Birth at birth center- description

[Zahrah5]

Hello

I am currently 20w and looking into my options.

I am schdeuled to have a birth at midwife-led birth center which is part of a hospital.
Can someone describe how does it work there? What do you do after you arrive?

My birth center has 8 beds and 4 pools. I would like to have a waterbirth. Is there a likeliness that all pools will be taken by other women at the time I arrive, and if yes, what will happen then?

After baby is born, can you stay in the room or do they move you somewhere else? Can your partner sleep there?


What happens if I have huge pains and will ask for epidural while in the poool. I gather this can not be administered at birth center and they will have to move me into consultant rooms? How does the consultant room would differ from birth center? And do you still have choices of birthing positions there or is it just lying on your back? What happens there after baby is born?

Sorry for all these questions, but I find this forum much helpful than my midwife.

[crazykat]

I had dd2 in a midwife led unit and it was the best birth experience I've had out of four.

She was born early hours and we were the only ones there. I had a room with a pool in though I didn't use it, it was much bigger than the old labour ward, though the new one is much better.

At the midwife unit you need to phone before you go to make sure its not full, but you phone the labour ward ahead as well. You go straight into a room which is where you stay until you go home. If the pools are in use you wont be able to use one and if all the rooms are full ten you'll have to go to the main labour ward.

We were discharged within a few hours (my choice) though as it was empty we could have stayed longer and DH would have been able to stay. Once dd was born we stayed in the same room until we were discharged. The MW asked when we wanted to leave and got the paperwork done there and then. It may have been slightly different if the unit had been full.

On the main ward you go to the main ward to get checked to see if you're in active labour. When pure in active labour you go to the labour ward where you have your own room. The rooms vary by hospital and some are bigger than others. Once you've had your baby, you have chance to get cleaned up and chill for a bit, how long depends on how busy the ward is. Then you move to the post-natal ward where you'll be in a room with 4-6 beds IME where you stay until discharge. Here your DH will only be able to stay during visiting hours which is usually 8am-8pm. He won't be allowed overnight unless you pay for a private room.

I much preferred the midwife unit as I always wanted to be back home ASAP. On the main ward it can take hours for your paperwork to be done as its much busier then the midwife unit.

[crazykat]

Forgot to say in that huge essay that on the main labour ward you can move about as much as you want unless you need to be on a monitor which I only had with ds2 as I was induced.

[Taura]

Just for perspective, my local hospital's labour ward has pools too (and portable ones for the rooms without), you can dim the lights, move the bed aside and give birth on a yoga ball or whatever suits. So don't be stressed if there is "no room at the inn" in the birthing centre, the midwives on the labour ward will be able to give you a similar experience in their rooms too, but with added epidural if you need one!

[squizita]

I gave birth at a mlu.
Arrived good to go (v fast labour!). They examined me in a side room and then gave me gas and air and I lay on a big plastic sofa thing while they poured the pool. After that I was in the pool.
All the medical equipment was there just hidden away. I felt it was more natural and patient centred BUT also reassuringly well equipped and close to surgery had a problem occurred. I would 100% choose it again and recommend it.
The best thing was afterwards you got your own room. MW visited you to help with bf etc but it was much more private. As a result everything (I think) got done very efficiently and I only stayed 1 night.

[squizita]

...oh also there was a mw there throughout but she was hands off - just encouraging and a kind presence until push time! She had a hand held hb monitor so again baby was monitored but in a more natural way.

[ScarlettOHaraHamilton]

My hospital was a similar set up. Everyone went to the MLU unless they were high risk. All the MLU rooms had a bath, as well as some of them being having actual pools, so even if you couldn't get a pool you could at least get in the water.

After the baby was born you could stay in the room as long as it wasn't needed. So if it isn't too busy you might be able to stay until you're discharged, particularly if you've had a good birth and don't need much care afterwards. Partners can generally stay in these rooms. However if it is a busy hospital and you need to stay a bit longer than you'll be transferred up to the ward and if it's the middle of the night your partner will probably have to go home.

As for heavy drugs, yes you need to transfer to the CLU if you want more pain relief. Our CLU rooms looked hugely similar to the MLU ones though, and still had a private bathroom. I think it just had a bit more medical equipment in but not much more. It might be the CLU but they are still hoping that many women will have a natural labour in those rooms, so it isn't the case of transfer over and be stuck on your back. Our CLU gives mobile epidurals so you could technically get yourself into another position with a bit of help.

[larryphilanddave]

Our hospital also has a similar set up - MLU and labour ward both in the maternity building of the hospital.

In terms of pools, it is uncommon that you can't get into one - even in the MLU a lot of people don't use one, but when they do typically things just work out! The MWs prefer you to be over 5cm, I think, before going in the pool here so they can try and organise things in advance if you arrive pre-5cm, or if after then they just try to get something asap. If you're planning a water birth then you get priority.

The rooms in the MLU have more obvious things for use when you walk in, like the pool, bean bag, futon, birthing ball, dimmable lights etc. The labour ward rooms contain more medical equipment from the offset, like machines for scanning, monitoring, checking baby post-birth, as they are naturally set up for more high risk issues and intervention. However on the labour ward the MWs will still support active labour, you can have mats, bean bags, ball etc, you just ask because they're not left in there like they are in the MLU. Likewise in the MLU if, eg, the baby needs examining post-birth they have the relevant equipment, it's just not in the same room.

The main difference between the two are epidurals and monitoring, if you need to be monitored or want an epidural then that has to be on the labour ward. If there is an emergency in the MLU you need to transfer to the labour ward or theatre you are fast tracked right out of there and it takes about 2mins max.

IME the labour experience was affected more by me and the support of the MWs than the room I was in, plus just natural factors I imagine (as in, I assume that some things just are as they are and the room/mother/MWs can't change that).

I had my first in the MLU and second in labour ward; for the second I had to be monitored due to signs of foetal distress hence I went to the labour ward. I had similar experiences of how things went though, my labour ward birth was very much like my MLU birth in that I used G&A for pain, MWs helped me into different positions for birthing, birth was non-instrumental (but that could be one of those out-of-our-hands factors). Even though I was being monitored, and therefore couldn't go walking around, I didn't give birth strictly on my back with stirrups in the movie way. I think I was on my side, hanging off the bed slightly with one leg in the air, or something

The difference could be with an epidural, in that if you are numbed you may not be able to move so much, but again the MWs are there to help you into different positions and I've heard of women who have birthed on their knees with an epidural, for example.

After the baby is born it is all pretty much the same between the two rooms and just depends on you, the baby and the way your hospital works. Provided neither of you require extra attention beyond regular stitching then you are given time to rest a bit, feed the baby, and slowly get yourself together; like have a shower, get dressed, pack your bags etc. There is no rush to get you out and they use that time to write up your notes, call up to the postnatal ward, and go through anything else with you. Once you're ready you are taken by wheelchair to the postnatal ward until discharge, each bay has 4 beds which I understand to be quite common. You have your bed, table, baby's cot and some cupboards and the beds are separated by curtains. There are designated toilets and shower rooms which are shared by each bay, as well as a tea/coffee making area, water coolers and assistants come round throughout the day to offer tea, coffee and water. MWs and MW Assistants manage the ward and are available 24 hours at the MW station or by buzzing.

DPs/birthing partners can stay throughout all of labour. Afterwards they're not usually allowed to stay on the postnatal ward overnight, but they can stay longer than regular visitors. However some DPs did stay on the ward when I was there so I think it varies and depends on the circumstances, the only way to really know is to ask and see what happens at the time.

Some of these things vary from hospital to hospital, but I gather it's not too different in many other places.

Good luck