Valerie Gommon Midwife’s Blog

Archive for the ‘Independent Midwife’ Category

Following the recent screening of “Freedom for Birth” a film documentary discussing the plight of maternity services and midwifery world-wide I have put together an Action Plan of ideas that you may like to consider to support the midwives and maternity services.  Please do as much as you can to make things better for women today and our daughters in the future.

ACTION PLAN

Please consider joining the following Facebook groups:

Independent Midwives UK

Fighting for Independent Midwives

The Birth I Want

ARM Conference 2012

One Born Every Minute—The Truth

One World Birth

Human Rights in Childbirth

Face of Birth

http://www.facebook.com/pages/Podpora-pro-%C3%81gnes-Ger%C3%A9b-Support-for-%C3%81gnes-Ger%C3%A9b/139577179421729?v=wall

Websites:

The Birth I Want:

http://www.thebirthiwant.org.uk

Register an Interest in Independent Midwifery at:

http://www.independentmidwives.org.uk/

The Association of Radical Midwives—Midwifery Matters:

http://www.midwifery.org.uk/

The Association for Improvement in Maternity

Services:

http://www.aims.org.uk/

The Face of Birth

www.faceofbirth.com

Sign the petitions:

http://www.change.org/en-GB/petitions/amnesty-international-europe-amnesty-international-to-save-persecuted-midwives-in-europe?utm_campaign=autopublish&utm_medium=facebook&utm_source=share_petition&utm_term=4998292

http://you.38degrees.org.uk/petitions/choice-for-mothers-to-be-saves-nhs-money

http://epetitions.direct.gov.uk/petitions/34513

 

View the short version of “Freedom for Birth” available November 2012

Write a letter of support for Agnes to President of Hungary, János Áder ugyfelkapu@keh.hu

 

On Thursday 20th September women (and men) around the world will be hosting film screenings to raise the profile of midwifery.  I am joining this event because I passionately believe that women are entitled to better maternity care.

Everyone in the UK knows that our maternity services are in crisis and indeed the Royal College of Midwives has strongly stated this.

I am planning to take a break from midwifery as I am totally burnt out … this is partly the demands of being on-call 24/7 for the past 8 years, but it is also due to the increasing scrutiny, red tape  and pressures on midwives.  I believe that most midwives do their very best for women.  Of course there are some rouge practitioners and the public needs to be protected against them, but the pressures on midwives are immense; more paperwork, more investigations of our practice, pressures of working with a system that is barely fit for purpose ….

At the same time Independent Midwifery, which gives “gold standard” care is set to become illegal unless an eleventh hour solution can be found to provide us with Professional Indemnity Insurance which will become mandatory from October 2013.

What will happen to these highly skilled midwives and the clients they currently care for?  I’m afraid that I feel ground down and beaten by all that is currently happening in midwifery … it is so sad, midwifery and childbirth has been my passion and my life for the past 20 years!

So, as my swan song to midwifery (for now at least) I am hosting this film showing in Milton Keynes and I hope this will serve to raise the profile of midwifery and to mobilise women to demand the service they deserve.

FREEDOM FOR BIRTH FILM SCREENING Thursday 20th September 2012 Two showings, 1pm and 7pm

The Bee House

Interchange House

Howard Way

Newport Pagnell

MK16 9PX

  • Entrance by donation – suggested donation £5 (Any profits to be donated to Midwifery Campaign)
  • Refreshments available at the venue
  • Birth related Exhibition and discussion after film showing

ALL WELCOME – please advertise widely! Please print and display the attached poster

For further information & to book a seat please email info@3shiresmidwife.co.uk

FREEDOM FOR BIRTH – GLOBAL FILM LAUNCHA new documentary that reframes childbirth as the most pressing global Human Rights issue today is launching with hundreds of premieres all over the world on the same day, Thursday 20th September 2012.

Freedom For Birth is a 60 minute campaigning documentary featuring a Who’s Who of leading birth experts and international Human Rights lawyers all calling for radical change to the world’s maternity systems.

Hermine Hayes-Klein, US lawyer and organiser of the recent Human Rights in Childbirth Conference at the Hague, the Netherlands says, “the way that childbirth is being managed in many countries around the world is deeply problematic. Millions of pregnant women are pushed into hospitals, pushed onto their back and cut open. They are subject to unnecessary pharmaceutical and surgical interventions that their care providers openly admit to imposing on them for reasons of finance and convenience. Women around the world are waking up to the fact that childbirth doesn’t have to be like this and it shouldn’t. Disrespect and abuse are not the necessary price of safety”.

Made by British filmmakers Toni Harman and Alex Wakeford, Freedom For Birth film tells the story of an Hungarian midwife Agnes Gereb who has been jailed for supporting women giving birth at home. One of the home birth mothers supported by Ms Gereb decided to take a stand.

When pregnant with her second child, Anna Ternovsky took her country to the European Court of Human Rights and won a landmark case that has major implications for childbirth around the world.

Toni Harman, one of the filmmakers says, “the Ternovsky vs Hungary ruling at the European Court of Human Rights in 2010 means that now in Europe, every birthing woman has the legal right to decide where and how she gives birth. And across the world, it means that if a woman feels like her Human Rights are being violated because her birth choices are not being fully supported, she could use the power of the law to protect those rights. With the release of “Freedom For Birth”, we hope millions of women become aware of their legal rights and so our film has the potential to spark a revolution in maternity care across the world. In fact, we are calling this the Mothers’ Revolution.”

Cathy Warwick, Chief Executive of the Royal College of Midwives (RCM), says: “A safe childbirth should be a fundamental human right for women. Sadly, for many, many millions of women and their babies across the world this is not the case. The world is desperately short of the people who can help to ensure and deliver this human right; midwives. There is a real need for leaders of nations to invest in midwifery care in their countries. I hope that the making of this film which the RCM is supporting with a screening will go a long way to help make skilled maternity care a reality for those women who currently do not have access to it.”

Lesley Page, President of the Royal College of Midwives adds, “Too many women across the world are dying or suffering terribly because of a lack of skilled maternity care. This is unacceptable and I call on all Governments across the world to give women the right and access to safe care in pregnancy and childbirth.”

Ms. Hayes-Klein concludes, “Freedom For Birth” holds the answer to changing the system. Birth will change when women realise they have a right to meaningful support for childbirth and claim that right. Birth will change when women stand up against the abuses that are currently suffered in such high numbers and say, No More.”

The filmmakers are aiming for 1,000 screenings happening across the world on Thursday 20th September, 2012. The countries with confirmed screenings include the UK, Ireland, Germany, France, Denmark, Spain, Greece, Italy, Norway, the Netherlands, Sweden, Austria, Poland, Bulgaria, Croatia, Slovenia, Slovakia, Belgium, Hungary, Israel, Sweden, Finland, Iceland, Russia, USA, Canada, Mexico, Colombia, Brazil, Argentina, Chile, Uruguay, Panama, Australia, New Zealand, Malaysia, Philippines, China, South Africa and India.

Each screening is being organised by local birth campaigners.

Freedom For Birth is Harman and Wakeford’s third documentary film about birth. They were inspired to make films about following their own difficult birth of their daughter four years ago. A cascade of interventions in their birth led to an emergency caesarean section.

Contact Information:

Toni Harman, Producer/Director, Freedom For Birth info@altofilms.com +44 (0) 1273 747837

Guest blog from Hazel Roberts, Jammy Cow MK www.jammycowmk.co.uk

Valerie says, “I am delighted to have been part of Milton Keynes Midnight Moo, and part of the Moos at Ten team!”

Hazel writes:

Last Saturday night  was the 2012 Midnight Moo – an all ladies 10 mile walk through Milton Keynes. The herd set off a midnight and whilst they were busy striding through the early miles, Jammy Cow and her heifer friends were busy preparing the final mile for their welcome home.
At the beginning of mile 10, ready to greet the herd for their final mile was the very professional Moos at Ten Cow, Mavis.  She is a very sensible and reliable cow and in stark contrast to the next cow round the first corner. Silly Cow, Connie giggled her way through the night.
Those of you who walked the 10 miles will know that most of mile 10 is uphill so the Moos at Ten team were ready to add that extra bit of encouragement as the herd came through. Having said that, Bossy Cow’s version of encouragement is about as friendly as bootcamp with her strident, “Keep moooving!” shout. It is at this point in the early hours of the morning that you realise exactly how far 10 miles is to walk. “Holy cow, aren’t we there yet?” you may mutter as you pass the pious Holy Cow, Mary.

Continuing up Midsummer Boulevard, the end is near and breakfast at Pret A Manger awaits, a thought not lost on the perpetually hungry Fat Cow, Victoria as she patiently waved the crowds through. Normally, Hetty the Mad Cow stands out as a bit odd but last night she was in good company with lots of ladies suitably dressed up for the night.

Through Witan Gate underpass and by now there is less than half a mile to go. Bed is calling and lucky you, you’ll soon be home and tucked up. Lucy, the Lucky Cow was there, cheering you on for the final push. And only another 50 calories left to burn, something Clover, the Skinny Cow was quick to point out. Nearly at the end of mile 10 now and so very close to achieving your aim. A point to feel proud and to reflect upon why you are doing this. Willen Hospice is a fantastic cause and everyone is impressed by your fundraising efforts. Remember those Concrete Cows you passed in mile 7, well one makes a final appearance here to salute your efforts on behalf of Milton Keynes.

And there, with the end in sight, Jammy Cow welcomes you to the end of mile 10 and congratulates you on completing the Midnight Moo. A big cheer, breakfast, bath and bed.

So can you work out how many cows there were on mile 10 of the Midnight Moo? If you can and you are local to Milton Keynes then why not enter our competition to win a fabulous hamper of goodies. Visit www.themoosatten.co.uk or email your answer to enquiries@jammycowmk.co.uk

Very sadly it looks fairly certain that Independent Midwifery will end in October 2013.  The Government and Nursing and Midwifery Council have for a long time been recommending that Independent Midwives should have professional indemnity insurance (negligence insurance) despite it not being commercially available in the marketplace i.e. insurers do not provide this insurance for midwives.  You can read more about the current situation here http://www.independentmidwives.org.uk/?node=11615

An E.U. Directive is now due to come into force to implement this change and our current information is that it will be illegal for us to practice without professional indemnity insurance from October 2013.  This means that women will be denied the choice of choosing an Independent Midwife and we will be denied the choice of working independently and will be forced to stop practising or to return into the NHS.

The Independent Midwives UK organisation has been working tirelessly for years to find a solution and it is just possible that an eleventh hour solution will be found but this is now looking unlikely.

A group of midwives have formed an organisation called Neighbourhood Midwives www.neighbourhoodmidwives.org.uk/ and are working towards setting up an employee-owned social enterprise organization, to provide an NHS commissioned caseload midwifery homebirth service, based in the local community.  This may prove to be a workable alternative to Independent Midwifery but at present (if it comes to fruition) the service will only be able to accept “low-risk” women and this is of concern to all of us who have supported women with more complex situations, for example first time mothers, vaginal birth after a previous caesarean, twins, breech birth and women who are not deemed “low risk”.  The aim of Neighbourhood Midwives will be to extend their remit to include more women as soon as possible.

There is already a precedent for this type of care as One to One Midwives in Liverpool www.onetoonemidwives.org have already managed to set up a caseloading midwifery service (similar to independent midwifery in that a woman will care for a caseload of women throughout the whole of the pregnancy, birth and postnatal period) within the NHS.

It is a very sad time for midwifery and for women’s choice, but perhaps good things will come out of it, I certainly hope so.

PRESS RELEASE ISSUED 8th December 2011 by IM UK

RESPONSE TO CONTROVERSY OVER
PRIVATE MIDWIFERY PROVIDER:

SOCIAL ENTERPRISE PROVIDES THE ANSWER
IM UK reads with interest the mixed reactions to news of a contract between private midwifery provider One to One (Northwest) Ltd and NHS Wirral.  The service offered is one the NHS can rarely deliver: continuity of care from a midwife the woman knows, through pregnancy, birth and postnatally. However, concerns have been expressed about the impact of profit-driven private providers on the NHS.

“IM UK believes that the answer lies in social enterprise midwifery: continuity of care delivered by an organisation run by midwives and service users for the benefit of the local community,” states Annie Francis of IM UK.

“That is why we are establishing a social enterprise, named Neighbourhood Midwives, to offer local, community based midwifery services.  Care will be free at the point of access for women but provided by a social enterprise, whose values and culture are firmly rooted in a social mission and purpose. We are well down the path and are ready to provide services from April 2012.

“We are keen to be fully integrated into the whole maternity care pathway, ideally through the planned networks currently being discussed. We will be able to offer care to women planning a homebirth but often unable to access this choice because of current shortages of midwives within the NHS.”

Historically, insurance issues have been a barrier for not-for-profit providers.  During recent debates on the Health and Social Care Bill, Baroness Julia Cumberledge emphasised the need for social enterprise organisations such as Neighbourhood Midwives to be able to access insurance via the NHS Litigation Authority (NHSLA). 
For further information contact:
Annie Francis
07977695948
annie.francis@independentmidwives.org.uk

Jill Crawford
07870924857
jill.crawford@independentmidwives.org.uk

Where to start?  Every day is different, so I’m going to give you a flavour of the sort of things I get up to.

Of course I have antenatal appointments; from the first tentative telephone enquiry I then arrange to meet up with a potential client (usually for an hour or so) so that we can discuss their past experiences, their hopes for this pregnancy, their concerns and most importantly so that they can get a “feel” as to whether they actually like and trust me.  Once a couple have decided to book me as their midwife I then usually give all their antenatal care in their own home (although I have done antenatal visits in The Bank of England medical room!).  The format of visits is that I carry out all the usual blood tests, urine and blood pressure checks, but also leave a lot of time for discussion so that over the course of the pregnancy we cover issues such as waterbirth, Vitamin K, when to call me and so on.

My clients come from a wide area – I am happy to take clients who live within approximately an hour’s radius of my home in Leighton Buzzard – so I do spend a fair bit of time driving, as well as liaising with G.P.’s and hospitals where necessary.

Four times a year I jointly organise an Antenatal Exhibition, this is an opportunity for pregnant couples to gather information about breastfeeding, pregnancy yoga, cloth nappies and the like.  We also organise Birth Preparation Workshops and am often to be found at the Community Desk in Central Milton Keynes on hand to speak to expectant parents and also regularly attend Study Day’s and midwifery meetings to ensure that I keep myself up-to-date with current research.

Obviously I spend much of my time being “on-call” for births.  My own family are now pretty much grown-up and the commitment isn’t as big as one might imagine as I rarely have more than two births during a month – it is important that I don’t over-commit myself as the whole point of what I do is that I guarantee to be there for the birth.  Babies don’t always read the text books though!  I have had three births in one week, as of course some babies do come early and some come late!  As you will appreciate, the birth is the big event, and it can on occasion go on for some time.

Baby being here doesn’t mean that my job ends!  In fact, postnatal visiting is often one of the busiest times as the family may need quite a lot of support in the early days.  The majority of my clients choose to give birth at home; however some either need to, or choose to give birth in hospital.

I visit my clients for up to four weeks postnatally and it is a joy to see the baby thriving and although discharging clients is always tinged with sadness it is also great to know that I have played a part in helping the family on to the next stage of their life.  (I do usually keep in touch, perhaps not as often as I would like, but I often get e-mails and photographs and usually pop in when I’m passing!).

So, in summary I guess the main differences between me and an NHS midwife are that you are buying my time; antenatal visits usually take around an hour and a half (instead of perhaps 10 – 15 minutes at your local surgery), are arranged more frequently and take place at a time and place to suit you. Most importantly you will receive full continuity of care – I will see you at each visit to build our relationship and plan your care and you will know that (barring exceptional circumstances) I will be with you in labour and available 24/7 for urgent help.

I am always happy to discuss anything that you are concerned about; please do feel free to call.

Written by Valerie Gommon, BA (Hons), RM, Independent Midwife

www.3shiresmidwife.co.uk 01525 385153

No two pregnancies are the same, so it is very important that you continue to look after yourself by eating and resting as much as you possibly can.  Remember this time you are also looking after your little one(s) too.  You may feel better or more tired this time around; and certainly having a toddler is hard work.  If your toddler sleeps then you should rest and not rush around doing housework!  If you are exhausted try asking a friend if they would have your toddler for a couple of hours so you can rest.  I can’t stress enough that you need to eat a good diet – ensure that you eat plenty of protein and iron rich foods.

You may notice that you “show” earlier second time around, this is because your tummy muscles have been stretched before and is quite normal.  You may also notice baby movements a little earlier because you know what you are looking for, but don’t worry if you don’t!

Some women say that they are anxious about labour second time around; if you had a difficult labour talk to your midwife about it – ask her what happened and why it happened and what are the chances of it happening again, however second births are usually much easier and shorter.  It is usual to be a bit anxious about labour – most women are, but remember you did it last time and you can do it again!

I think it is definitely worth attending childbirth classes if you can – I had four children and I went to classes each time – it gives you time to concentrate on this pregnancy and this new baby; and a birth plan is a great idea, second time around you are better prepared as you know what to expect, you know what you want and don’t want to happen so put it down into a birth plan and if you need advice speak to your midwife.

Successive reports have called for one-to-one care in labour as all outcomes are improved, for example women are more likely to have a normal birth if they receive one-to-one care.  However, to some women this means having the same midwife from booking, through the antenatal period, labour and birth and until postnatal discharge – this type of care may not be available in your area unless you employ an Independent Midwife www.independentmidwives.org.uk.

Consider having your baby at home, there are so many benefits, women usually have shorter and easier labours and this time you will be better able to read your body and can stay at home if you feel comfortable and relaxed and you won’t have to leave your first child whilst you are in hospital.  Staying upright and active will help with the contractions and also keep the baby in the best possible position for birth, but your body will tell you what you need to do; try to relax and have faith in the birthing process.

Women generally recover quicker second time around, this is partly because labour is usually quicker and easier – and also because being an experienced mother usually helps to establish feeding more quickly.

Unfortunately, the more babies you have, the stronger the after pains usually are – this is because your uterus is having to work harder to contract.  Ask for paracetamol which will help and is perfectly safe to take.

Remember that your other child(ren) will need extra love and reassurance – your new baby is much tougher than you think, try to involve the older sibling(s) in what you are doing and have patience – it is usual for children to regress a bit when they have a new baby in the house.  Accept any help that is offered and consider staying in your pyjamas for a few days – it shows that you are not at full strength.  I think women try too hard to be superwoman, just allow yourself some time to enjoy your new baby – they aren’t babies for long, although it sometimes feels like it when you are in the thick of it!

I am excited to tell you that I have a new promotional video which details the work I do at www.youtube.com/watch?v=5ah9GBnStVQ

I also have several other videos hosted on YouTube and plan to add more as soon as possible; I should tell you that some of the content is explicit and shows graphic scenes of childbirth.

www.youtube.com/watch?v=VO0PRvxoEzM

www.youtube.com/watch?v=S086qWgUG38

www.youtube.com/watch?v=ZfFz2QSRiGs

Another guest blog by Sarah:

Harlow Zen’s Birth Story

Harlow is my third baby having had Rohan 9 years previously and Nayt almost 8 years ago.  With Rohan I was induced at 10 days late, in hospital, with an epidural given as I was told he was back to back and it would be too painful, I ended up after 17 hours flat on my back, with a nasty tear and a pretty miserable painful experience to tell but a beautiful baby nonetheless.  I had Nayt 16 months later and keen to never set foot in a hospital again, we used 2 Independent Midwives and had an amazing natural home water birth, in less than 4 hours with no pain relief, no stitches and 23 days late! I was out and about within days, a completely different experience to my first. Both babies were reasonable sizes at 8lb 13oz and 9lb 2oz respectively.

With Harlow, because he was my husbands first and I was a bit rusty having had a good few years off baby making, we decided to use another Independent Midwife as the 1-2-1 care is like nothing else, and gives you the confidence that you will get the best birth outcome and overall experience possible, as they really get to know and understand you.  As my pregnancy progressed it was clear this baby was going to be on the large size, which I had kind of expected. I was advised to cut down on sugar but with a massive cake craving, this didn’t really happen, so I tried damage limitation by continuing to ride as long as I could and towards the end to swim daily and keep up with walking the dog.

I think my confidence in giving birth was knocked a bit towards the end because I had to have a series of late scans to check the placental position, as was slightly lying low at the 20 week scan. This showed up that at 34 weeks the baby was the size of a full term baby. I am reasonable at simple maths, and that added up to one BIG bubba!!

Because of this, I was told to expect an early baby. Unlike my other two pregnancies where I had no pre-labour signs whatsoever, I was starting to get runs of proper contractions about 3 weeks prior to my due date. I had so many signs in fact that I have decided there are no signs until the baby is literally crowning!! Along with contractions, I was nesting, had a show,  had a permanently bad tummy, babies head engaged….never happened to me before labour with the other two, bump shifted down….and then my due date came and went…and my bump un-engaged and shifted up!!!

On Tuesday 18th May after my husband Adam had taken the kids to school I started to get decent contractions. I really felt like today was the day. By midday they had gone, and annoyed I took my dog on a hill walk hoping to jolt the baby out with some gravity! Nothing! I was really sure that was it too, as my dog Phoebe had been all over protective, following me around and sleeping beside me wherever I went.

They started again around 11pm, but having sent our midwife numerous ‘I think its started’ texts over the last few weeks, decided to sleep on it.  At 1.55am Wednesday 19th May I woke up with a jolt as my waters literally burst all over the place. I managed eventually to wake my husband up who had fallen asleep on the sofa downstairs and after a massive clean up operation we called our midwife Valerie and she came out straight away.

The contractions had stopped but restarted around 3am and were roughly every 3 mins, reasonably painful (a 5-6) but not lasting too long. We all tried to get some sleep at 6am, but the contractions slowed down a lot.  By the time my kids woke up and we had agreed they could take the day off school, they were back to quite painful and we all thought finally ‘this is it!’. By about 9.30am I got into the birth pool my husband had busied himself filling and my labour ground to a halt and slowed down. My parents came and took the kids out for lunch as it was my Dads birthday, and gave me a bit of space and peace. At 1pm-ish we asked Valerie to examine me and I was disappointed to find I was barely dilated, and all that pain and hard work had merely helped Harlow to get into a better position.  Valerie left for home and me and Adam went for a walk, had some lunch and then at 5.20pm decided to get some sleep.  My kids were sent off to their rooms to watch a film.

At this point I was feeling despondent and was sure my pain threshold was rubbish. I started soon after to get contractions every 8-9 mins, lasting almost 2 mins and they were really painful. The peaks seemed to last for 40 seconds before subsiding. By almost 7pm I was crying and convinced I was still about 3 cm dilated.  I got very emotional and was convinced I would end up in hospital with a c-section. Adam was amazing and really supported me. He suggested we call Valerie, who had just text me. She came out with the entonox and as soon as she arrived I was getting the urge to push. I was on all fours and could not move into any other position…how I got downstairs I have no idea!!!

I managed to get downstairs and Adam re-filled the pool which we had drained down partially earlier.  I got in, and contractions were very close, strong and the peak lasted ages. Adam was great and helped me get the gas and air when I needed it, and provided emotional support as well as an arm for me to dig my nails in (sorry Adam!!), and Valerie helped me to get past the panicky ‘I cant do this’ with encouragement that I could really trust in.  At 8.20pm I could feel Harlow move down and he was born in the birth pool at 8.40pm. Valerie had called my kids down and they both watched their little brothers entrance into the world.

Harlow was born behind me, so with some jigging I was able to climb over my cord and hold him.  He cried a little and had a feed quite soon afterwards.  He was covered in vernix and his skin felt so soft.  He looked just like 3d scan picture and apparently my first words were ‘Hello Harlow’.  Adam cut the cord after it stopped pulsating and Valerie tied the cord with a cord tie I made specially for the event, and as I delivered the placenta naturally an hour later, Adam, and the kids had all taken turns to hold Harlow and make their introductions. It was the most special sight ever and something they will never forget, nor will I.

At 10.30pm we sent the kids to bed, and after a glass of champagne with Valerie; myself, Adam and Harlow settled down for our first night together. Perfect.

We were all a bit shocked that Harlow tipped the scales at 10lb 6oz, and I got away with a tiny tear and a graze and no stitches!! It was a more painful labour than Nayts birth, and the longest overall labour, but an amazing experience that 5 days after the event makes me ask ‘when can I do it again’???.

This is a guest blog written by one of my clients, Sarah.

I thought it would be interesting to cover having larger babies at home, having just had one (10lb 6oz) and to have a look at  some common worries.

I was lucky enough to have a great midwife for my last birth who was not in any way phased by the possibility of a large baby, however a flippant remark at a late scan made me worry that maybe we are scared into changing our plans by such remarks unnecessarily.  Happily I did go on to have my baby at home!

Common Concerns:-

The baby may be too big to pass through the pelvis (called cephalopelvic disproportion if you like!) – this is not generally considered to be an emergency situation, and if this situation arises, your labour will fail to progress, at which point you can then transfer to hospital to deliver your baby with medical help.  Therefore its realistic to continue to plan for a homebirth and to try for a homebirth with an open mind that you may have to transfer if needed.

Shoulder Dystocia – this is where the shoulders get stuck after the head is born. This can be fatal for baby but fortunately is extremely rare and is considered to be more likely to occur in a hospital birth as research has shown that induction in cases of suspected large babies has not reduced the incidences of this condition.

There are also positions that a midwife can manoeuver a labouring woman into to help to dislodge the shoulders should this occur.
Is baby actually big? Scans are often  shown to over estimate birth weight. One study found this to be the case in 77% of their diagnosis of a large baby. The estimated weight was only within 500g for 41 of the 86 women studied which is a considerable margin!

A UK  Govt  report (CESDI) into the death of large babies declined to use fetal ultrasound estimates as they felt the evidence of their inaccuracies was well documented and went on to concede that this could lead to unnecessary interventions.

Big baby = more pain – pain is subjective so this is a hard one to reassure.  Different labours can be more painful for numerous reasons (ie. position of baby, birthing position, maternal well being etc), and size may have a bearing on this. The head is the hardest part to birth, therefore a very small baby with a larger than average head may well be more painful than a large baby with an average sized head.

Conclusion:-

It appears that although there may be some reasons where a large baby may present problems, the majority are not a foregone conclusion, and generally not posing an emergency situation, and therefore its arguable that its not a reason to abandon plans for a homebirth.

Different positions can be adopted to aid the birth of a larger baby, and by having a larger baby at home, you are still reducing your chances of having medical interventions.
A larger baby is not a reason on its own to have a hospital birth.

PS From Valerie – women do not usually grow a baby that is too big for them.  Exceptions to this could be if Mum is particularly small and Dad is of generous proportions!  This said many smaller women will still go on to birth big babies!


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