Goodbye hospital birth, hello homebirth

Tick tock. Tick tock. The days have gradually been passing by and the arrival of our second child is growing imminent. 36 weeks is a big milestone. Chances are that the due date will come and go and we’ll still be waiting. But the prospect is very real that this baby could arrive any time now. I look forward to this. To finally meeting the unique new life I’ve wearily been growing for months and months. I also totally dread the prospect of having to give birth again. My last birth experience was not pleasant and if anything, the passing of time has only made me less happy with how it all worked out (other than the obvious relief that we all survived in relatively good health) . Unfortunately there’s no getting out of it. This baby is going to come out, one way or another. But it’s something that has played on my mind from the very early days of the pregnancy.

The business of giving birth has changed a lot over the years in Ireland – in fact it literally has become just another business in many ways. Planning for facilitating the maximum number of customers with the minimum amount of resources and costs. Anyone who has ever sat (or most likely stood) in one of the maternity hospitals queueing for hours to get a few simple tests done can see that. During my last pregnancy I was lucky to be able to walk (or waddle) to the hospital from work for my appointments. Showing up at the scheduled time to collect my file, generate a sample for testing, then join the rows and rows of other pregnant women uncomfortably waiting their turn. If anything, the numbers have grown, and the available resources have dwindled since then. Not favourable odds.

Luckily this time I could sign up for the local midwives clinic in my area. Only going into a hospital for the two scans has massively reduced the stress of medical appointments with a 3 year old hanging out of me. While the queues are still long with ~30 women being seen within an hour and a half, the midwives are lovely and happy to include siblings. Inevitably though, I’d have to return to a hospital to give birth with them. I’d also have to actually, you know, go through giving birth again. Obviously there’s the possibility that this time around a hospital birth would be a totally positive experience, but after the last experience it’s hard to ignore the reality of losing a lot of control over what happens to you once you enter a hospital. Totally relying on luck as to who might be providing your maternity care when you need it.

Since my hospital birth experience I’ve been exposed to a lot more information about the process of giving birth, and heard a lot more real-life experiences from other mothers. Some have births that are so far removed from mine that it’s hard to imagine what it must have been like. Others have tales that are very familiar. Having done it once, all have clear ideas on how they’d ideally like to do it again in future. These ideas vary from planned c-section to minimum intervention homebirths. All are totally valid options depending on your personal circumstances and preferences. Ultimately, the best way to give birth is however makes you feel the most comfortable, both mentally and physically. I like the ideals of respectful maternity care. Like many, I would have been quite anxious at the thought of not having access to hospital facilities on my first birth. I wanted to avoid medical intervention if possible, but wanted it readily available if I needed it. I was reasonably happy to place my trust in medical professionals to see us through the pregnancy and birth.

This time, the thought of being back in the hospital system makes me shudder. I’m more worried about what might happen because I’m in the hospital. If you want to reduce the stress of childbirth then a lot comes down to having trust in whoever is providing your maternity care, and you don’t really know who’ll be assigned to you until you show up. At which point you’re really not in the best frame of mind to advocate for yourself if need be. It’s very common to delay going into hospital as long as possible so you won’t end up ‘on the clock’. But that means commuting to a hospital in the worst throes of labour. There’s also the worry that in wanting to avoid going into the hospital too soon you could end up in leaving it too late and having an unintentional homebirth. That can work out quite well, or be rather stressful. Not wanting intervention is one thing, not having any qualified help at all isn’t an attractive option either… The logistics of arranging last-minute care for our firstborn was also stressing me out. It’s a bit of a shock as a new parent going from pregnant to suddenly holding a real baby in your arms. The Rascal would not be happy about being dumped somewhere while we disappeared off for an indefinite amount of time, and then returned with a strange new sibling.

I broached the subject of a (planned) homebirth with my husband. He didn’t look totally horrified. Not very enthusiastic, but then he’s not terribly happy about the idea of another hospital birth either. I’ve the benefit now of knowing a lot of mothers who had a very positive homebirth. Having done some research and weighed up the pros and cons, I was very much inclined towards having one. Cost would be the big barrier. I’m now on my husband’s health insurance instead of my own, and some investigation revealed that the VHI does cover a homebirth as a ‘private birth’. But with limited availability in Ireland, our only option is with Neighbourhood Midwives, a sister company of UK Birth Centres. VHI would cover nearly all of the cost for the basic mini-homebirth package that starts at 36 weeks. That was me pretty much sold, but not the husband.

What sold it to him was describing my gut reaction at the thought of going into a hospital to give birth again. Just discussing the idea too late in the evening was enough to guarantee that I literally wouldn’t sleep for half the night. Whether the fear is valid or not, just the thought of heading into hospital in labour significantly raises my stress levels. Even in the first trimester when it still seemed far off in the distance, it would make me toss and turn. Definitely not a reaction that’s conducive to being in any way relaxed and confident about giving birth. A short description of how I was feeling about giving birth again was enough. “Well then we should go for a homebirth”, he said. And that was us virtually decided.

All that was left to do was book a free initial consultation with a midwife and see how we felt after meeting them. It would have to be someone that we were comfortable to have in our house. Someone we could have confidence in. Someone calm and competent that would be the best option to support us through labour and delivering our child safely. We were assigned a midwife to visit us and answer any questions that would influence our decision whether to have a homebirth. She arrived and it didn’t take long to establish that this was exactly the kind of person you would want to have in charge on the day (or night). We had an informal chat and got a lot more details about the finer points of having a homebirth. This addressed a lot of my concerns and made me feel a lot more confident about having a better birthing experience this time round.

We didn’t need to consider it for long. I signed up a couple of days later to transfer my maternity care at 36 weeks. Then continued with the combined hospital midwife/GP care. All the way up until this week. This week, I finally transfer care. It’s really time to start focusing on what’s coming next. Things may not go to plan – we may have to do a hospital transfer. But the one certainty we do have about this birth is that we’ll have our own midwife that we know there to actively support us.