Can someone list reasons why someone *shouldn't* have a homebirth?

[Lisashepp]

I really want to have a homebirth, money is very tight and I just want to make 100% sure that I will be a good candidate for homebirth. I have been having some pregnancy related health problems and would just like a list or something with reasons women shouldn't birth at home.


Thanks!

[Artisan]

These are things I've heard other people say, and I'm sure you've heard many of them too.

-- If there is a true emergency, like cord prolapse, you want to get the baby out immediately.
-- If a woman hemmorhages, you want immediate access to drugs and blood products or possibly the OR.
-- If there is something seriously wrong with the baby, you want immediate NICU access.
-- If you need to transfer care to the hospital, you may be looked down upon for attempting a homebirth in the first place.
-- You may have to fight your insurance company to pay for the homebirth.
-- No one is there to take the baby and wait on you after a homebirth, as opposed to the two day hospital stay.
-- You have to arrange for tests for the newborn on your own time. PKU, hearing, etc.

[Boobs]

Good question! I'm anxious to read all the responses as I'm only like 90% sure I'm ready to do this. I want to be 100%.

[marisa]

If you are uncomfortable with accepting responsibility for your own birth (and the outcomes) you probably shouldn't birth at home.

[Changed]

Those listed are all "if". Those are always going to be there but from what I understand.....

The only reasons it would not be safe or optimal to have a homebirth are health reasons. If you already have a condition that could create complications; previa, pre-eclampsia, GD, ect ect.

Otherwise there are risks to homebirth as well as hospital birth that no one can prepare for.

[pamamidwife]

It varies so much state to state, midwife to midwife. I'd interview some midwives and talk to them about it. (Like, for instance, I can arrange all the newborn screening and do it at their home, including setting up appts for hearing screening if the parents want)

[chow46]

I had a pretty serious problem where the umbilical cord didn't attach at the placenta and there were concerns that the cord could snap during the labor causing the baby to die. It's pretty rare and was detected during an ultra sound. If you have a midwife, I'd consult with her. Each midwife has a different level of comfort for what they can/cannot handle.

[Artisan]

Just wanted to clarify that I am not trying to talk her out of a homebirth, just listing reasons why someone might not want to have one. If I have a third baby, I will have a homebirth.

[Jane]

You shouldn't have a homebirth if you don't want one.

I think if it's a financial concern, ie that you don't want to pay and then risk-out of the homebirth, then you actually need to shop for your midwife first. Her policies on payment and risk and probability are more likely to impact your birth than any hypothetical reasons.

[Lisashepp]

I know about the transfer reasons and everything, but I suppose my real question is who shouldn't *plan* a homebirth?

So GD is a good reason? I have PCOS and because of that I am at higher risk of GD, I didn't have GD with my first pregnancy, but I didn't have active PCOS then either.

I also have a prolactinoma, which could in theory grow during pregnancy BUT it didn't grow with my first pregnancy.

I also have a big cyst on my right ovary, ultrasound next Thursday to see the condition of it and if it has grown or shrunk.

I know why I want to have a homebirth, and I am willing to accept responsibility for the birth and any outcome, but I just want to make sure that I am a good candidate going into this.

Oh and my insurance wont pay a cent. There is only one midwife group I feel comfortable with here.

[weesej]

This IS very rare. However I have seen it twice. It is not usually noted on US and at the hospital they are far more likely to routinely use cord traction and cause it to snap. Versus at a homebirth when the placenta comes on its own. The vast majority of the time a velamentous insertion is noticed after the birth not before...and a midwives way of handling third stage is safer

[pamamidwife]

I don't feel like GD is an absolute risk out of my practice.

Then again, I'm not a huge believer in the GD diagnosis. I'd rather have a woman use a glucometer and make adjustments in her diet based on that.

[pamamidwife]

Originally Posted by weesej

This IS very rare. However I have seen it twice. It is not usually noted on US and at the hospital they are far more likely to routinely use cord traction and cause it to snap. Versus at a homebirth when the placenta comes on its own. The vast majority of the time a velamentous insertion is noticed after the birth not before...and a midwives way of handling third stage is safer

I agree with Jen. In fact, I've had one at a birth and her contractions, once labor got going, were spaced farther apart than anyone would expect for that stage in labor. Pushing took awhile, too. In my eyes, had someone broke her water or given her Pitocin or something, it could have been disastrous to that velamentous insertion.

Too many times something has become clear to me after the birth - and I'm so relieved that we werent' in a hospital situation that would have created more crisis with routine expectations and interventions.

[Changed]

Pam, I just noticed your sig but I'm not sure I get it. Isn't bradley supposed to be a good thing?

[pamamidwife]

Originally Posted by my~hearts~light

Pam, I just noticed your sig but I'm not sure I get it. Isn't bradley supposed to be a good thing?

The Bradley Method as it is currently is one thing, but the book by Dr Bradley, Husband Coached Childbirth (especially the earlier editions, of which I have a copy), is full of misogynistic belief systems around women - including the fact that women PREFER to have an episiotomy and that it's not a big deal.

Whatever the Bradley Method is today is a far cry from how Dr Bradley originally spoke and taught. He may have been responsible for bringing fathers into the birth room, but he wasn't exempt from being a sexist pig! :LOL

[Elyssia]

the books will say don't choose homebirth if you have multiples, a breech (or non vertex in general), placenta previa or some even say a low lying placenta, and some other health problems
you will find tho' that midwives go on a case by case basis and it has a lot to do w/ your commitment to birthing at home too
if you are very very dedicated and have a lot of faith and confidence in yourself, you will probably be able to find somebody who is willing to help you
a homebirth mom understands that she is responsible for her decisions and that things happen as they happen, as they are meant if you like to believe that
a homebirth mom trusts that her midwife is skilled and experienced and in tune w/ what she (mom) wants so that if something *does* go wrong, blame is not placed on mom or on the midwife
these attitudes probably have more to do w/ being a good candidate for homebirth than any general guidelines you will read in a book

i chose to have my twins at home
i chose to remain at home when babyA was breech
happily for all of us, everything was great but i would never ever think to blame my midwife if it wasn't
it was mine and my husband's choice to birth at home and our responsibility
and we had absolute faith in our midwife's abilities and pure intentions

[Breathless Wonder]

Don't have a homebirth if you will be worrying the whole time about what can go wrong.

IME, that is a transfer waiting to happen.

[Lisashepp]

Great!

So the ovarian cyst wont be a problem either?

I will call the midwives and make my first appt after I get my labwork and ultrasound results.

Would it be sensibe if the cyst is big or may be a problem to have my Dr follow just that, and have the midwives do all my pre-natal?

[georgia]

Some mothers choose to have parallel care w/an OB throughout. Whatever works for you and your comfort level, health needs, etc. Best wishes on a wonderful experience!

[Greaseball]

I guess that for every "no-no" reason, there have been women who have given birth at home in that circumstance. My midwife delivered a cord prolapse baby at home. She got it out in 4 minutes, which is how long it would have taken to get to the hospital anyway.

To me, the only reasons I would not attempt a hb would be if a vaginal birth was out of the question, like complete placenta previa or a transverse baby that could not be moved.

If I had something like severe toxemia, that would most likely have been discovered well before the birth and I would have already arranged for a hospital birth.

If the baby was preterm, like before 35 weeks, I would not want to do it at home. I think a midwife may not attend you before 37 weeks.

Women have had homebirths after classical incisions, herpes, with triplets, and postdates. (My midwife had a client go 47-48 weeks.)