Midwife Led Unit

[storminabuttercup]

In this area we have access to a midwife led unit and a 'normal' maternity ward, both within minutes of each other. I am currently under consultant care due to health issues, but these are anemia and i have suffered hyperemisis, so nothing that effects the birth IYSWIM

So anyway, i understand that i get to choose with the agreement of consultant tomorrow where i give birth.

So i'm pretty healthy (except for the 9 months of sickness) I want my birth to be as active as poss, ie i do not want to be confined to a bed, and i want to be relaxed, if poss i only want gas and air unless completely nessesary.

So i'm thinking the midwife led unit is the place for me, however i've been told i'm mad to consider this, what if something goes wrong etc etc....?

But surely midwife led units are perfectly safe.

what can i expect from being on a ml unit?

any advice and experience would be greatly appreciated.

thanks

[Welshexpat]

Ask how many doctor's wives have been near a midwife led unit. Thats your answer.

[storminabuttercup]

My pregnancy brain cannot decipher that i'm afraid Welshexpat

[PickleSarnie]

I've been thinking the same thing. I really want to go to the midwife let birth centre round here and I've heard nothing but good things about it. I'm just scared that I'm being a bit over-confident in my ability to handle this labour malarkey and if it all goes wrong, it's 15 minutes in an ambulance to the hospital.

So will be following this post with interest to see if anyone's had any experience of them.

[storminabuttercup]

Its a tough one. In RL the only thing people keep saying is 'you know they wont give you an epidural' which seriously makes no odds, i am petrified of the thought of an epidural!

this hospital literally had the ml unit and the mat ward over the road...

[Alicetheinvisible]

I was intent on going to the MW led unit when i had DD. But they wouldn't take me due to my Hb being 10.1. They needed it to be 10.3. Very minor thing considering they are situated in the hospital, but they have to have a cut off point. In the end i needed an emcs anyway.

[Welshexpat]

Well "storm" its a sort of consumer test.

Doctors wives, who presumably have good advice, can choose where to have their babies. If the majority choose a midwife led unit then that's a good route to follow. If on the other hand they avoid them like the plague then that's your answer.

Easy really.

[storminabuttercup]

ah - and here was me thinking that was a cryptic message!

calling all doctors wives, and indeed doctors......

[mum2oneloudbaby]

here's how i decided - how would you feel if you ended up in an ambulance on your way to the 'normal' maternity unit either during or after the birth?

Although not always going to happen it may do. I couldn't bear the thought so went for the maternity unit and good job I did because I tore badly and would have been in an ambulance immediately after the birth.

On the other hand I know plenty of people who have had excellent experiences at our local midwife led unit.

I had exactly the type of birth you described at the maternity unit - birth pool for part, gas and air only, very active, not confined at all and most importantly not overly faffed about with so don't necessarily assume that just because it is a traditional maternity unit that you will be treated in a 'traditional' manner. You can still have the birth you want.

[LouM10]

sorry, I can't be any help on the M/L unit issue, but I am having my first, and I'm having a home water birth. Surprisingly, the m/ws have been very supportive and think it's a great idea. As opposed to my family who were a bit shocked and tried to dissuade me.

I told them all the pros for it, and that the midwives thought it was brilliant. They had their kids their way, I'm having mine my way. So they can sod off!!! haha.

[breatheslowly]

I know a few doctors and they all say MLU. However mostly this is in places where the MLU and consultant unit are on the same site. I would worry about really rare things like cord prolapse, but that is because I am a bit of a worrier and those complications are more common in the type of pregnancies which would make a consultant recommend a consultant led unit.

[MumNWLondon]

I don't agree re: the doctors wifes comments. Doctors by their nature see the more difficult births and are more risk adverse. My friend is a midwife and her husband a pediatrician. She did eventually manage to persuade him to have DC3 in a standalone MLU though.

[emmyloo2]

I think where I am based, you are automatically in the mid-wife unit unless there are problems and then you go down the hall (literally) to the maternity unit. I must admit I need to ask my mid-wife more questions about the whole set-up because it is a bit of a mystery to me. I definitely want doctors in the building if things go wrong plus I want the option of an epidural. I think the doctors actually monitor you even in the mid-wife unit and you can have an epidural if you want one.

I would always choose a doctor led unit over a mid-wife unit but that is just me.

[Welshexpat]

breathesslowly

That's cheating. If the doctors are only a couple of minutes away then you are relying on this very important backup. Most births go without incident but some don't.

If its your birth that has complications do you want to be rushed around the country in an ambulance hoping that you get there on time.

I also know doctors (women) and doctor's wives I have yet to meet one who would be more than two minutes from expert care for a delivery.

[mum2oneloudbaby]

to be fair aren't most maternity wards midwife led with the doctors only getting involved if mw deems necessary? certainly seemed the case where i went and will be going again with no.2. and although they are more traditional hospital in layout you may find the philosophies and approach of the mw are very similar

[geekygiraffe]

My doctor said 'the fewer white coats you see during pregnancy/birth, the better - it's the midwives who are the experts'. So I'm going for MLU. But having said that, am very lucky, as it's on the floor below the main maternity ward, so can be whizzed upstairs if complications arise.

[Haliborange]

With my first I was on a CLU. I was at the mercy of a MW who kept me strapped to the bed like someone stuck in the matrix. She appeared once an hour to read the print out and tut at me. The doctors took about 10 minutes to show up when my baby's heart beat did something funny (although she was fine). When I eventually needed a cs this was decided in quite a leisurely fashion so it wasn't terribly emergency-like IYSWIM.

My second (a VBAC) was on an MLU. I went in right at the end and almost immediately the baby showed signs of distress. Within 5 minutes I was on the CLU (an eventuality I had prepared for - we'd agreed no heroics on the MLU) and it took the doctors about 10 minutes to show up, another 10 minutes to agree to a section and then another 40 minutes to start it even though it was category 1 (highly urgent).

I suppose part of my point is that when things do go wrong this "they'll have the baby out in minutes" phrase you hear may not be the reality - and in fact a few minutes to transfer may have little effect on the outcome.

If the MLU is near to the CLU (minutes away isn't much) then I would go there. You have all the back up you need, plus the comfort of knowing you have more care on hand should you need it. And tbh if you are allowed to do what you want in terms of moving around you are less likely to need back up anyway.

[rollerbaby]

welshexpat I was originally going with a consultant who is considered one of the top bods in London. His wife had 4 homebirths. So I'm not sure that really applies.

storm I've been around the houses on this one too (first baby) and have vacillated from consultant led birth (privately due to sheer fear) to Doula support to Homebirth to MLU. Most of the hospitals round here have MLU in very close proximity to the delivery suites where you can transfer quickly if you need to - i.e. on another floor.

It's also not "cheating" to go to a MLU knowing that you have the security of topnotch care if you need it. It's not a competition and obviously you want to have the best possible environment to help you be relaxed and therefore an ideally more straightforward labour. A medicalised (and therefore possibly stressful) alien environment is possibly not where you want to be in the beginning when you want to bring on labour.

Can you investigate more hospitals where this sort of set up exists? I completely agree (hence not doing homebirth) that for us the risk was not one we could take but we still wanted the reassurance that emergencies could be dealt with quickly.

Good luck.

[Palace39]

I'm not quite sure if there are some MLU's where there are ONLY midwives, but mine certainly has doctors also and having been to visit the unit and looked at it's history/stats/reputation i am confident that any 'complications' will be treated exactly as anywhere else. These people, no matter what their title, are healthcare professionals and i'm pretty sure you can be content in that you will be looked after wherever you go.

Can you ask to visit both sites and see which you feel more comfortable in? Just a thought...

[MrsGangly]

Welshexpat, they do allow women to become to become doctors too now!

I'm a doctor and currently planning a home birth for my first. The hospital is very close though so if I chicken out, as well I might, it is just a five minute journey away.

[PickleSarnie]

My ML Birth Centre is 30 minutes from the nearest hospital (presumably less in an ambulance). Am I crazy for considering it for my first?!

[japhrimel]

NCT advice is thar if you needed a crash EMCS, then it would take 30 minutes to assemble a team and prep for theatre even if you're in the hospital already. So transfer times of up to 30 minutes from MLUs or home births are not considered an issue at all as they could be prepping for theatre while you're on the way in an ambulance.

It's a choice between a more natural birth with less liklihood of needing interventions (the more doctors around, the more interventions are likely to be used and earlier and the more interventions, the more likely it is you'll need further interventions) against the risk of having an uncomfortable transfer if needed.

I'm going for a homebirth myself.

[Palace39]

Can i just add that it would appear MLU's differ in general as the one i am in has a room for EMCS, no need to transfer to a hospital.

Check on the specifics of the one you are being offered.

[redbird79]

Hiya, I am looking at the idea of a MLU for my first. My GP was an idiot and so the doctor's wife advice will not apply here (he didn't give me any advice on what to eat/not, folic acid, taking medication etc etc- but helpfully told me plenty about miscarriage, which terrified me). This is my first pregnancy, no health problems and he had no reason to tell me what he did: "As this is your first you would be better off at the main hospital". Apologies for the rant, but the doctors I have known have actually recommended their wives had elective caesareans so they "know when it will arrive". Hmm...
Anyway, if everything goes ok, I will be in our MLU. It's about 10 mins in an ambulance to the main hospital maternity unit if things go wrong, which gives them time to prep the operating theatre!

[redbird79]

Sorry I went off on one (had icecream now and feel much calmer). My advice stormina would be to have a look round both units if you can and have a chat with staff there. You should be able to find out online what the different stats are- like how many women were transferred mid-labour to the maternity hospital etc. I know I was a bit too heavy in my earlier post, but I am also realistic- I am not setting my heart on anything just in case!

[stripeyknickersspottysocks]

If you;re still anaemic then I'd doubt you'd be suitable for the midwifery unit, it could affect the birth and most units would want you in the consultant led unit. Are you taking iron?