Just been refused the use of the birth centre at local hospital!! am gobsmacked!

(43 Posts)
stellamel Fri 20-Nov-09 11:02:54

Just been for a visit to the Birth Centre at Stepping Hill hopsital. I was literally there 1 minute!

The midwife who went to show me round said I had to have had a straight forward pregnany (which I have). She asked if it was my first baby and I told her it was my second and she asked about that birth and I told her I'd had pre-eclampsia. Where upon she refused to allow me to go any further. Just out right said I wouldn't be able to use the birth centre and would have to give birth in the normal maternity unit - which might I add is only on the floor below, so it's hardly like I'd be a million miles from medical 'help' if required. I did point out that just because I'd had PE before didn't mean I'd get it again, she disagreed and said they wouldn't book me in! shock

I had a horrible medicalised birth with my dd read here and there is no way on gods green earth I am going into the normal maternity unit. They'll have to drag me there kicking and screaming.

Is this normal? I thought we had the right to give birth where we choose?

Don't know what to do now, seeing MW later, not sure what options I have left now sad

MamaG Fri 20-Nov-09 11:04:13

I think MLUs have very strict criteria

hoxtonchick Fri 20-Nov-09 11:04:57

i'm afraid they will only take absolutely normal low risk women at birth centres generally. but you should be able to have midwife led care in consultant led unit.

OrmIrian Fri 20-Nov-09 11:05:57

It doesn't have to be horrendous in a mat unit. Mine were all fine. Very low key and calm.

OmicronPersei8 Fri 20-Nov-09 11:11:15

I have a friend who had her 2nd baby in a birth centre (2 hour labour, water birth) after having had pre-eclampsia/induction/forceps etc with her first.

So some units do accept people in your situation - although this birth centre was in a maternity hospital, so easy to transfer at any point in pregnancy / birth. My experience with a different birth centre is that they can be very rigid in who they will accept.

Try contacting the NCT - I think this is the kind of thing they can help with (based on my vague memory).

mazzystartled Fri 20-Nov-09 11:11:41

I know that the MLU here is very strict on who would be allowed to have their baby there partly because of the resources available, and partly because they have to maintain a fairly high "success" rate.

It may be that if you explain your circumstances to your MW she can help to argue your case, or you can take it up directly with the Head of Midwifery.

However, I'd say that just because you go to the maternity ward doesn't mean that you would automatically end up with a medicalised birth - far from it. You just labour in something that looks like a hospital room rather than something than looks like a travellodge. In fact at our local hospital the birthing pools are in the maternity ward not the MLU.

Is a home birth not an option? Can you use it as a bargaining tool?

Don't lose heart. Oh the doula idea is a good one.

hazeyjane Fri 20-Nov-09 11:11:53

They have every right to say you can't use the birth unit, if they feel there is a risk. However, I was refused when i first asked to use the birth unit in Slough, with dd1 because I had had a molar pregnancy and was seen as high risk, and with dd2 because I had torn badly with dd1.

I spoke to another MW and a consultant and eventually got them to agree to letting me use the birthing unit.

Unfortunately with dd1 I ended up having to go to the labour ward because dd1 wouldn't come out, so I had to have ventouse. With dd2 I was only in there for 5 minutes because they found meconium in my waters!

I would add I had an horrendous birth with dd1, and ended up discharging myself because the ward was horrible. When I was in there with dd2 it was a completely different and better experience. Were there any good MW's from your first birth who you could have a talk to about your worries?

OmicronPersei8 Fri 20-Nov-09 11:13:43

Just re-read your OP and the maternity unit is in the same building. I really feel for you on this.

OmicronPersei8 Fri 20-Nov-09 11:15:16

Try speaking to other people - sometimes speaking to someone more senior can help. Good luck.

theyoungvisiter Fri 20-Nov-09 11:18:50

I would ask to discuss it with your consultant and the head of the centre.

They can do a lot to predict whether PE is likely to occur (dopplers and bloods etc) so they might be willing to do some tests and make a decision in the light of that information.

theyoungvisiter Fri 20-Nov-09 11:20:12

sorry, should have been reoccur.

heth1980 Fri 20-Nov-09 11:23:54

My local MLU is really strict and they won't let me in. However they will let me have a home birth (!!!!) seems to make no sense to me at all given that the MLU is actually joined on to the hospital whereas my house is a 15 min drive away......

serenity Fri 20-Nov-09 11:29:51

I wasn't allowed to use the home-from-home birth unit at St Thomas because I have hypothyroidism, despite having two completely fine G&A/no complications/no stitches, births before. They can be incredibly strict (if it hadn't been 5am when they were refusing me, I would have argued, contractions or no contractions)

theyoungvisiter Fri 20-Nov-09 11:31:13

heth - maybe because a MLU can be closed down, but homebirths can't?

So if they don't keep their stats impressive, they might risk their funding...? Not sure really, but that would be my guess.

Tangle Fri 20-Nov-09 11:32:33

I'd recommend talking to people - www.aims.org.uk may be able to point you in addition to the suggestions you've already had. There doesn't seem to be a good medical reason for not allowing you in at the moment, but ultimately it is up to them

heth1980 - as it is their MLU they can choose whether to let you in. They have no legal powers to deny you a HB if that's what you want (although most would put up a fight to get you into hospital...). Anyway, whoever said the NHS had to make sense hmm

gorionine Fri 20-Nov-09 11:36:25

stellamel, I gave birth to 3 of my 4 Dcs in Stepping hill hospital, I do not remember once having been asked if my pregnancy was straight foreward is the "Birth Center" the same as the "woman's Unit" or is it a new/different thing I have never been told about ?(DD4 was born 3 years ago)

FWIW had a fabulous experience there for the 3 of them (DD1 was born in St Mary hospital in Paddington (London) and my memories of it are not so good.

stellamel Fri 20-Nov-09 11:50:19

Thanks for all your replies, seems I was misled about the right to give brith where you wish.blush

I would actually like a home birth, but thought I'd be sensible and try the MLU as it's above the normal maternity unit and medical help.

Think I'll talk to MW about homebirth then. Sounds like I have more chance of that happening.

I am not giving birth in the normal unit, I had a v. v. traumatic birth last time that left me PND and a multitude of other issues. I am too scared to go through that again. I am not a wimp but I still feel traumatised by it 3 years later.

Gorionine - it's farily new addition within the last 2 years I think.

I will read all your posts properly later - got to go and get my dd from pre-school.

Thanks so much for taking the time to read and post
x

gorionine Fri 20-Nov-09 12:06:14

I really hope that you will get the birth you want! I think the "I would actually like a home birth, but thought I'd be sensible and try the MLU as it's above the normal maternity unit and medical help." is very sensible, I do not understand their reasons as like you said, you would be much closer to the normal maternity unit than if you had a home birth (unless you live on one of the wardsgrin).

How long have you got until your new baby arrives to try and convince them? Hopefully your MV will be more understanding and helpfull. Have you always seen the same MV? I saw a different one every appointment and found it very ennoying as you have to go through the same explanations every time.

flybynight Fri 20-Nov-09 12:45:53

I know that a woman gave birth to twins in our local "home from home" unit after threatening to insist on a home birth otherwise. You can use it as a bargaining chip. Good luck.

LadyTeasmaid Fri 20-Nov-09 13:28:36

Does it matter if you've got mood lightening and plinky plonky music?

If they say its safer to do it one way, I personally would be giving thanks on bended knee for the safe hospital I can still give birth in even though I'm not paying for it.

I know it's hard now. But once baby is here it wont matter, thats what this should be about, baby, not you. They wont remember where they were born. Long as they get here safe.

DaisymooSteiner Fri 20-Nov-09 13:32:39

LadyTeasmaid, you've obviously never had a traumatic birth then or you wouldn't be making such simplistic, patronising comments.

Tangle Fri 20-Nov-09 13:35:54

But LadyTeasmaid - they haven't said that being in hospital would be safer. From what stellamel has said she's been given no justificatin whatsoever as to why having PE with her last child makes her higher risk this time round. The baby may not remember where they're born, but if the mother is left with PTSD its not really ideal, is it? There is research that shows that the more relaxed the mother is the easier and less stressful the birth (for mother and baby) - if the mother feels stressed just thinking about going into hospital its not setting things up for a straightforward birth. If there are two options that are equally safe for the baby and one is much better for the mother, why not take it?

gorionine Fri 20-Nov-09 13:39:48

LadyTeasmaid, as I understood, Op does not wants a homebirth, she want to give birth in a less medicalised part of the hospital that is one flooor up to the medicalised one. Is it really taking too much risk? If somehing should start to concern the staff there, surely sending her in the lift 1 floor down would not be that challenging?

I do not think she wants that particular center so her Dc can have fond memeries of where they wre born but because her last experience was all but nice for her so she would like to have a more pleasant on this time round.

MrsHappy Fri 20-Nov-09 13:40:07

You need to speak to the consultant midwife and (if different) the person running the birth centre. The midwife showing you round was probably just repeating policy, but policies can be bent...

LadyTeasmaid Fri 20-Nov-09 13:45:07

Not safer? Oh they obviously turned OP down because they felt like upsetting a pregnant woman with a history of dificult birth.

African woman have a one in 16 chance of dying in childbirth and pregnancy, and we complain.

Daisymoo, I had horrid birth, 3 days then intervention. And I'm glad I was with medical professionals who did what they could to help me. Hence how I think they should be listened to and respected, rather than assuming all they are doing is stopping you from getting your own way.

LilyBolero Fri 20-Nov-09 13:47:00

I would ask to speak to the consultant. I had to see a consultant along with my 12 week scan, because my lovely mw (who actually delivered dd and ds2 at home) was concerned about their birth weights (they were both 10lb+) - she was suggesting that I shouldn't consider a hb this time, and should have a GTT, plus an extra scan at 36 weeks or so.

Well I saw the consultant, who basically said 'I'm not quite sure why you're here, you're v healthy, you've had consistently sized babies, I don't need to see you again, no need for a GTT, no need for an extra scan and have the baby wherever you'd like.'. smile

MWs have certain protocol they have to follow, but a consultant can make more of a jdugement call I think.

LiegeAndLief Fri 20-Nov-09 13:48:25

I can really empathise with you wanting to give birth in the MLU, but unfortunately the fact is that as you had PE in your first pg you are more likely to get it again in this one. PE can develop or worsen quickly during labour or soon afterwards, and can develop into eclampsia. It might help to have a chat with your consultant to see if they can give you some idea of risk based on your last pg, and then discuss the MLU with them.

DaisymooSteiner Fri 20-Nov-09 13:51:23

Yes, let's never complain about anything ever again because people die in Africa hmm

This is highly likely to be a political decision rather than a safety decision. That doesn't mean you will get them to change their mind stellamel, but it's worth fighting it.

theyoungvisiter Fri 20-Nov-09 13:51:40

ladyteasmaid please try to be a bit more reasoned. I don't think comments about women in Africa are remotely relevant to this issue.

Yes it MAY be safer for the OP to give birth in the main unit but she hasn't been given a single reason why that should be so, just protocol.

It may be that they want her in the main ward because of better equipment and staffing levels and feel that her pregnancy does show a risk of the PE reocurring. In which case fair enough.

On the other hand it may be that the MLU has targets for transferrals and vaginal births and don't want their stats spoiled due to the risk of having to transfer her upstairs if her bp goes up.

Either way, the OP's right to have a conversation about her specific risks and the reasons behind the policy is hardly unreasonable and has nothing to do with maternal mortality rates in Africa.

DaisymooSteiner Fri 20-Nov-09 13:57:27

And there's a big difference between having had a crap birth and being traumatised, not necessarily correlated with the length of level of intervention.

Toady Fri 20-Nov-09 14:00:39

just to echo what most are saying, tell them (I wouldn't ask) that you are having a homebirth, I think they might change their minds then. One floor above? 30 seconds in lift? What difference is that going to make?

Cadmum Fri 20-Nov-09 14:07:04

What an interesting predicament. I am surprised that the answer would be no based on a first pregnancy ending with PE. I have gone on to have three healthy pregnancies following my first with PE.
There seems to be plenty of great advice on here and I think that I would start with asking for another opinion from someone more senior in the birth-centre.

(Incidentally, how far along are you this time?)

JemL Fri 20-Nov-09 14:41:25

I was refused the MLU because of a previous c-section. As in your case, our MLU was a floor above the labour ward, in the same hospital. I saw two consutants, and a midwife consultant, and none would agree to me being on the MLU, although they did agree to remove some of the standard protocol for a VBAC (ie CFM) In my case, the reason was transfer time to theatre incase of uterine rupture - their argument was, in an emergency, even travelling one floor to get to theatre is an unacceptable time delay. My experience is that they are very strict on their exclusions, unfortunately, and as someone pointed out, part of the reason is to preserve their high "success" rate in terms of straightforward deliveries.

cory Fri 20-Nov-09 16:13:02

I believe there is a higher risk after a first pre-eclampsia; they certainly monitor you more carefully. I was in the ante-natal ward for weeks before with both labours, and the pre-ecl mums I met in there who had already had children did often seem to have a history of pre-eclampsia in previous pregnancies. This may mean that they will want to monitor you during the labour in a way that they wouldn't in the MLU; and it may also mean they will want you booked with the consultant for regular check-ups before going into labour.

Still, I would see the consultant and see how you get on. It may be that they find you are not that high risk after all.

Also, if you do have to go into the usual unit, do be extra careful with your birth plan, so you can eliminate stress as much as possible.

Lulumama Fri 20-Nov-09 16:16:47

my sister recently got signed off by her consultant to use the MLU , despite being high risk. ( blood clotting issues and other stuff) she ended up in the CLU as MLU was full, but she had a waterbirth with no interevention.

you can ask for a second opinion, and i firmly believe that the mother's experience of how and where she delivers is vitally important, as of course is the safe arrival of the baby. but the birth is likely to go better and more smoothly when the mother feels suppported, listened to and is at ease

if you develop PE symptoms, then you might be as well to go to the CLU. but if you don't and you are determined and are making an informed decision you can request a consultant to sign you off to give birth in the MLU

Lulumama Fri 20-Nov-09 16:17:40

and if all esle fails, ask for the supervisor of midwives to intercede and speak to AIMS

MrsHappy Fri 20-Nov-09 16:29:06

FWIW it is sometimes possible to negotiate your way into an MLU when you don't meet the criteria. I was allowed to try for a waterbirth VBAC at my local one after initially being told it was not possible. When I had to transfer (all signs being that the baby needed to come out right away) the only delay was the doctors on the CLU faffing. The transfer itself took 30 seconds. From a safety point of view being on the MLU was fine.

stellamel Fri 20-Nov-09 19:05:05

Lady Teasmade it's not about plinky plonk music and mood lighting. With my last birth I listened to the medical advice right down to the last word, because I respected and trusted them. I allowed them to induce me, to foetally monitor me inside and out, to deny me food and water for 48 hrs, to hook me up to a drip, to catheterise me (even tho I begged them not to, and promised I would wee in a jug so they could monitor my output), to give me an epidural for the blood pressure, to behave myself and lie on a bed for the entire procedure. My baby was so stonked out when she was born she wouldn't breast feed and I was no use as I couldn't stand upright due to the crushing headache I ended up with, cos of the hole in my spinal membrane caused by the botched epidural - a headache that lasted 2 weeks.

It took me almost 2 years to find that special bond with my daughter, due to guilt, the sense of failure as a mother, the failure to breast feed, etc My dd might not remember where she was born, but i am damn sure see remembers the fall out from it.

So I do believe that birth is about the mother as well as the baby. I am not trying to put my baby in harms way, my pregnancy has been totally straight forward, I don't see that I am a high risk mother.

BTW, I am 35 weeks.

I have seen a consultant at 16 weeks who said I should give birth where I wanted and that a truamatic birth should be avoided at all costs for the mental health of the mother. She could see no reason why I shouldn't give birth at the MLU.

I have been monitored v. closely during this pregnancy, I've been having 2 weekly MW appointments since 28 weeks, and had a growth scan at 30 weeks (all good).

I saw my MW this afternoon (I never see the same one either!) and she agreed that she couldn't understand why the MLU wouldn't have me. She is booking me in with the senior MW for my next appointment to discuss my options and see what can be done about my giving birth in the MLU. But she did say, in her opinion, that home birth would be bottom of the list, the MLU at Buxton next (because it's a 40 min trip to hospital) and the MLU at the Stepping Hill hospital preferrable.

Thanks for the AIMS link Tangle.

Brilliant advice on here as usual, thanks everyone.

Grandhighpoohba Fri 20-Nov-09 19:56:22

I got turned down by the MLU because I have asthsma. Its a dog allergy. Not relevant particularly to giving birth I would have thought, but they were adamant. I was transfered there the day after I gave birth as DS was jaudiced and I was anemic they wouldnt let us home, but unit was closer to home. The place was bloody empty. I saw one other mother in the 4 days they kept me in. I think they turn down so many, they have bugger all left. And the maternity ward at the hospital was bursting at the seams. its a fear of being sued I think.

As it turned out, I would have ended up at the hospital anyway, but i was so angry with the decision.

OmicronPersei8 Fri 20-Nov-09 20:03:34

Stellamel I'm glad you were able to talk to your midwife about it. It sounds like you will be going into your second birth with a very clear idea of what you want. I know birth plans don't always get followed, but being well-informed (and there's nothing like having been through it all before to 'inform' you!) will make a difference.

Fingers crossed for you.

OmicronPersei8 Fri 20-Nov-09 20:06:34

Oh and my friend who had the lovely 2nd birth had a doula, who she said was fantastic. I think it gave her and her DH the chance to relax because they knew they had someone there to fight for them if needed.

I cried when I heard her (2nd) birth story, it was just so perfect. And yes, part of that was being in the MLU where they turned the lights down, spoke in quiet voices and were deeply respectful of her as a labouring mother.

BeehiveBaby Fri 20-Nov-09 20:14:02

There is a very active homebirth support group in the area run by a lady with a wealth of experience negociating care specifi to her plans with this particular hospital's team. Email me if you would like to talk to her.....liz haslett 212 at hotmail dot com (no spaces etc...)

mathanxiety Fri 20-Nov-09 20:39:25

How well you are treated by the medical staff makes a big difference to how you manage afterwards. It's still shocking to see that medical staff are so hyperfocused on their own particular little niche that the big picture is obscured.

That being said, I would caution against relying on getting anywhere fast in an emergency if there's a lift involved. You should not take it for granted that a potentially serious hiccup will not happen at that point.

Even if you negotiate and get into the unit, have a backup plan in place in case they transfer you so that you'll get some of what you feel is necessary for your delivery even if the circumstances are not ideal, from your pov. And don't underestimate the potential trauma of the transfer itself if it happens.

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