homebirths refused due to staffing issues

[milkmachine]

I'm curious about anyone wanting a homebirth because the very thought of it frightens me.

Why is it that you want one?

And if you are worried that you won't have an NHS midwife with you at home, could you hire one yourself privately or even hire a Doula? That way, you would still have a professional with you so you wouldn't be alone, you'd know for certain that you were getting your home birth and if for any reason you did need to transfer to the hospital you would have someone with you who knew when to make that decision.

because i was treated really awfully during labour with my daughter and i had a still birth at the hospital where i was too treated appallingly.
private midwives cost about 4k which isnt an option and doulas have no clinical standing they are prof birth partners not midwives. i would rather give birth alone than set foot in my local hospital to have another baby.

 

[Jody R]

I'm curious about anyone wanting a homebirth because the very thought of it frightens me.

Why is it that you want one?

And if you are worried that you won't have an NHS midwife with you at home, could you hire one yourself privately or even hire a Doula? That way, you would still have a professional with you so you wouldn't be alone, you'd know for certain that you were getting your home birth and if for any reason you did need to transfer to the hospital you would have someone with you who knew when to make that decision.

because i was treated really awfully during labour with my daughter and i had a still birth at the hospital where i was too treated appallingly.
private midwives cost about 4k which isnt an option and doulas have no clinical standing they are prof birth partners not midwives. i would rather give birth alone than set foot in my local hospital to have another baby.

That's so awful. When Ally was stillborn I was looked after really well and when we went on to lose Elisabeth they were very good again. It was hard to be back in the same room, with all the memories of losing Ally and knowing Elisabeth would also die but I can't really fault the care they gave me. I was relieved to be in a different room for Joseph's birth though. We had so many complications and needs for his birth that I wouldn't have been able to give birth at home even if I'd wanted to, but being in a different room made me feel a lot better.

I hadn't realised it cost so much to get a private midwife and I thought doula's had some professional training in the same vein as midwives.

I can understand why your bad experiences have put you off the local hospital. Could you travel to a different one or are they all too far away?

 

[milkmachine]

too far away it was something i briefly looked into. i also had a botched d+c at the same hospital going there unless its absolutely ness just isnt an option.

 

[KandyKinz]

I'm curious about anyone wanting a homebirth because the very thought of it frightens me.

Why is it that you want one?

And if you are worried that you won't have an NHS midwife with you at home, could you hire one yourself privately or even hire a Doula? That way, you would still have a professional with you so you wouldn't be alone, you'd know for certain that you were getting your home birth and if for any reason you did need to transfer to the hospital you would have someone with you who knew when to make that decision.

Studies show there are several benefits to having a homebirth. Women who plan to have homebirths are less likely to require interventions such as augmentations (labours are less likely to slow down or stall at home), pharmacological pain relief (women tend to cope better at home), episiotomies, instrumental deliveries, cesareans, etc etc. Women and their babies who are born at home are also less likely to develop infections in the postpartum in comparison to women who deliver in hospital. Maternal satsifaction in regards to the birth tends to be much much higher among women who have homebirths. They get to remain in the comforts of their own space, wear their own clothes, they don't have to deal with hospital policy restrictions regarding visiting hours, videotaping/photographing the birth, having children present, being able to eat or drink, etc etc.

 

[rachiedata]

Studies show there are several benefits to having a homebirth. Women who plan to have homebirths are less likely to require interventions such as augmentations (labours are less likely to slow down or stall at home), pharmacological pain relief (women tend to cope better at home), episiotomies, instrumental deliveries, cesareans, etc etc. Women and their babies who are born at home are also less likely to develop infections in the postpartum in comparison to women who deliver in hospital. Maternal satsifaction in regards to the birth tends to be much much higher among women who have homebirths. They get to remain in the comforts of their own space, wear their own clothes, they don't have to deal with hospital policy restrictions regarding visiting hours, videotaping/photographing the birth, having children present, being able to eat or drink, etc etc.

My reasons exactly... the frightening things about childbirth, for me personally, are the medical things. Forceps/ventouse, IV augmentation, episiotomies. PPH was the one thing that I was mortally afraid of, before I got pregnant. By staying at home (even if, in the end, I have to go to hospital) I am dramatically reducing the risk of having those. Another reason is because I can't think of anything more horrible for my partner to go through than to say, at hospital "Here's your beautiful new baby son, and the woman you love! Now go home and wait for 8 hours before coming back" - how cruel!! He's done as much as I have during this pregnancy (almost!) and I want that bliss of curling up in our own bed afterwards, with a glass of champagne and a cup of tea, patting ourselves on the back for our new creation.

The actual giving birth part, knowing when to push and what to do, how I will cope with the pain, the availbility or otherwise of a midwife or doctor, don't frighten or bother me at all really.

 

[special_kala]

My area only has 2 MW available for homebirths at any time so if someone else is in in labour im afraid i luck out. Someone on BnB actually lives in the same town as me and is due the same day so things could get interesting

If i am told that they cant send anyone due to staffing issues i will try and wait as long as i can and call again but im not going to stamp my feet and demand someone come see me as if i drag a MW away from the hospital im taking them away from 2-4 other pregnant women and i dont think that the birth i want is any more important then the safety of those women and babies.

 

[rachiedata]

My opinion is that if they're so short staffed, I definitely don't want to be in the hospital!

 

[Aidan's Mummy]

I can see both sides. I completely understand the importance of a woman's wishes when it comes to birthing etc. And they are many reasons why homebirths are great for mothers and babies

BUT staff shortages are a real issue within the NHS and I have personally experienced this as a student nurse to the point of it verging on dangerous due to be short staffed. And it isn't the MW's fault they don't decide how many registered midwives they can employ I am sure they will be trying their best. So if they really are short staffed, dangerously so then other mums in labour may be put at risk if they loose a midwife to a homebirth.

Like I said at the beginning I completkey understand and empathise with a lady wanting a homebirth and that wish being threatned. But staff shortages are a huge issue and the staff can only do their best x

 

[Mervs Mum]

I agree it's a tough job when you are understaffed but a woman in labour has a MUCH harder job. Unless women stand their ground then how can the trusts respond to the need? if we go in then it will look on the surface of it that everyone's needs are being met when they are not. If there are not enough teachers in school do the kids get sent home?! No they get supply teachers in and suck up the costs. There are 'bank' MWs and IMWs that they can use they just dont want to pay for them as they are stretched financially. It's not about women, it's about money. And as Rachiedata says if it's too busy on labour ward or in the community to send a MW to a labouring woman then heaven help the poor women giving birth in the hospital - they are in the real danger. If that's the case then they need to get a bank or independent MW to either labour ward or the home birth.

 

[Aidan's Mummy]

Bank staff are a godsend. But again it's getting past all the red tape and people above you. I have already had a heated discussion with the matron on charge of our ears about staffing and supplying bank staff her reply was " you don't need any" even though we were full to capacity and more coming through the door. I totally agree that the mother is at the centre of care when labouring and every need should be met for a MW to fulfil her duty of care and I'm sure any good MW would agree with that. It's just trying to get past those above us to give the extra support. So many professionals within the NHS are saying every day "we are under staffed we need more help" and we get one reply " funding will not allow it" It is so frustrating and I have come home so many times literally fuming because patient care is suffering. Something needs to be done but I wouldn't know where to start or who to talk to.

It is shocking how much patient care isnt fulfilled but the MW's on the ground can only give what they have. The people away from the 'front line' high up need to be addressed but like I said o wouldn't even know where to start.

Having head a pretty horrible birth experience in a hospital I can see excatly why women prefer a home birth and why they havens more positive birth experience. So women should maybe start a campaign of some sort? To make it clear that there isn't enough midwives being employed and patient care is suffering as a result of this. But again I would have no idea how to go about this. But I can garuntee the good MW's will be frustated with the situation like all of you. And I hope you all get your homebirths because labour should be a positive experience x

 

[naturalgirl]

If you must have a hospital birth, you could look into getting a doula. They are great about helping you learn how to advocate for yourself if you want natural birth in the hospital. Plus, the doula will stay by your side for the entire birth, do special comfort measure cares (like the double hip squeeze to take pressure off of your tailbone) and can help you even if you end up getting an epi or c-section.

Just a thought.

 

[Mervs Mum]

There are lots of campaigns like AIMS https://www.aims.org.uk/
Or local campaigners like Airedale Mums. https://www.airedalemums.co.uk/

This isn't a new issue and no one is suggesting for a minute that the MWs aren't doing their very best but the only way for something to change is if women and their families consistently demand that their needs are met. Every time a woman abandons her home birth plans and heads to the hospital she puts pressure on the hospital MWs and sends the very managers you're talking about a message that the needs of the WHOLE community, be they home or hospital birthing women, are being met when they are not.

 

[KandyKinz]

I think due to the nature of birth and the unpredictability of it sometimes issues regarding understaffing for homebirths just can't be avoided.

 

[MadMummy06]

More a question than a reply sorry but i thought you couldnt be refused a homebirth due to staffing? My situation is slightly different because we have a team of 5 dedicated homebirth midwives which means someone will always be able to come but my first midwife gave the impression that once you tell smeone your in abour they are obliged to come to you?
xx sorry if any of that is wrong?

 

[GeorgeyGal]

More a question than a reply sorry but i thought you couldnt be refused a homebirth due to staffing? My situation is slightly different because we have a team of 5 dedicated homebirth midwives which means someone will always be able to come but my first midwife gave the impression that once you tell smeone your in abour they are obliged to come to you?
xx sorry if any of that is wrong?

Thats what I heard as well, if your having a home birth and call for a midwife they have to send one out to you, no one can force you to go into the hospital, if you stand your ground they will send someone out, they have to.

 

[KandyKinz]

I think it ultimately depends on where you are and if they have staff available to attend you. I live in a very rural area and there's only one midwife here who does homebirths so if she's at another birth what other option is there but to go to hospital And I've been apart of bigger practices in which there are 3 or 4 midwives all on call at the same time but then they'll be a crazy weekend where 4 or 5 women will go into labour at the same time. It's just one of those things and it's really difficult to avoid due to the fact that labour is so unpredictable. Term is a 5 week window and unless one midwife is going to remain uncall 24/7 for that entire 5 weeks (which still doesn't gaurantee anything and would make for a terrible life for that midwife) two midwives would always have to be allocated to one client and one client alone. It's just not practical and it would result in even more women having to turn to the hospital because they couldn't get midwifery care to begin with.

But then again it's a different system here as while the midwives do work both at home and hospital for their clients the hospital staff (Obs/consultants and nurses) ONLY work in hospital...

 

[GeorgeyGal]

From www.homebirth.org.uk

What about staffing shortages?
Women planning a home birth are sometimes told that the local health authority may not be able to provide a midwife on the day, because of staffing problems. If you hold out for a home birth in these circumstances, you may feel guilty that you would be taking midwives away from other women who need them on the labour ward. This is an understandable concern, but it is important to remember that staffing levels are the health authority's responsibility, not yours. You may sympathise with their problems, but remember that “where there's a will, there's a way”. Trusts which are fully supportive of home birth find a way around this problem; so can yours.

While sympathising with the health authority's staffing problems, you can ask what they are doing to resolve their staffing problems. Advertising vacancies is insufficient - perhaps providing their midwives with more autonomy and job satisfaction, for example with the opportunity to attend births at home, would improve their retention of midwives.

If women are persuaded to abandon their home birth plans on the grounds of staff shortages, the health authority will have no incentive to improve its services for other women - so by holding out for a home birth you are helping to improve choice in your area, and helping to make midwives' jobs more interesting - and you are also saving money for the NHS (see below).

Every health authority has access to what are called 'bank midwives', and most use them regularly when they have staffing problems in the hospital. These are midwives who work on a temporary basis, sometimes for just one shift at a time (a bit like supply teachers). Some will be midwives who are employed by the same health authority, who are taking on extra work - doing overtime - and others will be midwives who want to work part-time but who have not obtained a permanent part-time job, or midwives who are currently taking a career break to look after their own children, but will work occasional shifts, or semi-retired midwives. All 'bank midwives' are all fully-qualified midwives. If there was a genuine shortage of midwives on the labour ward then the health authority should always be able to arrange cover on the ward from a bank midwife, thus freeing up a community midwife to attend home births.

In some areas, independent midwives work as 'bank midwives' when they are not needed by their own clients. On occasion, independent midwives have attended home births on behalf of health authorities who could not arrange cover from their own employees. Sometimes such arrangements are made in advance - when people talk of arranging an 'extra-contractual referral' to an independent midwife, they mean that an independent midwife would be booked to attend you, but would be paid directly by the health authority.

See 'Home Birth Bullying' from AIMS for suggestions on dealing with this situation, and also 'Home Birth Alert' for a sample letter to send to your health authority. If you still have difficulty in arranging your home birth, please contact Beverley Beech of AIMS - she is very experienced in supporting women in this situation, and would far rather that people contacted her, than fought on alone.

 

[Rebecca_B]

Hi ladies,

I wanted to ask your opinion on what i went through last labour (8 months ago) and my labour this time see what you advise....

I requested a homebirth last yr with charlie. We were all set to go and i went into labour on Fathers day and rang labour ward to let them know contraction times and told them it was a home birth.

They said they would ring the homebirth team and let them know and they would ring me back.

They rang to say they were attending another labour and would release one of the midwifes to come to me as soon as her baby was born.

I progressed quickly and my contractions were back to back within the hour and i knew i was close to 10 cms.

Labour ward was rang and said to mum that home birth team hadn't delivered baby so i would have to transfer.

I went to hospital and on examination was 9 cms.

Had baby on all fours 20 mins later. Was home once all paperwork was done (3 hrs later)

I so want this baby at home this time, it would have been the perfect homebirth but how can i be sure i will have a midwife to see to me??????????????