Midwife-led unit or labour ward for birth: pros, cons and choices

Midwife led unit ONLY if it was attached to a hospital like mine was. I started in MLU and then transferred over to Labour ward. Baby was distressed and I had a crash section. Baby would have died in a home birth or if I was miles from a surgery theatre

Hi I have had both and personally only went with a midwifery led unit second time round because it’s in the same building as the delivery suite / theatres if I needed to be moved or needed intervention. Both my labours were super quick (under 2 hrs) so this escalated for me rapidly and I was left with little options for pain relief other than gas and air. I think if you opt for a midwifery led unit I think choosing one that’s pretty much close by to a delivery suite is a safer option in case you require any intervention. My birth in the midwifery led unit was much calmer and I felt more relaxed even though I was high on gas and air I couldn’t take in my surroundings much during labour. I found afterwards I wasn’t being rushed off to the postnatal ward and could be discharged six hours after delivery if things were fine with all our checks. If I had my choice again I’d still only choose a midwife led unit that was in the same building as a labour / delivery suite so I had options if things progressed and I needed more intervention. You would also want to consider the pain relief options for a midwife led unit as most only offer gas and air and pethidine. Good luck with whatever you choose

And in answer to the question, either Labour ward or MLU attached to a Labour ward. I think it’s important to have fast access to doctors if needed

Across my 3 births - all with epidurals - only my first needed interventions (episiotomy and ventouse), even though my last birth was an induction. With that one I didn’t even need stitches!

That said, I found pushing tough. I don’t know whether that was partly down to the epidurals 🤷‍♀️

But overall, no regrets.

I chose labour ward and if I’m ever lucky enough to have another then I’d pick the same again.
My hopes for labour and delivery were to have it as intervention and pain relief free as possible - BUT I wanted all options to be there if my baby or myself needed.

I know many women choose home birth or midwife led unit as they feel more relaxed not being in the clinical environment but that couldn’t be further from my feelings 😅 Give me somewhere where I know almost any situation can be dealt with there and then 👍🏻☺️

@Shopaholic100 Do you mean you were moved from a midwife unit to a labour ward, which was understaffed?
There's no doubt that midwifery services are stretched and that goes for both MLU and hospital labour wards. I had a very long wait to get into a suite as none were available (baby boom year!) and after one birth I was discharged within 4hrs of giving birth (straightforward delivery obv) - which was probably due to the conveyor belt of others coming in but it was exactly what I wanted at the time.
I stayed in for a few nights with my first as there were a few health concerns and I felt very unsupported actually. It does feel like a lottery unfortunately, which is exactly why the midwives i know have left the job.

Excellent experiences of a midwife led unit within a hospital, although wish that I'd been brave enough to have home births.

I had one of each. Induction is what caused my issues, but they tried to suggest an unnecessary intervention without even considering my lack of consent (I had made it clear I wanted anything tried before this one thing) and it was not needed.
MLU was a great experience but it was above the labour ward in the hospital so didn't really need to concern myself with transfers etc.
I would not give birth at home due to the ambulance delays these days, and I wouldn't use a MLU if it was not in the main obstetrics hospital for the same reason.

I had two inductions and two water births - first in the MLU, second on labour ward (because my waters had broken early so they wanted to do continuous monitoring).

So just to counter some things that have been said on the thread - labour ward doesn’t automatically mean no water birth (obviously check your hospital) and inductions don’t always mean an epidural is necessary (albeit I just had gel both times - I think drip is much worse).

My actual birth experiences were almost identical. I had gas and air both times, smooth fast labours, being in water was amazing. The difference was that post-birth the MLU was SO much nicer. I got to stay in the delivery room overnight as it wasn’t needed, so DH and I had a large double bed and en suite, vs the hell of the post natal ward second time round.

At my hospital the MLU is essentially next door to the labour ward, so everything was on hand if there was an emergency. I wouldn’t have gone for a stand-alone MLU I don’t think, but I’d always opt for it as a first choice if given the choice and if the labour ward was close by.

First was hospital ward - chaos, noisy, dirty bathrooms, horrible ward.

After that mw led unit all the way. Calm, peaceful, birthing pool, quiet.

I gave birth at St Georges in London and they ran a study where everyone got a 36w scan as standard. It massively reduced surprise breeches and other issues. NICE were supposed to be looking at it to consider implementing it in the guidelines but ive no idea when they will make a decision.

Pesky indecisive babies 😆

I've had both and would say they were both midwife led.

My first I arrived at hospital fully dilated got into the pool in the midwife led unit and gave birth within the hour. I was grateful that it was in the same building as the maternity ward as I have birth to a rush of drs and nurses coming into the room. The midwife had pushed the emergency button as her shoulder was stuck, she was able to free it and she was born without issues. I had 2 paracetamol in early labour and some gas and air for the delivery.

My second was an induction on the labour ward. I had one midwife looking after me during the induction. She read me quite quickly and realised I'm a "quiet one" so even when I wasn't showing obvious signs of things getting too much she listened to me. She removed the pessetry after 4h as I was at risk of hyper stimulating and I was moved to the labour ward once the paracetamol I had had wasn't quite enough. I then had gas and air through out the labour. I only saw the Drs when they came for ward round. I asked about some blood results they were monitoring which had led me to be induced and didn't see them again. I had 4 midwives over the course for 6h. The majority of the time it was a student midwife and midwife 1 except when they went on their lunch break, midwife 2 covered the lunch break. Baby went into distress as midwife 1 came back from lunch break so the head midwife joined them for a bit. They determined baby was ok but needed to be born quickly and that this was likely. The head midwife left and the student and midwives 1 and 2 stayed until he was born.

I had 2 stitches with my daughter and none with my son. I had a shower, tea and toast with both and then went to the ward. The only difference between the two really was one was in a pool and the other on the bed. I would only give birth in a midwife led unit if it the hospital ward was readily available, both my labours were on the edge of needing intervention. My son was born blue and with the cord tightly around his neck which was causing the distress and a friend's son was born full term but not breathing and was whisked off to the NICU before she could ask if she has had a boy or a girl.

Planned C section.

All women are different and their choices will be different, too.

As a HCP myself I chose a midwife led unit attached to labout ward. I had easy births with gas, but we'll aware of risks and didn't want to need blue lighting to another hospital if baby or I were in a life threatening condition.

Midwife if low risk though ideally in a hospital annex! I didn’t need pain medication, not all women do, the ball was sufficient

I actually did have a late private scan at almost 40 weeks to check her position and she was not back to back!

All credit to the hospital, they did scan me twice when I was in labour and her heart rate started to show decelerations. The first time she was back to back and then she half turned.

I think it depends what sort of birth you are wanting but for me I wanted low intervention so would go midwife led - or homebirth.

My first was an induction, I was given diamorphine as I didnt feel able to cope and wasn't believed when I reached the pushing stage. I felt so out of it when baby was born and upset at the whole process.

My second birth was a homebirth, born 5 minutes before the midwives arrived. I felt so much more able to cope and calmer, felt so aware of everything my body was doing and the joy when he was born was amazing

If your local hospital is like mine then don’t get too hung up on the Midwife Led Unit (if that’s what you decide upon) as if the maternity department are short staffed, which they often are, the staff and you will end up on the main one anyway so they can shut the MLU and prioritise keeping one ward fully open.

Same thing different country.

we just pay with taxes as opposed to health insurance.

also check out Kemi Birth joy Johnson on Instagram.

Yes I wish we had late scans as standard, for this and lots of other reasons. Many other countries do. Although to be fair babies can change position even very late in pregnancy.