Refused a midwife to attend home birth?

[Chellepot]

For those of you who have had home births, did any of you initially get refused midwife attendance because they were "too busy"? If so, what did you do?

Part of me is concerned that a midwife may not be available and I heard the other evening my local hospital "suspended" home births. Can they do that?

I have hired a doula but can't afford an IM if I do decide to have a home birth, my husband might not even have a job come July due to redundancies in the Armed Forces so we have to be careful with our money. I have looked at a few websites but they don't really answer my questions.

Grateful for any wise words

 

[disneyleanne]

I attended a home birth a couple of months ago, one that the hospital fought with the mum on all the way. when we called for a midwife to attend they said that they were very busy, but they cannot of course refuse to come out as they have a duty of care, so they sent midwives from a different area.

I would recommend you read a book from AIMS called "Am I Allowed" as there is a great letter in there that explains the hospitals duties when it comes to a home birth.

 

[Chellepot]

I would recommend you read a book from AIMS called "Am I Allowed" as there is a great letter in there that explains the hospitals duties when it comes to a home birth.

Brilliant thanks! I have their VBAC book already and found it very informative but I didn't know about the other one

 

[booflebump]

They HAVE to send someone out to you - make sure your birthing partners know your wishes regarding this and make it their job to fight the fight should the need arise

xxx

 

[Chellepot]

They HAVE to send someone out to you - make sure your birthing partners know your wishes regarding this and make it their job to fight the fight should the need arise

xxx

I have a doula, who I am sure would fight my case with passion, but whilst I initially they thought they HAVE to send a midwife I cannot find evidence to support this. The law does not enforce the attendance of a midwife to a home birth. My understanding is that they can say "we are providing a midwife at the hospital".

I worry as anyone in attendance at a birth where there is no midwife could be prosecuted and I would hate a battle of wills to drag on so long that I end up giving birth at home without a midwife because they are testing my metal.

 

[lozzy21]

If you say im in labour and I'm not coming to hospital they have to send one out. They can't not, it falls under duty of care.

People in attendance would only be prosecuted if they deliberately took the part of a midwife, doulas, fathers ect that catch the baby because the midwife hasent arrived in time arnt prosecuted because it's classed as an emergency situation.

 

[Samie18]

They don't have to send a midwife if there isn't one available. If the on call team are at another home birth they won't leave that lady to attend you and if the unit is absolutely full and there isn't a body spare they can't send anyone. It's unlikely that this would be the situation but it can happen.

If your close to delivery or delivered and no midwife is available they would send a paramedic and obviously advise you to come in.

But like I said it is unlikely but staffing is low and there isn't always an escalation policy left if there is already a home birth going on.

Hope it works out for you though! x

 

[Chellepot]

I actually live equal distance from two hospitals but only one of the hospitals has a team that covers my area. I wonder if they would contact the other hospital if the team covering my area wasn't available. The distance they would have to travel is the same after all

 

[Samie18]

Yup that's an option too! If there is a body free then they will send someone, you would probably just have to mention it.
x

 

[lozzy21]

If the team is allready out at another homebirth and you refuse to go to hospital they have to send one. Alot of NHS trusts use independent midwifes as back up as alot of them are on the bank for the NHS.

 

[Chellepot]

Oooh I didn't know about the NHS using IM though i do know that one of the midwives at one of the hospitals near me works as an IM also, though she works at the hospital that doesn't cover my area lol.

 

[Samie18]

They don't have to send one if they can't. If there is no one to send then its impossible. The RCOG homebirth guidelines state if there are any possibilities that the service will not be available then this must be stated in early pregnancy. That's the get out clause and they will have it stipulated in the info on home births so their back is covered.

But they do aim to provide the service and if you ring up and say your in labour and hang up they can't refuse you your homebirth. And I know most if any don't pay for you to have independant midwives. If they are on bank then they will be called in if needed to help cover a shift not necessarily for the home birth, but then they will have an extra body somewhere to supply a midwife.

 

[Chellepot]

Oh It really does seem trying to have a "normal" birth is pointless. You want a water birth in hospital - you cant because you are "high risk", you try have one at home - you cant because the NHS is so short staffed you aren't going to get a MW. I'm sick of all these barriers in the way - no wonder women give in and elect for CS.

 

[Samie18]

Aww there are lots of Barriers but what I've said is worse case and the homebirth rate is still quite low so I'm sure they will be able to facilitate it for you, don't worry too much it will happen and you will get your beautiful baby at the end =o)

 

[disneyleanne]

They will send you a midwife, please don't worry. If they didn't send you a midwife and something went wrong they are open to all sorts of litigation. The AIMS letter outlines this perfectly.

 

[disneyleanne]

Forgot to say, not sure if I can mention a fb group that I know you will find useful. It's full of experienced doulas and people who know this stuff inside out. I know they would be able to reassure you.
Let me know if you are interested in it.

 

[lozzy21]

I dident say they will pay for an IM midwife for you but they will find you a midwife from some where even if they have to ask some one in on there day off or ring some on the bank.

 

[Chellepot]

I dident say they will pay for an IM midwife for you but they will find you a midwife from some where even if they have to ask some one in on there day off or ring some on the bank.

I didn't interpret what you said as them paying for an IM for me, I just didn't know they sometimes use IM's as backups, as you had written in your previous message. Sorry if my reply caused confusion.

 

[freckleonear]

Contrary to popular belief, they do not have to send you a midwife. If there are no staff available then they will send an ambulance instead. If bank midwives (sometimes including independent midwives) are available then they should hire those to cover any staff shortages, although they may be reluctant to do so due to the cost.

When I was pregnant, I got the fairly common "you can have a home birth depending on staff availability" speech. However, because the head of midwifery is a family friend I know the reality behind that. In my area, there is a team of midwives in my town and a team in the town 10 miles away. They cover a huge rural area and there are no other teams within a reasonable distance. When one team is short staffed, they borrow from the other team but that sometimes means using midwives who haven't slept properly for days. There are no bank staff and one independent midwife who covers an even larger area. At busy times they can be short-staffed at the hospital, let alone having two midwives spare to send out for a home birth. Fortunately I was lucky last time.

Obviously if I'm ever told that they can't send a midwife out then I will fight hard for my home birth, but I'm aware that it simply may not be possible and they may just send paramedics. Next time round I will be preparing for an unassisted birth as a backup just in case of staffing shortages.

 

[freckleonear]

Sorry my last post sounded rather negative. Just wanted to add that AIMS recommendation is:

AIMS suggests that the woman immediately writes to the director of midwifery services relating what she has been told and informing the director that she has no intention of going into hospital in those circumstances; the director has had x months to sort out staffing issues, and if she has any problems she can always give a contract to an independent midwife. It is not for Mrs X to resolve the problems by taking the additional risk of giving birth in hospital.

If you refuse to go to hospital in labour then it's unlikely that they will continue to refuse to send a midwife out.