Stay consultant led or move to CMU?

[Belfa]

Hi

Just wondering if anyone who's been consultant led can give advice - or even anyone who's moved from consultant led to midwife led?

I am Consultant led only because we had an assisted conception. So far everything has gone well (*touching loads of wood*) and I have expressed that at my next consultant appointment at 36weeks, I would like to have the option to move to midwife led care to which the consultant agreed.

Reason I am doing this is my midwife built a strong case for the CMU early on and our hospital has plenty of birthing suites with pools and I like the sound of a water birth. She said that for a consultant led delivery you're stuck to a bed on monitors.

Firstly, I don't know if this is a biased opinion - is a consultant led birth really like that and whats the main differences between the two with regards to how much attention / assistance you get? We are getting a tour of the CMU in the next few weeks but we don't get a tour of the labour ward where you go when consultant led.

What are my pain relief options like at the CMU? I know they're limited with a water birth and I assume that, if I wanted an epidural for example, would I need to go back to the ward with the consultants?

No one has really fully explained the differences and I feel like one side is biased for the other. Having spoken to ladies I know IRL, they are steering me towards staying consultant led so I get (again I'm assuming) access to more pain relief? x

 

[Mayflower85]

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[LaceyKeo]

I'm at the same hospital as Mayflower.

It is brilliant that you can go in midwife-led, and if need be they can transfer you across literally as quick as pushing you through a door, but I know a lot of hospitals are not like that so that would be a factor to consider.

At a 17w scan with DS, they found "bright white spots" in his abdomen. Because of this, I ended up consultant led.

I never got round to a pool as labour started and DS was here in just under four hours. I don't recall thinking anything much about how I was labouring, just that I wanted DS here.

I had a trace thing put around my stomach, but I kept moving around too much and "losing" baby, so they stuck one on his head instead. I stayed on the bed, alternating between back and all-fours.
This was my choice as I don't think I could have stood up to move if I'd tried.

Pethadine made labour MUCH easier, and I'll be opting for it again.

I honestly have no bad things to say about a consultant-led birth. Xx

 

[Belfa]

Thanks! The consultants are just one floor down but I suspect the midwife's don't give in easily and let you go down just because you think you can't hack the pool and are now demanding an epidural.

I'll have to make sure I ask loads of questions when it comes to the labour part of the antenatal classes! x

 

[Rooster30]

I was consultant led but I now have a choice too. I've chosen to give birth on the consultant based unit purely because I'd like to have all options available to me nearby. I'm not and never have been one who is particularly bothered about 'natural birth', more bothered about just GIVING birth! I want my baby out safely and healthily and I like the security blanket of having consultants/doctors/painkillers on hand incase things do take a bad turn. I'm hopeful things will be okay and I won't require anything but I like knowing 'just in case' then everything is there.

 

[Kiagirl]

I was consultant led but didn't really see anyone until half way through my induction. If you are CL at my hosp you can still have a water birth etc

 

[Mayflower85]

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[buggy1]

I think it can depend a bit on what your hospital is like. I know the two that are near me work a bit differently from each other!

Generally, a birth centre is only for low risk / mw led care and is a bit more relaxed and you have the option of a water birth etc. For my first labour I went to a hospital (different one again as before I moved) and was in the birth centre. I found the rooms a bit nicer and I wanted to use water so it suited me. However, the midwife I saw panicked about my heart rate and made me go over to consultant rooms to be seen by a doctor and be monitored. The doctor said it was normal for my heart rate to be high as I was in labour/pain! He said there was no need to be monitored and I was allowed to go back to the birth centre. I went back to the birth centre room for a bit but once I was nearer to the pushing stage I was moved again to another room with a pool. I pushed in there for about an hour but DD wasn't coming out so I was made to get out of the pool and sent back over to the consultant side to have an assisted delivery. All in all it wasn't a bad labour and I didn't feel unhappy with the experience but looking back I was moved about a lot and I'm not sure I'd want that again.

My second birth where we lost our daughter, I wasn't monitored but I was induced so I was stuck on a bed. In fairness though I didn't care as it wasn't a nice experience anyway and I had a lot of morphine so I was quite out of it for most of it. In many ways that was a good thing!

This time I think I will need to be monitored because of the bleeding, however, baby is healthy and the placenta seems to be healthy so there should be no reason for me not to have a 'normal' birth. I really don't want to be stuck on a bed, I want to be free to move around and hopefully use water, even if it is just a bath! The first hospital doesn't really work like that. It's either higher risk and be monitored in less than desirable rooms/wards or the birth centre. The second hospital (I've now asked to be transferred to) sort of bulks it all together so you go to the same bit whether you are high risk or low risk, looked after by the same midwife. You just get seem by a doctor too if need be. So, if for example you go in as low risk but something happens in labour you wouldn't have to be moved, the doctor will just come and see you. This sounds a lot more suitable for someone like me as I feel I'm in a bit of a grey area between the two!

I had a chat with the ward manager yesterday on the phone and she was so nice, she put my mind at rest a lot. She said that it's my birth experience and they'll facilitate what I want as best they can. For example, she said if they think I need monitoring that they would advise it, but if I really didn't want that they would just listen in intermittently.

I'd suggest you do something similar and try to speak to someone that works within the midwife led unit and get them to be a bit more specific of what your options are. Tell them what you want and ask if it's possible. Make your decision based on that. You can always be transferred over to consultant led if the need arises during labour.

The pain relief in the birth centre is usually paracetamol and codine, or gas and air. I think they might give you something like pethidine but I only had gas and air with my first so I can't say for sure. Epidurals is definitely consultant led only though.

Sorry I've blabbed on but hope that helps x

 

[Belfa]

Thank you! I feel a lot more comfortable with the idea of the consultant led path now.

We had an antenatal class yesterday when we were told that their target to have you discharged after birth is 6 hours ! I am not sure if this is the whole maternity hospital or just the midwife unit but at our next class we get a tour etc so I'll be making sure I find out more about that! x

 

[buggy1]

I had an assisted delivery and still left about 8 hours after DD was born. As long as baby has fed, you've pee'd enough and there are no other issues you can go!