Step this way to help shape the future of maternity services in England

I wish to be able to choose to have access to adequate pain relief, which includes an epidural, without anyone trying to talk me out of it because I'm 'low risk', or 'won't need it for your second one'. Anaesthesia in childbirth is a basic human right, and I'll be the judge of whether I need it or not. This is particularly important because while a woman can theoretically choose to do without pain relief and there's nothing medical staff can do, choosing anaesthesia requires medical staff to be on board with this. So the ability to access anaethesia is the most important issue regarding women's choices in birth.

Key barriers from preventing women from making the choices they wish to- paternalism. Medical staff being unwilling to honour a woman's request for pain relief, or indeed to do without it. In my case, a midwife simply deciding she didn't want me to have an epidural.

I would also like to see more information provided regarding formula feeding. I was sent home from hospital with a leaflet about care of a newborn that included a great deal of information about how to tell a breastfed baby was having enough or not, but nothing about formula fed babies at all. Outrageous, when over a quarter of mothers leaving hospital are not breastfeeding.

Oh i agree about postnatal care. It's terrible in the UK unless you have some kind of caseload system (like one to one). If you're struggling with feeding, or mental health, or anything really, you might need visits daily which last an hour or more. Not just a quick "everything ok? Good! Bye!"

Which choices do you wish to be able to make about the maternity care you receive?

I'm a healthy, fit, and had a no issue low risk pregnancy.
I intended to have a midwife led water birth. At 20 weeks and 28 weeks I stated that if i reached 42 weeks without going into labour naturally then I wanted a c section. That I would refuse induction.
This information was disregarded. And at 38, 39, 40 and 41 weeks I was told I had to come in for induction.
After spending a whole day in the assessment unit, being told that 'my baby will die' 'that I must have an induction' 'that c section is dangerous and I could die, and that my future reproductive potential would be damaged' although monitoring didn't show any concerns. I eventually relented when the Dr said 'I'll book you in for a c section only if you have a sweep today' even tho I expressed concern that it would break my waters but not start labour.

Waters broke, I had contractions. I came in when they said I had to. They said I wasn't progressing enough? And that was the end of my water birth.
The next 18 hours consisted of me refusing an induction. Every 15-30 minutes they asked me if they could start the induction. I felt like I was loosing my mind. My husband felt like he was loosing his mind.
Eventually there was a shift change, and a c section was agreed.

From that moment the care I recieved was care full. It went brilliantly. I was up and about the next day, my scar healed well, the breast feeding started straight away, and I felt on top of the world.

My birth plan was shown to midwives in my appointments, but never discussed. It wasn't read at all by the midwives and Drs who treated mean the first day I was in labour.
The only person who read and acknowledged it was the Anethetist and Dr who did the c section,
I don't understand why we are asked to write a birth plan if the nhs refuses to consider them.

What are the key barriers preventing women from making the choices that they wish to?
The system. The fact that you see lots of different of staff. There's no continuity of care.
I would have been happier to follow the line had I not been encourgaed during the nhs ante natal classes, to think about, read about and prepare for birth.
But the information I read about natural birth, about natural oxytocin, and our body being ready to do its job, was pretty compelling, and I couldn't see how an induction would give a positive outcome.
Everyone talks about choice, and how we can't be told what to do, but in the end they won't listen to choice unless you stand absolutely solidly.

I would like more family centred postnatal care for high risk women. It seems unfair that women in the MLU who are only in for 6 hours post birth get the nice homely room with the double bed and the high risk women have to stay in the shared ward from hell for days.

Hi, another one in favour of a birth centre in my area! When my mum had me these were a lot more common and I remember visiting my little brother when she was there! It seemed quite friendly compared to going into hospital, which quite frankly I find quite intimidating! I love the idea of a birth centre but fear my nearest one is still too far away! We shall see.

Its I interesting that people are asking for midwife lead units because I have had 5 children, with 13 years between the first and the last, all born at my local midwife lead unit. The experience was fabulous, caring but honest and professional every time. Personally, I felt very vulnerable and inhibited about childbirth, I hate the idea of losing, what I saw as my dignity, but they reassured me by being real people, real women were whatever position I chose, or funny ideas I had about birth, where ok. For example, I didn't want them to announce the gender of my babies, I wanted to find out myself straight after delivery, it was so very special to me. I liked that they chatted away with my dh and I, it seemed to normalise things, putting an ease around the room. I guess what suited me having real, but professional people that don't behave with superiority.

Ditto antenatal breastfeeding support, thats a teally good point.
I would add: consistency in allowing choice of birth method. I requested a c section with dc2 due to previous 3rd degree tear but elcs are refused at my healthcare trust. If i lived somewhere else i could have made that choice.

I would like to see more information about breastfeeding (and getting in touch with breastfeeding groups) in the antenatal classes. Women who wish to breast feed need to know ahead of time who and where to go for support and questions. Trying to find out after the fact when they are sleep deprived and struggling is setting them up to fail. Ditto the induction process - I believe it's a large contributory factor to the UKs high cesarean rate.

Another one in support of birth centres.

I second the request for more birth centres / mlus - there isn't one in my area. If there was I would probably use it but instead I am hoping for a homebirth.

I would like the option to see the same midwife throughout pregnancy.

I would like my own midwife who stays with me throughout labour - this is offered at home births here but not in hospital, and is a key reason why I'd like a homebirth.

Which choices do you wish to be able to make about the maternity care you receive?

I wish there were more choices of stand alone birth centres, run by midwives. There are none which are close enough to me to attend.

Why can't services like one to one (which are paid for by the NHS but run separately) be more widespread?
I wish trusts would look at each others guidelines and have similar ideas (ie, in one hospital a vbac could go to a birth centre, in another they couldn't). There's no consistency and it feels unfair.

What are the key barriers preventing women from making the choices that they wish to?

Lack of resources within the NHS. Not enough funding for birth centres or other services. Being stuck in the dark ages "it's how we've always done it"

I basically want more options than standard nhs midwife care at my gp, and birth in a hospital. Both these things are fine but I know there is more choice in other areas of the UK.