Birthing Centre or Hospital???

[SR35]

Hi ladies, I am looking for some advice on where to give birth. My options are the birthing centre which is a few minutes from where I live or the RUH in Bath which is about half an hour away.

I really like the idea of the birthing centre as it's so close, plus I know the midwives are really lovely and helpful after the birth with breast feeding etc, and you get a lot more attention there as opposed to the hospital where I have heard lots of stories about them being understaffed, you get left alone quite a lot and they want you to leave as soon as possible after the birth.

My main concerns with the birthing centre are that if something does go wrong during labour then it's at least a 30 minute journey to the hospital whereas if I'm already in Bath all the care is there straightaway. Likewise if the baby is born and has breathing difficulties or something, are the birthing centre able to deal with this? Also with this being my first baby I don't know how I will manage with the pain and might really need to have an epidural which isn't available at the birthing centre. But then I think if it's not there, I will just have to get on with it and this may be a good thing?

Has anybody else had these concerns and what did you decide in the end? I would be grateful for any advice.

Many thanks

Sarah

 

[Sprk]

With my first, I never gave it a second bought....had a hospital birth. She was born in the states, and hospital births are really considered the 'norm' over there. Very happy about it though, as we needed an emergency c-section. Since I'm in the uk now and I have consultant led care, we'll be in he hospital again...but after my first experience, I wouldn't have it any other way.

It's a personal decision and I completely understand why people have home births or use a birthing centre. You want to be where you feel comfortable - I just happen to be comfortable in a hospital lol. Might I suggest calling the birthing center you are considering and have a chat. Tell them you are considering them, but want to know what they have in place, just in case there is an emergency.

 

[JoeyClare]

My personal choice was the birthing centre but only because it was attached to the hospital, so any problems and it was a corridor away for intervention. In the end I got pre-e and so had to have a consultant present and hospital delivery. I wouldn't want to use a birthing centre that was too far from hospital. A friend of a friend had a perfect pregnancy and labour was progressing well, but her baby became stuck when she was pushing. She was 20 miles from hospital and sadly her little girl was born with brain damage due to lack if oxygen and passed away before her 2nd birthday. Incidents like that are very rare and there is no saying that they'd have prevented the brain damage in hospital, but that's why I would only use a centre attached to a hospital.

 

[NhoodMidwife]

The latest guidelines based on up to date research say that first time Mums should be told that;

• Birth centres are just as safe as hospital for 'low risk' women
• Women who give birth in a birth centre are more likely to have a straightforward birth with less medical intervention

Midwives within the birth centre will have specialist training in emergencies. Why not have a chat with staff there about any concerns that you may have.

All the best!

 

[SR35]

Thanks all for your replies, as much as I would like to go for the birthing centre I think for peace of mind it's going to have to be the hospital. Being my first baby I don't want to risk something happening and not making it to hospital in time. Think I would feel much happier knowing that that extra care is available immediately. Thanks again for your replies.

 

[Fospetil]

So, I had this worry and I'll tell you my experience and how I came to my decision. I know you've made your decision, but just for anyone else who is wondering what to do.

I had the same worries, albeit the distance is about 15 minutes door to door from hospital to birthing centre. First thing I would say is go to birthing centre for a tour and with a list of questions! I had a list and they answered every single one I had! With regards to emergencies they went through every emergency that might occur and what would happen. If the baby came out and had problems they have the advanced peadiatric life support, the same as doctors on a labour ward. They said to me that, even on a labour ward, if you needed to be in theatre for emergency c/section forceps etc and needed an epidural it isn't as simple as just going, theatre have to scrub up, they have to get anaesthetist, therefore this not a fast process so by the time the ambulance had got me to a hospital you would be wheeled straight into theatre. There is less of a chance of baby needing intervention on a birthing centre (this is proven in bmj article) due to the fact that MW spend 1:1 time in labour with women and know what to look out for whereas a dr may panic and intervene when it isn't needed, which can then cause baby more distressed. At the birthing centre you have 1:1 MW care whereas on a labour ward you are left unless you need it as there is less staff. They said aftercare is a lot more thorough, I can stay for aslong as I want after, they will make sure baby is latching on comfortably as all their support staff are trained breast feeding advisors. Partner can stay all the way through and until you leave, they will even get another bed in the room for them. Visitors can come at any time and, aslong as they aren't rowdy, there can be as many as you want at a time. Things like there are kitchen facilities, champagne flutes for congrats bubbly, visitors can fetch you take aways in!

I was honestly going to go to labour ward as I was so scared what may happen in an emergency, however going for a tour and talking to the MW staff and my community MW really changed my mind. My community MW said how much better reports she gets from people's births at birthing centre compared to labour ward. She said that the women who went to the birthing centre are a lot less stressed after birth and more prepared when they leave hospital, they also reported that they feel better about the entire labour process.

Just wanted to put a different point of view on here because I know a lot of people are abit skeptical about birthing centres, and rightly so, everyone is entitled to their opinion and want what they feel is best and the safest option for their baby. However all research says that if mother is more relaxed birth is usually more straight forward and I know I wouldn't relax in a hospital so for me, there being a different option, is brilliant!

 

[SR35]

Thanks fospetil for your reply, that does all sound really positive and the one to one care would really put my mind at rest that things were progressing well rather than being left alone wondering what is going on. It really is a tough decision, I know the birthing centre would be so good with much better care during and after birth, I am just such a worrier and would hate for something to happen that might have had a different outcome had I been in hospital already. But that's a good idea to take a list of questions for the midwife, I think I may do that at my next appointment and see if it sounds as good as yours does! Thanks again xx

 

[Fospetil]

Aww I'm glad it helped you a little but! I know it's different due to the time difference, but you may find if you ask that in an ambulance it might be half the time? They will have had this happen before I'm sure so it might be worth asking! It's such a hard decision to make as your stuck between wanting a relaxed calm atmosphere with good care to being somewhere that has the better facilities in an emergency! So many decision for hormonal women to make! Lol! Xx

 

[BunnyN]

The thing to remember is that things can happen in hospital too. In fact things like unnecessary interventions and infections are much are more likely to happen in hospital so just being in hospital doesn't necessarily make you and your baby safer. I know two people who died from infections in hospital after going in for unrelated problems. They were not there for giving birth but it shows that hospitals hold dangers too.

While it is good to be in hospital if you need an emergency CS it is well known that some hospitals over preform sections and some women who think their babies have been "saved' by a CS may actually have never needed one. Interventions like augmentation of labour and pain medications can cause baby to go into distress and make a CS necessary too.

I'd suggest looking into the problems that can occur and how the MWs can deal with them. Many emergency measures will be just the same in the birth center as in hospital. If you need surgery I asume they will communicate with the hospital so they can be ready for you. When you are in hospital it usually takes at least 20mins to have an operating theater ready even in a true emergency.

In the end there are advantages to either choice you just have to decide what makes you more comfortable.

 

[cornishfairy]

I had the exact same dilemma as you, I was favouring the bc for the fact it would be more relaxed, could have water birth etc but hubby was more worried about possible complications and favoured the hospital. In the end it was out of my hands as I was 2 weeks late and had to be induced. I was dreading the hospital environment but to be honest when I was there and labour kicked off, I didn't cope anything like I expected to. I'd gone prepared with my tens machine, massage oil, gym ball etc and I tried all these early on as well as a bath, and nothing cut the mustard and I was asking for an epidural from 5cm! I was convinced I'd cope well with the pain etc as I'm usually quite good with pain, but nothing prepared me for that...! However it did take 3 hours from asking for the epidural to getting it so I could have made the journey in that time if I'd been at the bc, also there was meconium in my waters and my little man ended up staying in neonatal and the children's ward with an infection for 2 weeks; but if I'd been at the bc and had mec in the waters there was still plenty of time between them breaking and him arriving in which they could have transferred us (ours are 40 mins apart).I guess what I'm saying is that I'm glad now I was already in the hospital because of these complications, but if I hadn't been then it wouldn't have been a crisis, they'd still have been able to get me there from the bc. Obviously each labour is different though, if mine had been quicker (was approx. 12 hours from when I reached 5cm) maybe there wouldn't have been time, and no one will ever know how their labour will pan out, but from all the midwives I spoke to during pregnancy they all reassured me there was no risk to using the bc despite the distance from the hosp and that they'd pick up on any issues early on. Xx

 

[SR35]

Ah thank you, I did speak briefly to my midwife last time and she said they are very good at foreseeing any problems before it gets too serious and I would trust them to know what they're doing. I also worry a bit tho about if I started bleeding lots afterwards and how they would quickly deal with this but I guess that's something I can ask about. Like you say cornishfairy, if I end up being induced it will be out of my hands anyway!

 

[wifeywifey]

Just to add my stories. Im so pro bc. My eldest was back to back the unit was very busy so much so they called in extra staff it took her ten min to arrive anyway he got stuck his heart rate was dropping mw tried moving me to different positions when that didn't work they did an episiotomy (4 midwives in the room) and he was out and healthy. I later found out they had a ambulance waiting for me a resus machine for baby but thanks to the midwives actions I didn't need them. My second son same bc had meconium in his waters she took a sample back two min later said its nothing to worry about and that was that. The idea of the clinical labour ward bothers me that much im determined this will be at home because we moved and no mlu near by. Im convinced the mw actions kept me out of theatre and if id been in hospital it would not have been as simple.

 

[BunnyN]

Ah thank you, I did speak briefly to my midwife last time and she said they are very good at foreseeing any problems before it gets too serious and I would trust them to know what they're doing. I also worry a bit tho about if I started bleeding lots afterwards and how they would quickly deal with this but I guess that's something I can ask about. Like you say cornishfairy, if I end up being induced it will be out of my hands anyway!

In most cases bleeding is stopped by giving Pitocin which contracts your uterus. I am sure the MWs at the birthing center have this drug on hand so the treatment you received at the bc or hospital would be the same. They also use uterine massage, try to deliver the placenta quickly etc, which again would be the same at the bc or hospital, even at a home birth the treatment is the same. In rare cases where the bleeding still won't stop you are sent to an operating theater. Then you are back to the fact that they need to get it ready for you and they can be doing that in the time you are being transferred to hospital. Many risk factors for hemorrhage like preclampsia will likely be caught before you even go into labour or long before they become critical and then you would be in the hospital anyway. Again unnecessary interventions can cause hemorrhage so in some ways the risks are lower at the bc.

 

[cornishfairy]

Might be worth asking about bad tears - I hadn't thought about what happened with mine but I had a 2nd degree tear which bled badly and I lost a pint of blood from it before they managed to get me stitched up, and they had to get the doc/surgeon (was too spaced out to know for sure what he was but I know he was someone important...!) in to stitch me back together. Not sure what they'd have done about that if I'd been at the bc. I think the midwives can deal with most 1st and 2nd degree tears (that's what I'd always assumed anyway) but seeing as they had to call this doc in to sort mine makes me think I'd have needed to go to the hospital to get that sorted and as it was bleeding so badly that could have been an issue, but again I don't know for sure. Might be worth adding to the list of questions for your next appointment!x

 

[Fospetil]

I've just had my BC birth and it was an amazing experience! Got to be in the pool to birth which honestly helped more than any painkiller! Constant MW supervision, checking baby every 15 mins in 1st stage and 5 mins in second stage! They had all the kit to suture you up if needed! I had heavy bleeding after because I had a natural 3rd stage however it is completely normal to bleed a lot! I panicked but if you think, you have a lot of blood to get rid of!

The best part for us was the after care! Honestly, when your in the throws of labour, you could be in middle of asda and you wouldn't care! But I gave birth at 6.15 and we stated until the next morning to establish feeding, changing etc. MWs were so attentive and thorough, and I know that the labour ward in my area just do not have the resources to be like this! In my experience, it was the best choice for us! Xxx

 

[claire_louise9]

SR35, I have a choice of paulton hospital or RUH , providing everything in my 32 week scan is OK I am going to paulton. I hate the RUH and would do everything I can not too go there. Paulton hospital is 10 mins away from home and its a lovely comfortable place. If anything goes wrong then they will transfer me to bath.

 

[Goat]

I was low risk first time round and things went terribly wrong with my daughter. Luckily she's fine as being in the hospital was what saved her. Personally for a first time birth I'd go to hospital, if you have a fab experience then use the birth centre or a home birth next time. But I guess the decision comes down to the trust you have over your own body and trusting those who are caring for you. I am very jealous I will never experience a birth centre birth or home birth but I'm obviously grateful I have my daughter safe and sound and I'm having extra care with this one.xx

 

[Rooster30]

I find myself in this exact situation now. I don't like taking it for granted that everything will be okay and things will be fine and dandy at the birthing centre. Alright you no doubt get wonderful one on one care, but I chose hospital because nothing is guaranteed and don't want to leave things to chance. I'd personally rather be in a hospital with everything that's needed for myself and my baby if things don't go well. Otherwise, I may as well have a home birth and I personally don't want that because I want to be near expert care if needed.

 

[SR35]

In the end I went for the birthing centre but as it goes I couldn't cope with the pain so ended up going to the hospital anyway as I wanted an epidural!

 

[Rooster30]

And that's the other reason why I chose hospital! How was the birthing centre before it got too much?