Home Births

Peared

What's the good the bad and the ugly regarding home births?

What happens, for example if something goes wrong?

As you haven't been booked into a certain hospital, if you needed hospital care during labour would you just go to the one that is closest and would it mean then going to a public ward?
Any info appreciated.

Nevyn

http://www.homebirth.ie/

This site has an absolute wealth of information.

The two specific risks which cause most anxiety are post-partum haemorrhage (PPH) in the mother and failure of the baby to breathe. As mentioned above, complications happen rarely in home birth situations

PPH - What would happen?

Ergometrine would be injected intravenously to contract your uterus and stop the bleeding. Your uterus would be massaged and bladder emptied by catheter. If required, the midwife would call an ambulance, though it is safer not to transport a woman in shock unless absolutely necessary.

Distressed baby What would happen?

Distress might be indicated by a change in the baby's heart rate, and if it happened in the first stage of labour you could be transferred to hospital. During the second stage the distressed baby would be delivered as quickly as possible.

Baby not breathing - What would happen? If the cord is still pulsating it will not be cut as this is an oxygen supply. It is important to keep the baby warm, possibly using massage as an extra stimulus. If required, the midwife would use an ambubag and/or mouth to mouth resuscitation. An ambulance might be called for transfer to hospital. If necessary, a tube might be placed down the baby's throat into its windpipe by the midwife.

Please remember, distressed babies are a rarity when mothers are not stressed. It is wise to discuss these eventualities, however unlikely, with your midwife and find out what steps she would take and what equipment or drugs she carries to cope with an emergency, i.e. Ambubag, Ergometrine or Syntometrine, I.V. drip, oxygen etc.

Midwives have all the medical equipment they need and asses the labour and
they will be in touch with your local maternity unit if anything untoward were to happen.

http://www.vhi.ie/hfiles/hf-107.jsp

Home Birth Care Options
Women who do not want to have their baby in hospital can opt for a home birth. On the plus side, home births allow you to give birth in familiar surroundings and you can have as much privacy as you want. However, if anything goes wrong medical backup is not readily available. Fortunately, the chances of a medical emergency are small but it is important to speak to your midwife/doctor about your personal circumstances and whether it is a safe option for you before you make a final decision. Home births are not recommended for women with a risk of complications.

If you do decide on a home birth, you have 3 options: public midwifery care; private midwifery care, and the Domino/Home Birth Scheme.


Public Midwifery Care

Public midwifery services are provided free-of-charge by the health board and include antenatal care, labour and delivery, and postnatal care for up to 6 weeks following after the birth. They will also supply the "maternity pack" containing all the medical necessities for home delivery. To avail of this service, write to your health board community care section informing them of your decision to have a home birth and to request the names and contact details of midwives who might attend you. It is important that your midwife signs the form of application for maternity, which your health board will send out to you.



Private Midwifery Care

If you wish to employ a private midwife, The Home Birth Association (36 Springlawn Court, Blanchardstown, Dublin 15; Tel: 01 2853264) can provide you with a list of private midwives in your area. You may then apply to your local health board for assistance in covering a portion of your midwife's fees.

If you have private health insurance, your healthcare plan may have a contribution towards the cost of a private home birth.

Domino/Home Birth Scheme

Designed for women who are classified as being at "low risk of complications", the Domino/Home Birth Scheme allows you to see a team of midwives for you antenatal care free-of-charge. It also gives you the option of delivering your baby either at home or in the hospital. Antenatal visits take place either in the Community Midwives' Clinic or in a health centre near you. Some antenatal visits may take place in your home.

At approximately 18-22 weeks into your pregnancy you will receive a routine scan and a complete physical examination to assess your suitability for the scheme during the remainder of your pregnancy. As part of the programme you are entitled to early hospital discharge and home visits from a midwife for up to a week after your baby is born.

The Domino Scheme currently operates out of National Maternity Hospital and the Rotunda Hospital but these services are limited to specific areas of Dublin city. Similar programmes have been developed in Waterford, Wexford, Galway and Cork. If you are interested, contact the Community Midwives at one of these hospitals.

http://www.citizensinformation.ie/categories/birth-family-relationships/before-your-baby-is-born/home_birth

Dfens

I would imagine that a home birth would be a better idea on a second or subsequent birth, as you would have some idea from how the first birth went on whether you felt comfortable with a home birth or not.....just my 2 cents...

Peared

I suppose to be specific I am wondering what happens if things get to the stage where you feel you need some pain relief, would it mean going to hospital straight away?

Could you for example arrange a home birth but have an arrangement that if it wasn't going to happen you could go to hospital privately?

Also would it mean that after shelling out up to 5 grand on a private home birth and you have to go to hospital you end up on a public ward ( I know this may not matter to some but to others it's a big deal)

crazy cat lady

Homebirths are a great plan for women who have the confidence in their bodies to be able to deliver their babies without the need for medical intervention.

I'd love a home birth, to be in familiar comfortable surroundings, not to be confined to one room, to be able to take a bath, light candles, listen to music, watch telly, eat and drink...

You'd be surprised how the clinical environment, bright lights, noise, strangers poking at your private parts, technology... It all can have a negative effect on the process of labour.

I've lost count of how many times I would be assessing a woman who had been getting regular strong contractions at home, and then as soon as they get to the hospital they just stop! Then they get home again and away they start again!

Should you choose a home birth, always have a back up plan as, although rarely, complications can arise.

If you wanted a home birth but also wanted to book privately with a hospital, I'm pretty sure that you would have to pay private consultants fees as well as your independant midwives fees. (although these would be almost entirely covered by the HSE and your private health insurer) You would also find that consultants are generally not at all supportive of independant midwifery practice as it is not reliant on the medical model of childbirth.

Grawns

Saw something on tv about this recently and I don't think they ( as in the powers that be!) encourage home births for a first birth. Whereas if you've already had a straightforward 1st birth a homebirth is then a good option.

shell42970

Our son (my second child), born September 19th, was delivered at home.

We were pre-booked at the maternity hospital months in advance, in the event that a hospital transfer was needed (this is part of the home birth agreement; 1 in 10 deliveries wind up transferring), and the ambulance company was notified the night I went into labor and was on standby, with directions to our house that they were sent prior to my due date. It's all very carefully organized in advance by the midwives.

The Irish home birth scheme, because it is still a government pilot program, is free to participating mothers, and is a fantastic program for women who would like to deliver in the comfort and privacy of their own home. The only expense my husband and I had was the birthing pool rental (100 euro). My midwife's contract also included 10 home visits after the birth to monitor the progress of the baby, and to keep tabs on how I was healing and getting along with nursing, which allowed me to focus on resting and taking care of our baby.

I can't recommend this program highly enough. I believe that how a child comes into the world has an impact on their temperament. Our son arrived without a whimper in a birthing pool in our living room, with only my husband and midwife in attendance. I was able to labor as I chose to, which contributed to a faster, more relaxed delivery. Our son was born at 2:52 am and by 6:30 the midwife had gone home, leaving our little family nestled comfortably up in our bed to rest and get acquainted. Our little guy is a very calm and contented baby who settled into life outside the womb very quickly. I think a lot of this has to do with how peacefully he entered it.