Home birth - with complications?

I'm thinking about having a home birth for various reasons. I am quite keen on the idea, but my biggest reservation is that I live 40 minutes drive from hospital (and I'd travel through the Manawatu gorge, for those that know the area). There is an ambulance depot 5 minutes away, but its often not staffed so is probably 30 minutes away in terms of the people getting organised to get here.
If the problem is failure to progress, thats do-able, because that doesn't happen suddenly and we can transfer to hospital with a bit of time to spare. But there are other things (haemorrhage is my biggest worry) that could complicate things and need treatment much faster.
Has anyone had an emergency in a homebirth situation? How was it dealt with? Would you do it knowing you are at least 40 minutes away from the hospital?
Thanks heaps for any feedback.

Hi there, while I haven't had issues with homebirth, I just wanted to reassure you that your midwife will carry a fair stack of medical stuff with her for "in case of emergency". They have to stock everything that a maternity unit has to offer even though these things are rare.
When I had my homebirth I was at least 30 mins from a main hospital (rural living) but I had my two midwives at my beck & call if I needed them

Hijack away Trish I want to know anything and everything about it really!
Thanks for feedback thus far. I guess I should do some research into family histories.

i am wanting a homebirth but my worry sounds pretty much the same. i use to live 2-5mins from the maternity unit so id actually be that much closer to the big hospital need i be transfered. however we have moved house and now live 10mins from the birthing unit and even furthur away from the big hospital. it would take 20mins for a ambo to get here then 30mins to get there. apart from that my only worry is where to put the pool and how on earth are we suppose to fill it.

I think it's 1 in 400 deliveries that require lifesaving treatment for post-partum haemorrhages and trust me, 40 minutes is too far for that. I love the idea of home birth if you're well supported and not too far from emergency treatment - but since you're not.....things DO go wrong unexpectedly and do you really want to risk yourself and bub even if it's just a risk? That has come across more opinionated than I mean it, but I watched a 24 year old woman bleed to death after delivery in a rural hospital where we couldn't provide the emergency care she needed.

I too have a less than favourable outlook on homebirths. I love the idea for those who are close. But working in the neonatal unit and getting the babies after something goes wrong at home, who have had to last the 40min drive from out of town..quite often through that gorge, I have seen a few things that make me quite against the idea.

Again though - that is a very skewed veiw as all I do see is the stuff that goes wrong and I am sure there are plenty of homebirths even in rural areas, that do go well and to plan.

Really what you need for any home birth - as near or far away, is to make sure that you are a good candidate, ie don't have any risk factors such as the histories that others have said or other conditions that might make things a bit more risky in terms of medical problems you already have, or any that might arise during pregnancy - your midwife can talk to you about any of those though and tell you whether they are conducive to having a successful home birth or what the risks are.

Also you need a midwife that is skilled in assisting home births - it is good to have one that specialises in this sort of thing or has carried out a fair few in order for her to have the range of experiences needed to be able to handle the situation if it does indicate problems.

Apart from that - you need a good birth plan - something that.. if you do choose to have a home birth, will indicate at which stage you would be wanting to "pull the plug" so to speak, or consider transfering for either your safety or the baby's - this ties back in with the midwife's experience, and listening to her knowledge and intuition of the circumstances and being able to know how things might go and how long you will need to transfer.

Have a really good talk to your midwife about her experiences, find out her opinion on the idea and whether she thinks tha tyou are a safe suitable candidate for a home birth, and take it from there. It is a hard decision to make, and being further away from a primary care facility does add time in the event of any emergency, but as i said before, there are plenty of others who have had the beautiful home births they have planned and it's all gone swimmingly.

good luck. :)

Edited by mum2paris

Thanks for all the comments (yes, yours too Sasha and mum2paris). I want to hear all sides. My MW specialises in homebirths and I will discuss it with her in much more detail, I just wanted to collect ideas/opinions from others too.
I guess ultimately I have to weigh up 2 outcomes - (a) everything goes smoothly, in which case I'd have a slightly better birth at home; or (b) something goes wrong, in which case its much more likely to turn bad for bubs or I if I'm at home... Not much of a choice really is it?

I won't be going to a birthing unit - Dannevirke has the nearest one, and that puts me almost twice as far from the hospital as I am at home, without any real benefit that I can see.

Is it your first baby? I personally wouldnt take the risk, but its totally your call if there are no health issues before hand.

My midwife has advised against the birthing unit, just incase I need a c-section or epidural. She said the 30 minute drive to the hospital will the the worst of my life! We are pretty close to the hospital, so Ill be going there.

you guys are all so luck to live so close to a hospital...and yes I think 40 min is close. Here, the nearest hospital is 3 hours away and a lot of the midwives here are, in my opinion, bordering on negligent. They actively encourage home births and I know so many cases that have ended up in helicopter rides to hospital!!!! Including on the other night where the mother was helicopter and, get this, the baby had to travel with Dad by road and dad had gone home for the night and had to come back. Our maternity care sucks the big one here!!

Just my 2cents worth - I had a large PPH with DD1 and i had her at a birth centre, even though i was 10m ride by ambulance to the hospital it was very scary, i had to leave our new baby with my husband at the birth unit while they took me to hosp and he had to dress her etc and put her in her carseat and drive to the hospital and meet us there, it was a truely awful experience. I had dd2 at the hospital (we live 40mins from the hospital now) and it was really good knowing that everything was there incase of emergency.
But in saying that only a small number of people need to be transferred to hosptial whilst giving birth at home/birthing centre. We were told at our antenatal class that it was 1 in 5 approx that needed to transfer for various reasons.
Maybe just go with what feels right.

Edited by my2girls