Home from Home Unit or MLU at hospital?

[Bojangles33]

I'm due to have my first baby in 6 weeks and am deemed low risk so have the option of giving birth at a 'Home from Home' unit at a community hospital or the MLU which is attached to the large acute hospital. I would like to try for a natural birth as possible but obviously being my first I have no idea how I will cope once it gets to it! The HFH is about 15-20 minutes from the hospital and would be attended by community midwives who stay with you throughout, and there is no overnight stay. Once baby is here you get a few hours then discharged - I think this is maybe the scariest bit because I have no idea what I'm doing with a newborn! But on the other hand if i go home I will have DH on hand to help - he is not allowed to stay at the MLU and I know the midwives are so busy there you don't necessarily get much support post birth.

Has anyone got any experiences of a HFH unit or being discharged within a few hours after first birth? Am I being naive thinking I can cope with this?!

[Bojangles33]

Bump?

[NinaMarieP]

Personally I would go for a MLU attached to a hospital.

That's where I started out, was in the pool and had gas and air but my baby's heart rate was worrying them so I was moved - after I'd started pushing - to the delivery suite. It was a three minute journey in a wheelchair and I can't imagine having to be moved to an ambulance and then being driven to another building.

[NinaMarieP]

Oh and I ended up being in for two days after a bad tear.

Best laid plans and all that!

[laelti]

I had the choice of a stand alone MLU or a one attached to a hospital. The hospital one was in a maternity unit also containing the main delivery suite and NICU. Partners could stay the first night, and visit between 10am-10pm. I'm not sure what the standalone's policies were on staying.

I took the one in the hospital - as well as geographically closer I liked the safety net of the hospital! Like you I was hoping for natural but staying open minded. In the hospital one there was always the option of if I decided I needed an epidural I would be moved up the corridor to CDU!

My birth was very straightforward (arrived around 11am and he was born 4.16pm) but baby did need some assistance breathing at birth so they pulled the emergency alarm and a Dr appeared from somewhere. He ended up just needing some help getting his airways cleared and being given some oxygen (done just outside the door) and was back in with us in 20 minutes.

I would assume though that a standalone MLU would also have lots of plans in place for that kind of thing happening. Any issues during labour I think they will transfer you as soon as possible. Baby did have one heart rate dip during labour, but I was told I could stay in the MLU so long as he didn't have a second - I'm not sure if in a standalone one that would mean a transfer straightaway.

Afterwards I stayed in 2 nights and left early in the morning on day 2 - I found the midwives and MCAs really helpful and supportive, though admittedly busy. It was good to have the help to get breast feeding established too. I felt I wanted the reassurance of having them the first night at least!

Can you do tours? They might be able to give you an idea of the post natal set up at the hospital one.

[Bojangles33]

Thanks for your responses.

Yes the home from home unit has all the same kit as the MLU in terms of helping babies with breathing etc and I think you're right that they just have less tolerance for things before transferring you, so if there were heart rate dips I'd probably be taken straight away.

I find I really hard because I feel much more comfortable with the idea of the home from home unit but people keep telling me how short sighted I am being and that I am putting baby in danger by going to the home from home and that it's irresponsible when I have the option of an MLU attached to the hospital. I did a tour of the MLU yesterday and it's fine, but resources are limited (only one birth pool for example) and post natal ward is very cramped and not a nice atmosphere. Obviously I don't want to put me or baby in danger and I know childbirth can be a dangerous business but on the flip side millions of women do it with no problems and with far less medical interventions than we are used to so I just don't know.

[NinaMarieP]

There probably isn't a significant danger in having to be moved to the hospital providing it's a short journey - and transport is available, because as you say they will have a lower tolerance for problems.

It would more be the stress of being transferred I think, or it would be for me anyway.

My MLU only has four rooms, two pools and four postnatal beds. The stand alone units are all 30 miles away in smaller towns so it made no sense for me to go to one, the fifteen minutes to the hospital was bad enough!

[Bojangles33]

Home from Home unit is about 15-20 minutes from the main hospital, so not too far. Just so hard to know what to do because I feel like potentially I can have a much calmer birth there.

[laelti]

I think you hear a disproportionate amount of horror stories - yes things do go wrong but the majority of births are fine. Women have been giving birth for millennia, and for most of history not in hospitals at all.

Obviously it's amazing that we do have the medical provision available now, but even if your in the HFM MLU, you are with experienced medical professionals and you're a short transfer to hospital for the more serious (and hopefully not needed) stuff. You sound like you've done your research and you'd prefer to be in the HFH really, and being comfortable and as relaxed as possible with your location is a good start in labour!

FWIW My MLU had 3 delivery rooms, each with a pool. I think one other was in use when I was admitted (obviously no idea if she was using the pool!).

[Ninjamilo]

Always good to remember as well that how you feel can affect your labour - generally the more calm and relaxed you are, the better labour will be. The more stressed you are, adrenaline kicks in and labour can slow down.

That was a big factor for me as I am petrified of hospitals - I don't think I'd manage a natural birth if I was in an overly medicalised environment so would feel much more comfortable in a HFH unit.

Have a look at some stats around the risks if you're not sure - there really isn't a big difference in outcomes in either.