I cant decide ...

[Georgina1712]

:
Im driving myself up the walls here . When we planned this pregnancy i was definite about a homebirth ( which I still am) but now I cant decide wheather to go with the hospital based homebirth scheme or an independent midwife. I like the security of the hospital based one but they have very strict criteria ( no more 14 days past DD and if waters stained you must go in to hospital for birth I reckon there would be alot more monitoring too) but its free and I reckon youd be treated alot better than if you just transferred in and they didnt know you. Are you all still with me!
The independent MW is lovely but costs about $4000 ( some back on insurance) , you see her in your home... it seems so much nicer if every thing goes ok . Of course everything will be ok Ive no reason to think it wont - all pof my other labours were fine apart from too much intervention and lots of shouting to push ( I really hated that) .
Any words of wisdom here??
Oh yes My DH thinks should go for hospital based one as its safer. But I can swing him around

[bloominmamas]

I would just be hesitant about the fact that just agreeing to do the hospital based one that they will take it as aggreement with their view on birth, very structured, very time limited etc. I imagine if you and your dh have no problem vocalizing and everything it might not be bad. but with the other option you won't have to worry about being on the defensive, and to still go to the hospital if needed. Does this make sense?

[flapjack]

YES! YES! YES! YES! I HAVE ANOTHER BRIT IN MY DDC!!!!!!!!!!!!!

Can you tell I'm a bit excited about this? (I'm sorry if you get horrendously offended by being described as British, but honestly, I'd be as excited if you were Icelandic or German. It's just nice to have someone on the same timeline as me.)
Are you in N.I? From what I've heard (a few years old now) finding an independent midwife over there is like looking for a pot of gold. A couple of years ago, there was only two practising, but I gather the situation is improving.
I've had four homebirths on the NHS, including my first daughter who died at 24 weeks (cord rupture following PROM) and in a situation that sensitive, we had no difficulties getting a midwife to come and support me at home, despite the fact that its totally outside the realms of normal protocol. I've also had a 43.5 weeker at home and a 42 week baby at home with no problems during active labour and only mild concerns leading up (referrals for scans for breech babies, threatened c-sections for transverse babies, nothing out of the ordinary and nobody saying "you can't have a homebirth because...." The key issues, really, are that the NICE guidelines specify that hospitals have to offer certain courses of action in certain positions: before 37/8 weeks they have to recommend you go in. If there's fresh meconium, they have to recommend you go in, etc, etc. HOWEVER you have the absolute right to refuse any treatment, including a ride in an ambulance to the hospital. It's called informed choice, and a hospital CANNOT take this away from you without getting you detained under the mental health act (i.e. incapable of making an informed choice.)
My background- we recently moved from an area with a 3.2% h/b rate, nearest independent midwife was 60 miles away to one with a 1.2% rate, plus a couple of thriving independent midwives whose statistics aren't included in the 1.2%. The advice given by our local homebirth support group coordinator is to go independent- so far, I'm sticking with the NHS until I've met my midwives and I see which way the land lies. If it comes to it, I'll go private later, if I think it's needed- I'm probably more likely to choose the "whoops, that was fast" forget to call the m/w route, if I'm honest.
I'd go post to the homebirthUK list with this question, and see what they say: one of the mods is Irish and has had a 41 weeker and 4 post-date babies at home.

[mom3b1?]

Originally Posted by Georgina1712

:
Im driving myself up the walls here . When we planned this pregnancy i was definite about a homebirth ( which I still am) but now I cant decide wheather to go with the hospital based homebirth scheme or an independent midwife. I like the security of the hospital based one but they have very strict criteria ( no more 14 days past DD and if waters stained you must go in to hospital for birth I reckon there would be alot more monitoring too) but its free and I reckon youd be treated alot better than if you just transferred in and they didnt know you. Are you all still with me!
The independent MW is lovely but costs about $4000 ( some back on insurance) , you see her in your home... it seems so much nicer if every thing goes ok . Of course everything will be ok Ive no reason to think it wont - all pof my other labours were fine apart from too much intervention and lots of shouting to push ( I really hated that) .
Any words of wisdom here??
Oh yes My DH thinks should go for hospital based one as its safer. But I can swing him around

I'd definitely go for the DEM not the Hospital Midwife. I can give you a million reasons, but I'll be briefer than that.

Treating birth like a medical problem usually turns it into one. Once the interventions start, they tend to snowball and mother's and babies get hurt. The price is just too high to my body and to my babies to go that way.

There is sooo much research to show that hospital based birth is less safe than unmedicalized birth for healthy women and babies. If safety is your top priority then, in my opinion, there is only one choice, and it's not the Hospital system.

Kiley

[nolonger]

:

[flapjack]

Would it make any difference to your (US based) mamas decision if you knew that these midwives had had exactly the same training and had exactly the same professional qualification? One chooses to remain within the public healthcare system where she has a guaranteed income, a guaranteed number of hours and the other chooses to be self-employed- THAT's the biggest difference.
Don't forget, potentially independent midwifery could be illegal in the UK by the time we give birth. Details here. That might inform your decision too, and it's certainly a question that needs to be asked at this point if you're interviewing an IM.

[mom3b1?]

Originally Posted by flapjack

Would it make any difference to your (US based) mamas decision if you knew that these midwives had had exactly the same training and had exactly the same professional qualification? One chooses to remain within the public healthcare system where she has a guaranteed income, a guaranteed number of hours and the other chooses to be self-employed- THAT's the biggest difference.
Don't forget, potentially independent midwifery could be illegal in the UK by the time we give birth. Details here. That might inform your decision too, and it's certainly a question that needs to be asked at this point if you're interviewing an IM.

There is a lot more to it than training. Many MWs are dual trained here. The one I'm thinking of hiring is. She only does homebirths but she's fully qualified to work in a hospital, if she wanted. The fact that she chooses not to, says a lot about how she sees birth.

Because she works outside the hospital system:
She won't be forced to induce me, or send me to the hospital for birth if I go past 42 weeks, which I almost certainly will.
I can refuse tests more easily.
If my labor lasts more than 24 hours, which it almost certainly will, she isn't forced to transport me to the hospital.
If I want my babies cord left uncut for a while so he or she can get all his or her cord blood, she can do that.

The UK system is a lot more flexible than ours, but still once you get into the hospital system there are a lot more rules and requirements.

Kiley

[Georgina1712]

Thanks for all the replies
Flapjack Im in Dublin ( definitely not a Brit ) .
So im just 4 weeks today and 2 of the independent mws are not available. Spoke to the hosp based one this morning ( it appears that there are lots of consent forms to be signed in the event they want to transfer me to hospital in labour ie that i wont refuse). So that leaves 1 independent mw or the hospital . Actually for the hospital based homebirth scheme - all your visits are in your home (apart from booking visit for bloods) and it seems that they'd be delighted to have me.
What Im concerned about is that if i had a problem It would be much harder to transfer in later or in labour. Im a worrier , as you can see I come from a neonatal nursing background and know that an awful lot of what i saw was the result of intervention theres always this niggling voice at the back of my mind saying " yeah but what if.... " This process to decide who will be my midwife is part of my growth and i think that I will feel like Ive chickened out if I go for the hospital based scheme