nhs honebirth or independant midwife

[summerhat]

Just looking for some advice on which to choose.
after having my first in hospital 2 years ago I knew I wanted a homebirth this time, labour and birth went ok but I think the interventions I had led to lots of issues and a 7 day stay in hospital. I was tempted by homebirth last time but not quite brave enough to go for it, if I had done and was with the nhs I would have been made to go in anyway but if I had hired the midwife I want now I most probably would have stayed at home and all would have been fine.
so just wanting to know if anyone has any experiences or words of wisdom to help me decide, the independant midwife is expensive especially when I could get it for free but I know it will be money well spent.

 

[MindUtopia]

One thing I would look into is if there is a dedicated NHS home birth team in your area. If there is, you might find that you already have supportive local midwives with lots of home birth experience without the cost of hiring an IM. That might be something to consider researching and deciding if you'd be comfortable birthing with them. It seems like your experience last time was less due to not having midwives who were supportive of home birth, but simply not opting for it and ending up in hospital where it was easy for all the interventions to unfold. If you can stay out of hospital with supportive NHS midwives at home, you might find it's a totally different experience without the cost.

That said, my first birth was a home birth with NHS community midwives (we actually didn't have a dedicated home birth team then, though we do here now). I have few complaints about my antenatal care and birth support. The midwives were generally really lovely and supportive. I do think it would have helped a bit had they known me and known my wishes a bit more as sometimes they didn't always give me the total support I might have needed during my birth, but really it was a good experience.

But next time, I'm opting for an IM, simply because I want better postnatal care. My postnatal care was awful and the midwives I saw postnatally were really unsupportive of breastfeeding, which I was at the time struggling valiently to do, despite having a baby who was losing a lot of weight and not latching well. I just saw a different person every time and they all had advice that conflicted what the last one said and we ended up going in for a 5 day hospital stay so they could monitor my daughter's weight and "provide breastfeeding support", which basically just involved me sitting in a room ignored for 5 days while no one did anything to support us. Next time, I really just want one person I trust seeing us and supporting us and not just an endless stream of nameless, grumpy midwives who were annoyed that I was preventing them ticking their boxes to discharge us from care because I wanted to breastfeed. I want one person I trust to provide that postnatal care. Also, it's our last baby, so if I want to have that experience of having an IM, this will be the last chance to do it. I think that plays into our decision too, and maybe yours as well?

But I would really say look into whether there is a special home birth team in your area and maybe even meet with them for your booking appointment to discuss your options. You may find you feel really supported and connect with them and not feel the need for an IM, or it may convince you that they aren't the right midwives for you and solidify your decision to go with an IM.

 

[BunnyN]

I think there are advantages to either. I am not in the UK anymore so NHS was not an option for us. We have had 2 lovely HBs with an IM.

Cost is the most obvious advantage of going with the NHS but unless you really can't aford it I wouldn't base it on cost alone. Doing what makes you feel most comfortable and gives you the best birth possible counts for a lot.

One of the things I loved about an IMW was getting the same person before during and after the birth. I felt it made my care very consistent and I got to know my MW well and got comfortable with her. I knew what her veiws on birth were and that she was willing to listen to me and work with my wishes. With a team you don't know exactly who will be there on the day. On the other hand there was no one to back up my MW if she was at another birth or had a personal emergency. The second time she was on holiday when I got to 37 weeks so I was a little nervous what I would do if I went into labour early.

NHS midwifes work with a higher volume of births so often have more experience. On the other hand you get less of a personal service and they are under the pressure of NHS polocy. It is always your choice if you are transfered to hospital or not but some MWs will be more supportive than others if you decide to go against policy. Some don't really support HB at all and will just be looking for excuses to transfer you, so like utopia says its worth looking into what they are like in your area. I felt very comfortable with our choice of a HB but think it would likely have been a battle to stay at home with an NHS team. 1st baby, large baby, high BMI, high BP. 27hrs active labour, stalled at 6cm for sevreal hrs. Second time the labour was not as long but I had high BP and baby was almost 11lbs. Our MW did have some real concerns but talked it through with us and was very supportive

I got the best of both worlds with an experienced MW that had worked for the state for many years then gone independent but if we hadn't found her I wasn't very confident about the amount of experience other IMWs in our area had.

It wouldn't hurt to look into what is available in your area for IMWs too. They can book up quick. From the first conversation we had on the phone with our MW I knew she was the one I wanted. We had talked to several before that that I wasn't too keen on.

 

[summerhat]

Thanks for your replies, utopia I didnt realise there were special homebirth teams but looks like in my area it's just the cummunity midwives so I would be a little anxious about getting someone I had never met and probably even more worried that that they would be short staffed and there would be no one available.
Postnatal care is also a big part of it too, I could almost accept going in for the birth if I knew I could go straight home afterwards. Postnatal care wasnt great last time for many reasons, breastfeeding was a nightmare as baby wasnt able to latch on at all and although the hospital has very good breastfeeding support it wasnt available due to staff shortages, he had to have formula untill I could express enough. I asked why he couldnt do it and if he could have a tongue tie but was fobbed off, he finally was able to latch on but not very well and he did have a bad tie. I have been let down by the nhs a few times now and just want someone i can trust.
I did some classes during my last pregnancy with the IM so I know her a little and she works in conjunction with 2 others to cover for illness and act as second midwife at birth, I think the plan is that I would get to meet them at a antenatal appointment. I have arranged a consult with her and hoping shes happy to take me.

 

[Button#]

I had an NHS home birth and I really can't fault it. It was the community midwives who attended me and they were all lovely. I knew some mums in the area who had had home births so I was pretty confident that I would have a good experience with the NHS midwives.