Travelling more than 45 mins to hospital in Labour - experiences please.

(31 Posts)
CouncillorRebeccaHanson Mon 17-Oct-16 21:14:48

Dear Mums,

I'm a councillor in West Cumbria. We're currently going through a consultation to establish the implications of suspending maternity services at West Cumberland Hospital (due to deteriorating staffing problems more than cuts). This will mean that the mums living here who want a hospital birth (typically 3 mums a day) will need to travel between 45 and 90 mins to hospital along twisty roads. That's best case scenario on a very good run - it could be much longer.

There's incredibly little research available on the impact of journey times over 45 mins on childbirth.

I'd be tremendously grateful if mums who had to make journeys during labour which were always going to take at least 45 minutes and which were at least 25 miles could possibly share their experiences.

How far did you travel? How long did you take? Do you think that your journey length had an impact on the decisions you made or on the progress of your labour?

I understand that it's really hard to tease apart any effect of your journey from the impact of other factors so if you can't do that don't worry, just try to describe what happened over all.

Thanks, Rebecca

Nuttypops Tue 18-Oct-16 22:38:59

We had to travel about 30 miles to our nearest maternity hospital when I had DD. The local midwife led unit had been closed for similar reasons, so a home birth or the hospital 30 miles was our only option. It took about 60-75 mins, depends on traffic and road conditions. We lived rurally in an area with twisty, dodgy roads at the time and DD was born on a very foggy, wintery Nov weekend so road conditions were not the best.

I made the decision to go into hospital probably earlier than I would have had we lived closer. I was happy at home but concerned about travelling in the middle of the night and being delayed or roads being closed as they were fairly often due to accidents or weather conditions in the local area. I do think the decision to go in when I did, at 5cm dilated, contributed to the decision for me to have the syntocin drip shortly after arriving as staff were worried DD was taking too long. 10 hours later, DD was eventually pulled out via forceps. I lost a lot of blood following her birth and required blood transfusions and a few nights in hospital, DD was thankfully fine. It is hard to know, but I think had I been able to go in slightly later, my labour may not have stalled and I might have required less intervention.

GraceGrape Tue 18-Oct-16 22:45:24

That sounds awful. I had a 15 minute journey and it was horrendous both times. The car is NOT the best place for a labouring woman. Having said that, I was in well-established labour as my hospital wouldn't let me come in any sooner. It might be workable if the hospitals in question were told they must admit women from outlying areas in early labour. Even then there will be problems with women who have quick labours.Could the trust or council might be deemed liable if something happened to a mother or baby because they had to travel a long distance to hospital?

GraceGrape Tue 18-Oct-16 22:47:21

Sorry, just re-read and realised you specifically wanted stories of women who had to travel a long distance.

frikadela01 Tue 18-Oct-16 22:52:16

I can't speak from experience since my hospital is only 15 minutes away. However I imagine you'd have a higher number of women labouring in hospital for much longer than if the hospital was closer. As Nutty said she went earlier than was probably necessary because of the distance and risk of traffic etc. And it's not like you can realisticly send women who aren't far along home if it's a long journey.

Are all maternity services possibly moving? Because you also have to bare in mind antenatal care like day clinics, ultrasounds etc. What's the local demographics like? If it's a poorer area then cutting access to services can have quite a profound affect.

CouncillorRebeccaHanson Tue 18-Oct-16 22:56:14

Thanks so much for your post Nuttypops - that's hugely helpful.

GraceGrape that's also for your comments and don't worry at all. I think I'm going to have to relaxt the restrictions as, to be honest, I don't think I'm going to get very many examples because I don't think it happens often.

Besides which - cyberspace if free - it's not going to fill up. So chat away! grin

CouncillorRebeccaHanson Tue 18-Oct-16 22:59:36

my own experience is of 40 minute transfers. At 2cm dilated and with regular contractions I tried to transfer but kicked out of labour and ended up having to go home again and giving birth 2 days later. With another child I left it later to avoid the same problem but only just made it to hospital. I think with longer journeys you're more likely to kick out of labour even if you're going along well but you need to leave earlier because you've got a longer journey.... but I really want to hear other people's experiences and I'd particularly like to hear from people who made journeys of over an hour without any problems.

CouncillorRebeccaHanson Tue 18-Oct-16 23:08:24

Thanks also for your comments frikadela01. I think it's most likely well be left wtih midwife led services in West Cumbria and clinics could also be run by consultants visiting from other hospitals - if anyone can recruit any. Yes West Cumbria has some areas of substantial deprivation.

There are two main drivers in this - one is the national recruiting crisis for consultant obstetricians and paediatricians. Their conditions are much better in large urban hospitals than in rural ones so the rural ones are particularly badly hit and we're running on locums which is bad.

The other driver is the impending funding crisis in the NHS combined with the fact that no allowance is made in NHS funding for rurality so in an urban area you can provide 1 hospital to serve twice Cumbria's population. In Cumbria we really need 4 but manage with 3 as people in the south-east of the county go to Lancaster. So it's vastly more expensive to run but that isn't funded. North Devon are facing the same consultation issues.

Penhacked Tue 18-Oct-16 23:14:44

I didn't want a hospital birth, I wanted a home birth, but if your nearest hospital is 50 mins away, you would be in serious trouble if they needed to blue light you.

It was my second baby, but so I was very stressed about labour being fast as my first had been, so I had to go at the first contractions. This led to the contractions fading again as I finished the long journey but being stuck in hospital. The doctors wisely let me sleep on a ward rather than putting me in a Labour suite but this meant I ended up labouring on a ward which is really awyl, because basically I couldn't risk or cope with the journey back and forth in the car. It also meant I had to leave my toddler Ds with friends for two nights which didn't help my stress levels.

The journey was ok because it was very early in my labour but it was a mental stress during pregnancy

Penhacked Tue 18-Oct-16 23:17:57

Sorry 34 miles and 50/55mins

frikadela01 Tue 18-Oct-16 23:30:30

Also what's the funding like for the ambulance service around there? Because I imagine there would potentially be more calls to them if people don't drive.

I imagine planning any healthcare for rural populations is an absolute nightmare. I don't envy you.

CouncillorRebeccaHanson Tue 18-Oct-16 23:32:16

Thank you Penhacked.

For anyone reading this thread who's got a 40 min journey I'd like to add that I ended up with 2 fabulous birth experiences.

I've just always been aware that I think if I'd gone further it would have been different. Not necessarily terrible but I think I would have had to labour almost completely in hospital and I was not good at early to middle stage labour in hospital.

Penhacked Tue 18-Oct-16 23:53:51

Yes, my birth was also really positive eventually with no interventions.

I would say, I don't live in the UK, I live in a mountain community in italy. It may help to post on forums like alfemminile (just post in English) and ask the question there, because it is much more common in italy to have that kind of journey as there are a lot of rural communities.

GiddyOnZackHunt Wed 19-Oct-16 00:02:27

My journey to hospital in labour with dc1 was about 35 minutes at 6am. On main roads. My waters didn't break and sitting down was agony (I stood up for most of my labour). I don't think I could have gone much longer wedged into the car.

Redkite10a Wed 19-Oct-16 09:02:42

I live in north Buckinghamshire and it's a minimum of a 45 min drive and 21 miles to our nearest NHS trust hospital. It's the other side of Aylesbury centre so in rush hour it has taken us up to 1 hour 15. There is a closer hospital in a different trust only 20 min away (outside rush hour) but it has a bad reputation. I'd guess based on my pregnancy yoga class that over 50% choose this hospital, less than 25% the closer one with a bad reputation, and the rest a couple of other hospitals in different trusts (both at least 45 min away). The nearest midwife led unit is co-located at our nearest NHS trust hospital.

It's been a bit of a pain for scans - not so much for me as I get the time off, but it makes it hard for my husband to come without taking either holiday or unpaid time off work.

I was admitted into the HDU at about 28 weeks for a couple of nights and what was difficult was the distance made it impossible for my DH and DS to pop in for short visits which is all my then 19 month old DS could cope with. I found it scary having to be by myself when that ill, and I don't want to think about how it will be if I have to be admitted after this baby is born (39 weeks now, planning a homebirth).

Friends who've had theirs there say the drive in labour isn't great but you just have to go in earlier. What is apparently more of a pain is if you have to stay in, or keep going back for any reason (e.g. breastfeeding clinics).

frikadela01 Wed 19-Oct-16 09:08:33

Might be an idea to post this on scotsnet. Considering when I went on holiday there it was 45 minutes to the nearest supermarket I imagine some women are doing pretty long drives to the maternity hospitals. Could get some good perspectives.

OvariesForgotHerPassword Wed 19-Oct-16 09:11:42

I know my mum had to travel two hours through a storm while in labour with my sister. My sister was fine but I think my mum thought she was going to give birth in the car (although that's probably more to do with my dad not taking her to hospital until he'd finished checking his emails...).

InTheseFlipFlops Wed 19-Oct-16 09:26:23

I was just over 45 mins away in no traffic up to 2 in rush hour. It was ok, but i did go in earlier then i would have done if i was closer. Although i knew i would be in for the long haul i was worried about the journey. Quite a few friends who were pregnant at the same time (different hospitals) were sent home in early labour and told to come back. How would that work? I didn't have any appointments (just 2 scans when pregnant) as i was lost on the system, but it would have caused problems with work
What about anyone who ends up with a baby in SCBU Being that far away from home or your baby would be really hard

Shiftymake Wed 19-Oct-16 09:26:44

I live about 45 minutes away depending on traffic as they had shut down the maternity ward in the hospital that lays 5 minutes away, ended up with a home/street birth because I could no longer be moved due to the hospital pushing my partner to keep us at home "until the waters broke". Water broke 5-10 minutes before delivery... Thankfully paramedics managed to get here on time (literally! the head was coming when they sped around the corner) and the midwife within 20 mins after delivery. Not ideal and I am still fuming at the hospital.

CouncillorRebeccaHanson Wed 19-Oct-16 10:25:31

Thanks for all these comments ladies. I'm just getting ready to go through to the next consultation in Whitehaven.

I'm in London so didn't have a long journey in terms of distance - the hospital I was booked in at was only 6 miles away but the time could vary hugely depending on when I went in, so I had to take that into consideration when deciding when to leave. I chose to go earlier than I maybe needed to with my first to avoid the morning rush hour (and still spent 45 minutes in the car!) With my third my waters broke and we had to do the rush hour, and I think it took an hour/hour 15. TBH I don't remember much, I was trying to breath through the contractions and not panic my poor mother (who was driving)
However, it was my choice to continue going to the further hospital - my local one was not brilliant, and travelling further was far far better than labouring there.

XinnaJane Wed 19-Oct-16 10:59:23

A big problem with these sorts of cuts is access to home birth. I live in a rural county with similar staffing issues and you basically can't get a home birth here. This is shocking when you think about it, because the evidence shows that it is the safest option for low risk second-time mothers. In what other part of the NHS would it be acceptable for the safest option to be unavailable due to staffing?

InTheDessert Wed 19-Oct-16 11:16:19

It was 25 mins to hospital. I never made it there. My second child was an unexpected bathroom floor delivery. I had 2 and a half hours from first contraction to having a baby in my arms. The proposal above would mean I would have needed to set off as soon as labour started. And what then if I'd had a long labour??
How would you deal with women like me who labour fast? (were not having a third, but the paramedics and midwife left me under strict instructions to have any further deliveries as planned home births - the first paramedic arrived, delivered my son, the second found the Entonox and came upstairs after I'd delivered.)

InTheseFlipFlops Wed 19-Oct-16 13:02:49

It also takes away choice, some ladies on this post have made the choice to be at a further hospital, if your nearest is 45 minutes you have to take that regardless of the care that hospital can provide.

Cherylene Wed 19-Oct-16 13:33:08

We had a similar consultation in East Suffolk when they changed things so that all heart attacks went to centres outside of Suffolk - Norfolk and Norwich, Addenbrooks (Cambridge) and Basildon (I think - somewhere at the far end of Essex. For gold standard treatment, instead of an injection by the paramedics, you were supposed to have surgery within a certain time (1 hour?) as soon as you reached the hospital. But you could not be given the injection if you were to have the op.

Trouble is, it takes more than an hour to reach any of these places when the traffic is good, and mostly it is not good. The roads are all bad, mostly only 2 carriageways where they are not single and all routes would require crossing the Orwell Bridge which is sometimes closed. Also, the ambulance has to get to you first, which is extra time.

There was a campaign and in the end, they moved the centres out and people in Suffolk were to receive the injection and be operated on the next day.

It worries me about the maternity services because often they will not let you come in until they 'think' you are in labour. I had quite a difficult battle to get into hospital with early twins, having had a 3hr first labour. A long journey would have made my DH apoplectic! They would need to change the way they deal with people and have space and facilities for people to labour in hospital, rather than be sent home.

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