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Home Birth Dilemma

Thursday, 13 January 2011  |  Admin

It's not often that I do really personal posts but I need to get this down on paper so that I can stop thinking / talking about it and boring everyone around me, including myself!
As you might know, I'm expecting baby no 4 in just over two months time and would like this one to be a home birth. Why? Well I just really like the thought of pottering around at home in labour, getting into the bath near the end, pushing the baby out, having a nice shower and back into my own bed for a snooze with H and bubs. My last two labours have been very straightforward water births in hospital, just gas and air and I've gone from zero to delivery in about 6 - 8 hours, so this isn't an unreasonable idea.
We wouldn't have to hang around hospital for 6 hours afterwards, with me covered in crud and waiting for a shower. I'd have a bit more dignity too, rather than lying naked, semi covered in towels, boobs out and baby attached. Not a pretty sight.
We'd be able to help ourselves to a bite to eat too (during and afterwards!), rather than relying on dodgy hot chocolate from the vending machine and a couple of bits of toast. And then what bliss, to be able to climb into my lovely comfy clean bed and snuggle up with my baby girl and H.
So why am I feeling like I have to justify my decision?
My H is happy to support me whatever I decide because as he quite rightly points out, it's my body. But he'd rather we go to hospital because he perceives it as safer. My Mum (who works in a maternity unit in Belfast) thinks I should go to hospital. As do the majority of midwives in her work but that's probably because there were a grand total of 91 home-births last year in the whole of Northern Ireland, as opposed to 35 just in my local area. Again, they cite 'safety' as the main reason for this.
My friends range from being vehemently opposed to thinking I should definitely go for it. The key behind whether they support me or not seems to be based on their own birth experiences which is fair enough. But what are the facts and what am I considering when I make my decision?

In a recent study of 330,000 planned home-births there was no difference in the perinatal infant mortality rate between the planned hospital birth community and home births. No difference. That surprised me but the numbers speak for themselves. So I could challenge all those people planning hospital births about why they are choosing such a risky option....
You're less likely to need intervention if you choose a home birth. Less intervention means less chance of needing a C Section, less chance of haemmoraging afterwards from a little cut made by an inexperienced junior doctor.
If you do bleed or the baby needs resuscitation, the home birth midwives are equipped with the same basic equipment that would be available in hospital - drugs or oxygen as appropriate.
Cord Prolapse is the one nightmare scenario as it requires a crash C-section but even with cord prolapse there are early indicators such as the baby being in an unusual position and the baby's heart rate dropping. And it's very unlikely to happen in 'normal' pregnancies, something like a 1 in 300 chance?
Other children
I've been very lucky in that all my labours have started overnight, so I'm reasonably certain that if it happens again, then my other 3 will be sound asleep and will be blissfully unaware that their little sister is making an arrival until they wake up next morning. I don't think it's necessary for them to see me squeeze the baby out, but I fully intend to prepare them for any noise by explaining that when Mummy is pushing their baby sister out, it's hard work and I might sound like a cow mooing! So potential trauma to other children is very unlikely.
Mind you, I'm more likely to go to hospital just for some peace and quiet if I start to labour midday with my two youngest at home!
Mother's Intuition

You'll notice that I described my 2nd & 3rd labours as easy and straightforward. My first should have been, but due to a combo of meconium in my waters and a horrible midwife who insisted I lie flat on my back which (unsurprisingly) slowed things down, I ended up with a forceps delivery.
However it was very nearly a C-Section because at one point the horrid midwife was insistent that the baby's heartrate was dipping. The room filled with medical staff in scrubs and my H was asked to sign the C-section consent form. I was sure that we were both fine however and kept repeating 'We're fine, my baby is fine' and kept up my deep breathing and kept calm. Sure enough eventually the medical team concurred with that everything was OK and left me for another while to get on with it. I'm sure if I'd been able to sit up as I wanted then I could have delivered him myself, but unfortunately I never got the opportunity.
My decision

As long as everything looks good at 38 weeks (baby in good position, nothing weird or wonderful), I'm going to plan to stay at home, but also happy to transfer to hospital if anything looks awry. After all, I'd have been making the trip to hospital anyway....
And I promise to shut up about it now. For at least another 8 weeks.