Where should I give birth?

[PrincessJenga]

When my midwife asked me at my booking appointment where i wanted to give birth I immediately said '[local] hospital'. I've had various gynae problems, several surgeries and a miscarriage in the past so I wanted to be near the doctors 'in case anything goes wrong'.

Fast forward to now (32 weeks pg) and the pregnancy has gone smoothly: I'm officially 'low risk' and under midwife led care (started under consultant care but signed back over to midwives at about 16 weeks)

The only delivery suite in our town is the consultant led unit at the hospital I'm booked in at. I like the hospital and they looked after me well when I was ill in the past. It's also only a 15 minute drive from our house. However, it has high intervention rates and DP really doesn't like the 'hospitally' feel of the place. There's also only one room with a pool so they can't guarantee a water birth (which I'd really like) and friends have said it's very much an 'on your back' kind of a place. After the birth you're usually put into four-bed pods on a bigger ward.

The nearest big city (about a 40 minute drive) has a midwife led unit that focuses on natural births. There's aromatherapy wafting the halls, each room has a pool and a ball and there's not a hospital bed in sight (after the birth they pull down a double bed from the wall and leave you, baby and DP to relax together) The consultant led unit is just down the hall, so help is nearby if you need it.

WWYD? Local hospital or longer drive to the MLU? Having never given birth before I have no idea how uncomfortable that drive will be. I'd really appreciate your ideas.

[squiggleywiggler]

Homebirth?

More info here //www.homebirth.org.uk.

All the comforts of home, the 'hands off' midwife-led approach and the consultant-led unit for back-up if you need it.

Perfect!

[vintageteacups]

With dd, we lived 20 mins away (16 miles) from the hospital where I chose to have her. Our nearest sounded much like the one in your town you describe; busy, high intervention rates, less natural births etc.

Is there anyone you could go and stay with living at the 40mins away one so that when you go into labour, you can go to that one and not worry about the drive? Or, if you are entitled to go there, see if they'll have you in earlier than normal once you go into labour and if it's all going too fast, go to the closer one in town.

It's a tricky one but if you were consultant led to begin with, then if it were me in your position, I think I'd choose the closer one.

But if there's any way in which you can stay near the other until labour begins, I'd go with that.

[scarlettsmummy2]

I went mlu at a very similar unit to the one you are describing and it was about a thirty minute drive away. I was a bit anxious getting to it when I was in labour, but once I was there I knew I made the right decision. It was so lovely having my husband be able to stay with me all night (I was in for four nights) and the midwives were brilliant. I would say go for it. The doctors are close by if you need them.

[scarlettsmummy2]

I should mention as well that although my contractions on the drive to the hospital were painful, it was bearable, and it was another twelve hours after I arrived that I actually gave birth. So I wouldn't panic too much about the drive. Also if you are going midwife led you may not be able to have an epidural so you are still going to be in the same position when you get there.

[stella1w]

Personally I'd go for the second option even if it is a bit further away... if it is your first child, you should have such a super fast labour. I recently went to our local birthing centre and their approach is to keep the woman up and active as much as possible as flat on your bed denies the baby oxygen and also makes it harder to deliver.
Home birth is also an option - but you might feel better having consultants down the hall..

[vintageteacups]

Also, just because you've heard about the negs for the closer hospital, it may seem like that because they have a much higher number of births so would obviously higher intervention rates etc.

You are the person having the baby; read up on the type of birth you want and just be assertive at whichever hospital you go to. Know your info and chat to your dh too so that you can both make informed choices.

If there is no medical reason why you should lie on your back, tell them you don't wish to.

[PrincessJenga]

Thanks ladies. Our NCT teacher was very persuasive about the benefits of homebirths squiggly and DP loves the idea, but I'm not so sure. We're in the middle of moving house so I think part of the problem is that I can't picture where I'll be (here or in the new place) and 'here' is a tiny flat with very thin walls so I don't much fancy keeping my neighbours awake! Maybe if we get moved in the next few weeks I'll give it some more serious thought.

vintageteacups and Scarlettsmummy2, the MLU is about 15 min drive from my parents' home so that could be an option. I don't really want to move in there for weeks on end though. We'd thought about going to mum and dads' as soon as things seem to be starting, pacing the rooms there for a few hours during the first stage and then heading to the MLU when things seem to be speeding up, but mum says her births were so quick she wouldn't have been able to do that (she also says I'll be begging for intervention so just to go to hospital and take whatever they'll give me!) Again, never having had a child I just don't know what to expect! Is my labour likely to be fast as my mum's were?

[PrincessJenga]

Sorry, cross posts, thank you stella too

[vintageteacups]

Well I'd defo try and stay with parents; what's putting up with them a week before the due date if it means getting the hospital of your choice. Even if you were a week late, I think it'd be worth it.

And no, your births won't necessarily mirror your mums.

[nannyl]

it sounds to me like the MLU is what you want.

If thats what you want then go for it.

Personaly, so long as i continue to be low risk (and even if i dont, for a silly small reason) I will be opting for a homebirth which is the safest place to give birth if you are low risk.... (although you may have issues with a birth pool (but can hire or buy or get from ebay))

Im a good 45+mins away from the only hospital that i can possible "choose", and 20mins from a lovely midwife unit which sounds nearly as nice as you describe (no double bed!)

[CollieandPup]

Hi, I?m reading this thread with much interest. I hope you don?t mind me hijacking with a question for anyone.

I'm only 16 weeks but expect to have some initial questions on where i want to give birth at my mw apt next week, who is VERY pro homebirth. So far I am under the care of my most local HA which only has 2 options. Homebirth or Hospital. Its my first dc so am anxious about homebirth but am not thrilled about delivering at my local hospital, which has mediocre reviews and hasn't seen investment for over 15 years. My other options include 2 other Health Authorities. One with birthing centres separate to the hospital and another city centre, brand new MLU. I'm trying to figure out what my best option is.

A lot of you have made some really great suggestions for princess to think about like drugs available, size of wards, number of private rooms, DH being able to stay over night v's being kicked out, transfer rates from MLU to hospital, availability of birthing pools etc'

So, this is probably going to seem like a stupid question but how do you find thins things out, to help you make an informed decision?

So, this is probably going to seem like a stupid question but how do you find thins things out, to help you make an informed decision?

[YesterdaysPants]

Lurking as interested in opinions and experiences. I'm hoping to go to my local MLU, it sounds lovely. My only concern is, being my first, I have no concept of the pain I'll have to endure, and am worried that if I want an epidural I won't be able to have one. End of the day though I know women have managed to give birth for years without!

[CalmInsomniac]

I hate the line that "you don't know what it's like, and you'll be begging for everything going" that 1st time mums are so often given to dissuade them from home or MLU births. If it turns out to be the case and you're at home/MLU then you ask to transfer. I mean, if you give birth in hospital, you have to make the journey to get there at some point in labour anyway, sometimes several times if you go too early. What's the big deal about transferring from a homebirth? At least you get gas and air on the way.
I chose a homebirth. I didn't wake the neighbours! I first called the midwife within an hour or two of contractions starting as they were full on (90 sec and every 3-4 mins right from the start) but I was only 1cm so she left me to it. Sure, I found that part hard to cope with but they would have sent me home from the hospital if I'd gone there so I was no worse off being at home and the MW had made the journey rather than me .
I knew I just had to get my head down and deal with it, which I did in the dark in my bathroom with my DH holding me tight and helping me control my breathing. After 4 hours I couldn't hack it anymore and went and got in birth pool my friend had set up in my kitchen. Soon I felt the urge to push and the MW came back out. Baby born 50 minutes after MW arrival, everyone gone, I was stitched and every thing cleared up within 3 1/2 hours after that.
There's nothing special about me, I usually take painkillers for every little twinge, I don't have an especially high pain threshold, but I wanted to do birth my way and not obey anyone else and not have to fight my corner while in labour (before you say I'm being reckless, I have PhD in birth trauma so I know something about it). It was fine. And I would have been fine transferring in for more pain relief as a friend did, if that was what was needed. A friend had 15 hours of labour at home, the pain got too much, she went in for an epidural, got great care and still had a vaginal birth.
Don't buy into the "what do you know, you've never done it before" line. Read through the homebirth website even if you don't want a homebirth as it will give you lots of facts and figures to help you make your decision.
Best wishes for getting the birth you want.

[Spudulika]

Second a homebirth with CLU for back-up.

"Again, never having had a child I just don't know what to expect!"

No, that's true. But if you can't manage the pain at home you always have the option of going in and having an epidural.

Go in to a CLU 'just in case' you need an epidural and you're far more likely to end up needing one than if you stay at home.

At home you can guarantee one to one care plus access to a birthpool.

[CollieandPup]

My concerns about a homebirth aren't particulary limited to access to drugs. For me, its more about the potential complications and then having a distance to travel. I know someone who did opt for a homebirth first time around and encountered serious complications that put both her and her ds at a significant risk. She had to be transfered at the very last minute and it was touch and go as to whether her ds would make it. My local hospital is about 15-20mins away, but its not really my preferd choice, and there are no birthing centre options. My other options are 30 mins away.

I also think not knowing what to expect is a fair factor to consider. IMO you are less prepared for what is to come, and the potential complications so your judgement and panic is likley to be effected by this is things didn't go to plan - and they seem to tend not to.

Any tips on how to find out the performance and outcomes of each centre and facilities etc - see my post above?

[MoonFaceMamaaaaargh]

collie there is a book published each year i think it,s called "dr fosters good birth guide" which is a big list of the stats for each hospital.

I transfered in from a hb (meconium liquor) and it was all absolutly fine. Ime mw's get you in asap if they even suspect a problem might come up (in my instance delivery revealed, guess what, no meconium!) and are much more likely to spot any issues ariseing as you have min one to one care. (as opposed to hospital where you might not see a mw for ages). This is born out in the stats on relative safety as i understand it.

Please don't panic that "things seen not to" go to plan. I'd really recommend ina may gaskin's guide to child birth. A really empowering read.

[CollieandPup]

moonface thanks i've googled the Dr foster guide and you can get the info online and its just what i was after. Do you have any idea why a hospital would be missing? My closest is not on, neither under MLU or Consultant led

[PrincessJenga]

Ooh, this has moved on a lot since I last checked. Thank you everyone for the extra info. I'll also check out the Dr Foster guide and I've started listing questions for my midwife at our next check up so that I have more of an idea of what the options are. DP has been googling pools for home births so I know where his preferences lie!

[Spudulika]

"and they seem to tend not to."

No - labour often doesn't turn out like we expect it to. Especially if you opt for a hospital birth.

I think it's totally understandible that your friend's experience would have put you off.

But it's important to take on board that there will be other people whose babies will have a really rough ride at birth BECAUSE and not IN SPITE of their mums being in hospital. When there's a near miss in hospital, people never consider that the mother being in a medical environment might have had anything to do with it, but we know that sometimes this does happen, even if it's not possible to pick out individual cases and show a cause and effect relationship between birth environment and a non-progressing labour which eventually leads to fetal distress and a difficult birth.

Would add, that as someone who's transferred in from a difficult homebirth, it's not always the nightmare you'd think it would be. Most women who opt for homebirth but transfer in to hospital during labour would still choose a homebirth with their next baby. They're also still more likely to have a normal birth than women who choose a hospital birth from the outset.

[TadlowDogIncident]

I had DS in a MLU and it struck me as the best of both worlds - nearly as comfortable as being at home, but it would have been really quick and easy to transfer to the main labour ward if things had gone wrong or I'd decided I couldn't cope without an epidural. The thing that swung it for me when I was deciding where to give birth was that DH would have been able to stay with me if I'd needed to be in overnight, and I was far more terrified of being left alone on a postnatal ward with a brand new baby than I was of pain in labour! Another factor is that staff/patient ratios were much better on the MLU, so I had a MW with me throughout my labour, and two there for the delivery.

In fact, I was really lucky, had a very straightforward labour and delivery with gas and air and a pool for pain relief, and we all went home six hours after DS was born .

[Spudulika]

"too many bad things can happen"

Can you think of any sensible explanation why homebirths DON'T have worse outcomes than hospital births TSC? I mean, thousands of babies are born at home every year in the UK. They seem no more likely to die or be harmed than those babies born in hospital.

[Spudulika]

You're not alone TSC. Most people ignore the facts when it comes to forming an opinion on this subject.

[CollieandPup]

tadlow at the moment I think I'd agree with you in that a MLU unit is the best of both worlds but unfortunately that's not an option within my most local health authority. So for now I'm trying to figure out what's on offer elsewhere, and how they compare, and how that balances out the extra distance I'd need to travel. Another friend of mine recently started her labour in a birthing centre but then was transfered after 20 hrs as she needed assistance. It seemed to work well for her, although I know even she questions did she really need all the interventions.

Spud I do get your point about being more likely to have an intervention If in hospital and I have a rl friend who also feels strongly about this. But I also think some of your points are unfair. There are pros and cons to a homebirth and non-homebirth all unique to everyone, so think it's unfair to be so critical of other peoples choices that aren't the same as yours.

To also clarify, I am by no means anti homebith, and nor have I decided against it. In fact at the moment I am less keen on giving birth in my local hospital, but that's why I'm posting on here, to hopefully get all the information I need to help me make the right choice for me.