Birth choices

[MoominGirl]

I thought I'd post in here as the labour and birth section never seems to be very active.

Interested in all experiences good and bad as well as from first timers like me as well as those who have done it before!!

We are looking at our options for where to give birth. We live in a small town which is about half an hour in good traffic from a hospital or stand alone MLU in various directions. We've decided against a home birth as it's our first.

If you'd asked me 6 months ago, there's no way I would have even considered a stand alone MLU for the common reason that I wanted doctors on site 'in case something went wrong'. However now the more I'm reading and thinking about it, I'm wondering if a small stand alone unit will actually give me a better chance of the positive birth experience I'm aiming for (availability of pool, staffing ratios, general environment). Of course the downside is that I would need an ambulance transfer if something went wrong.

I'm an NHS nurse myself so I'm very aware of the pressures that hospital staff are under and that they are being spread even more thinly so although I'm not suggesting that staff don't aim to give good care but of course it will be compromised when they are so short staffed. Our nearest hospital is a major regional centre that caters for so many people that it's a very real possibility that I could get to the MLU there and find there's no room and I'd end up on the delivery suite probably without a pool and a very different birth experience.

I've booked tours for all the units We're thinking about so I can ask lots of questions but I would love to hear some experiences and thoughts!!

 

[MissKW]

I also decided against a home birth with my son as he was my first, however as that went smoothly I will definitely be having my next at home if the pregnancy goes as well as last time!!
In hospitals you tend to get much more intervention, and you have the drugs ready available so it's very easy to just give in and have the drugs even if you really want a natural birth. I'm sure you are aware by now that drugs generally greatly increase the risk of complications (slowing down labour, tiring, tearing, needing help via forceps etc, emergency section, floppy baby, baby more likely to have difficulty breathing etc). There's no question that natural is better. I really wanted a natural birth but the pain was something else and I started to cave, I started to consider any pain relief I could get but the unit was very busy, I was left to labour in a small visitor's lounge on a sofa and nobody was around to get me pain relief if I wanted it. Not even gas and I couldn't even get a midwife to come check up on me, my husband tried desperately to get someone when I was in agony with pressure in my backside feeling like I was almost ready to push, but nobody came for another hour (I hoped for a pool birth with dimmed lights, calming music and gas if needed, Not to be dumped in a visitors lounge for the entire thing! The few hours earlier when i called they said all pools were available so it got very busy very fast). Eventually at 9cm (I was in the unit from 3cm) they had to move another lady out of her room to get me in to give birth, my son arrived no more than 20mins later. I ended up with no pain relief other than gas once I finally got a room. Next time will be at home as I really don't want to have to go through all that again because they are sooo busy, I would have been much better off and much more relaxed if I stayed at home. I was aloud to go home just a few hours after the birth anyway and it seemed pretty pointless making the journey to go in the first place.

However, generally if you are in a MLU they listen, know your birth plan and help you stick to that. They will help you labour the way you want to without pushing temptation upon you, keep you relaxed and gently encourage you so it all goes as smoothly and relaxed as possible. They said they are very rarely busy like that and I was just very unlucky, everybody else we know who has birthed at the centre had a very good experience and got what they wanted. So I would still opt for the MLU over a hospital personally. Just make sure you demand you get the care you need if they are.
They are set up and ready for most things if they were to happen but they generally know if things arnt going to plan (though most births go smoothly and shouldn't be any need for intervention) and would get you sorted very quickly. I think it's definitely worth being in a MLU, you would feel much more relaxed and be far more likely to have things go your way
For me though, home births are definitely the way forward lol!

 

[Shanivy]

Hey hope this helps you a little. You probably know this but Its worth noting too that they will only let you have the MU if youre green pathway and low risk. So the chance of something happening is always there, but would be low. And a lot they can still deal with there.

Both my daughters were born in (the same) a birth pool in my Maternity Unit, though i live in Dundee. And our maternity unit is in the hospital. So i knew if anything went wrong i was already in hospital. But after two labours, if i had to chose either a hospital or a separate MU, i'd still go for the MU

The maternity unit is definitely much more relaxed. I have super quick births. My first i was living slightly outside Dundee and ended up being blue lighted to the hospital. Nobody expected it to be so fast and I got there pushing. And my 2nd daughter was 2 1/2 hours from labour starting to placenta delivery.

Despite this, both times the DMU were very determined to follow my birth plan and my wishes. I got my pool births with both. The first time I was distressed because i was on my back in bed and i said that wasnt what id wanted. I was already pushing but the midwife ran the birth pool asap in like five minutes,and got me in it, between contractions. I am so grateful for that. With my 2nd they had ran it for me coming in since they had my history.. Despite the fact i was only in the pool 12 minutes lol. I dont feel like the hospital would have made such an effort to go by my wishes to give me such positive experiences. They have so much to do, high risk births coming in etc. I cant praise the mu staff enough . Midwifes in the MUs are just fab

Also with my first i had complications after birth that had me transferred up the the hospital ward and i hated it. With my 2nd i got to stay down in the MU and it was so much more relaxed and positive. I had help with breastfeeding. Whereas with my first they were too busy to really help with it, they had higher risk mums and babies to look after.. If i had to choose Id choose the MU every time.

I guess its up to you if you feel comfortable being away from hospital in the end xx

 

[Princess81]

My son was born in an obstetric-led unit. I was not “permitted” nor facilitated in the majority of my wishes. As a midwife I try extremely hard to ensure women get what they want, but constant overriding by the “powers that be” leave me hugely frustrated and sad for the women in my care.
Next time it’ll be at home, hopefully as far away as possible from a hospital! I do think I’d be happy with a MLu as well, but would be happier in my own surroundings.
Midwives tend to be extremely on the ball about things deviating from normality and would certainly get you to where you needed to be if the situation arose.

 

[MoominGirl]

Thank you for all the responses so far. Everything is really helpful and confirming a lot of my own thoughts.

As I'm a nurse in the NHS, I'm so very aware of the staffing pressures. Also like nurses, midwives are trained differently to doctors and therefore are likely to take a very different approach. I work as part of a nurse led service and I know our team work very differently to on the acute wards so I would imagine midwifery led services would be similar in that respect.

MissKW - that's exactly the kind of hospital experience I'm scared of. Our hospital is just is just massive and the stretched staff can't possibly deliver the sort of personalised care I would get in a MLU. I don't have a problem with the MLU attached to the hospital but it only has 5 rooms and only 3 have pools so it's a real possibility that I won't get a pool or even a room at all. I don't have an issue with being in the delivery suite if there's a genuine medical reason but I don't want to just end up there due to lack of space.

I also think that the postnatal care is likely to be better in a MLU and I would be more likely to get breastfeeding support and also be happier to stay longer if I feel supported and comfortable.

I think I'll know pretty quickly when we visit the stand alone units but at the moment I think the distance from a hospital is a trade-off worth making!!

 

[Summergurl]

I have no idea what the difference is between a midwife led unit and a big hospital, although I can hazard a guess.

Here in Plymouth we have no choice. The maternity unit is within the main hospital.

Taking a stance from my previous birth I would always (and would said the same back then) go to a hospital where there are doctors and surgeons etc close by and not an ambulance ride away. The maternity ward here, even though it's in the hospital is brilliant. I didn't encounter one midwife, transitional care nurse, doctor or anyone else for that matter that wasn't helpful or didn't have time for you. I had a stay of two days after I gave birth on the transitional care ward and I could not fault them. I would have hated having to have an ambulance ride to go to a different place to have my emergency c-section soon that respect I would always chose to go somewhere where everything was on hand.

Of course, this is just my opinion and whatever you decide will be the best choice for you xx

 

[MoominGirl]

I have no idea what the difference is between a midwife led unit and a big hospital, although I can hazard a guess.

Here in Plymouth we have no choice. The maternity unit is within the main hospital.

Taking a stance from my previous birth I would always (and would said the same back then) go to a hospital where there are doctors and surgeons etc close by and not an ambulance ride away. The maternity ward here, even though it's in the hospital is brilliant. I didn't encounter one midwife, transitional care nurse, doctor or anyone else for that matter that wasn't helpful or didn't have time for you. I had a stay of two days after I gave birth on the transitional care ward and I could not fault them. I would have hated having to have an ambulance ride to go to a different place to have my emergency c-section soon that respect I would always chose to go somewhere where everything was on hand.

Of course, this is just my opinion and whatever you decide will be the best choice for you xx

Thanks for your reply. This is exactly what I would have said 6 months ago so it feels strange to feel so differently now. What is swaying me is that our hospital is notorious for staffing issues to the point that it's not unusual for them to close the midwifery unit as the delivery suite is so poorly staffed. If I do need to be on the delivery suite, that's fine but I want to be there for the right reasons.

I hope you don't mind me asking but why did you have an emergency c-section in the end?

 

[Summergurl]

Ah ok, I can see why you'd be worried about that. What do they do to mums in labour if they have to shut due to staffing?

I had to have a section as our daughter was on her right side and didn't turn herself to get out they way they should. She was also stuck really low down and my cervix wouldn't open up the last cm. frustrating but they've said this time I'm in a very good position for a vaginal birth, thankfully!

When do you have to decide by?
I'm sure you'll come to the best decision for you, one day it'll click and your gut will tell you what to do. I'm a firm believer in that stuff xx

 

[MoominGirl]

Ah ok, I can see why you'd be worried about that. What do they do to mums in labour if they have to shut due to staffing?

I had to have a section as our daughter was on her right side and didn't turn herself to get out they way they should. She was also stuck really low down and my cervix wouldn't open up the last cm. frustrating but they've said this time I'm in a very good position for a vaginal birth, thankfully!

When do you have to decide by?
I'm sure you'll come to the best decision for you, one day it'll click and your gut will tell you what to do. I'm a firm believer in that stuff xx

From what I understand they would move them downstairs to delivery suite. I definitely need to make more enquires.

I don't think the MLU would take me unless baby was head down - again more research needed.

I'm not sure there's a time as such that I need to decide by but I want to as I think it will helpful to have a plan in mind. I'm also a big believer in gut instinct and I think visiting all the possible units will help me decide.