Hospital is 1/2 hour away, I want a home birth, what to do?

[SarahBear]

Hello,
I'm not pregnant yet, but I'm thinking a lot about kid #2 these days. My first was a home birth after a 3 hour labor. I have since moved to a rural area where I am unable to find any information about a homebirth midwife. Even if I could find one, chances are, she'll be far away which could be a problem, given that a second labor is often half as long as a first labor. Also, my husband doesn't drive, so even a hospital birth could be problematic as a half hour drive while in precipitous labor is a really bad idea. I am sooo tempted to just give birth at home and call an ambulance afterward to check us over after the fact. A more realistic consideration of mine is to rent a place for about a month toward the end of my pregnancy, in the same city where I gave birth previously. This would allow me to have the same mid-wife and a non-hospital birth. I don't know how realistic it is financially, though... arg.

 

[BunnyN]

If you have a MW who can communicate with the hospital 1/2 really isn't as far as you would think. Most medical emergencies can be taken care of by a MW if she has the right equipment and medications with her (it's a good ting to ask) and if you require surgery it would generally take more than 20 mins for them to get ready for you even if you were in hospital.

If you have no MW it's a bigger decision. Renting a place could be a consideration. Would you stay there full time or just go at the first sign of labour? if you go overdue it could mean staying away from home for quite a while. What country are you in? Is it an independent MW? We had an IMW and she had no issues with coming from almost 1/2 away.

 

[Yo_Yo]

I'm in the same boat.
Not pregnant either, but my last birth was 40 mins from the first twinge, so I worry about getting to hospital which is 30/45 mins drive away.

I'm planning on a home birth as I think I've no other choice.

You could always call an ambulance when you up into labour if you want s hosp birth i guess?

 

[SarahBear]

I'm in the US where the only independent midwives do homebirths. Hospital midwives work in the hospital and they work under an obstetrician. I'm not concerned about an emergency. I've given birth at home before. The distance is only an issue if birthing in a hospital is my primary plan.

If I rented a place, I'd be staying there full time. The town where I gave birth previously is 3.5 hours away and if I were to rent a place, I'd want to use the same midwife I used last time. I'm not concerned about what would happen if I were to go into labor too early, because that would be a 911 call and a hospital birth, anyway. If I go into labor late, that's a different story. I'm hoping that since I gave birth before my due date last time, I'll go into labor before my due date next time.

I'm thinking that renting a place might be my best bet. Open to other ideas if they're out there, though.

 

[madasa]

You say you want a home birth - so plan for that. Go into labour. Call a MW, if they can't make it in time then you may be offered/want to ask for an ambulance.

If baby arrives before a MW or ambulance, remember: when birth happens fast, it's usually happening well! So stay calm, keep warm, keep baby skin to skin and covered and leave the cord alone. After a fast birth, some babies are a little slower to start using their lungs, but keep using the placenta while they transition to life on the outside, but it's really important for you to stay calm

 

[MindUtopia]

I agree, if you want a home birth and you feel good about it because you've done it before, then plan a home birth. I'd have no qualms about being 1/2 hour from hospital (we're about 20 minutes ourselves). Where would the closest home birth midwife to you be? My friend hired a midwife who was 2.5 hours from her (by choice, there were some closer but she liked this one). She did wait too long to call her (well after labour started because her first birth was 3 days and she didn't expect it to be shorter), but if she'd called midwife at the start of labour (which was 12 hours), she would have easily arrived in time. I expect to go quickly next time, just a feeling I have and my feelings about my first (a home birth) were 100% right, so though I'll hire a midwife (independent midwife here), I still plan to at least prepare to birth unassisted if it happens. It's not the ideal, but if the choice was to stay at home for a quick birth or rush to a hospital, I'd always stay at home.

 

[SarahBear]

You say you want a home birth - so plan for that. Go into labour. Call a MW, if they can't make it in time then you may be offered/want to ask for an ambulance.

If baby arrives before a MW or ambulance, remember: when birth happens fast, it's usually happening well! So stay calm, keep warm, keep baby skin to skin and covered and leave the cord alone. After a fast birth, some babies are a little slower to start using their lungs, but keep using the placenta while they transition to life on the outside, but it's really important for you to stay calm

But first I'd have to find a home-birth midwife in the area... See, that's the trouble.

 

[madasa]

If there are none in your area, then maybe you can find one who can travel? (Not sure if that is feasible). If not, then either a resolve to birth alone or plan a hospital birth (which can still be a positive experience - what choices of hospitals do you have? What are their stats relating to normal birth?)

Have you hired a doula? I'm just trying to think of ways to help you have the most positive experience possible, even if you are not where you ideally hoped to be.... And if your labour is progressing quickly, it could be helpful to have someone calm and knowledgeable on hand when deciding when to make the move to hospital.

 

[Pearls18]

My first labour was 4 hours and my second ended up being 1 hour, I planned a home birth but the MW didn't make it in time so hubby delivered baby. All was fine MW turned up shortly after there was no need for an ambulance, I am so relieved I planned to stay home so we werent trying to get to hospital with anything happening en route. I would look into what doulas/MWs are in your area first, this sounds simpler than resorting to renting somewhere closer to a hospital, that would be worst case scenario for me, sounds like a lot more effort.

 

[SarahBear]

My first labour was 4 hours and my second ended up being 1 hour, I planned a home birth but the MW didn't make it in time so hubby delivered baby. All was fine MW turned up shortly after there was no need for an ambulance, I am so relieved I planned to stay home so we werent trying to get to hospital with anything happening en route. I would look into what doulas/MWs are in your area first, this sounds simpler than resorting to renting somewhere closer to a hospital, that would be worst case scenario for me, sounds like a lot more effort.

I wasn't considering renting a place closer to a hospital. I was considering renting a place close to a midwife.

 

[SarahBear]

Turns out there is a midwife near me... not sure I want her though... https://theworldlink.com/news/local...cle_fe8c935c-be46-11e2-a4b7-0019bb2963f4.html

 

[BunnyN]

We were faced with a similar choice. One of the only MWs in our area had been in the news shortly before. In the end we did actually decide to contact her anyway and see what she had to say and what impression we got from her. It turned out she wasn't available for our dates. It is off putting but then it's one of those things that can probably happen to a good MW under the wrong circumstances.

 

[SarahBear]

We were faced with a similar choice. One of the only MWs in our area had been in the news shortly before. In the end we did actually decide to contact her anyway and see what she had to say and what impression we got from her. It turned out she wasn't available for our dates. It is off putting but then it's one of those things that can probably happen to a good MW under the wrong circumstances.

I read about a couple situations in which she should have sought intervention and didn't. In one case, the mother needed an emergency Cesarian and the midwife got upset when the mother chose to transfer. In this case, the baby had multiple clear signs of distress and she didn't advise the mother to seek medical attention. I feel pretty confident about my ability to give birth and the ONE thing I want out of a midwife is the ability to spot the need for intervention. She seems to be opposed to letting the medical establishment "interfere" with "natural" labor. I am as well, until a medical need arises!

 

[Shadowy Lady]

honestly I'm all for home birth but in your situation I don't think I would do it. Your baby may come so fast (given your quick first labour) that your hubby may have to deliver him/her. It can be done but I personally would want that task for my midwife only.

I may have missed it but are you against birth at hospital with a midwife? I'm in Canada so things may be a bit different here. But I had my first at a hospital with a midwife and it was an amazing experience. I had a 4 hour labour/delivery and was home only 3 hours after she was born. I would want the exact same setup if I ever were to have another child.

 

[madasa]

Sometimes labour happens fast and you can't get to hospital in time, or the midwife doesn't make it. On balance, even if you're not a fan of home birth, it's usually (not always, but usually) a better option than, say, a taxi birth. Or a roadside birth. I've even heard of some midwives recommending home birth as a better option for women with a history of precipitous labour. Not all HCPs will agree, of course! But I'm fairly sure many will agree that a mad dash to hospital with a labouring woman and terribly distracted driver isn't very safe.

Note: I edited my last post to clarify - I mentioned doulas thinking it could be an asset for a hospital birth in your situation, not as a replacement for a midwife. Obviously a doula could never replace a skilled and competent midwife, the roles are very different

 

[Pearls18]

One of the reasons I home birthed was because my first labour was 4 hours which is relatively quick for a first and I was worried about not making it to hospital, just as well I did because DS2 was out in about an hour from waters breaking to delivery, I just wouldn't have made the hospital in time even though the hospital is only 5 miles away, if you factor in sorting out DS1 and London traffic plus we had no idea how quickly it was going to go because my contractions weren't terrible so I thought I had a way to go so we weren't rushing, we hadn't even started getting the pool up straight away. As my MW told us before the birth the births that are so quick that they happen before the MW arrives are usually the most straightforward, my husband did deliver DS2 (well he watched him come out and then wrapped him in a towel ) and all was fine, I definitely would not risk a journey to the hospital in our scenario, doing that on the side of the road would not have been better I don't feel, it would be safer for an ambulance to come out to us if something hadn't gone right, at least we would have been easy to find and had towels, heating etc (baring in mind it was December).

 

[BunnyN]

I was thinking the same as what other ladies have said. If you are at risk of giving birth on the way to the hospital i wonder how much safer it would be than to plan a HB.

 

[Kirstiedenman]

im in Australia and half hour was fine for a home birth that is how far I lived from my hospital and it stated as a requirement to have a homebirth that you had to live within half hour of the hospital so I would say it would be fine unless it is different around the world

 

[SarahBear]

im in Australia and half hour was fine for a home birth that is how far I lived from my hospital and it stated as a requirement to have a homebirth that you had to live within half hour of the hospital so I would say it would be fine unless it is different around the world

Hospitals don't do home births here in the US. If you want a home birth here, you have to find an independent midwife. You also can't give birth with a nurse midwife unless you're in a hospital, in which case, the midwife must work under a doctor. Your choices here are basically doctors or midwives who are not nurse-midwives. So the trouble with being a half hour from the hospital is that I'd have to drive there or call an ambulance.

 

[misspriss]

im in Australia and half hour was fine for a home birth that is how far I lived from my hospital and it stated as a requirement to have a homebirth that you had to live within half hour of the hospital so I would say it would be fine unless it is different around the world

Hospitals don't do home births here in the US. If you want a home birth here, you have to find an independent midwife. You also can't give birth with a nurse midwife unless you're in a hospital, in which case, the midwife must work under a doctor. Your choices here are basically doctors or midwives who are not nurse-midwives. So the trouble with being a half hour from the hospital is that I'd have to drive there or call an ambulance.

Well, you can get a homebirth with a CNM, but most of them work for hospitals and don't do homebirths. I just found a CNM in my area that works independent of the hospitals and does homebirths. She might be my only option if I wanted to try a HBAC, since CPMs aren't allowed to do VBACs in my state.

Here at least, you can either have a doctor in the hospital, a CNM in the hospital, a CPM at home, or if you are lucky, you can find a CNM who has chosen to go the less-profitable route of being a homebirth midwife.