Midwife Led Units Vs Obstetrics Hospitals - risks involved?

[Little miss pink]

Hi Everyone

I was wondering if you could help me out with something.... I've trying to decide which hospital to go with in our area and the two i'm stuck between is an Obstetrics Hospital ( i think thats the correct term but basically a main hospital with doctors, surgeon and obstetricians) and a Midwife led Unit Centre

The obstetrics Hospital has fab reviews but as with all hospitals at the moment the midwifes are really over stretched and they also don't offer water births which i really wanted and also your partner is told to leave outside of visiting hours once the baby is born and the mothers and baby's are placed on wards.

So because i had my heart set on a water birth i went to view another local hospital that has a midwife led unit which offers water births plus with it being a MW led unit you have a more one on one care from the midwifes as they are less stretched and they have birthing pools and also you are kept in your own room which contains a sofabed where daddy can stay with you at anytime/all times.

I understood that if i wanted an epidural or needed a c-section at any point they would transfer me to the above obstetrics hospital (takes about 18min) but after chatting through how all this happens and being reassured that they don't wait till its an emergency my worries were calmed and i thought i would go for the water birth I'd had my heart set on so opted for the midwife led unit.....

But now my OH and mum keep saying "what if the baby is born needing some kind of treatment and they cannot give it the care it needs at the midwife led unit - Are you not running the risk of losing the baby by not being in the obstetrics hospital" Other than needing oxygen (which the midwife led unit can provide) i don't really know of any unforeseen events that happen after the babies born that means you shouldn't be in a midwife led unit. Does anyone know what kind of things can occur so i can get a better feel for the risk i'm taking... I really want a water birth but if anything did go wrong after the baby was born and god forbid we lost our baby i feel like all eyes would be on me for the decision i made!!

What are you all doing and whats your opinions on this?

sorry its so long but any thoughts would really help me in thinking this through!

LMP x

 

[ASD123456]

Hello

I'm having the baby in hospital because unfortunatley the Birth Center here won't be built until September

Personally I would've much prefered to have my baby at the birth, I'm sure if your in the more relaxed environment as the birth centers have, you much more likely to have the birth you want without intervention. Also the risk of the baby having compliations after birth are very slim and 18 minutes is not a long transfer time really- lots of women have their babie at homes which are 30+ minutes away from hospitals.

I think go for th birth you want, and seeing as thats a water birth and only the birth center offer it go there

Alex xxx

 

[Sherlock]

Ditto the above advice. If your pregnancy has been good then I see no reason to not go for the MW led unit. There are many throughout the UK and they generally have a very good reputation. The MW's will monitor you and LO throughout labour and as has been said, if there is any cause for concern they will transfer you. Same if you want more pain relief.

I think you are thinking the absolute worst case scenario which of course is natural. I had to consider the same thing when opting for my homebirth and being over 30 minutes from the hospital but truthfully I never felt I or my LO were ever at risk and I believe keeping a positive mental approach and having the kind of birth experience I hoped for made for a better experience. As I was so relaxed about things I never felt the need for more pain relief such as an epi and so on. The birth pool was amazing pain relief. Trust your own body also, I do believe if you feel during labour that something isn't right you will yourself choose to ask to transfer.

Also point to consider, in either place unless there are complications it will be a MW who delivers your baby. I'd rather have the more personal care from a MW in a MW led unit than in hospital where they are more stretched for time with each person.

I can understand your OH's and your mums concerns but tbh, I think they need to trust that you know your body and remember you've had a good pregnancy. Its a small minority of births that have such serious problems and it sounds to me like your MW's at the MW led unit will do a good job.

I'd say go with the MW led unit as it is the kind of birth you would like (in water) and more one on one care with all the other benefits that matter to you. Your OH being able to stay etc. It all adds up to making for a better labour I feel and that can only be a good thing.

 

[babyroo]

Hi
Sorry i've been nosy and browsing in here.
I was transferred from a Midwifery Led Unit at a Hospital to a Consultant Led ward at a Hospital about 15 mins away at pushing stage due to meconium in my waters (my waters didn't break had to be broken for me). If there were any signs that there is anything wrong with you or baby like bp, heart rate or any signs of distress whatsoever they will arrange for transfer straight away. I will be honest that the transfer was scary.
I had good care at both places, I had one to one care all the way through my time at the MLU and the same midwife transferred with me and stayed until Jess arrived. I transferred back to the MLU about 8 hours after Jess arrived just because my OH could stay with us, was more private for us to bond and the staff had more time to help with breastfeeding and showing us things with baby. It was very cosy.

ooo just noticed your from the North East me too, if you would like to tell me which Hospitals youre thinking about , i might have used the same ones (small world etc.) just drop me a pm and you can ask a bit more about the in's and outs.

 

[JulesK81]

Hi LMP,

I'm lucky cos the hospital I am going to (Rosie in Cambridge) has the midwife led unit, delivery units and neonatal intensive care unit all in one building, so I don't have this dilemma. I am opting for a midwife led birth for a much more relaxed atmosphere, but if I want any drugs or need to be transferred, the option is there.

I say go for the birth you really want - if you want a water birth, then you go for it. The chances of anything happening are slim and, anyway, you will be monitored during your labour and the second the MW sees anything is amiss, you'll be transferred straight to the hospital.

You need to be happy and comfortable in the environment you are giving birth in and if you aren't sure about the hospital, don't go there. If you have had a healthy pregnancy and are a good candidate for a MW led birth, there's no reason not to do it. If we all thought 'what if' we'd never leave our houses!!!!

I can understand your worry, now I am getting closer to due date I worry about complications, but they are rare. And you'll be getting the best possible care at hospital should anything happen.

I wouldn't worry too much about what your mum says, thy are all super overprotective and if anything like mine, have the habit of being pessimistic as opposed to optimstic! It was different in 'their day' as mum keeps saying - even women with straight forward births were kept in for 2 or 3 days! It's changed a lot since then (thank god!!!!).

x

 

[Hazel]

Hi
If there were any signs that there is anything wrong with you or baby like bp, heart rate or any signs of distress whatsoever they will arrange for transfer straight away.

I asked about this and they said they don't take any chances and transfer you if they think necessary.

I'm having baby in birthing centre (or at home ) rather than hospital. I want a water birth and my DH has said that he wants to spend the first night with me and baby which we can do there and they have private rooms.

My local hospital is minging so I'm only going there if absolutely necessary.

 

[Little miss pink]

Hi
Sorry i've been nosy and browsing in here.
I was transferred from a Midwifery Led Unit at a Hospital to a Consultant Led ward at a Hospital about 15 mins away at pushing stage due to meconium in my waters (my waters didn't break had to be broken for me). If there were any signs that there is anything wrong with you or baby like bp, heart rate or any signs of distress whatsoever they will arrange for transfer straight away. I will be honest that the transfer was scary.
I had good care at both places, I had one to one care all the way through my time at the MLU and the same midwife transferred with me and stayed until Jess arrived. I transferred back to the MLU about 8 hours after Jess arrived just because my OH could stay with us, was more private for us to bond and the staff had more time to help with breastfeeding and showing us things with baby. It was very cosy.

ooo just noticed your from the North East me too, if you would like to tell me which Hospitals youre thinking about , i might have used the same ones (small world etc.) just drop me a pm and you can ask a bit more about the in's and outs.

Hi babyroo

Thanks for the advice,

I'm from County Durham so the Hospital would be UH of North Durham or the Mid Wife led unit that is based in Bishop Auckland, do you know of any of them?

Theres so much to consider isn't there, its not an easy choice!!



LMP x

 

[Little miss pink]

Thanks for all your advice ladies it sounds like you are all thinking along the same lines as me which is great.

Does anyone know more about what kind of complications that can make it unsafe, excluding the ones that result in a c-section as i know about all of those and would be transferred, its more the complications that could occur once baby is out and therefore would be treat at the midwife unit.... i only really know of the baby needing oxygen.... anyone else know of any others! I'm guessing its really rare worst case scenario stuff yeah?

LMP x

 

[Happybunny]

Hi LMP!

I live in Washington and two of my friends from NCT chose to have their babies at the Bishop MLU and two chose UH Durham.

Both of my friends at Bishop MLU had to be transferred to Darlington in the end. First lass was because labour was going too slow and baby was distressed, so theu transferred her to give her the Sintocin (sp?) drip. My other friend got transferred because after a long time pushing, baby was not making an appearance and she needed forceps.
Both friends were transferred back to the unit after delivery.

Both my firends at UH Durham had good experiences, although one needed to have a CS in the end after some complications. Both friends really rated the care they recieved.

Out of interest, I gave birth at Sunderland Royal Hospital. It was a really fantastic experience and I would opt to have my next one there no problem.

If you have any specific questions about the Bishop MLU I could ask my friends for you...it sounds like a nice place though!

 

[babyroo]

Gosh, very small world. I was at Bishop Auckland MLU. I do know someone who had to have a C-section at Durham and she said the staff there were ace.
Any questions about Bishop MLU i'll do my best to answer them.

Gonna drop you a pm too.

 

[joani]

Complications that would result in transfer once the baby was born would either be related to you eg heavy bleeding or retained placenta or severe tear or related to the baby eg an unforeseen problem where the baby required more resuscitation than just oxygen, which could be one of hundreds of things, all of which very unlikley.
All these things are pretty uncommon but still possible is what you have to remember. If you've had a straightforward and uncomplicated pregnancy then there's no reason to think they would happen, but no guaruntee that they wouldn't happen.

An emergency situation where there was not time to transfer and you or the baby were put at risk is highly unlikely but you can never say never or have a 100% guaruntee that it will all be fine. I think you have to go with what you will be comfortable with, whether its the back up of full medical staff if there were a problem or the calmer surroundings of the midwife led unit.

 

[scaredbuthappy]

I have the choice of hospital or MLU and im opting for MLU. For me i would be more worried about the fact that midwives are so stretched now in hospitals that in most cases they have to look after several women at one time. This would worry me more than the unlikely event of complications at a MLU.
I would much prefer to have more one on one care and better surroundings. IF there were to be an complications they would usually be able to transfer you before anything got too out of hand. We were explained all this at our antenatal class and most of the women there by the end of the class had opted for MLU! I feel things are more likely to go wrong when you dont have one on one care throughout labour and just have a midwife flittering in and out all the time.
Also MLU are so much more pleasant and homely and you wont get chucked out after a few hours because they need the beds! I also found the one near us alot cleaner and well run than the hospital.
Remember most people have a straightforward birth without complications rising but even if you are unlucky and problems arise then being at a MLU at least you will get the efficient care and attention and transferred easily if need be.
Good luck xxx

 

[moss]

Sorry if I am repeating what someone else has said. I say you should go for what you want and are happy with. The chances of anything happening after your baby is born that require a transfer are very slim and if your transfer is short, chances are you will have seen someone in the same amount of time it would have taken if you were in hospital, anyway. For example, depending on the time of day your baby is born, it can take a while for a doctor to come if they are busy somewhere else... In the absolute worst case scenario, if you or your baby needed surgery, it takes a long time to prepare the theatre and this can be done whilst transferring, probably meaning you arrive before they are completely ready for you.

Apart from that, you will be transferred by your midwife at the first sign of trouble and these days homebirths are often safer than hospital births due to risk of infections you have never been exposed to. Hospitals may seem more sterile but you haven't built up immunity to any germs there the way you have at home.

 

[abcd1234]

I was researching midwife led units in my area last night as no-one has mentioned them and i was wondering if there was even one around!

I did find one, it's 8 miles from bath hospital and 12 from St micheals where i was going to have baby. Depending on the time of day it could take ages to do those 8-12 miles.

I think it's true that if yout pregnancy has been uncomplicated then you shouldnt have any problems but for me theres always going to be an overwhelming fear if i know all the stuff isnt there to hand. My mum was meant to have a home birth with my sister but had to go in to hospital due to her blood pressure at 39 weeks and went in to labour whilst there, if she hadnt have been in the hospital my sister would have died as she filled her lungs with crap whilst coming out and spent 10 days in hospital.

This isnt something that happens loads but because it happened so close to home i wouldnt wanna do it, just like i'd love a home birth but it scares me to much.

I also have the good fortune that my hospital has a birth pool and a good reputation on the labour suite for care. However the wards are meant to be nothing special, so i intend to leave asap after lol

After reading the home birth and midwife led unit birth stories i would say they do seem to be a great thing and those that had them seemed so much calmer and relaxed