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.

@BatmansBoxers if a healthy woman can give birth to a healthy baby without the need for epidurals, ventouse, forceps, episiotomy, c-section (obviously that's not possible for everyone in every situation) why would it not be the goal? Why would you AIM to have any of those things happen unless completely necessary?
I absolutely accept that it can make women feel like they've 'failed' in some way after intervention, but you have to accept whatever is necessary for mum and baby's health.
But if it's not needed, why wouldn't people want to aim for birth without medical intervention? Wherever that takes place, home, MLU, consultant unit, etc

I got far more support and attention from the midwives at my first baby’s birth in a MLU than I did for dc3 which was a VBAC in hospital. My dc2 was a CS and the hospital was fine for that. It felt as though their focus was very much on births which arent straightforward (like my dc2)

Interestingly one of the midwives in the MLU told me she had far more job satisfaction there than in her previous hospital job because she was able to utilise all her skills and see mums right through pregnancy, Birth and post natal care rather than feeling she was dipping in and out with obstetricians.

Obstetricians have their place, of course, but I found my midwives at the MLU amazing

harper because birth is painful, no matter what. It will also involve vaginal trauma, no matter what. Those things might not be an issue to some people but knowing that it will involve them to some degree at least, why would you not try to limit that? Or counteract it?

Can you please site some good quality evidence for your claims?
I'm a doctor (not obstetrician) and personally wouldn't give birth in a stand alone midwifery led unit, partially because I've had exposure to many birth complications which has skewed my ability to rationalise the decision though.
The majority of evidence suggests that midwife lead births in a unit with close ties (practical and geographical) to a labour ward have the best outcome.

Agree re later scans but this is gradually being introduced and in areas where it isn't routine yet the threshold for extra scans is very low in my experience.

The very word 'medicalised' (and 'intervention' ) implies failure.
Medicine developed to keep people alive and healthy, and to prevent pain. It is a positive thing.
Why would you choose pain over no pain?
The stupid myths around childbirth are what cause the problems. Medical professionals should not be peddling them.

Unless it's a cesarean that should say. That won't involve vaginal trauma as a definite.

Why would you choose pain over no pain?
The stupid myths around childbirth are what cause the problems. Medical professionals should not be peddling them.

I don't know why people would choose pain either!

Well, I’d have to agree. But that’s because things would have gone very badly for me and my baby had I been far from a consultant led unit. I was young, had an uncomplicated pregnancy and was deemed low risk. Turns out the baby was huge (I was quite petite) and got stuck for a few hours of pushing. Because of all the vomiting I was extremely dehydrated and was on a drip, suffered temporary kidney failure and had an unexplained infection in my blood sample. They tried forceps and then eventually an emergency c section and I felt very ill afterwards. I will always be greatful for the care I received and consider myself lucky to have given birth in a university hospital.

Elective c-section Batman. Lovely and medicalised. Almost pain-free.

@BatmansBoxers maybe I'm too blasé about it, but of course vaginal childbirth involves vaginal trauma? How would medical intervention prevent that? Most women tear, I did, and I suppose it was medical intervention that sewed me back up, but that wasn't my 'goal'. I just find it hard to understand why someone would make it their goal to need a lot of intervention. I'd accept whatever was necessary but I wouldn't aim for it?

What do you mean by 'intervention'? Do you think you should have been giving birth alone in a cave?

“Why shouldn’t women aim for a birth without medical I intervention?”

Because generally it’s not something that can be ‘aimed’ for. You either need it or you don’t.

FaFoutis I have had an elective cesarean and I liked mine too. I've never seen anyone who has had one say they hated it.

My attitude to birth is give me all the drugs going, I want to be numb from the waist down and do not want to feel any of it.

I didn’t aim for an emergency c section but if I hadn’t had it then we might have died...but maybe I should have “aimed” higher

And I’m definitely having an elective next time because I’m never putting myself through that again!

@FaFoutis who me?
No I'm not a huge supporter of cave birthing, too many bats, bears, Thai youth football teams for my liking.

No I mean women should be able to give birth somewhere they feel comfortable, the perfect example of that being a MLU.
I think women should be allowed to give birth however they want, with whatever pain relief/doctor/midwife/surgeon supervision they want. I just didn't see why someone was suggesting that the aim should be as medical a birth as possible.

Me too, numb is good.

I really don't understand why you would aim to be in pain and to rip your vagina in half. What are you achieving?

@nos123 to be fair I think you've hit the nail on the head there, I see what you mean, we can 'aim' for wherever we like, it doesn't make much difference when it comes down to it, we'd do what we had to.

'comfortable' - is that what giving birth feels like? This language obscures reality.

Maybe someone could explain to my babies that the time they chose to be born I wasn’t in the “correct” place. Perhaps I should have held them in manually?

Less choice for women, that’s what we want! Not safer procedures, better research, better trained staff, higher quality care. Nope, we just want to restrict women and their freedom to informed choice.

Sorry not read thread but hasn't some new scandal come out in last few days about women being left incontinence... from birth and they are too embarrassed too get help

My birth experience was about as medicalised as it gets - one baby stopped moving, both twins delivered by Emcs, taken nicu, didn’t get to see them at all for hours. But I would never have been allowed to have my twins in either MLU here, even the one right next to the labour ward(literally 30 seconds down a corridor, or less if you’re running!).

Of course things can go wrong even with low risk births. The risks of needing or wanting to transfer are very high with first births, and the risk of adverse outcomes is higher with first births, but with second and subsequent babies and low risk pregnancies the risks are much lower. Women need as much information as possible and then to make their own decisions on that basis- we shouldn’t be forcing women into obstetric units. One of the units here is very much like a home birth and not every women has a safe spacious home that can accommodate a pool or would be a good environment for a birth.

@FaFoutis I think we'd just have to accept that we've had very different experiences of birth and that's that. I don't know what you experienced and you don't know what I did. A comfortable environment to give birth in was entirely plausible/possible for me, I can only speak from my own experience.

But back to the actual thread, I think MLUs and midwives have an important role and shouldn't be done away with.

Just to add for anecdotal evidence.... from moi.
I had two deliveries , one straight forward text book no stitches.. second elc my choice supported by amazing consultant.

The elc suited me far better, it was so much calmer and more organised!!
Afterwards wasn't a walk in the park by any means... but preferable to the in imaginable pain of labor.

I didn’t find giving birth comfortable - it hurt like fuck. But I did find it hugely empowering because I was so well supported in the MLU. If a woman wants to give birth numb from the waist down that’s fine too- her choice. It’s about respecting each other’s choices and not trying to deny others a choice just because it’s different to yours