Low risk women/better birth facilities - unfair?

[Glassofshloer]

When DD was a baby we attended a breastfeeding appointment at my local stand-alone birth centre and WOW! To say it was gorgeous is an understatement - double bed, huge whirlpool bath thing, fairy lights and bouncy balls in every room. Looked like the Ritz compared to the tiny, dimly lit room on the CDU where I gave birth. Just a bed and some wall stickers of flowers

AIBU to think this is unfair on high risk/Consultant led women? And that we all deserve equal facilities, high risk or not? Fully prepared to be told IABU!

Yeah it sucks to be high risk. I gave birth in a tiny room and the wires I was hooked up to meant I could either be on the bed or in a 1m square section of floor. No ability to move around, very limited options for different birthing poses, very stressful and clinical environment compared to the birth center downstairs which offered water births, mood lighting and loads of different birth aids.

I gave birth in a midwife led unit inside a hospital; this current pregnancy is looking like it'll probably end up on labour suite. I do agree with you to an extent but I think it's probably to do with the fact that labour wards are designed "like hospital wards" whereas midwife led units are a bit "freer" in their design allowances? Although our hospital has birth balls in both places (I suppose they might only be brought out in labour ward as needed, and quite a number of mothers might be unable to use one if under continuous monitoring or something?) and there is one water bath in the labour suite (which I guess may have been put in after the ward was originally built). But active birth is definitely encouraged as far as possible in both locations, I suppose "most" women in a midwife led unit would be able to be active wheareas it might be a lower proportion on labour ward? Certainly there are some types of foetal heart monitors that aren't waterproof so if you need one of those you can't be in the bath (our first baby's heartbeat was only monitored at 15 minute intervals during delivery).

This is partly why I have left midwifery.

Resources focused on the demographic that least need it.

High risk women, bame, none English speaking etc directed to Labour ward that desperately needs updating and has no where near enough staff for it to be safe.

If you are high risk your birth has become a medical procedure almost and the wards are designed as such. If you are low risk this isn't the case. So home births and birthing centres births won't be as clinic as they aren't medical procedures as such. If that makes sense.

Well I am due in 3 weeks and I am high risk, I honestly do not care about the room set up as long as I can give me and my baby the best chance of a safe delivery!

Don't low risk women deserve equal access to the back up of rapid access to consultants, theatres, blood bank, paediatricians, and a neonatal unit?

@nocoolnamesleft

Don't low risk women deserve equal access to the back up of rapid access to consultants, theatres, blood bank, paediatricians, and a neonatal unit?

They have it, don’t they? MLUs are usually attached to hospitals and if they feel that strongly about it they can choose to go to the CDU.

YABU. If you're high risk they need the appropriate equipment in the delivery rooms to cope with a high risk birth. On an MLU/birth centre they will only take low risk births so they don't have any of the equipment. Each room only has so much space. Any sign of trouble and you're immediately whisked to the nearest hospital.

The maternity unit in my local hospital is lovely- all private en-suite rooms including ante- and postnatal wards, massive birthing pools (although not in every room so there may not always be one available) birthing balls, big squashy floor mats, you name it.

Not even sure what the point of all the facilities is though. Was only let into birth centre at 9cm dilated (first baby) and 8cm (second baby) by which point I was essentially ready to kneel on the bed and push. No time to try out different things to find the best position and way past the point of mood lighting. I take your point though.

Childbirth seems somewhat underfunded. DC1’s head was visible before a midwife examined me, I had been waiting outside the ward (standing) for two hours.

YANBU but there is also geographical inequality. Our city has a massive teaching hospital serving a wide geographical area with no MLU. Nearest one is an hour’s drive away. Everyone is in a poky room. One birth pool in the whole unit. If someone gets it before you, even if not having a water birth, tough shit.

Entirely agree when I had DD2 I looked at a different hospital. The birthing unit was beautiful and had all the same equipment just hidden behind cupboard doors. The birthing unit was something like call the midwife and the toilets were down the corridor from the birth rooms.

I do see your point. But it’s hard to make a medicalised room look pretty without getting in the way of the wires etc. And clinical space is always sparse in hospitals so the rooms are small.

I started my labour in MLU and was transferred to labour ward just before the end. I would never give birth in a standalone MLU - it was bad enough being transferred along a corridor and up a floor - would hate to be transferred from another site.

By that point I really did not care what the room looked like.

Having been 'low risk' but needed to be blue lighted across several towns to get a consultant I think its unfair that these MLU's exist! I believe they were introduced to save money but everyone should have access to doctors when in labour!

That's how it is in my local hospital too, OP. The m/w birthing unit is attached but beautiful. Huge rooms, aromatherapy equipment, baths, stereo systems, ambient lighting, fridges and kettles, double beds. It was closed when I had my first for refurbishment. DC2 and 3 were riskier so I got lumped into the broom cupboards covered with umpteen layers of peeling gloss painted anaglypta, no windows, not even a fan in 90 degree heat, no access to a fridge for diabetes meds. No real medical equipment in situ either, so it makes feck all sense. Surely if one is prepping for medical intervention, a bit more space would be useful?

I know what you mean, I was allowed into a low risk room briefly whilst being checked over. It was gorgeous, massive in size a huge pool in one corner , sensory lights and music. The room I gave birth in was tiny and full of doctors. I looked at it when the drama was over and thought how crap it was compared to the room you get if they expect you to have a ‘nice birth’. However Plotato is right they only let you in the room when you are about to push anyway so not much point.

Yeah I was destined for grim hospital room just because I had IVF.

My pregnancy turned out to be high risk anyway and I needed several doctors in the room. Being able to have those doctors there was the most important thing obviously. But I would have loved a nicer atmosphere and better facilities. Yanbu.

I feel the absolute opposite and hate that low risk women are fobbed off with fairy lights instead of doctors. It’s why I went private.

Totally agree.

My actual pregnancy has been problem free, no complications, but I was put under consultant led care because of a pre existing condition.
I’m very keen on active birth and would ideally want a water birth.
Looks like I’m going to be denied this just by virtue of having the pre- existing condition.
Even in the hospitals online video promotion it’s depressing- similarly showing an MLU woman in a huge room with sky ceiling, pool, birthing couch, vs a Labour Ward woman strapped to a bed with wires in a cupboard 😞

@nocoolnamesleft

Don't low risk women deserve equal access to the back up of rapid access to consultants, theatres, blood bank, paediatricians, and a neonatal unit?

But you can choose, if low risk you can still opt to go directly to hospital if the unit is standalone, or if the unit is on the site of the hospital you do have those nearby.

I agree OP, I was fortunate enough to be deemed low risk (although the threshold seems to vary, and by no means does high risk translate into needs medical intervention for certain), and the birthing Centre was incredible. Free use of the kitchen, TV room, our own room with a bed for DH as well as for me, a birthing pool, mood lighting, basket of towels and stuff, birthing ball, fan- just an amazing room and chilled atmosphere. Hospital wards look like hell, and as research shows oxytocin helps during labour which is why birthing centres are set up as such; the benefit of that would surely be greater for those who are higher risk. I guess its mainly money, and then staffing as they have driven tonnes of midwives away with rubbish working conditions.

@LakeShoreD

I feel the absolute opposite and hate that low risk women are fobbed off with fairy lights instead of doctors. It’s why I went private.

You can choose, you don't have to use a MLU.

Having been a low risk that went wrong in labour, that wait to see a consultant followed by a wait for an operating theatre wasn't much fun. No amount of mood lighting really helps when you think you both might die.

If that’s what you want when high risk, pay to go privately.

The MLU in our local hospital is the ward next to the labour ward, it takes them less than 30 seconds to transfer you from one to the other. I do agree I wouldn't like to give birth in a standalone MLU but I suppose some women must be happy doing so - it's a bit like a home birth perhaps in the sense that if you do require medical intervention you'll have to be transferred by ambulance?