Homebirth an hour away from hospital (VERY RURAL)

[MKmama10]

I just found out that I am pregnant with me second!! My husband and I are super excited.  We had our son in a hospital in the Midwest in 2010, which was fine I had no problems and loved the birthing process.  However, I do not feel that I could have another hospital birth.  I can't really explain my feelings I just can't picture a hospital or birth center birth.  I want to be at home.  I want my son to be there and comfortable, I want to be able to go to bed in my bed.  So it would seem like a no brainer to have a homebirth. The problem that is standing in our way is that we live at least an hour away from the nearest hospital on a back country mountain road.  It is a fully paved road, expect for a half mile road to get off our property, so assuming there are no cars in the way we can make it in under an hour if we were speed during the straight spots. I am having a really hard time deciding what I want to do.  My husband is totally on board with a homebirth if that is what I want, but I am kind of scared.  Everyone that I have talked to thinks that I am crazy for considering having a homebirth.  So, what do you think?  Am I crazy for considering it?  How far from the hospital would you birth from?  Are there any good links that I should check out?

I should add that I have not spoken with a midwife yet and even know if they will deliver this far from the hospital.  Also, I have spotty at best cell service, and we run a generator and solar power, I am not sure if that matters.

Thanks for the help!   

[Adaline'sMama]

Personally, I wouldnt do it. I made the decision not to have a homebirth with my last because the hospital is over 30 minutes away, and on back country roads. Everyone has to make that decision for themselves, and both of my births turned out to be totally fine and I could have totally had them at home.

[eggsandpancakes]

im in a similar situation as far as the drive to quality medical care. after talking to  my midwife, when you are not on drugs things go downhill very slowly, so you have a couple hours to go somewhere. even my (first time dad) husband is totally okay with me having this baby at home.

[rnra]

Originally Posted by eggsandpancakes 

im in a similar situation as far as the drive to quality medical care. after talking to  my midwife, when you are not on drugs things go downhill very slowly, so you have a couple hours to go somewhere. even my (first time dad) husband is totally okay with me having this baby at home.

Are there any studies or evidence to back up this statement?  During birth there are some problems that develop slowly, but there are also many that can happen quickly (with or without pain medication) that definitely don't give you a few hours to sort things out.  

[fruitfulmomma]

Yeah, sorry but that is not even remotely true. Placental or uterine rupture, prolapsed cord, and hemorrhage are just some of the things that can go wrong fast and require immediate attention. 

OP, my absolute limit is 30 minutes under non-emergency conditions with ability for an emergent transport taking place faster and phone coverage is a must. Any possibility of finding a rental or hotel closer?

[MKmama10]

We have been considering renting a place in town to birth at.  But it still isn't home.

[Mamma Mia]

I would call some local midwives and talk to them about the situation. I think their insights will be more relevant to your situation, as they'll likely live in the area and have the experience to help you with your decision. I think MDC is more the place for you to process the information you get and your feelings about the decision you make, but probably not the place to help you make an informed decision about this.  Any local midwife will be more than happy to help you with this decision, and no midwife wants to set herself up to have a poor outcome, she will be looking out for your best interests, which are also in her best interests.

[JamieCatheryn]

Looking into exactly what your options are locally will help. Contact midwives, there might be a birth center like halfway or midwife who hosts clients in her house closer to the hospital, or a B&B that will let you birth there. Oftentimes if that's available you relax there maybe 3 hours after the birth then go straight home to bed. Some might draw the line and simply not attend a birth so far away for transport. You might be limited to very few if any midwives who come to where you are. The most common complications are slow developing (slow but still excessive bleeding after birth, maternal exhaustion, mild signs of fetal distress, etc) but yeah there are some things that need immediate attention beyond the techniques, meds, and oxygen the midwife can bring to you. You have to decide for yourself and your child if you can accept that risk and still be most comfortable with birthing there, and the midwife has to decide whether she can be involved when that long transport time is a factor. If my prayers and intuition all assured me home birth would be alright, and I could find a midwife to attend or even convince my husband of UC, I very well might homebirth even an hour out of town. Though, I'm due in Jan and moving somewhere snowy, so that long a travel time complicated by snow could well push the risks out too far for me. Spring weather should be fine unless you're in a big storm though.

[Kynid]

I would not personally feel comfortable doing it that far away. Even though it's rare, things can go bad quickly, and then you can have only minutes to seek medical attention. With that said, you have to do what is best for your family. I would go for a birth center in town if I were in that position. 

[themothership]

I am 45+ minutes from the hospital, and am having a homebirth. Things can go bad quickly, yes, but it is a risk you take when you decide to birth at home. I am okay with taking that risk for many reasons, some women aren't. You need to talk to area midwives and make an educated decision.

[scruffy too]

I am 45 minutes from a hospital and I'm 98% certain I'll be homebirthing in March. 

[tash11]

I live in the country ( though I don't consider it "very rural"). My midwives are more then happy to come to me (though the travel fee was considerably more then it was when I lived in the city). The closest hospital is about 14 miles and 35 min, but it has a horrible rep for everything. The next closest is about 20 miles, but through horrible traffic depending on the time of day it could be 35 min to a hour and a half. (that is my midwives choice backup for me). Another one is 22 miles, and about 45-50 min, and seems ok if you want a c/s (but not great). The one we would probably do if traffic was bad for the other is 26 miles and about 45 min. The best NICU in the area is about 35 miles, and something like 45-55 min (again, depending on traffic).

Anyway, as you can see I have been over all of this, and my midwives have talked about it with me at at least two visits.

I have had two easy births, and my midwives have a great history too. I am fine with the distance. Most transfers (especially with my midwives) are non-emergency and are generally for premature labour, prolonged labour (where the mom is tired and wants an epi or something) and other things like that.

Where I live there are no birth centers so that is not an option even if I wanted one.

For me, personally, at home is the safest, no matter the distance to a hospital.

For you, I say interview some midwives and ask them specifically about your concerns over distance to the hospital, see if there is a birth center and interview them, then interview an OB or two if you like. Talk to other moms in your area and see if they can tell you about their experiences with the midwives/OBs around.

I think it's also awesome that your husband is supportive of whatever decision you make :D

[iowaorganic]

I home birthed twice 50 minutes from the hospital.  The hospitals around me don't generally have a full staff anyway- so it would take time for them to all come in if things went bad anyway.  My midwife said her most usual cause of transfer is stitches- and that isn't exactly an emergency situation.  Bad stuff and and does happen- it is the obvious risk you take for being out of a hospital.  

[soveryblessed]

I live 45-60 minutes away from the hospital as well. About 5 miles of road from my house is back roads, and the rest is highway until you get in to the city, which there is another good 5-7 miles of more "back roads." 

Anyway, I have had 2 homebirths and am planning a third one. To me, I'm more at risk of having a problem being IN the hospital than I am being at home. My last labor was also pretty quick so I figure it's better to be at home than to push a baby out on the road. 

[Oliver'sMom]

I personally would not be comfortable birthing an hour from a hospital.  There are multiple studies showing that homebirth is very safe when backed by a modern hospital.  I've also read that you're the most safe if that hospital is within 15 minutes of your home.  I can post links if you'd like.

I had both of my boys at home.  After my second, I had a severe PPH and had to be transferred to the hospital.  From the time my husband called 911 to when I arrived at the hospital, maybe 10 minutes had passed.  I don't mean to scare you, but things can happen fast and without warning.  I'm a huge home birth advocate, but only under safe conditions.  Being an hour away from a hospital is not safe, imo.

[mwherbs]

You always live that far from the hospital.. You take that risk everyday. What if you have an abruption or precipitate birth or a preterm birth or earily in pregnancy a tubal pregnancy, or slip and fall in the bathroom just any day opregnant or not I mean you live there all the time and take a chance all the time that you are going to be fine even if you plan a hospital birth you still live that distance... So in any case is there a helio transport system in your state? How close could they land to you? Where is the ambulance, firedepartment parameidcs? I have lived very rural and I have lived in the city, sometimes city transfers are nutty and slow and dont make any sense like a desire to transfer a mom with retained placenta to a heart hospital because the hospitals with births were so full they were on diversion... If we hadnt asked destination and said heck no that is were mom would have ended up in a fairly usless place for her... In any case just saying you and only you can figure out what you feel comfortable with ...

[dayiscoming2006]

I'm of the opinion that homebirth is safest most of the time because of all the interventions with hospitals. Are there any decent birthing centers that are potential options for you? I like the others suggestions with talking to some midwives. I would personally have a homebirth in that situation if all was going well with the pregnancy. If a midwife would come out, at least you have a knowledgeable person there to help you should anything come up.