"Discouraged home birth"

About: Northumbria Healthcare NHS Foundation Trust

(as the patient),

I wanted a home birth with my fourth baby (after three unhappy but relatively straightforward hospital births). I felt the community MWs were very discouraging and I believe at one point a MW deliberately tried to frighten me into a hospital birth by suggesting my baby was unusually large (7lb 5oz when born – I think very average). I was instructed to go directly to hospital for a scan at a routine antenatal appointment as the measurements, I was told were 'so extreme'. Hospital did nothing and said they saw no reason for concern. After this I was very upset and lost all confidence in the community midwives, I felt trying to frighten me like that was so terrible and it really shocked me. I naively thought MWs would be full of support for home birth. I sought support elsewhere and did my own research into birth issues and also my homebirth rights. I was told many times there may not be enough midwives and that there was no entonox for me. I even tried to buy my own as I really feared not having any pain relief.

In the end I did nave a wonderful home birth which I am so glad about. I didn't need any pain relief despite having entonox available after all. The MW who attended was very professional on the day even though she had come from attending two other home births consecutively. It was very difficult for me to feel relaxed and focused leading up to the birth. I think it is very dangerous for women to lose trust in their MWs during the antenatal period, I will certainly never again automatically assume that health professionals have my (and my children’s’) best interests at heart. I think the reason for the problems I had were staffing levels and shift patterns, maybe some individual MWs anti-HB opinions played a part, I don't know for sure and never will, I am just guessing.

I'd like to add that the MW who attended my home birth did so after attending two others, I do not think she should have been put in this position, the home births were known about for a long time in advance and arrangements should have been made for better cover. My birth progressed very quickly and I believe if no MW had been sent I would probably have given birth unattended or even worse, in transit.

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Responses

Response from Northumbria Healthcare NHS Foundation Trust

It is very difficult to respond to individual cases without more information, however I will give a generalised overview of the service we offer women within Northumbria Healthcare NHS Foundation Trust.

Our service offers a full range of care options. This includes a choice of

medical-led care at Wansbeck General Hospital or midwifery-led in one of our four midwifery-led units at North Tyneside General Hospital, Hexham General Hospital, Alnwick Infirmary and Berwick Infirmary as well as the option for women to choose home birth. We offer continuity of care from a team of midwives to all our women. A woman is allocated a community midwife as her lead professional, but other members of the midwifery team would cover during holidays and days off.

All women attend an early pregnancy appointment which gives them all the information to help them to make an informed choice of where to have their baby. Having a home birth is a choice that we do routinely offer women. As midwives we would support any women in her chosen place of birth, however for safety of both mother and baby we follow the Royal College of Obstetrics and Gynaecology recommendations and complete a risk assessment of all women to determine whether their pregnancy is classed as high or low risk. If someone has had 2 previous PPH, this would prompt further discussion and planning with medical colleagues.

As identified in the Health Care Commission Review in 2007 we have adequate staffing levels to offer women an excellent standard of care throughout the Trust including midwives allocated to cover home births. We provide midwifery on-call provision for women planning a home birth from the 37th week of pregnancy up to 42 weeks. If more than one lady goes into labour at the same time (which sometimes happens) and a midwife (although this is unusual) had to attend one home birth after the other she would do so within her allocated hours of duty.

All community midwives have had training with water birth, and we do have provision for entonox and underwater sonic aids for all home births without exception.

If you wish to discuss your case in further detail, I would be happy to do so, please do not hesitate to contact me:

Jan Henry, Clinical Lead Midwife

Northumbria Healthcare NHS Foundation Trust

0844 811 8111