Not sure if I should have a homebirth

[Barefoot~Baker]

Hi everyone Our baby (#3) is due in July.

I've toyed with the idea of a homebirth, but there are 2 concerns that we have. 1, we're 30 minutes away from the nearest hospital. I'm really scared that something will happen to the baby and we won't get there in time. We live in a rural area, and once when I called an ambulence when I had an asthma attack, it took them 20 minutes to get here.

The second thing is, I'm afraid I'll lose focus and be a crazy woman all the way to the hospital.


My last 2 births were not what I wanted, 1st a posterior baby and lots of agony (had a spinal block and vacuum delivery), 2nd was induced with an epidural.


I'm studying Hypnobabies now.

Thanks for advice!

[Peony]

The distance doesn't bother me, I was 30 miles from a hospital for my last home birth. It did concern my DH though. What made him relax some was knowing that MW's carry meds, O2, etc... Most transfers are not where time is of an essence, mom wants meds or is tired, etc... If there is a true emergency then an ambulance will be called, a MW can call ahead to the hospital let them know what is going on. An emergency c-sec is often 30 minutes out, an OR has to be cleared or prepped, docs and RN's found. If it is after hours then those people have to be called in unless the hospital has staff ready and waiting. So it really doesn't matter if you are there or not, arrangements can be made while you are being transported in.

[lotus.blossom]

I am also 20-30 minutes away from the nearest hospital, and we only have a volunteer EMS crew in my town. But I am not worried. Midwives are trained to know when its time or not to transfer. In speaking with mine, they assured me that they haven't even had to use an ambulance in any of their transfers (they have been practicing for over 20 yrs)

The closest hospital to me is only a community hospital anyway. I'm sure I would get there at the same time as the anesthesiologist anyway, since they don't have one on 24 hrs a day.

I too had an agonizing posterior labor with my first but i have come to believe that the your surroundings really can create your birth experience. I feel that I would have been successful in avoiding a c/s had I planned a homebirth, but the way my labor unfolded in the birth center made that impossible. Add a little pitocin to the mix and you have a recipe for distress.

Have you spoken to any midwives in your area yet?

[Barefoot~Baker]

No, I haven't and I don't know where to begin either lol! My husband and I watched the Business of Being Born yesterday together (I'd already seen it and hadn't mentioned a homebirth to him) and although he was dead set against the idea, after watching it and all of the hb's in it, he said that it looked ideal and so natural. He's funny, he seems so stubborn and then if he just listens to reason he changes his mind lol.

[lotus.blossom]

Yeah, my DH is funny too. Once I get him involved in my many soap box topic he becomes the biggest advocate for it!! (anti-circ, homebirth, cloth diapers being his top 3! )

BOBB is a great place to start! Have you checked in your area of Finding Your Tribe? You may get some recommendations. Not all midwives are created equal and its important to find one that you and your husband are comfortable and compatible with. If you find that there are none like that then maybe its not the option for you. At least you have a starting point for your research!

[wbg]

Originally Posted by lotus.blossom

BOBB is a great place to start! Have you checked in your area of Finding Your Tribe? You may get some recommendations. Not all midwives are created equal and its important to find one that you and your husband are comfortable and compatible with. If you find that there are none like that then maybe its not the option for you. At least you have a starting point for your research!

I agree with this. Finding the best support team is crucial!

With regards to distance, the home birth midwife will be equipped to recognise warning signs well early and most HB transfers are done without a mad last minute dash to the hospital. MW's are trained to look for warning signs and to recognise the need to transfer in a timely manner as opposed to those made for tv dramatic last minute dashes! Make sure you discuss these concerns with your midwife and ask her how she handles transfers and various childbirth emergencies. She should be able to give you some peace of mind.

The other thing is that should you need to transfer, you can also make the choice to call 911 and meet the EMT's en route to the hospital, thereby reducing the waiting around time. Look further into how the EMS works in your town. Where I live, in a true childbirth emergency, both the volunteer EMTS plus the ALS (advanced life support) paramedics would be dispatched and if they get dispatched between your home and the hospital you( your birth team) can start transporting you towards them. Not ideal, but an option?!?

Most important and in answer to the question should I homebirth...I feel that every woman should give birth in an environment where they feel safe and secure and with a fantastic support team in place. Ask yourself where that is and you will know where to give birth! I loved my homebirth, but also my hospital births! Each one was based on my needs and desires at that time in my life.

All the best....

[boscopup]

In my area (also rural), if there were a true emergency where I needed to get to a hospital ASAP, it'd be best for my DH to just drive me there rather than waiting on EMTs. There are only *2* EMTs in my fire department's district, and it's a volunteer department. So if it's while the EMTs are at their day jobs or one is out of town or something, they have to call another department's EMTs. Then it usually takes 10 minutes for the EMTs to drive to the house, then the ambulance has to come from the city, etc. DH is a volunteer firefighter, and I've heard the EMT calls come in, where they say there's someone that needs help, then a minute later they call again because there's been no answer. Then a minute later they call another department, and might have the same thing happen. It isn't quick! My department really needs more EMTs.

Also, the EMTs here aren't trained in childbirth/newborn stuff like a midwife is. The EMTs where my midwife practices don't even have newborn resuscitation skills. I'd be better off letting my midwife handle it as we drive to a hospital, especially since it takes a bit to get an ambulance out here.

So personally, I'd concentrate more on making a plan for what to do in an emergency - ie, what's the best route to the hospital, have the numbers of the hospital available so you can call ahead and let them know that you're coming and what they need to be ready for, etc. And as someone else mentioned, you could always meet an ambulance partway if you thought that would be beneficial. You can talk to your midwife about her experience with local EMTs. Mine has called EMTs a few times (different department), usually in cases of PPH where she was just calling them "just in case", as she administered pitocin. That way, if the pit didn't work, the EMTs would be there and ready to take her to the hospital.

[Barefoot~Baker]

Thank you,

I think another concern that I have is the cord being wrapped around the baby's neck. How do you know, and what is done about that?

Thanks again

[dnr3301]

lots of babies have cords around their necks. that in and of itself is nothing to worry about. I was a doula at a birth (in a hospital) just yesterday with a baby with a cord around its neck, they did the same thing a midwife would do at home: unwrap it and proceed with the rest of the birth.

[wbg]

Originally Posted by Mrs. Turner

Thank you,

I think another concern that I have is the cord being wrapped around the baby's neck. How do you know, and what is done about that?

Thanks again

Google emergency childbirth, nuchal cord and you will find loads of great resources on how to handle this. It is very common and usually easily fixed. I am an EMT and we are trained to provide basic life support to a mom and newborn, including dealing with a cord around the neck, be it wrapped loosely or tightly, but I hate to give actual medical advice online!! But it is easily fixed! Look it up!

[Krabs]

If you are not 100% comfortable and do not think you will have a good support system, it's ok to look at other options. s:

[SublimeBirthGirl]

I'm 20 minutes from the closest hospital if I speed. I had a UC. Lots of people that far from the hospital or further have homebirths. I don't think that's a reason to not do it, by itself. I'd work through your fears, what you think might go wrong. Remember that it's not like everything has to be perfect or tragic. You'd have a trained midwife there, who knows how to handle complications, rescusitate, etc. A lot of midwives don't call 911 anyway because so many paramedics are inept with newborns. So they just drive to the hospital if they have to transfer. Odds are excellent that your birth would go fine and no transfer would be necessary.

[wbg]

Originally Posted by Krabs

If you are not 100% comfortable and do not think you will have a good support system, it's ok to look at other options. s:

yeah that, too!

[NaturalMindedMomma]

It sounds like you want to and that's a start! It's a personal choice that only you can make. Honestly most complications are "made" by inteventions in the hospital. MyMW has never transported frantically in a life or death situation! She has transported a few times and they were for tiredness (by choice), meconium baby who was having a little trouble breathing and even THAT was FINE and they went in the mom and dads car and she gave the baby oxygen the whole way there and all was fine! MW's have most everything that a hospital does other than an OR and honestly, it tkaes longer than you think to be prepped and get into an OR. In those types of crazy rare emergencies, hospital outcomes are not much better than home. It's really a false sense of security.

Good luck in deciding!

[DahliaRW]

Definitely talk to some midwives. Distance to hospital was a concern for me too, but my mw for ds2, who did lots of rural deliveries, eased my mind. She also said that transfers for 2nd time+ moms are very very rare. And, that further out for the hospital, the more conservative she is about transfers.

[Talula Fairie]

I'm 30 minutes from the hospital and not worried at all about that, I'm having a homebirth. I had TWO posterior babies vaginally, in fact, when I told my midwife that she was like "you're a perfect candidate for a homebirth!" I mean, think about it, if you had an OP baby you know that your pelvis is niiiice and wide. I also was induced for #2. I don't really think that's a factor that makes homebirth dangerous.

You have to think, transfer is actually pretty rare. It really only happens in like 5 to 15 percent of cases. That means 85 to 95 percent of women who choose homebirth actually have one. Yes, there are risks to homebirth, there are risks to just having birth! But studies have shown that homebirth is as safe as or even safer than hospital birth. You're calmer, you're not afraid, which allows your labor hormones (specifically oxytocin) to work better. You'll have less pain. You won't have a cascade of interventions that raise the risk of a C/S.

I reccomend reading Ina May's Guide to Childbirth and The Thinking Woman's Guide To A Better Birth.

[Belle]

Originally Posted by Mrs. Turner

Thank you,

I think another concern that I have is the cord being wrapped around the baby's neck. How do you know, and what is done about that?

Thanks again

Dd2's cord was wrapped around her neck loosely twice. It was no big deal. The midwife started unwrapping it from her neck, but it didn't even slow her down. The next contraction and she was out.

[durafemina]

cords around necks just need to be unwrapped - almost never a cause for concern.
As far as your distance from the hospital - I can think of at least two ways your midwives might ease that fear for you; with my dd we pre-registered with the local ambulance so they knew we were having a homebirth (and my due-ish date) and with the midwife I have now (different country) she will drive the mother/baby in to the hospital if it is a rural (and I mean even more rural than you are talking!) and we can make it in faster than the ambulance can make it out. She carries oxygen, drugs etc and the one time we needed to get in quickly (I am her student) she drove while I administered the oxygen in the back - as we are trained to do. Everything was fine Midwives know to transfer before it becomes too emergent.

Plus, midwives will generally phone the hospital to let them know before you leave so the hospital can prep for you - keep in mind that even at the best/biggest hospitals, they don't have everything ready in an instant. Talk to your local midwives about the procedures they have in place - they should have lots of reassuring answers. Good luck

[Barefoot~Baker]

Thank so much everyone!!! Your advice gives my dh and me so much more confidence. Only problem is, I can't find a midwife!

[Talula Fairie]

Originally Posted by Mrs. Turner

Thank so much everyone!!! Your advice gives my dh and me so much more confidence. Only problem is, I can't find a midwife!

Try this link

http://cfmidwifery.org/find/index.aspx