Is this a good recipe for a homebirth?

[aob1013]

Definately thinking ahead here, but next time i am determined to have a home birth. I have a few issues though:

1) Leni was prem, so i may not be 'allowed' one. I'm at risk of having another premature baby, so is it even worth planning a HN?

2) Nearest hospital is 40 mins away. Leni went into distress last time and he was out in about 10 minutes, so i know now how crucial time is and how quickly things change

3) I had an emergency section lastime, what about the risk of rupture? Etc?

 

[Ouverture]

I'm no expert. . .just speaking from what I've heard.

Every baby is different - just because Leni was early doesn't mean all your babes will be premature Plus, if you go into labor early. . .you can go to the hospital. If you go to term, you might be ok/more comfy doing it at home.

As far as the c-section - I'm no expert, but I hear that the risk of uterine rupture is actually very very low (like 1-3%) but it depends a bit on your incision. If it's up and down, VBAC is a no-go. If it's across your bikini line, and the uterine incision is as well, then you are a good candidate for VBAC.

I'd say call up a homebirth midwife and see if she would be on board with you doing it!

Good luck

 

[aob1013]

Thank you hun x

 

[kiwimama]

You won't be allowed to have a homebirth before 37 weeks anyway, so if you do go into premature labour, you'll be off to hospital anyway.

Is the nearest hospital 40 mins away by car? It will be substantially less if you go by blue light ambo, so that's worth remembering. Do you know the reason Leni went into distress? Just because he did doesn't mean that your next baby will. If you need to transfer, you will go by blue light ambo and they will usually have the surgery set up and ready to go the second you get there.

I'm sorry I don't have any advise about rupture etc. https://www.homebirth.org.uk/ is a very useful site full of information, stats, and answers to the typical "what ifs" people have when considering a homebirth.

When the time comes, find a very supportive midwife who is pro natural/ homebirths. It makes everything alot easier and less stressful.

 

[Mervs Mum]

As Kiwi said you'd go to hospital before 37 weeks. What if you go to 41 weeks and didnt plan out in case you went early? Surely the sensible thing is if you want one plan and change your mind later? You can go to hospital any time from home but if you go to hospital and wish you were at home I'm afraid the Mws will not come with you!

Mws are watching for things much sooner than at home. They would transfer at the first signs of anything they felt they'd rather be in hospital to deal with. They factor transfer time in to that too. Your baby was probably showing a pattern and then they reacted after they'd waited as long as they could where as at home they dont wait.

Ultimately only YOU know if you are a good 'recipe' for home birth

 

[Bournefree]

If you are premature there still is no LET or ALLOWED as far as Homebirth is concerned... it will be recommended, and it is your choice to go in or not. You will know at the time how you feel about this, and it shouldn't stop you from planning a homebirth... and as MM has said it is easy to plan for a HB and then have to transfer if you feel you need to, rather than wantting to be at home if you are in hospital.

Risk of uterine rupture is 1 in 500 that is in fact 0.02% and if it does happen it happen very slowly, so there would be plenty of time to get in. Plus your care at home will be 1 on 1, not something that your likey to get in the hospital or birthing centre. At home your MW will NOT leave you to go and attend to another lady.

Also at home you will be monitored, but you won't be constantly monitored, as I'm sure you were with your first. There are many variences with babies HR during birth that isn't fully understood and some of it occurs naturally. You also won't become distressed yourself.. having to listen to every beat of your babies heart.. and wondering why it varies so much - as there is a significant link between mother's stress and the babies distress. It is a factor of the slipery path on intervention that leads to so many of today's strange stats on numbers of c-sections in the "modern" world.

Ultimately it is about your choice, based on evidence and information - so you can make an informed decision; and where YOU will feel most secure and comfortable.
XxX

P.S I have jsut been talking to a friend of mine who is just 3 weeks ahead of me in her gestation, and she is trying to wiegh up the benifits of a vbac v elective. I couldn't empathise how important it is to her to be fully informed of the stats, research and information that is availible on VBAC. She is 20weeks, and although she has already had several meetings with her consultant.. the risks of VBAC have been explained to her, but HAVE NOT been put into context (she hasn't recieved any information on the data). How is she meant to make an informed decision on her body or baby, without this?? It boggles the mind!
Her first birth baby was back to back, and she was labouring slowly (as women ofen do with baby in this position) so she was on the clock, offered to rupture her membranes, then she didn't progress enough, so she was offered IV induction drip, got to 7cm, she was in alot of pain and very tired, offered and epidural, still failure ot progress, she and baby bacame so distressed after an ordeal of 17hours in the hospital, she was offered the emergency c-section after 24 hours. I hope she wouldn't mind me telling you, that this is a classic slope of interventions.
You offer yourself a better chance of a normal delivery and a lower risk birth by planning a homebirth - which a statistical fact.

 

[aob1013]

Thank you all for your food for thought

I didn't make my first post clear enough, i know i would have to go to hospital and i wouldn't be allowed to have a HB if baby appeared prematurely again. What i meant was would they even give me a chance for a HB considering my history? x

 

[Bournefree]

Thank you all for your food for thought

I didn't make my first post clear enough, i know i would have to go to hospital and i wouldn't be allowed to have a HB if baby appeared prematurely again. What i meant was would they even give me a chance for a HB considering my history? x

I'm sorry to keep on at my point - but there is NO let or ALLOWED! It is your body, your choice - they can only advise you.

So you can have a HB if YOU want to! So the chance of a homebirth is upto YOU. Seriously, I'm not kidding around here.

The same goes for a birth centre birth, if that is what you choose to do - it doesn't have to be all or nothing. Please make yourself informed or your rights and choices.
XxX

 

[Mervs Mum]

The word 'ALLOWED' is BANNED on this board

 

[aob1013]

Thanks girls!

So they actually cannot refuse me??!

 

[Mervs Mum]

What are they going to do? Send the police around and drag you into the hospital????? (I'm not being factious here honestly!!) They cant MAKE you go anywhere and they have a duty to send someone to you. No one wants a fight but if you feel you are making an informed choice then you can birth where the heck you like!

 

[Tegans Mama]

What are they going to do? Send the police around and drag you into the hospital????? (I'm not being factious here honestly!!) They cant MAKE you go anywhere and they have a duty to send someone to you. No one wants a fight but if you feel you are making an informed choice then you can birth where the heck you like!

legally if you call a hospital whilst in labour and say "I am in labour and staying at home, please send someone to assist" they can't refuse. I say this to everyone who asks but they don't believe me!

 

[Celesse]

I definately agree that on these boards the word "allowed" needs to be replaced with "recommended". Unfortunatly "allowed" gets used too much and prevents us from making our informed choices. Health professionals may "recommend" a hospital delivery at before 37 weeks because there is a high chance of breathing/feeding problems and the baby needing help and monitoring. But they may also "recommend" a hospital birth for a VBAC as there is a small chance of a uterine rupture and a high chance of being sued if it does happen. Instead of informing us what the risk is and how likly it is to happen, medical professionals tell us what we are or are not "allowed" to do and remove that choice from us.

I would say do your research, know what the risks are and then decide if that is an acceptable risk to you. I think you should plan for where you feel most comfortable and adapt if things change.

My next baby will be a VBAC labour and I intend to plan for both hospital and home and decide at the time where I feel most comfortable. I don't want to be in hospital attached to a monitor if everything is normal, but I also don't want to feel presurised to stay at home cos I've had to fight to get a home birth.

 

[Jenniflower]

The word 'ALLOWED' is BANNED on this board

Hear hear! hahaha And actually it should not only be banned on here, but also in our midwives vocabulary. It's amazing once you start looking into it how many rights you actually have. Your consultants and midwives will sometimes recommend other courses of action, some will be very persisant, some even use the horrid word "You're not allowed" But technically THEY'RE not "allowed" to say that! lol. I know what it's like first hand to have a small "fight" here or there with your midwives but really in the end they've respected me more and we have a great relationship. My midwife has told me on more than one occasion I'm stretching her knowledge as a midwife, but that it's a good thing!

 

[aob1013]

I didn't actually know it's up to me and nobody can tell me otherwise!

At my booking in app with Leni was i was hmm about 12 weeks she asked me what i wanted to do, and i said i wanted a homebirth, she told me 'no' ... next time, i will be TELLING her so!

 

[Jenniflower]

I didn't actually know it's up to me and nobody can tell me otherwise!

At my booking in app with Leni was i was hmm about 12 weeks she asked me what i wanted to do, and i said i wanted a homebirth, she told me 'no' ... next time, i will be TELLING her so!

Midwives sometimes.. I swear... I'm so glad you came on here then so you can get all the confidence you need to go back in there next time and tell them how YOU want to give birth! YAY! I love when people learn they have a choice. It makes my heart fuzzy.

 

[aob1013]

I'm glad i asked, as i honestly didn't know it was up for debate. I thought what MW says, goes. Like the thread in BC, being told i can't wear my own nightie??!?!? FGS!!! I can't wait to do it in my home, my own way. I never ever ever ever want to be induced again. It was vile. Obviously i had no choice at the time, but if i go full term and they start pushing for an induction, i'll have to decline that too!

 

[KandyKinz]

Definitly research the guidelines for the midwives working in your community, but it seems to appear that you UK girls are entitled to midwifery assistance at home regardless of the situation.

Here where I am in Canada it is slightly different. The midwifery guidelines have established four contraindications for homebirth which include: breech, multiples, prematurity (7 weeks) and postdates beyond 43 weeks. If a woman pages in labour and has one of the above contraindications the midwife can legally refuse to come to the clients home forcing the woman to either have an unassisted homebirth where she could potentially face charges for negligence in obtaining medical assistance during childbirth as well as potential infanticide charges should the outcome is not good...... or she could meet the midwife in the hospital.

Midwives can recommend hospital births for other risk factors present eg previous cesareans, previous hemorrhages but they cannot abandon care or deny homebirths for such reasons. So in your situation, you would still be considered a candidate for homebirth though there would be ALOT of discussion in regards to the risks involved in terms of rupture.

 

[Bournefree]

Legally speaking in the UK an individual Midwife can refuse to come to your home when you make the call that you are in labour and require assistance. (They would need good reason) However, there is a legal duty on the Women's Hospital or Birth Centre (or where ever she made the call to a point of the health authority) to take action for her care.

Inter partum care is defined in statute as a primary care need. So, what I'm trying to say is, even if all the midwives at the unit refuse to care for the lady (and they would need very good reasons.. such as an inability to attend certain presentations.. although these would be at the very serious end of care need, as midwives have a duty to train and keep there skills up to date.. i.e it wouldn't be enough that they hadn't attended a labouring women in water) The health authority (or a person acting on behalf of the health authority) could arrange to send an ambulance as an alternative to a midwife. However it is debatable whether this would be appropriate..(I think it isn't) Ok to transfer you in, but the expertise of a paramedic isn't of that of a midwife and could be seen as woefully inadequate level of care, and a failure in the health authorities duty towards the women. You have the right to refuse any treatment including being taken into hospital. However you have to accept your proportion of what making that decision has lead to the causation of outcomes if you do.
So they have a duty to offer you care but the law is wide open at the moment to WHERE that care is - as the statue is not prescriptive about where the care should be. (I personally see this as a legal positive to women staying at home) There are government guidelines to health authorities where there is a onus on them to offer choice to a women for her place of birth and this is clear statement of intention.. but it isn't law. So until we see a test case it is unclear if there IS in fact a legal right to MIDWIFERY care in your own home.

I'm facing staff shortages at my NHS trust, and they may not be able to send me a midwife when I'm in labour. However I am giving them plenty of notice, so they should be able to do so at the time and with an appropriately trained, confident midwife. If they can not increase the likelihood of me being seen at home, then I will be bringing this test case myself.
It is clear as mud isn't it.. and far from black and white! The key is that you are entitled to Care in labour and that does include home.
XxX