Serious Question (Warning: Death Mentioned)

[anne1140]

I have wanted a homebirth for a few years now (if I could get pregnant!). I've always believed in the safety of it, read "the" study, and everything.

I'm having serious doubts now.

A woman on another message board just had a homebirth. Everything was going wonderfully, and then her water broke. Her baby flipped to where his feet were coming out, and she had cord prolapse. The midwife did not try to deliver the baby then, but they were rushed to the hospital where she gave birth to him on the operating table (too late for a c-section). He had major brain damage and passed away yesterday.

My heart is breaking for her. I cannot even imagine. But now I'm worried that the homebirth was what prevented everything from being okay. I wonder if she was in the hospital, if they would have been able to get him out in time, and if he would have survived. Of course I can't ask her that question. That would be horribly insensitive of me. So I'm asking here.

I know that sometimes things go badly in homebirth, but that they usually go just fine. I know the statistics. I am just wondering, in this specific instance, if a hospital birth could have prevented the baby from passing away.

I hate to say it, but I may consider a hospital birth because of this. I'm pretty shaken up.

[claddaghmom]

Originally Posted by anne1140

I have wanted a homebirth for a few years now (if I could get pregnant!). I've always believed in the safety of it, read "the" study, and everything.

I'm having serious doubts now.

A woman on another message board just had a homebirth. Everything was going wonderfully, and then her water broke. Her baby flipped to where his feet were coming out, and she had cord prolapse. The midwife did not try to deliver the baby then, but they were rushed to the hospital where she gave birth to him on the operating table (too late for a c-section). He had major brain damage and passed away yesterday.

My heart is breaking for her. I cannot even imagine. But now I'm worried that the homebirth was what prevented everything from being okay. I wonder if she was in the hospital, if they would have been able to get him out in time, and if he would have survived. Of course I can't ask her that question. That would be horribly insensitive of me. So I'm asking here.

I know that sometimes things go badly in homebirth, but that they usually go just fine. I know the statistics. I am just wondering, in this specific instance, if a hospital birth could have prevented the baby from passing away.

I hate to say it, but I may consider a hospital birth because of this. I'm pretty shaken up.

What a tragedy!

Pregnancy is a contradictory time for humans. We have life in our wombs. We have created life and we want to bear life to the world....to die. This existential dichotomy really seems to hit us during pregnancy. The more we reflect on the little life within us, the more we find ourselves paying attention to death.

Although this is something all of us must process in our own way, with our own experiences and research, those who birth outside the hospital have a unique situation where they more clearly see the parallel between life and death. Our culture has presented us with an image that as long as we have a doctor in the hospital, equipment strapped to us, a diagnosis board at our feet, we will outrun death. It's easier to ignore reality. It's easier to hide from the guilt.

And if death does come for our little one in the hospital, then our culture is very forgiving. Everyone assumes that surely the doctor did all he could. Surely the mama was not at fault; she followed the rules. Surely all equipment was utilized, all tests tried. It was futile from the beginning and thus meant to be.

But what is the response to a homebirth loss? Immediately the parents are suspect. The midwife is scrutinized. The mama didn't do something right. The midwife didn't interfere soon enough. The equipment was DIY and failed. A doctor and a hospital would have saved the day.


Are there cases where immediate intervention might have prolonged or saved a life? Absolutely. Just as there are cases where hospital intervention shortened or took a life.

You have a direct, and horribly tragic experience to dwell upon when making your decision. But does it change anything in the big picture? A baby flipping breech while in labor and presenting with cord prolapse? Not one, but two rare presentations? I find it somewhat irrelevant (to the decision making process) to even think about the outcome in a hospital vs. homebirth. Breech presentation hovers around 3% and cord prolapse occurs in about 1 out of 700 births. Cord prolapse is also considered an emergency regardless of birth setting.

http://www.ispub.com/ostia/index.php...ol1n1/cord.xml

I am no professional and simply replying to a post online, but it sounds as if the cord was too short, and additionally there was a cord accident? A flipping baby could mean the baby couldn't descend due to the cord?

I wish you luck in your journey.

[nikirj]

I'm sorry to be answering this in passing...can't give it a ton of time right now so this answer is very academic.

The studies don't show that homebirth is "safe." What they show is that homebirth is "as safe as" hospital birth. The unfortunate fact is that sometimes, babies die. What the studies show is that the numbers balance; the same percentage will have issues because of being born in the hospital as will have issues because of being born at home. Which means for every baby that couldn't be transported in time, there's a proportionate number (more, because more babies are born in the hospital than at home) that have died BECAUSE OF the hospital. Who died because they acquired infections there. Or because their moms were given wrong drugs or wrong quantities of drugs, or weren't paid proper attention to. Or any number of ways that babies die in hospitals, but we don't typically think to blame the hospital.

[MyFillingQuiver]

Originally Posted by claddaghmom

What a tragedy!

Pregnancy is a contradictory time for humans. We have life in our wombs. We have created life and we want to bear life to the world....to die. This existential dichotomy really seems to hit us during pregnancy. The more we reflect on the little life within us, the more we find ourselves paying attention to death.

Although this is something all of us must process in our own way, with our own experiences and research, those who birth outside the hospital have a unique situation where they more clearly see the parallel between life and death. Our culture has presented us with an image that as long as we have a doctor in the hospital, equipment strapped to us, a diagnosis board at our feet, we will outrun death. It's easier to ignore reality. It's easier to hide from the guilt.

And if death does come for our little one in the hospital, then our culture is very forgiving. Everyone assumes that surely the doctor did all he could. Surely the mama was not at fault; she followed the rules. Surely all equipment was utilized, all tests tried. It was futile from the beginning and thus meant to be.

But what is the response to a homebirth loss? Immediately the parents are suspect. The midwife is scrutinized. The mama didn't do something right. The midwife didn't interfere soon enough. The equipment was DIY and failed. A doctor and a hospital would have saved the day.


Are there cases where immediate intervention might have prolonged or saved a life? Absolutely. Just as there are cases where hospital intervention shortened or took a life.

You have a direct, and horribly tragic experience to dwell upon when making your decision. But does it change anything in the big picture? A baby flipping breech while in labor and presenting with cord prolapse? Not one, but two rare presentations? I find it somewhat irrelevant (to the decision making process) to even think about the outcome in a hospital vs. homebirth. Breech presentation hovers around 3% and cord prolapse occurs in about 1 out of 700 births. Cord prolapse is also considered an emergency regardless of birth setting.

http://www.ispub.com/ostia/index.php...ol1n1/cord.xml

I am no professional and simply replying to a post online, but it sounds as if the cord was too short, and additionally there was a cord accident? A flipping baby could mean the baby couldn't descend due to the cord?

I wish you luck in your journey.

Thank you so much for this...it's so hard for some mama's (me) to go from a mainstream (against all intuition to do so, as well) birth history to a mindful and researched and intuitive homebirth..part of that is seriously due to stigma attached to homebirth being a selfish event for mom..and the issues surrounding loss at a homebirth (often viewed in the mainstream world as a selfish act) vs hospital birth ("we did everything we could")

I have recently faced the fact that babies do die at birth/full term. I have lost a child near the end of the 1st trimester in the past, and dealt with that, but never fully recognized the fact that it happens sometimes for no reason and with no warning...life is delicate, and the one thing no human will ever fully understand.

So, with that said, thank you for this post. It's very important for everyone to realize (not dwell on but realize) that life is fragile, and that homebirth is safe, and the mama is making a safe choice that no one could guarantee a healthy baby as a result of-whether home or hospital.

[kitkatkaddoodle]

Could the baby have been saved at a hospital? In this specific instance, maybe, but as others have said, it's an emergency anywhere. What if she'd never planned on a homebirth, had been hanging out at 4 cms without labor, and broke her waters and had a prolapse while out shopping somewhere? The outcome might have been just the same.

It is a hard fact of life, but sometimes babies die. Sometimes moms too, though it's one of those taboo things that people don't want to think about, much less talk about.

[briome]

I'm sorry, I know that is scary to hear about and imagine happening in your life.

I always try to remind myself that it is possible (and I have also heard personal stories) of deaths contributed to or caused by hospital procedures and deaths that could not be avoided regardless of location of birth. I know that is no true comfort to know that we are all really in danger at any time....but that is how I have dealt with my generalized fear and anxiety.

Of course, remember that hospitals have a certain 'way' of making sure nothing looks like it is ever their fault. You rarely hear (or even belive it if you hear it) that something bad happens at the hospital because they have a well crafted marketing, legal department and the public's general belief that everything done at the hospital is based on the Hippocratic Oath. I don't think it is EVER that clear cut and dry. Maybe in this situation it is easy to play 'what ifs'.

......having homebirth in a few weeks

[emnic77]

What an awful tragedy. I'm so sorry to hear of that.

Claddaghmom said everything beautifully.

The only thing I will add is that how you process it with regards to your personal situation is exactly that...how YOU process it. A very close friend of mine lost her second child after her homebirth. Lack of oxygen, she was taken off life support at 8 days old. The midwife's actions were questionable, in regards to the monitoring that was done and other details I won't get into.

I was there when the paramedics arrived, helping with her DS. That memory will never leave me, ever, and when I had my DS almost 5 years ago, he was a hospital birth, even though after my first hospital birth with DD I swore to homebirth the next. But I couldn't, I just couldn't get past the fear or the images I had from my friend's birth. Logically I knew the risks and statistics and whatever, but my emotions hadn't caught up with the rational stuff yet. It took me a long time to get over it, and nearly 9 years later I'm planning my homebirth. I still think of my friend (who has since moved away) and her daughter, and I talked about it with my midwife who knows I'd like to have a bit more monitoring than usual, just for my peace of mind...

[cathicog]

ITA with what Claddaghmom said. Your friend's birth truly was tragic.
But the chances of either one of those situations(baby flipping breech in labor) and prolapsed cord, are so RARE, the chances of having something go awry in the hospital, to me, are greater. But it is something to think about. I chose to homebirth. I could be in better control of the situation. Something to think about too, midwives are usually trained in how to do vaginal breech births, and what to do with prolapsed cords...on the way to the hospital. I am sorry for your friend. You have to decide which risks are greater for you...nothing is without risk.

[aims1029]

Anne. I'm glad you posted here. I'm on the same forum with you so a lot of the same things have been on my mind. Especially with my HB coming up possibly any day now. Would he have survived if she were in the hospital? Maybe or maybe not. Like the others said, cord prolapse is such a scary and RARE emergency wherever it happens. When we interviewed my midwife it was my biggest concern. She has dealt with 3 cord prolapses, all with great outcomes. I am still 100% confident in my choice to home birth but I hate having this in the back on my mind. She is constantly in my thoughts.

[Burnindinner]

: I'm so sorry. This is a good place to process and talk with other moms who will really listen and talk with you.

I hope you will find peace in any decision.

[Baby_Cakes]

What an incredible tragedy. I get what you're saying, with regards to planning a hospital birth after hearing about this.
But what if she had been planning a hospital birth, and was simply laboring at home for as long as she could? This could have happened regardless of whether she planned/attempted a homebirth or not.

There is no way to know that any dr or hospital could have definitely for sure saved her baby.

You must be incredibly shaken up. It is really hard to hear about the death of a baby. You obviously have to go with your gut feeling on what path you personally take, but I implore you to truly think about the chances of something like this woman's story happening again. Both a cord prolapse and flipping breech are incredibly rare. Obviously, that doesn't mean they don't happen, but even when they do, the outcomes are usually good. This is just one of those cases where (and I hate to say it) probably nothing would have/could have saved that baby -- unless the mother went to the hospital at the first sign of ctx and followed that route (put on a clock/intervention after intervention/probably c-sec).

After typing that, I realize I would definitely rather have a c-sec than lose my baby. But there's no way to know that you're baby is going to die when you're in early labor and ctx are just beginning...

All this to say -- yes, this is a horrible story. Horrible. It is incredibly sad. You have every right to have doubts now. But, on the other hand...if you truly believe in homebirth, your body, your midwife, etc, you have also have a great opportunity to have a fantastic birth experience.

[Juvysen]

Originally Posted by Baby_Cakes

After typing that, I realize I would definitely rather have a c-sec than lose my baby. But there's no way to know that you're baby is going to die when you're in early labor and ctx are just beginning...

yes, but then, c-sections have their own risks associated - higher chance of maternal mortality, for instance...

Sadly, part of birth is death - we're lucky that we have modern medicine to help us lower the chances, but even in the hospital it's still there. And from what I understand, the maternal mortality rate is higher in the hospital than at home, so there's that, along with what PP have said about the risks to baby being *different* at the hospital, but at about the same rate.

I think the question you need to be asking is whether you want to have more control over your situation or less... because at home you have more (and can, say, go to the hospital at any time if you feel like something's not right), and at the hospital you have less - but with the control comes more feeling of responsibility vs. less. IMO, it's not a question of risk (because the rate of risk is about the same) but a question of resposibility... do you want to avoid feeling responsible if something horrible should happen? This is something I thought a lot about before my home births - because no doubt the mother is blamed for wanting a "good experience" by society, but I can pretty much guarantee I have personally internalized some of that blame for myself, thus I'd likely hold *myself* responsible in the case of a loss at home, even if there was nothing that could have been done. However, if there was a loss at the hospital it would be easy to blame someone else...

I don't know if I'm really making sense, here... I've sort of started rambling

[blessedwithboys]

my sister was planning a HB then switched to hospital (not out of fear, MW had personal emergency and dropped all pt for that month). her placenta abrupted at term and her dd was gone in moments. she delivered spontaneously a few days later. the only way to have prevented it was if she had been on CFM for 40 whole wks, JIC. and thats extreme, of course, who would do that?

then theres my mother who smoked, drank, and never had prenatal care. she had an unplanned HB at age 37 after a 20 min labor. my sister was born healthy, though she was rushed to the ER and stuck in a plastic box for a week, JIC.

then theres my 2nd birth, an "emergency" csec. it took them 3 full hrs to get me into the OR.

even a true emergent surgical birth can take up to 30 mins to get the baby out. if your home is close enough to the hospital, and your mw is trained and experienced enough to knwo when its time to transfer, you will be fine. even if you are in hospital, what happens if all the ORs are full, as they often are in this csec happy world in which we live and birth?

[LilPenguinMama]

Originally Posted by anne1140

I hate to say it, but I may consider a hospital birth because of this. I'm pretty shaken up.

You are allowed to feel how you feel! Remember the basic reason that most of us are drawn to homebirth -- we want a place where we feel safe.

If you have been shaken up, and it is close enough to home that you will have a nagging doubt, then maybe home is no longer "the best place for you."

Homebirth is all about getting the ENVIRONMENT that you want. Above all, you want to feel safe. If you don't feel safe, your mind will get in the way of your laboring. You can't force yourself to change how you feel. You feel how you feel. If you give yourself permission to be frightened, you might be able to get past the feeling, and re-embrace the idea of homebirth. Or you might not. But, you need to honor your instincts, truly grieve for your friend's loss, and not feel guilty that your instinct is to protect your little one, even if that means giving up your dream of homebirth.

There is nothing wrong with you if you suddenly feel the need to have the medical community around. That is your right.

Sure, you know all the reasons to have a homebirth. But, you got a scare.

I think the best way for you to make the decision of if you want to change is to give yourself permission to really make it a choice again. Start the decision making process over again, and be patient with yourself. There is nothing wrong with you, you are not "chickening" out. You are a kind and empathetic human being, who has brushed up against a rare tragedy that makes the thread of human life seem so much more delicate.

When you give yourself permission to make the decision over again, you may be surprised. Maybe, you will find your own comfort and safety in your home again. Maybe not. Remember that you started this journey looking at was right for you and your baby. Keep true to that path and you will find your way. Forcing yourself into one place or the other without really feeling your way through it isn't going to give you the peace of mind you need. Good luck!

[rparker]

My husband is a pediatrician. I asked him if he thought the baby would have lived if she had delivered in a hospital. His opinion was that if the midwife called 911 (I couldn't tell from your post) as soon as the cord prolapsed, and they went immediately to a hospital, and a c-section still couldn't be performed in time then the outcome would probably have been the same either way. His reasoning was that it takes a certain amount of time from recognizing the need for a c-section to being able to have an operating room and surgical team ready.

Please don't read this as medical advice. You have to do what you're comfortable with. We didn't have a home birth with our daughter because he was a nervous first time father. We aren't having a home birth with this baby because I'm uncomfortable with the local home birth options (we're in a fairly remote medically underserved area also). If I lived in a less rural location, near a good hospital, with an experienced midwife I liked, who had physician backup and felt comfortable with emergency transfers I'd definitely have a home birth over a hospital birth.

[kitkatkaddoodle]

Yes, please do what you are comfortable with. My attempted homebirth with my son ended up as an urgent hospital transfer for thick mec due to a tightening true knot in his cord as he descended. Very uncommon, though not unheard of, and while everything went fine at the hospital with a little last minute help of a vacuum assist, it was a bit scary for a while. Still, if we were living in the same town with the same birth attendants, I'd be trying for a home birth this time, but I'm not comfortable with this state's policies regarding homebirth, and we live further away from a hospital should we need to transfer, so I am comfortable with my birth center choice.

[MeepyCat]

We can never know what might have happened.

In this particular case, I think that the baby would have had better odds of surviving had the mother labored in hospital. It would have been a crash section of the scariest kind - basically, she'd have had someone trying to relieve the pressure on the cord by hand while frantically calling a code - and there are no guarantees. (Where I live, hospitals with OB units keep one OR on the L&D floor empty in case of emergency - there is always an OR ready in case the need for crash section arises. How long it takes to get a surgical team together is harder to guess. They don't necessarily have a spare anesthesiologist on the floor, people still have to scrub in, and the night my daughter was born - via emergency c-section - the attending had to send someone to wake the resident assisting. Hospitals may boast that they can get a baby out in no time flat, but they clearly do not include "waking the surgical team" in that time line.)

While studies have shown that homebirth is as safe as hospital delivery in uncomplicated cases, these studies have not been done in the United States. Midwifery isn't licensed, so there is no authority requiring that all midwives meet any standard, and the insurance climate is making it difficult for midwives to partner with physicians in many areas. Practicing midwives vary wildly in training and capability - some are very good, others are not.

You should certainly discuss your concerns with your midwife and see what she says. My feeling is that the odds of a baby flipping during labor are very low, and that there are signs, both of breech positioning and fetal distress, that should be detectable either before or during labor. My hope is that you have a capable midwife who can reassure you now and take care of you no matter what happens during labor.

[Vespertina]

Originally Posted by kitkatkaddoodle

Could the baby have been saved at a hospital? In this specific instance, maybe, but as others have said, it's an emergency anywhere. What if she'd never planned on a homebirth, had been hanging out at 4 cms without labor, and broke her waters and had a prolapse while out shopping somewhere? The outcome might have been just the same.

It is a hard fact of life, but sometimes babies die. Sometimes moms too, though it's one of those taboo things that people don't want to think about, much less talk about.

This. And ditto the previous posters.

I'm a member of the pregnancy/birth loss forum on here. There are mamas that lost their babies during their births (some at home). Knowing their stories helped me accept and realize that sometimes babies die no matter the location of birth. I've read through many stillbirth/homebirth stories and I can't say it really changed my thoughts on homebirth. I accepted the grim reality that losing a baby can happen at any time. I needed to be in the right place for my next birth so I knew dwelling on the possibilities of a complication or emergency would not do me any good.

I've read it all from complete placental abruption to cord compression to shoulder dystocia. I've read stories where there was a complication discovered after the birth when it could have been prevented. Cord prolapse is very rare and the conditions have to be right for it to occur. It's something we had to prepare for when I was pregnant with ds1 as I had a significant case of polyhydramnios and one of the risks is cord prolapse. We knew it required immediate medical attention. It could happen anywhere at any time. It's easy to second-guess one's decision or choice when something has gone wrong. I did it myself after losing ds1. Even though I knew in the back of my head what happened, I still questioned myself and whether I should have done this or done that. In the end, it wouldn't have made a difference.

I think the best thing to do is research and read up on what you fear the most. Become familiar with situations and complications that can occur and develop a plan of action. Remind yourself of the statistics of these complications so you can put it into perspective. All you can do is prepare. Surround yourself with a good support system and do your research.

[ShadowLark]

You guys have some great advice! I came here with some fears and questions of my own, but I THINK I've found my answer.

Bit of background - I'm 28 1/2 weeks pg, baby is frank breech and keeping sex a surprise (silly cutie), third kid, first homebirth, other two were Hospital vag deliveries. My son (1st baby) was born with IUGR due to a partial placental abruption in the 3rd trimester which NO ONE caught - there was blood in the amniotic fluid but he sailed right through an induction (my water broke, or so I thought. They tested it and came back pos for amniotic fluid but it WASN'T bloody until they broke the rest of my water during labor. Go figure!) with PITOCIN! And yes, I had the Stadol and the epi and the whole crappy, yucky birth experience that generally goes with inductions - the only good part was being able to deliver vaginally. He was 4 lbs 14 oz, (at 37 weeks 2 days), they never did figure out what caused the abruption (it was 5%) and my best guess is that his umbilical cord was on the short end of normal.

My daughter was born 13 1/2 months later. PERFECT pg, TONS more energy than with Boy Boy. They found a "soft marker for Down's" on her heart at the 20 week u/s, so when I read that babies with Down's who are late have a higher than average risk of m/c, I called and asked about it. I'd been begging for an induction and they told me 41 weeks. Well, after my question came up, it was suddenly "you have an induction scheduled". Dude, it was a QUESTION! But who am I to complain, right? (And ftr, late still means late - 42 weeks plus, NOT 40 weeks and a day. And the reason the risk is higher is because babies with DS lay down more calcium and it's calcification of the placenta that causes the aging that leads to failure and dead post-term babies. So 41 weeks would have been FINE, unless a NST said otherwise.) So she was born with back labor (she hadn't dropped yet - oops!) and Pit and NO PAIN MEDS!!!!!!! Yep, I'm still proud. 8 lbs 4 oz 14 inch circ head AND her arm was up and BARELY any tears (up top). Oh - and she doesn't even have Down's! (Which is a blessing, because my boy has ASD and developmental delays and I'm still trying to figure out HIS care.) They're 3 1/2 and 2 1/2 now.

So - on to my concerns. I'm pretty much happy with the fact that baby is frank breech right now. I'm a bit scared of the prospect of baby flipping because I DO have a low lying placenta (it was partial placenta previa but it moved) and I'm worried about the possibility of a short cord. (Within normal limits, but on the short side.) If baby has a shorter cord like I think Boy Boy did (and that will forever remain a guess, btw, because some student reached in and cut the darn thing before he was even out of me all the way! Yes, she got reamed a new one, but we're STILL mad - that was SUPPOSED to be daddy's job, and Boy Boy CLEARLY needed the oxygen!) and baby tries to flip, it could cause another abruption. And Boy Boy got lucky - his clotted off and he was fine. What happens if it's a COMPLETE abruption? I'd rather have a breech baby and have him/her be healthy.

So - baby stays breech. Delivery day comes along. I'm doing a homebirth with my m/w (who needs the experience) and her backup (who's done this sort of thing a hundred times). Cord comes out with baby (not prolapsing, just normally, since the butt comes first) and then it's time to get baby's head past the cervix. The placenta is above the baby and the head is the widest part of the baby's body. Won't getting the head through the cervix cause a cord compression? How would that be avoided? (Is it even possible to avoid it?) What would it do to the baby? I know I can push the baby right through - my girl and boy BOTH slipped right past the cervix with me barely noticing. They were out in 4 pushes, even Girl Girl! So we wouldn't be talking about 20 minutes worth of compression, here, more like two or three. Would that even be enough to matter?

And would the risks of cord compression in a transient situation like that be outweighed by the risks of a C Section? (Which I guarantee would be the ONLY option in a Hospital around here.) And I don't mean an emergency C Section because the compression has been going on for too long. I mean a "we know your baby is breech so how does this date sound" C Section like they'd want me to have? HELP!

[GoBecGo]

I have a friend who lost a baby in a similar labour. Baby was scanned the day before labour and was head down, but when mom was pushing the membranes broke and revealed a little butt. The mw called emergency (this was in Europe, and in a country where midwives cannot deliver breeches at home) and did what she could to help out. The baby came down with her head completely unflexed, and her head caught under the pubic arch. The contractions completely stopped. She was stuck for a long time, and when she was born her placenta came down right away, having detached some moments earlier. They got a HB and the ambulance rushed her in, but the baby died a few weeks later. The mw and mom both felt that there was something wrong before the baby flipped, something which made the baby flip, which made the baby extend its head (most babies flex like they would for a head-down birth, which means descent and birth of the head is usually a fast and smooth affair, and even when the head is unflexed it is often possible to flex the head by hand, but this baby was actively unflexing, so the midwife could never reach her mouth to pull her chin down) and which made the contractions stop so abruptly. The mom had been depressed the whole pregnancy and had made no preparation for the baby, having sent her DH out just days before the birth to pick up a few baby clothes. She feels in retrospect that she kind of knew the baby was never coming to stay, and she accepts it. She had another baby recently, born in hospital, just, they got there pushing and the baby was born whole and healthy a few moments later, before they got her into a delivery room.

I am still having a homebirth. Babies die sometimes. You cannot prevent it. Not always. Luckily for us, medicine offers many answers and solutions, and can really help, but it cannot prevent all deaths. With a complex pregnancy, underlying problems and any of the many warning signs that birth might not be too straightforward, a homebirth might not be the safe choice it is for healthy women having normal pregnancies. The studies show that home is AS SAFE as hospital. Which means babies dying at home were not less likely to have died in hospital. Specific cases can be harder, because for every situation where a baby dies, there will have been many individuals involved, whether at home or in hospital, and any of those individuals could have subtly or blatantly directed how things went. There is no way of knowing, this is the reality of life, of birth.

Shadowlark, if my baby was in frank breech i would probably have a homebirth. The butt without feet fits nicely into the pelvic inlet and makes cord prolapse unlikely. The circumference of the thighs against the abdomen are similar to, or larger than, that of the head which means the head will usually birth a push or so behind the rest of the baby. I would need to really trust my mw though, and i would want to know exactly what her technique would be. Studies i have read indicate that the safest way to birth a breech is upright (standing squat) without touching it (hands off the breech). Trying to "help" can cause complications and any help needed needs to be sensitively given. Have you asked specifically what your midwife will actually DO during birth?

At 28 1/2weeks your baby can and probably will move. Especially as you've already had several babies. Visit spinning babies and see what advice is offered for helping baby to move, consider ecv (which you may or may not want, i personally would take it because it's safer for me than the vaginal breech birth with a somewhat inexperienced caregiver or the cs which is what i'd have to choose between) and tell your baby to move. I know no fewer than 5 women who had frank breech babies who were told "frank breeches can't usually flip so easily" and all but one did (the one who didn't was born drug free in hospital and on her way home 4 hours later).