I need some advice regarding the safety of having a homebirth

[StrawberryMumma]

Hey guys

I'm in a pickle and looking for some advice as to whether to have a hb or birth at the hospital.

I just got home from the gp who I discussed birth options with. Now I wouldn't say he was COMPLETELY against having a hb but basically he said why would you want to do that? and went on to say that if something goes seriously wrong quickly then you don't have a chance (ok, no quite his words but to the same effect).

So realistically, is there much chance that something will go wrong so SUDDENLY (with no warning), or do complications usually happen more slowly? By then we will be living out of the city so it will be a bit of a drive to the nearest hospital..is that distance putting us at too much of a risk??

Also wondering..Midwives bring Oxygen don't they? and a bag and mask for bub if they are struggling when born? Do they bring anything else?

My other concern is that if I do choose to have a hospital birth, is that I may not make it to the hospital anyway and could end up having the baby on the way anyway.

Background info, my 2 other births were smooth and natural. One was posterior (7.5 hour labour) and the other my ob broke my waters to start labour (as he was worried about low amniotic fluid) but no intervention after that (3 hour labour). I also had second degree tears with both of them.

I guess my last concern is that I am of small stature! and if the baby got stuck but neither of my other children needed help to come out (my son was almost 4 kgs too. Big for me!).

I am so confused and don't really know who to talk to, so thanks if you can offer any advice!

[Oorki Galoorki]

Yes midwives carry all equipment needed in an emergency.
there are only a few instances where "it" can hit the fan so quickly. BUT your m/w is with you the WHOLE time(unless she has to go to the toilet ) and will know the signs of 'trouble' before it gets bad.(unlike in hospitals where they have to go to other patients or fill in paper work in the office)
m/w still monitor your baby to.
M/ws are experts at birth! if bubs get stuck there are position changes that can also help bubs.
i recomend reading birthing from within, ina may gaskins guide to child birth, a thinking womans guide to childbirth... these will give YOU so much power and information over your birth.

[Schmickers]

DOudou is right. Midwives at a homebirth carry oxygen ,equipment for cannulation, IV fluids - all the stuff needed to stabilise you or your baby in the event of an emergency. Emergencies during birth almost always occur with warning signs , and homebirth midwives are generally highly experienced and well-versed in detecting those warning signs. And at a homebirth ,your midwife is youts alone, you don't share her with anyone else, so she can focus solely on you and is more likely to detect problems before they occur.

The research is pretty clear on the fact that there is no benefit to continuous electronic monitoring, in particular for a low-risk pregnancy, and the initial treatment for obstetric emergencies is just the sa,e at home as it is in a hospital.

Homebirth is a wonderful option ,and there is a huge body of peer-reviewed research that indicates it is also a safe option. I say go for it!

[BellyBelly]

It also takes the same time to set up for surgery in the time it takes most people to get to hospital in an ambulance than already being there. If you have bleeding after the birth they have syntometrine on hand which is what they use in hospital to stop bleeding. If you talk to some independent midwives though they can give you their transfer rates. Their c/s rates are very low.

[Inanna]

It is a big decision & I am so glad you are thinking about your options and not just going with the herd. Good on you!

I can't really add more than any of the other great replies. Just know that your body has birthed a 4kg baby - it's a pretty amazing body!

Make an appointment with an IM & have a talk. I believe once you do that you will find it easier to make a decision.

It's my personal opinion that a homebirth is the "hilton" of birth experiences. In your home, your way with a trusted midwife and your DP, candles and a lotta love. Birthing is a normal natural experience and midwives are the experts in the field of "normal" birth.

[Kitt3n]

If you have bleeding after the birth they have syntometrine on hand which is what they use in hospital to stop bleeding. If you talk to some independent midwives though they can give you their transfer rates. Their c/s rates are very low.

Yep this is what happened to me. To add, I truly think having a HB saved me from a fate much worse as my labour was so rapid that I would not have made it to hospital - and the ambo's don't carry the synto therefore I would have bled the whole way to hospital.

Meet some midwives, talk to them. You will meet one who makes you feel very comfortable and secure.

My mw's transfer rate was 17% (from memory!) and most of them were first time mum's who wanted pain relief.

[LadyNoor]

I haven't met many midwives but I get the impression from mine that SAFETY is their first priority. If there's any slight chance towards complication they would access it quickly and get you to transfer if necessary. My hospital is only 10 minutes away though, so no issues for transfer.

Mine also explained that if any of my conditions changes during pregnancy (i.e. high blood pressure, gestational diabetic, labour before 37 weeks, overdue past 42 weeks, and so on), I'd have to say good by to HB and we'd deliver in hospital.

The OB I met at hospital appointment earlier in pregnancy said NO to my plan for HB, he supported my VBAC attempt but would rather me having it in the hospital. I think his main concerned was that I'd go past 42 weeks, or if I became unwell. I can understand that, but so far I am well and under a good quality care of my IM. I haven't decided for homebirth then, I thought I'd stay home as long as I could then birth at the hospital. Then I thought why would I want to do go to hospital if everything goes smoothly?

[Alan]

Hi Lee
No one can deny that things can and sometimes do go wrong at birth, be that a home or hospital birth. Midwives are trained to look for any signs of things going wrong. Many of these things can be treated at home but sometimes it is better to go to the hospital. All IM’s should know their limitations and be afraid to transfer should the situation dictate.
Kelly is right when she says that “It also takes the same time to set up for surgery in the time it takes most people to get to hospital in an ambulance than already being there”. Should I need to transfer I would first call the ambulance then I would call the maternity unit and fully explain why I am transferring. By doing this the hospital is fully aware of the problems and are usually ready to go as the ambulance arrives.
Some of the equipment I carry include Oxygen (enough for about 45 minutes), bag and mask, suction, IV needles and fluids, a small amount of drugs, various tubes, suture equipment, lots of dressings.

[StrawberryMumma]

Thanks everyone. It's a big help getting your input.
I think my main concern is getting transferred to one of the outer city hospitals (which scares me a bit).

If my baby comes in July, would that mean that with the changes I wouldn't be able to get an IM? (I've been looking into getting into the CMP as I thought that would be my only option for a hb?) All a bit confusing!!

[Alan]

Hi Lee
You would need to talk to a couple of IM's in your area. I have just taken a booking for July.

[Karen van]

Hi Lee

You are doing a great job of being responsible for yourself and your baby - and that is the first support for a safe birth. As Alan and others have pointed out - there are inherent risks always with birth - even with low risk pgns.

I am very small framed - 5 ft 1/2 in and have birthed two bubs at home with two different IMs - with the support of my midwives, pg yoga and upright positions I have experienced little trauma in the way of collatoral damage to self thru birth.

Seeking out an IM and finding one who you feel comfortable with, who is informed and gives you a sense of confidence both in yourself and her/him is the key to deciding whether hb is for you. Both my midwives were very different people but were both excellent in their continuity of care and their expertise.

You have a good understanding already of birth and an inherent chance to believe in its success and your body's capacity for it - this helps immensely too!

In terms of July, the Fed Govt has created a two year extension in terms of the registration provision - so really there is little difference in how they are operating - there is the declaration of operating without insurance (as they have been forced to since 2001) and your acceptance of that circumstance and the implication of it - different IMs have different ways of doing this - some get you to sign contracts, some have 'handshake agreements' but really until we can resolve this one way or the other - IMs are still operating under the status quo that has existed since 2001.

I understand the opposition you have faced and how that can undermine faith - it is very hard sometimes!! I hope all the contributions here have helped you to decide which path you might like to pursue - and whichever one it is I wish you a joyous and healthy pg and birth!

Much love
Karen van

[Dedicated Doula Gillian]

I had 2 homebirths and I'll never forget walking into my passage way just after my MW arrived for my first birth and it looked like a mini hospital with all the stuff she had bought with. The second birth I was wanting to 'push' before she arrived so she ran into the house with a pair of gloves and she had her friend and my mom-in-law help bring in all the other important stuff. My second child was born 45 min later and I did start to bleed quite a bit once the placenta was born and she had drugs on hand to help that stop.
Having studied as an advanced doula in South Africa and learning all that in’s and outs and emergency care, a good midwife should have what she needs on hand and should treat accordingly if there are any complications...
Keeping in mind that if there's major problems at a homebirth the midwifes livelyhood is "in danger" - hence why they have such high safety standards, where as in a hospital if there's complications, it can be hidden in the paperwork and can be paid out by their insurance company (which don't support midwives even though they have such strict standards...) But that's now coming from having worked in South Africa so...
I feel if you are fit fine and healthy then you should be offered homebirth as a birthing option from your OBGYN so they can focus more on the moms who do have pregnancy problems and other moms who might be having birthing complications... but I guess they don't see it my way