they have staff shortages; and women with a slightly raised BMI they are too large; etc etc. I think you need to present the facts above and stand your ground.

Soph x

 

[wiggle]

Thank you all for your amazing replies and advice. I have had 3 fantastic homebirths and labour quickly so after the initial lack of energy to question further with the midwife, I have started to wonder if my risk at trying to get to hospital before the baby pops out is higher than a bleed - I think probably yes. Its funny how vulnerable you become - I am usually so sure of all reasons for birthing at home and have been a Doula! Great to read that others have tried and succeeded. I shall begin my research.

 

[Celesse]

So I'm geeking HBAC (again, and I'm not even pg yet) and reading the NICE guidelines and found you something. https://www.nice.org.uk/nicemedia/live/11837/36275/36275.pdf

See pg 65. It lists baby#6 as an "Other factors indicating individual assessment when planning place of birth". It does not list grandmultiparity as a "factors indicating increased risk suggesting planned birth at an obstetric unit." and its baby #6 not baby #5 mentioned in the NICE guidelines.

Big fail on behalf of your midwife and doctor who need to read the NICE recs! That should give you some ammunition in getting your h/b.

 

[snagglepat]

I've had a client who had her 5th and 6th at home. She chose to have a managed third stage for the sixth just in case - and she had had a PPH with one of her earlier births - but that was her choice. She was asked to have a meeting with the consultant each time to discuss the risks but it was fine both times - though she was clearly very well informed.

I'd definitely go back armed with some of this research and ask them why their recommendations don't follow up-to-date guidelines and studies. A quick letter can work wonders as well. Questions and concerns given in writing have a lot of power in these matters.

Good luck!

Gina. x

 

[mandy121]

i had my 5th at home and now there saying i cant have my 6th at home but i will dont care as it more relaxing at home and i got a nearly 3 yr old and no one to have him xx

 

[rach247]

Hi all just wanted to say I have finally been agreed a homebirth for my 5th baby yay . The guidelines from NICE have changed its not the 5th baby that is the issue now its 6th baby. This changed from me being referred to the consultant to me actually seeing him lol. He is the one who has approved my homebirth. Hope this helps

 

[mandy121]

i spoke to midwife and have a appointment to see the consultant about home birth and she said my last one went ok and no problems with bleeding after so i hope i can get it this time xxx

 

[Poppypants72]

I'm sure you will do a fab fab job with 5 love...us women know who to multi-task!

I'm del, I have 4 girls (2 sets of twins - 5yr olds & 2yr olds) and we are currently TTC No 5 I'm so excited about it all, it will be a challenge but I know we are ready for it!

Good Luck love! x

 

[Aunty E]

Good luck - my mum did have a post-partum haemorrhage with her fifth, she was in hospital, but she'd have had tons of time to get to hospital (if she hadn't been there already), I don't remember much panicking or rushing around or anything, the staff were pretty chilled about it.