Homebirth – Recent report

“ Costs for antenatal visits and tests, staff presence in labour and delivery, procedures and pain relief in labour, perineal damage, and most importantly, days in hospital, all confirmed the greater cost of hospital delivery.” [1]

Does that take into account the expectation that hospitals must be ready to deal with complications (both for hospital and home births), or that if you suspect there might be complications you wouldn’t opt for a home birth in the first place?

“The average uncomplicated vaginal birth costs 68% less in a home than in a hospital.” [2]

Those appear to be based on US healthcare costs, which are so out of proportion to those in the UK I don’t think you can draw any conclusions.

Thanks again for all of your comments, each destination clearly has it’s pro’s and cons. Why would we want to be in a hospital any longer than needs be? Noise from other births, no facility for partner to stay over, medical intervention unnecessarily hasty (stories of Dr’s wanting you to “get on with it”), just a number or a stat etc. Homebirth was definitely the choice, but as I’ve said the report has clouded our view and made us feel a bit down about something we were getting really excited about (finally after 9 mths!).

Your stories and opinions have been most helpful, some more extreme than others, but I wish you all (especially Jambo) the best of luck too. I’ll see how the next couple of days go and may be in touch with those that have offered more direct contact. Cheers.

I was born at home it was fine, not sure I remember much bonding stuff though. A former colleague and his partner recently had their second child at home, unfortunately this was due more to an extremely quick labour and him not taking it the build up too seriously – result one new born baby dropped by him onto it’s head and three hours with an aquavac cleaning the living room carpet 🙂

I’ve just quickly read through the paper in BMJ. Two things jumped out at me: (1) Planned C-sections were excluded. (2) the report notes that the “adverse outcomes” were all lumped together, and are not necessarily implicated in a long term adverse effect.

I think the first is important because patients who were planning hospital delivery and are “borderline tricky” for any reason are more likely to be convinced to go for a planned C-section. Patients who are very keen on home birth are much less likely to go from one extreme to the other. Likewise patients who had a scary first birth are less likely to go home birth the second or third time round – hence the difference in the stats.

The second point is quite important – a recorded adverse event doesn’t necessarily translate to a long term problem. It may even be that a midwife in your house is more likely to ‘diagnose’ a minor adverse event to be sure (and get medical intervention) when a hospital team would watch and see before formal diagnosis – and so very minor cases do not get reported.

However what is very clear is that there is a strong correlation between medically assisted births and planned births in hospitals. There is a known relationship between medical assistance (forceps, ventouse, c-section) and post natal depression. Now it may well be wrong to say if you choose to go to hospital you are more likely to get medical intervention because if your case is complicated medically you may not have any choice, but its not as black and white as saying one option is safer than the other.

Do whatever seems right to you, and talk to your midwife about it. They will only be keen on home birth if you are already a low risk category. Ignore “3 times more likely” because it is misleading. If I was 3x more likely to win the lottery it would still not be a good bet.

My sister was a homebirth. This meant I was left alone to my own devices at 2 years old.

Someone had to knock on the door of the house to tell people I was sitting on the ledge of an open first floor window dangling my legs out, shouting “I’ve got a new baby sister”…

Sometimes plans change, live with it. The missus had all sorts of fancy birth plans, by the time we got to the hospital it was already too late for all that malarky and baby breatheeasy was already on her way out, bless her. Scared all the couples on a nice little ‘tour’ of the maternity ward I can tell you!!!

Don’t force your other half to do something she’s not 100% comfortable with just because you want to do it ‘cos it sounds trendy and the ‘right’ thing to do. If the midwife can’t calm her fears then just go with the flow.

I’ve just checked and it’s 45 days now. One day blurs into another.

My point was not to overplan it and get hung up on the detail. The health of my wife and child very quickly over-rode any preconceptions of what kind of birth it would be.

Speak to any Obstetricians and Anaesthetists that you know….. Ask how many of them had a home birth.

Go to hospital.

dr death – how about Wendy Savage 🙂

Dr Death – I wouldn’t ask any doctor for a view on risk – IME they all have a rather skewed view on risk in general because they see all the bad side and quickly forget the many many simple cases… …after all how many will even have been to a homebirth.

sorry if this has been said but I havent the time to read the whole thread, I’m pretty sure that report said that 45% of first timers end up being transferred to hospital. That sounds pretty horrible as a way to spend some time to me. We had ours in hospital and depite it being pretty fraught at the end (I’ll spare the details, but had we been at home I’m really not sure what would have happend). We both felt hospital was the best place to be. We went and looked at the midwife led bit and it looked much the same as the main bit a couple of flowers and some crap cheap art doesnt relax either of us much!!!

As a counterpoint to the doom and gloom – both my son and daughter were born at home – no complications and a very stress free experience (well as stress free as births are anyway…). Two midwifes were present for both births.
That said the community midwife set up where we live is very good (Allerdale) and they will always ere on the side of caution – basically if you are in a high risk group, the option simply isn’t encouraged.

I’ve heard it said that a “normal birth” is only ever a retrospective diagnosis…

Mrs AMV gave birth to our son last week at home. It was awesome!! We did the hypno birthing thing as well and found it all really good stuff. My advise would be to go for it. Every one is different though and for some people the security of being in a hospital means that is best, for others the environment and ways of the hospital is the last thing that is needed for a good birth.

It was much better than when our daughter was born… or rather who was yanked out with the ventose, even tho labour was going well. the reason was that they needed the delivery room cleared and ready for the next birth. We also had to argue the reasons why we didnt want the epidural and were made to feel stupid about it; one doctor told us we were being disrespectful. WTF!!!!!

According to our limited research complications are very very rare if the whole pregnancy has been normal – after all giving birth is a natural thing to do right? An experienced midwife friend of ours we spoke to about it said that if you look into the small number of home births that have gone wrong, quite often the people concerned have not listened to the midwife when they have said “you need to move to hospital NOW”. This same midwife told us that on her ward more natural births occur at the weekend or other times when doctors are off duty.

The midwife we had has an array of emergency medical equipment from anti hemoraging drugs, saline drips, drugs to halt contractions should you need to move to hospital and more; as well as a whole load of “holistic” bits and bobs that were really great.

Speak to any Obstetricians and Anaesthetists that you know….. Ask how many of them had a home birth.

You could also ask how many of them use/recommend yoga, meditation, herbs, diet to treat common ailments (like back pain or anxiety) or prefer to pop/prescribe a few pills…

How many of those 45% of first timer transfers would have gone ok if they’d stayed at home? Nobody knows do they, but I bet it would be a high proportion.

How many of those 45% of first timer transfers would have gone ok if they’d stayed at home? Nobody knows do they, but I bet it would be a high proportion

But, crucially, not 0%

No its not zero but the figures for other births would suggest its as good as zero.

The high rates of intervention at doctor led units and the strong medications involved are also not zero risk.

Walking down the street while pregnant does not carry zero risk.

The point I am making is that waving around that 45% stat’ is meaningless with out further research. Unless you know why labour was moved and how many of those were due to complications in the labour its unhelpful to people thinking about a home birth. It does make a good news headline I suppose.

IMO what is needed is better education about home birth, more support from the medical industry and more support for families who chose home births. Not only would it make many childbirths easier and safer it might even save a few pennies.

Dr Death – I wouldn’t ask any doctor for a view on risk – IME they all have a rather skewed view on risk in general because they see all the bad side and quickly forget the many many simple cases… …after all how many will even have been to a homebirth.

Thta’s exactly his point. Apart form the skewed bit and forgetting the simple ones. They don’t it’s just when childbirth goes wrong it can go wrong big time.

Giving birth is NOT a medical procedure. Some women (a small amount) need help but if you are near dr’s then they will intervine if its not going how they think it should. I think that its great that that this country is moving back away from this. Midiwfes are very well trained for this seeing as they do a 3 year university degree on just this. The Maternity hospital here (Princess Anne Southanpton) has both a Dr lead labour ward and a midwife lead ward there is also the option of the birthing centres for those that want a close to home birth experiance. We opted for this due to the complications we had with our first. My wife lead the midwifes on what she wanted not once did they suggest anything to her. She pushed our son out and due to th fact she could get in a position she wanted (the body is very clever like that) she chaught him as he came out and the midwifes never touched him. Dr’s are to quick on connecting you to heart rate monitors when there is no need which means that the women is lying in a poor position to carry on giving birth (ie lying on her back).

WOW! Really you believe that’s what Dr’s do?

I’ve not read any of the replies, but here’s my experience.

Check out mid-wife led units – hospital base or stand alone. First boy was born in a mid-wife led unit, so if there were complications we’d have to have been taken upstairs in the hospital. The wife also looked at a separate mid-wife unit (stand alone, that’s all they do there) but we’d have been bundled into an ambulance and taken down the road to the main hospital if there were complications, but it was very nice and homely. We only went for the hospital based one as they had an extra birthing pool (which were both in use anyway!).

Mid-wife led units are ace. They popped a mattress on the floor for me and I stayed the night (he was born around 10pm IIRC). The whole birth went well with just gas and air.

1st boy was straightforward so we decided to go for a homebirth next time – egged on by the mid-wife too. So, 2nd boy was born at home and that was brilliant. We sort of knew what to expect from boy No. 1 and the birth itself was quick and much easier (quoting from the Mrs!) and it was great to have boy No. 1 around to meet his baby brother. We were then able to potter about the house, shower, bath, have tea and coffee and do what we wanted. Mid-wife came back later that day (No. 2 born at 7am) to do the normal checks and it was all good.

I’d recommend a home birth, but maybe not for the first, just in case – you only get gas and air at home. Mid-wife led units are excellent and you should check those out.

Drac – thats certainly used to be the case.

mat units have these expensive heart rate monitors and want to use them – using them stop the women from moving around as they wish.

Maybe things have changed but thats what used to happen for sure. a part of the reason why you get more intervention in hospital

we’ve had 3 at home, each went smoothly, the midwives were fantastic. The best thing is you are in a more relaxed atmosphere and as soon as the midwives have gone you’re at home without having to stay in hospital. I could then stay with MrsF and new born, then the other kids could come back and we didn’t have to work round visiting hours. Thoroughly recommend it. pm me if you want any more advice / tips etc

mat units have these expensive heart rate monitors and want to use them – using them stop the women from moving around as they wish.

My wife had one on, there was no restrictions in where she wanted to move to. She had to wear one for her medical history. There was no Dr involved in putting it on. The Dr’s were only involved for Epidurals and with our first when the wife failed to progress and they had to use Forceps. They gave her as long as they could to try but when Amy’s heart rate started dropping, they heard it one the expensive monitor, they intervened. Not just because a Dr was there but because they had to. I’m glad they did.

1st one couldn’t have at home due to waters breaking 24hours before kick off, went to hospital not a great experience. 1st midwife was rubbish, (2nd midfwife after a shift change was great) was connected up to a heartmonitor and had to ask to be helped to turn over/move around etc, this was met with “tut alright then if you must” Labour stalled, nowt happened for ages ended up in theatre with forceps. Labour could have stalled anyway but mrs felt the atmosphere certainly did not help.

2nd at home (just) much better atmosphere, still slight complications and ended up going into hospital afterwards (another not very good experience) but labour was certainoly better for all of us. Had 3 midwives, 1 as standard, another helping coz no one else was delivering that day and one who hadn’t done home delivery before.

When mrs first said she wanted home birth I wasn’t keen, but after our experience I’d recommend it. Plus you get nice momentoes, “see that stain on the carpet son, that was you being born wot caused that” 🙂

Speak to any Obstetricians and Anaesthetists that you know….. Ask how many of them had a home birth.

Go to hospital.

Obstetricians and anaesthetists by definition aren’t involved in normal births.
It skews their perception.
I would suggest look at the evidence, or at least ask people that deal with normal labour and delivery- midwives.

Hospital births for both my Boys Mrs SMA would not even talk about home births, even though we did the NCT thing. First one was just over 5 weeks early and had a spell in ICU. At this point you value to the whole medical team being available. Second one was late, but never even saw a doctor in the Hospital as the midwife managed the whole process. My better half spent the night on the ward, as she was so knackered with not sleeping that she feel asleep almost at once and it was felt better to keep her in.

My own opinion here, based on my own experience.

If we had of had a home birth my wife would now be dead! She had a massive blood loss ( half the blood in her body). She is only alive now because she was in a recovary room next to the operating theatre when it happened.

Simple. Dont risk it.

My advice FWIW…don’t listen to anyone here (including me?!). Every birth is individual and it’s completely down to what you and more importantly, what your Mrs wants. Whether you go for a home birth or not must be your decision and one that you are both happy with. Yes, homebirth has it’s risk but equally a hospital birth also has it’s own risks too. Whichever way you decide to go, if it’s not what your mrs wants, she’ll feel stressed, literally tighten up when and where she needs to be relaxed, and that’ll not be good for giving birth.

Take in the ‘facts’, listen to what the medical professionals say but make your own choice.

FWIW – ms orena45 and I had a water homebirth for our daughter 2 years ago yesterday. No medical intervention, all natural and just us (the two midwives spent most of the time in the other room drinking tea and only needed to come in for the occassional check and just help at the end). Our birth story is up on ms orena45’s web site here if it’s any help in coming to your own decision. 🙂

+1 for the post above. It’s very important that your wife decides what she’d be comfortable with. I just made sure that my wife knew not to be disappointed if things didn’t go the way she wanted. As it was we had a textbook delivery and she didn’t even have gas and air. Should have bought some earplugs for the neighbors though 🙁

The midwives do make it clear that at the first sign of anything abnormal you’d be off to hospital. Happened to 3 friends of mine where the labour wasn’t progressing, no drama at all. Of course there will be scary stories where it would have gone horribly wrong if you were not in hospital. There will also be tragedies where infections are caught etc. where the home birth is much less risky. But they’re all still small risks.

We had our first in the local hospital, and then our 2nd at home

same here. Second time was definitely smoother – experience counts for a lot and the mid-wife was better.

I’d advise having the first one in the hospital, just in case. Some births/mothers are very problematic.

I don’t know about this too much and suspect my (one man’s) experiences are limited and not representative.

2 ways of looking at it.

1) The human birth thing works pretty well on it’s own, there are billions of us and lots of those born without hospitals or problems.

2) After seeing my wife struggle and get rushed into theatre during our 2nd I was glad we were at a hospital.

In the words of Obi Wan Kenobi:

You must do what you feel is right, of course.

Simple. Dont risk it.

I really agree with this. How would your wife ever forgive herself if something went wrong and help was delayed because you were at home.

Homebirths are very trendy right now, but not worth risking your baby for imo.

Well, reporting back after the midwife chat. Change of plan and we’re now ruling out the Homebirth. The midwife could only do her duty and that is to give us the information and leave us to make the decision and the stat’s are firmly lodged in my wife’s head, so safety first and we’ll go in to Hospital and hope for the best!! Thanks again for your comments, positive and negative, they have helped, but ultimately as many of you have suggested, we have to do what’s best and try and relieve the pressure on what has become a very stressful end of pregnancy! We packed the bag together last night, which helped and I now need to reassure my wife that she will be perfect through the process and that we are doing the right thing! I know birthplans can go out the window and a lot of it will be “seat of the pants”, but Mrs JJ will not want to hear that incase it’s seen as a negative comment. Positivity is what’s now required, anyone know where it’s sold?!!!

If she doesn’t want to hear it, just tell her it will all be great and be positive!!

Tips for labour.

Do as you’re told
Try not to look freaked out, be calm.
Do as you’re told
Don’t tell her it can’t possibly hurt as much as she thinks (it does)
If she says she wants an epidural don’t argue with her
Do as you’re told
Don’t pop out to get your book at the crucial moment (as done by my friend, admittedly second birth arrived rather more quickly than expected)
Don’t cry when the baby arrives. (only joking – you will)

Oh and try and avoid being induced with the drip thing if at all possible.

My mate’s girlfriend died as a result of a homebirth, so perhaps I’m biased, but the way I see it, you have a choice between providing proper medical supervision and care for your family, or not providing it.

Whatever notional benefits you might think a homebirth has, they don’t even come close to outweighing the negatives.

Homebirths are very trendy right now, but not worth risking your baby for imo.

Recent experience shows this isn’t the case – the midwifes said they only have about 5% of their business as home births .. saw a survey in the Guardian that was roughly the same. They were of the opinion it was being actively discouraged in our area.

My experience

1. Hospital – 1st child, we were somewhat nervous 🙂 – but not a terribly pleasant experience on reflection.

2. Birthing center – very relaxed and all round a good experience for all involved.

3. Homebirth – there were no complications with the first two, and Mrs b had delivered with just gas and air and crushing my wrist. So we wnet for a homebirth as it was what she wanted and we saw no significant risk – this lark has been going on for some time you know.

As it turned out, there is no way we would have got to hospital in time, and luckily 2 midwives were just finishing up around 5 miles away, else I’d have been delivering it. Aside from that, no drama, and the best experience all round. Ruined the mattress though 🙂

ou have a choice between providing proper medical supervision and care for your family, or not providing it.

Whilst I see your point, the midwives ARE proper medical supervision. We got better care at home than in hospital. But if there were any hint of issues we’d have been booked in to the hospital.

brassneck – Member

Whilst I see your point, the midwives ARE proper medical supervision. We got better care at home than in hospital. But if there were any hint of issues we’d have been booked in to the hospital.

Not criticising midwives in any way, but if something goes seriously wrong, they’re not surgeons, there’s no operating theatre, there’s nobody else. My friend’s wife died from loss of blood, possibly similar to what the chap further up the thread encountered, but thankfully he/they had an operating theatre nearby to help them, my friend’s girlfriend didn’t.

Now, you can argue that it’s highly unlikely that any of that stuff would be needed, and I would agree with you, but there’s still that chance.

Whether you’re happy to take that chance on the life of a child/wife/girlfriend or not is entirely up to you, but it’s not a chance I’d take, however small the risk.

My experience is zilch, had both of ours via emergency c section on a Sunday night, both at 7.04pm, on the same table, with similar teams just 16 months apart. I like it when the universe does stuff like that 🙂

Anyway, two mates of mine have 3 kids each, all born at home with absolutely no problems whatsoever. I do remember that for the first one, they both had an ambulance outside in case, but I don’t know if that’s policy or just a local thing.

Another friend had the worst possible outcome, 15 minutes away was too far. 😥

My advice would be to be as careful as you possibly can, listen to your mid wives and other professionals and think beyond the birth. IMO the most important thing is to get them out safely, end of.

Its not as simple as that honourablegeorge. there are known, documented and proven downsides to hospital births as well.

any indication of anything other than a simple straightforward birth then hospitals are best. No contraindications to home birth – its a matter of preference and a balance of risks and benefits

From my experience the correct and only choice.

Good luck! Being a daddy is the greatest thing in the world. There is no point risking it , your wife, your child and your own life! for somthing that you dont have to do.

Hope it goes well for you.

Mrs trb is a nurse, so her birth plan read something like “You let any Doctors near me and you die, no, first I’ll divorce you and then you’ll die”

So we had both of ours at a Midwife lead unit (which was still 20 minutes away from the hospital under blue lights). A very pleasent experience, mrs trb stayed in for a couple of nights with no 1 which was her choice, No 2 we rolled in at 5pm and were home for a cuppa by 11:30pm. Not hugely different from a home birth but she had the moral support of a couple other new mums and there was less cleaning.

My sister had one of hers at home, someone forgot to send the adaptor to connect the gas & air, so she had a drug free birth – which sounds lovely in the NCT class, not sure she appreciated it at the time though.