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Midwife led units - experiences?(24 Posts)
Just had final all clear scan from fetal cardiology (phew) but the consultant can't 100% rule out any abnormality and has recommended the midwife led unit rather than my wished for home birth... just in case the baby needs help when born.
My first birth experience was induction following SROM, which was fine, but post natal ward was horrible and we were stuck in for two days until ds decided to feed. Really wanted to avoid that this time hence home birth (had planned hb for first too) and not sure how MLUs fare compared to hb and hospital?
I think my main worry is the level of control I'll feel once the baby is born, and dh having to go home (which we both hated last time). Granted we have ds now so have to be a bit more flexible anyway...
I had my DD (Now 18 months) in a midwife run unit and honestly thought it was fantastic.
I went in at about half 11pm and got straight into a water bath, had 2 midwives all to myself as it was quiet that evening.
Gave birth on the bed eventually and having the midwives there to encourage me (and administer my diamorphine) was well appreciated.
I then stayed overnight, it wasn't great that DP had to leave but it gave me time alone with Isla to get to grips with my feeding etc.
What do you mean you worry about the level of control once baby is born?
My local Trust has two MLUs. One is next to the CLU and IME is indistinguishable from it, apart from there being no Obstetricians on the MLU. The other is in a different hospital and is, again IME, entirely different - more relaxed, better staff ratios, better at supporting BF, etc.
Have you visited any MLUs yet, to get a feel for them?
I think by control I mean that, with ds, we felt completely at the mercy of the post natal ward staff and we got so many conflicting opinions about breastfeeding that it was a really stressful experience. There wasn't much support and we felt imprisoned, if that's not too strong a word!
As for visiting them, apparently ours is so busy that they don't do torus anymore - but there may be a virtual tour online so I'll check that out. Will chat to midwife at 28wk appt, but just interested in others' experiences. It's also likely I'll labour very quickly this time, so slightly concerned about getting there in time! It's a 20min drive.
I had a water birth in a MLU in a hospital, but after the birth was transferred to the postnatal ward as there isn't a separate ward. I had a great experience in the MLU but the postnatal ward was very busy. Fortunately I didn't need a lot of support but was generic hospital ward.
My unit didn't do a tour (I asked.)
I laboured quite quickly for a first birth (went from no contractions to having Isla in 8 hours) and we are about 30 mins away. We got there in time only issue was that its hilly and speedbumpy and was quite uncomfortable!
I think as its a second baby the midwives will be less inclined to interfere with you after birth. In my unit (and many near me) if you have a straight forward labour etc. then you can leave within 6 hours. I only stayed overnight as I was struggling to feed. My midwife popped her head in every 2 hours (at my request) but other than that I had a curtain around my bed and they left me to it. I had a very straightforward labour though so don't know how it would have been if it had been more complex.
Do you only have one MLU nearby? Personally I would be a bit concerned about a unit too busy to offer tours.
I was booked into a MLU last time and wasn't able to use it in the end because I had to be induced. But they let me have the room after I'd given birth for a day or two. The midwives were lovely and it seemed brilliant. I'm not going for it this time because of my worries about this pregnancy but if you are low risk then I'd say definitely go for it!
At my unit they didn't do tours simply as a matter of policy, nothing to do with it being too busy. I think that this is the same in a lot of them.
Is your MLU a stand alone or attached to a CLU?
If it is attached I can see your consultant's point, but if it is stand alone I'd be interested to know what in particular he thinks the advantage of the MLU is over home?
It's attached to the delivery suite. Only four rooms and I guess if they were full we'd have to go to delivery instead? Argh, I don't know! Would it be really irresponsible to still push for a home birth?? Midwife at the hospital said one issue might be the paediatric check after birth, which not all gp surgeries offer now...
Its up to you I suppose in the end but my gut feeling would be that if you are being advised against a home birth it really is for a good reason.
I would be slightly more circumspect as some consultants are just anti homebirth generally and will think it's a bad idea for any number of very minor reasons. But no one on here will be able to comment because we don't know your full medical history. Is there someone else you could talk to - a mw maybe?
I can't see that how paediatric check can be a major issue. What, you just don't get one if you are born at home any more? Surely if GPs have stopped doing them in your area then there are arrangements for home births to pop into the hospital or something? Can they explain that to you a bit more?
I know, I can't help thinking the consultant is being over cautious (though he was very complimentary about the mlu and said he was in favour of hb). The original issue was query three chamber heart at 20wk scan. Detailed scan x2 showed four chambers and was probably just wriggly baby problem - so in my mind there is no greater risk of heart abnormalities now than if we hadn't had extra scans...right? But due to the initial concern apparently the consultant will want the paediatric check asap after birth and therefore the delay in getting to post natal (if hb) might not be advisable.
Everything else normal and I laboured quickly with ds. Otherwise low risk birth candidate.
I will talk to midwife, but won't see her for another month now.
Can't you make an appointment to see her earlier to talk about this?
I am not a doctor, I know nothing about this. But if it is just: we couldn't see X properly at scan, we did another scan and X was normal, I do think it might be worth having a chat with someone else or a second opinion. Then you can make your mind up fully informed.
I had our first at the local MLU rather than the big teaching/university hospital and it was an OUTSTANDING experience. More like a hotel than a hospital. Hope this one will be delivered there too.
The midwives were amazing during the birth: so attentive, someone with me virtually all the time, drinks brought to me during labour, pool filled, encouragement and pushing me to focus to deliver. It was so clean and ordered, calm and had enough medical stuff for me feel reassured.
The visiting times were more relaxed and I had a room on my own at no cost. Dh could stay in the room overnight but had to make do with a reclining chair.
After the birth: senior midwives to stitch me, lots of midwives or midwives' assistants checking I was ok, amazing help with breastfeeding, help with bathing baby and had some checks to baby done before I left (had to go back for a couple that I missed). Food was brought to me or I could sit at the table with a couple of other mums.
I had a horrible long stage of pushing (3.5 hours), tearing and agony as I arrived too late for drugs but the wonderful ladies/ environment made it much better.
I feel so so fortunate.
Im sure your local unit will be great. def go and visit.
At chucking out time you can either go with your dh or set up a little nest outside the ward with your duvet and snuggle up together?
I had a hospital birth and a MLU.
For me the hospital felt like others describe a MLU to be. lovely, relaxed and unhassled.
the MLU was horribly understaffed and the staff who were there were unhelpful over everything from having a shower not a bath after the birth to breastfeeding.
More importantly there was a brief moment after birth when it looked like it was all going wrong with the placenta. at that moment the thought of a 20min transfer did not appeal, I wanted help and I wanted it now!!!!!
point is none of the rest will really matter if heaven forbid you need help right away. Having that help there and ready to go accounts for a lot.
oh, you cant visit. i think mlu in general are much less rigid than hospitals. i visited the large hospital and it felt like being in outer space compared to the mlu. friends have said it wasnt terrible, reassuring but less attention it seems compared to the mlu.
Can't you just plan to self discharge as soon as the baby is given the all clear? I had a similar experience last time (wanted home birth but was very strongly advised against/prevented given that it was a VBAC). Birth itself was fine. What was awful was the postnatal care. I nearly discharged myself early (wish I had) and then it all went pete tong and we were 'trapped' in hospital for a horrendous 4 day stay. If I do end up back in hospital this time I will be discharging myself immediately regardless of medical opinion (well obviously not if something is definitely wrong but I'll ignore any 'we really don't think it's a good idea' or 'we really wouldn't advise' comments coming from mws).
You might not have to stay in, or be transferred to the post natal ward. Both my DDs were born in a MLU. I had DD1 at about 2.15pm, and left after 6 hours, and DD2 was 12.30pm I think, and l left after 4 hours. After all the relevant checks had been done on both me and the baby. Stayed in the delivery room both times. DH constantly with me. Obviously it was very lucky that I went into labour and then gave birth at times which meant no overnight stay was necessary, but just wanted to flag up that it's not inevitable.
My experience was fab. Gave birth and stayed in the same room with dh overnight. Private bathroom and a microwave meal when it was needed rather than when the trolly came. Little area where you could make a cuppa and toast.
Wow bulby, that sounds like a flat! Seefood, that's exactly my worry but like you say, I think I'd feel more confident to self discharge this time (if nothing wrong of course) and trust that feeding would establish at home if an issue.
With Xmas and everything its not long till next appt anyway so will def chat about it there. The positive stories are helping though! Less mess I suppose too no idea who'd have ds though.
oh and re paediatric checks. Where I am lots of the mws are trained to do them at home so no need to go to gp or hospital at all (this is an extra qualification so not all mws will be able to do them, and I expect this is yet another thing that changes from area to area).
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