To think we should do away with midwife led birth centres

[Orangecandycane]

..let doctors lead the care for pregnant mothers and introduce third trimester scans for all? Maybe this could help reduce the high level of still births in this country compared to many other european countries.

Often as many as a third of women who are first time mums have to get transferred to hospital from a midwife led unit and the time taken for the transfer can be dangerous for mum and / or baby. I dont care if the majority of births at these places are okay or if they are cheaper to run, because im not talking about widgets im talking about human beings - babies and mums dying or babies suffering brain damage because mums are given the choice to give birth somewhere that has got neither the staff nor the equipment neccessary to save lives.

They should all get shut down imo, the sooner the better and midwives should not be given responsibility for overseeing what they deem to be low risk pregnancies...there should always be a doctor on hand to supervise who has the ability, if neccessary, to carry out an emergency csection.

I know doctors make mistakes too but so many women i talk to have been let down by rubbish midwives. Let the doctors assess the risk level of pregnancies, scan women in the third trimester when so many complications go undetected, let surgeons repair tears so women dont need to go back for painful revision surgery after a midwife has made a mess of stitches and ensure that all women give birth in a hospital with scbu or nicu...hippy BS like candles and home birth becomes meaningless if your baby ends up dying because i think as a nation we have forgotten just how dangerous child birth still is...and we should be reminding mothers to be that its dangerous and also considering the needs of the baby.

At what point did I say giving birth was comfortable??? I think women should be allowed to give birth in a place they feel comfortable with! Aka they feel happier being there. Which might be an MLU

One more thing, I'm all for women being given facts. so I think every woman needs too be given feedback form and follow up tracking after births so once and for all we can get true feedbacks on injury from birth.

Because women that then Go too doctor with issues.... Doesn't get linked back too the birth.... we need proper long term study's.

Fighting in the dark right now.

It's first time mothers who have bought into the myths that I worry about.
If you have experienced birth before then maybe you are in a position to make the choice of a MLU.

I've always found the stat that something like 75% of women tear as a horrible thing.

IIRC ELCS due to maternal request have the highest satisfaction rate, certainly the case for me!

I don't actually think MLU as long as attached to a hospital are a bad idea, I just don't necessarily believe they're particularly feasible as there's simply not enough midwives. I feel the same way about home births as well, though obviously that's a different kettle of fish.

Ideally, we'd have enough staff, better care and conditions in a hospital as well so MLU become fairly redundant. So you could get the lovely, relaxed atmosphere if it helps, but with medical care on standby. Or hell, both whale music and an epidural.

But I think you've got to take into account the scope or the different degrees to that statistic. It might be that 75% of women tear (I don't know, I've not looked it up) and some of those tears will be third degree and cause long lasting damage, which of course is horrendous, but an awful lot of them won't be that serious and will heal relatively quickly and not cause further issues.
How would you prevent women from tearing in childbirth? I feel like it's just a reality of the process? What steps can be taken to stop it? I'm genuinely asking as I don't know if there are any?

MLUs attached to Labor wards are useful and amazing. MLU’s miles away from hospitals are dangerous. They give a false sense of security and I don’t think first time mothers are fully informed of the risk of them. With my first It was told to me as ‘you’re low risk therefore you have the luxury of being able to go to the birth centre’ they painted this amazing image and said the only downside is not as wide range of pain relief.
Had I known how common it is for things to go wrong and how dangerous it is not being near a hospital, I would never have considered it.
It’s putting woman in danger (which is fine if they’re fully informed and want to make that choice) but ultimately it’s down to cost cutting at the detriment of woman and babies.

C-section harper. No vaginal tears from that.

That statistic is terrible.

There’s definitely room for improvement. I’d like to at least see the same midwife more than once for instance. Likewise, woman’s birth choices should be respected. For many women the mlu is what they want (if all goes to plan. Most are attached to the hospital for emergencies and many births are straight forward.

However, I felt a bit ‘forced’ to go down this path when in all honesty I wanted an epidural! In the end I had no time as my son flew out within and hour and a half of being in hospital. However,I was certainly told that I could not plan for an epidural I could just request one when I was admitted (to the mlu). Woman who want pain relief or a section are bullied out of it under the guise of ‘nature being better’ but I am sure cost has something to do with it. Midwives have a lot of power to push their agenda but it should be mothers choice.

You think every woman who gives birth in the uk should have a c-section? To avoid vaginal tearing? 🤨
I think anyone who wants a c-section should be able to have one, or be given the opportunity. I think anyone who wants to give birth in a MLU should be able to do so, or be given the opportunity.
I don't think you and I can have a rational conversation about this so nighty night.

Seaseasea this!

It's not truly offering women an option if you only offer the downsides of one option (usually c section) and paint the other as risk free.

At my NHS antenatal classes, they glossed completely over potential injuries from instrumental births and the midwife running it explained they're not allowed to go into that.

Same with formula feeding!

The midwife running it was perfectly nice so I kinda doubt it was her choice.

I’d like to at least see the same midwife more than once for instance.

This is being addressed - there’s a national deadline for 20% of women having continuity of carer through pregnancy, intrapartum and postnatal (possibly later this year or next year, I can’t remember), and then a further deadline for the majority of women to receive this. There’s lots of scrambling going on to try and make this happen.

I had a home birth and would again. I wouldn't go to a hospital unless absolutely desperate.

I gave birth to my first in a MLU but was floor below the doctor led unit with the highest level of NICU on site. Everything was straight forward and never even made the ward before being discharged.
I know there were more babies born it maternity triage at the hospital I gave birth in that in a stand alone MLU in another hospital.

MLU have their place and if they had a high rate of abverse outcomes they would be shut down.

seaseasea I think what you and a lot of others are missing though is that for women who live in rural areas the option of having a stand-alone MLU is still better than having a 1-2 hr journey to the nearest hospital.

If things start go wrong I would much rather be at a MLU waiting for an ambulance transfer than on the hard shoulder of a motorway with only my DP.

It's an hour and a half in quiet traffic to my nearest CLU, 30 mins to my nearest MLU. If I didn't have the option of the standalone MLU DC2 would almost certainly have been born by the side of the road.

Babies being born in ambulances and cars is a reasonably regular thing in this area for that very reason as the MLU has pretty strict criteria as it is.

pastabest I do wonder what the solution for this should be- obviously ideally they'd have a small, fully functional unit including drs and an anaesthetist for epidurals etc

I live in a rural area...they have closed several of the MLU, and the recommendation was either home births or hospital.
I had to be hospital as high risk, however, the hospital is now over stretched with not enough beds at times. I also worry with the distance to the hospital. My landlady only made it in time because she ignored the midwife who told her over the phone to leave coming in until later when labour had progressed...had she left it, as she said, the speed that the baby arrived would have meant that she had the baby on the A30.
I don't see the problem for low risk births, especially as if things go down hill the ambulance to get them to hospital will know where to find them (another issue with living rurally - when DH was ill, and we had ambulances out in several occasions, twice they couldn't find us)

It just wouldn't be financially viable though.

The MLU I had DC1 at had about 200 births that year. The one I had DC2 at only had 23 that year. Both were attached to community hospitals with no other maternity services.

They were staffed by community midwives on an on call basis.

It was made very clear to me what the risks were in using a MLU. it was also made clear what the processes were if stuff started going wrong. For me MLU was an acceptable compromise over a very long car journey whilst in labour for two low risk pregnancies.

I note that most of the people saying they or their DC might have died had they given birth in an MLU start their post saying they were pushing for hours... No way that would ever happen in an MLU you'd have been transferred long before and probably been escalated to other interventions sooner as the midwives would have recognised the labour was failing to progress a lot earlier than a different midwife popping into your room occasionally!