Home Birth

[Anonymous]

A good CNM will have protocols in place for newborn resuscitation, maternal hemorrhage, meconium aspiration, etc. They will also have relationships with local obstetricians and hospitals and procedures for transfer before or during labor. They will have pitocin and oxygen and all the stuff you hope you won’t need (but might). My third was born with midwives in a hospital and had to be resuscitated by the NICU team; when my fourth is born with midwives at a non-hospital birth center, they will be able to do exactly the same thing if it becomes necessary. (Seriously, they read my chart from the last pregnancy, we discussed it.)

[Anonymous]

Anonymous wrote:OP has never come back to answer questions about her risk factors and I get a strong impression she's FTM. This is a terrible idea.

no, I'm low risk and a 2nd time mom. I haven't had time to come back and check all of the comments, and I am greatly appreciating all of the different stories. I had no complications at all during my 1st birth, but I didn't love the experience. it felt cold and impersonal, and I haven't liked my COVID prenatal experience so far (not at all the dr's fault, but it isn't a warm environment when you're getting an ultrasound and everybody has masks gowns and face shields). I imagine labor in these times would be similar to my prenatal experiences and was looking for something warmer and that I connected with more.

[Anonymous]

Anonymous wrote:

Anonymous wrote:OP has never come back to answer questions about her risk factors and I get a strong impression she's FTM. This is a terrible idea.

no, I'm low risk and a 2nd time mom. I haven't had time to come back and check all of the comments, and I am greatly appreciating all of the different stories. I had no complications at all during my 1st birth, but I didn't love the experience. it felt cold and impersonal, and I haven't liked my COVID prenatal experience so far (not at all the dr's fault, but it isn't a warm environment when you're getting an ultrasound and everybody has masks gowns and face shields). I imagine labor in these times would be similar to my prenatal experiences and was looking for something warmer and that I connected with more.

So experience matters more than safety? Just make sure you’re honest about priorities. Because that will only matter to you if your birth is uncomplicated.

[Anonymous]

Anonymous wrote:Both home births and hospital births have risks. Stop trying to convince others that one is clearly superior in every aspect than the other. It’s not, they both have pros and cons that are hard to put a value to.

For me the main difference is that for a hospital birth you don’t need to think or prepare for how you’ll deal with every possible complication since there’s already a protocol in place. For a home birth you need to set up those protocols with your midwife and be sure you’re comfortable with the risks for you and your baby.

I’m a FTM and I’m going with midwives in a hospital since that’s the level of risk we feel more comfortable with as a family. We’ll see next time.

Spoken like a FTM who doesn’t understand that not all risks are equal. You really think a 10-37 percent homebirth transfer rate is NBD?

[Anonymous]

Anonymous wrote:

Anonymous wrote:OP has never come back to answer questions about her risk factors and I get a strong impression she's FTM. This is a terrible idea.

no, I'm low risk and a 2nd time mom. I haven't had time to come back and check all of the comments, and I am greatly appreciating all of the different stories. I had no complications at all during my 1st birth, but I didn't love the experience. it felt cold and impersonal, and I haven't liked my COVID prenatal experience so far (not at all the dr's fault, but it isn't a warm environment when you're getting an ultrasound and everybody has masks gowns and face shields). I imagine labor in these times would be similar to my prenatal experiences and was looking for something warmer and that I connected with more.

What do you think is best for your baby notwithstanding your birth/prenatal experience? I’m not saying at all that your comfort doesn’t matter. But I could never forgive myself if harm came to my child because I didn’t want to experience the discomfort of a hospital. I know that the COVID risks and (arguably) the maternal complication risks in hospital births are real. The question is whether those risks outweigh the known risks of home birth.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Even though baby and I had no risk factors, my third would be dead if I had him at home. Don’t.

This is absolutely ridiculous and just the kind of histrionics I'd expect on this board. You have no idea what the issues were with her 3rd or if she really even needed medical intervention. Do you see how many women here claim they needed an "emergency cesarean", yet they weren't placed under general anesthesia? Here's a newsflash, that's called an unplanned cesarean, almost always done unnecessarily.

I've had a free standing birth center birth, homebirth and I'm planning another homebirth. I'm a big advocate for birthing at home.

I will say, it's not for the faint of heart. I doubt many of my friends have the pain tolerance to handle it. They'd likely demand a hospital transfer after a few mins of transition. I do believe it's almost always healthier for the baby and mother to deliver in the home environment. Also brings baby into a calm and loving environment, that's a much better way to be welcomed onto the earth side.

"Almost always done unnecessary" - please site your source.

Her posterior.

Yes, I’m sure the technical difference between “unplanned” and “emergency” is is totally relevant when the professionals are worried, they rush you down the hallway, and have a NICU team standing by for your baby. Thank you, terminology police.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:OP has never come back to answer questions about her risk factors and I get a strong impression she's FTM. This is a terrible idea.

no, I'm low risk and a 2nd time mom. I haven't had time to come back and check all of the comments, and I am greatly appreciating all of the different stories. I had no complications at all during my 1st birth, but I didn't love the experience. it felt cold and impersonal, and I haven't liked my COVID prenatal experience so far (not at all the dr's fault, but it isn't a warm environment when you're getting an ultrasound and everybody has masks gowns and face shields). I imagine labor in these times would be similar to my prenatal experiences and was looking for something warmer and that I connected with more.

So experience matters more than safety? Just make sure you’re honest about priorities. Because that will only matter to you if your birth is uncomplicated.

I am absolutely not saying that. I simply posted saying it was something I was researching and asked for experiences, opinions, etc. I am listening to all of these experiences and taking it all in. never did I say that I care about my experience more than my baby's safety or that I was even definitely doing it. I'm not even 50/50, I'm leaning far more towards a hospital birth. I just asked to hear from others who have been there.

there is really no need for the rudeness or implications that I'm being an idiot or not caring about my child. listening to others is an important skill

[Anonymous]

Anonymous wrote:

Anonymous wrote:Both home births and hospital births have risks. Stop trying to convince others that one is clearly superior in every aspect than the other. It’s not, they both have pros and cons that are hard to put a value to.

For me the main difference is that for a hospital birth you don’t need to think or prepare for how you’ll deal with every possible complication since there’s already a protocol in place. For a home birth you need to set up those protocols with your midwife and be sure you’re comfortable with the risks for you and your baby.

I’m a FTM and I’m going with midwives in a hospital since that’s the level of risk we feel more comfortable with as a family. We’ll see next time.

Spoken like a FTM who doesn’t understand that not all risks are equal. You really think a 10-37 percent homebirth transfer rate is NBD?

Homebirth transfer rates vary tremendously on how serious the midwives are about risking out patients. The Birthcare midwives have a 10% in-labor transfer rate but it’s mostly women who decide they would like an epidural.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Both home births and hospital births have risks. Stop trying to convince others that one is clearly superior in every aspect than the other. It’s not, they both have pros and cons that are hard to put a value to.

For me the main difference is that for a hospital birth you don’t need to think or prepare for how you’ll deal with every possible complication since there’s already a protocol in place. For a home birth you need to set up those protocols with your midwife and be sure you’re comfortable with the risks for you and your baby.

I’m a FTM and I’m going with midwives in a hospital since that’s the level of risk we feel more comfortable with as a family. We’ll see next time.

Spoken like a FTM who doesn’t understand that not all risks are equal. You really think a 10-37 percent homebirth transfer rate is NBD?

Homebirth transfer rates vary tremendously on how serious the midwives are about risking out patients. The Birthcare midwives have a 10% in-labor transfer rate but it’s mostly women who decide they would like an epidural.

1 in 10 is still significant.

[Anonymous]

Anonymous wrote:Do not recommend....friend has a permanently brain damaged child from one. It’s fine the vast majority of the time- which is why most anecdotes you hear will be happy stories and women thrilled with their experiences. But you only know in hindsight whether it would have been ok or if you are that rare unlucky person who has a tragic outcome that could have been prevented with access to a crash CS or other interventions that are only possible in a hospital. I don’t say that to try to scare you, just that this is a scenario where the downside risk is worth fully understanding, and it is hard to talk about without being accused of fearmongering.

Hospitals are increasingly adding home-like features to the rooms, tubs, that sort of thing...and good hospital based CNMs can be a great fit if you’re wanting an all-natural birth.

At Yale New Haven hospital they now have two options you can choose between (assuming you're low risk)--the main hospital L and D ward by the NICU or the satellite birthing center which is midwife-run, for birthing only, and more home-like (but still has the benefit of being part of the Yale system and having a physician there and the ability to transfer you and your baby in minutes down the street to the main hospital).

[Anonymous]

Anonymous wrote:

Anonymous wrote:Do not recommend....friend has a permanently brain damaged child from one. It’s fine the vast majority of the time- which is why most anecdotes you hear will be happy stories and women thrilled with their experiences. But you only know in hindsight whether it would have been ok or if you are that rare unlucky person who has a tragic outcome that could have been prevented with access to a crash CS or other interventions that are only possible in a hospital. I don’t say that to try to scare you, just that this is a scenario where the downside risk is worth fully understanding, and it is hard to talk about without being accused of fearmongering.

Hospitals are increasingly adding home-like features to the rooms, tubs, that sort of thing...and good hospital based CNMs can be a great fit if you’re wanting an all-natural birth.

Yeah, I had a friend who had 3 successful and happy home births and died delivering her 4th. I just...can't get past that.

We had a midwife in my town die giving birth at her midwife center. She refused to go to a hospital when things went south. She died less than a mile from a hospital.

[Anonymous]

Have you watched the documentary “Why Not Home?” It’s very well done and walks thru the evidence on home birth risk. It surprised me to see medical professionals opting for home birth. One OB equated it as a personal comfort level with risk, similar to how we choose to drive our kids around in cars despite the high rate of accidents.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Both home births and hospital births have risks. Stop trying to convince others that one is clearly superior in every aspect than the other. It’s not, they both have pros and cons that are hard to put a value to.

For me the main difference is that for a hospital birth you don’t need to think or prepare for how you’ll deal with every possible complication since there’s already a protocol in place. For a home birth you need to set up those protocols with your midwife and be sure you’re comfortable with the risks for you and your baby.

I’m a FTM and I’m going with midwives in a hospital since that’s the level of risk we feel more comfortable with as a family. We’ll see next time.

Spoken like a FTM who doesn’t understand that not all risks are equal. You really think a 10-37 percent homebirth transfer rate is NBD?

Homebirth transfer rates vary tremendously on how serious the midwives are about risking out patients. The Birthcare midwives have a 10% in-labor transfer rate but it’s mostly women who decide they would like an epidural.

1 in 10 is still significant.

Why are you so concerned about transfer rate? There should be a percentage of home births that need transfer. Plenty of births need assistance. Not every transfer is a life threatening emergency.

Unless you’re being induced or operated on, the place you plan to give birth is really only ever an intention, as you can tell from the many babies who end up born at home or in a car by accident. There is a percentage that don’t go to plan.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Don’t do it

Too much risk

Why chance it ?

Why not educate yourself? There's very little risk involved with a homebirth, they will calculate your risk and determine if you're a candidate. You're far more likely to pick up sepsis in the hospital than have a problem with your homebirth.

Hello, made up statistic! (a/k/a lie)

Risk of maternal sepsis - 4%

Risk of needing a transfer to the hospital during home birth: 10-37%

The vast majority of transfers are for failure to progress or because the mom needs medical pain management. For example, my 3rd was a "failed" birthing center birth because I didn't continue dilating after my water broke and needed pitocin. The numbers you're siting here are comparing grapefruit to eggplant.

A lot of people in this thread are also lumping together unplanned outside of hospital births with planned homebirths with a medical professional. Those are not the same thing at all and the risks are much higher with unplanned out of hospital births. Similarly, you can not assume emergent situations that are the result of hospital practices would also result at home -- e.g. complications of epidurals, while common in a hospital, do not happen during homebirths. You're effectively trading risks.

The one factor that is most worrisome to me is that the hospital system in the US consciously persecuted midwives almost out of existence and the legacy continues today where it's basically unheard of to receive continuity of care during a transfer from a planned homebirth with a CNM to a hospital birth. So even if you do transfer for something as simple as hydration and pain management, your established care provider may not be allowed to stay with you. The other failings of the British medical system aside, this is one thing I wish we could model in the US.

I've had both homebirths and a planned freestanding birthing center birth with a midwife that turned into a hospital birth with a midwife. While birthing in a freestanding birthing center attached to a hospital is probably the best of all worlds, IMO, you have to recognize that the practicing midwives will be bound by agreements they've made with the hospital that will guide what they are or are not allowed to do. For example, almost all of these birthing centers won't allow you to birth in a tub due to these types of regulations on the CNMs.

OP, I'd recommend you contact BirthCare in Alexandria and see if they are running info sessions or can set up an info appointment. They are all CNMs and have a relationship (though of course not privileges to practice) with a hospital. While you can choose a birthing center birth, their birthing center is not attached to a hospital. It is more akin to having a homebirth in their "home".

[Anonymous]

Anonymous wrote:

Anonymous wrote:Even though baby and I had no risk factors, my third would be dead if I had him at home. Don’t.

This is absolutely ridiculous and just the kind of histrionics I'd expect on this board. You have no idea what the issues were with her 3rd or if she really even needed medical intervention. Do you see how many women here claim they needed an "emergency cesarean", yet they weren't placed under general anesthesia? Here's a newsflash, that's called an unplanned cesarean, almost always done unnecessarily.

I've had a free standing birth center birth, homebirth and I'm planning another homebirth. I'm a big advocate for birthing at home.

I will say, it's not for the faint of heart. I doubt many of my friends have the pain tolerance to handle it. They'd likely demand a hospital transfer after a few mins of transition. I do believe it's almost always healthier for the baby and mother to deliver in the home environment. Also brings baby into a calm and loving environment, that's a much better way to be welcomed onto the earth side.

Plenty of necessary sections occur unplanned. Just because a csection isn’t a matter of life and death that very second doesn’t mean it’s not necessary.