Interesting question Rory.

I would dearly love a homebirth this time around. I had a pretty horrid birth experience the first time around as far as the m/w's were concernced- they were dismissive, unsupportive and would not let me up off the freaking bed o matter how much I begged them- but the hospital ob who came in when things went a bit haywire was fantastic. I'd like a hb to avoid the sterile, cold, brightly lit atmosphere of the hospital, to avoid the medical feel, to avoid he feeling of disconnection I got when my baby was scooped out of my arms into the arms of those who seemed to think they knew so much better than me.

Having said all of that, a hb is just not possible. I have a heart condition that could prove very dangerous if it were to act up during labour, both for me and my baby. I've discussed the possibility with my midwife and cardiologist, both of whom have talked me out of the idea. (I know there are some people who will think i could definately have a hb anyway, and maybe I could. But that is a risk I'm not prepared to take.)

However, I am in the situation you describe- I'm in the public system with a caseload midwife, so she does all of my care and will be attending the birth. She has promised to be an advocate for me, to help me avoid intervention, and to follow my wishes in terms of birth and post birth care. The caseload midwives have 'control' of one birthing suite in the hospital, which is kept dimly lit and warm and has a bath, shower, bean bags, etc. So I will have a calming birth centre environment, minimal intervention, immediate acces to emergency care if it's needed, and an early discharge if I want it. I am having my cake and eating it too.