This objection will depend very much on what happened before, but need not necessarily be discouraging, even if you have previously had a Caesarean section. You may, however, find it hard to get a booking, although it still remains your right. It is up to the health authority to make the best possible provision for your individual circumstances; this might include taking some blood for crossmatching in the event of your needing a blood transfusion, and making sure the midwife who attends you is experienced and has some back-up.
There are in fact a number of good reasons for having a baby at home after encountering difficulties with a previous birth, all of which contribute to reducing the chances of it happening again. Firstly, it is not your first baby and the vast majority of second or subsequent babies arrive far more easily than the first. You should feel completely relaxed in your surroundings; feet far freer to adopt any position, however unusual, that you instinctively feel will help the baby out; you will be able to eat and drink as you wish; and you will be able to remain upright throughout labor, which is also influential in assisting the baby’s passage. You will be far better able to respond intuitively to the message your body sends about the way to behave, and there is much less likely to be an atmosphere of controlled impatience and eagerness to get it all over and done with.
Because labor can only be accelerated in hospital, there is a far greater acceptance at home of it taking as long as it takes,» and your midwife should be with you until the end. This is particularly important in the second stage, which in hospital is often limited to one hour for first time mothers and half an hour for women who have already had a child (although the NICE draft guidelines suggest women should be referred to a consultant after two hours and one hour respectively. After these intervals ‘help’ (usually ventouse or forceps) is often given automatically.
You will be more able to adopt the position of your choice to give birth if you are at home. This is of especial benefit to anyone who has experienced difficulty before, as a squatting position can widen the diameters of the outlet of the pelvis by as much as 5 cm, as well as being a position where gravity also helps the baby out.
Epidurals are not available at home, which can be an advantage as they are often responsible for a delay in the second stage when they can prevent reflex action of the muscles of the perineum from rotating the baby’s head. They can also reduce the urge to push and are sometimes responsible for halting labor. Continuous electronic fetal monitoring is also unavailable, so that ‘normal’ fetal distress is not detected and acted upon. All these reasons are likely to ensure a good outcome in a subsequent labor, but you can improve your chances still further by consciously preparing for labor throughout pregnancy.
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