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!

I agree OP. It shouldn’t have to be a choice between appropriate medical care on hand and an environment that’s conducive to giving birth. Yes, a hospital is going to look more clinical because they have more equipment but that shouldn’t stop them from making it feel like a safe and comfortable space.

I think some hospitals do actually get this right though. The one that I chose for DD, and will use again for current pregnancy, is in a hospital but has the feel of a MLU with individual rooms with pools, dim lighting, etc. We’re just lucky though I think that we happen to be close to this particular hospital, as many other have to choose between hospital care vs MLU comfort.

@Wagglerock

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.

Has anyone said it does? I think a lot of people are being (probably purposefully) obtuse. OP is highlighting the disparity of facilities between low risk and high risk women, and actually the ironic thing is that here you're much more likely to get one to one or a very low ratio of midwife care if in a MLU, and low risk. You'd think it would be the other way around, and that the research for what is conducive during labour would be considered for both sets, especially as risk is often calculated by some arbitrary tick box somewhere along the way.

Although the space in labour rooms is often limited and more clinical looking, you can ask for the lights in the room to be dimly lit (there will be lights the MW can adjust so she can write her notes and do her checks on you), if they cant be dimly lit you could take those battery operated candles. You can also play music through your phone, stick it in a cup or take a portable speaker.

Also if you’re not having a epidural there is nothing stopping you from getting off the bed and standing up and moving around the bed if you’re hooked up to monitors and drips, or asking for a ball, or a mat to get on the floor.

You can also change the position of the bed and get on all fours and move position etc.

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

That’s completely unrealistic for 99% of women. Not being able to afford private care shouldn’t mean poor care. And I think that’s exactly what women get when their complete needs are not considered.

Totally agree. My birth had complications which meant I underwent a few procedures while in hospital and wasn’t allowed to stay in the low risk ward. I had very poor breastfeeding support and my birth partner was removed 2 hours after the birth. Friends of mine who gave birth in the low risk ward had a very different experience. Lactation consultants spending hours with them for support, partners were allowed to stay all day after birth.

@StripeyBadger

I’d happily pay to go private however that only seems to be an option in London.

@mummyh2016

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.

But the wards could easily incorporate things like mood lighting/aromatherapy etc without compromising any of the equipment required in the high risk rooms?

I got to go into a low risk MLU room briefly but had to be transferred to consultant led ward. Thankfully I’d packed my own incense/lights etc so was able to make the room look just as nice but otherwise would have been very depressing! My room wasn’t small though so sounds like I was luckier than some!

@Cosmois

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.

Not necessarily. Take a woman who has to go to CDU because of a condition like GD, who has had multiple straightforward births before, no other issues - she’s far more likely to have another intervention-free birth than a first time mum in a midwife led unit.

My local hospital is like this too. The MLU is attached to the labour ward, just separated by double doors. The MLU is like a spa in comparison, but very small and can only accommodate 2 labouring women at a time.

I ended up having DC1 on the labour ward (not by choice - ended up bullied into a wholly unnecessary induction), and thanked my lucky stars that my next two pregnancies were as low risk as they come, so I chose to give birth at home rather than return to the hospital hoping for the MLU, find it full and end up on the labour ward production line again

The room I was in was done up nicely. It had fairy lights and nice lighting. Sure I wish I had an option of the water birth as those baths look nice but given the situation I think they did well with the labour ward I was on.

I wasn't high risk and ended up in a shitty hospital

Yanbu. I was high risk for dc3, dc4 and dc5. I felt that the low risk women got all the "nice" things in the mlu. It was worse when I had a baby in neonatal. I was trying to establish breastfeeding my 4 day old baby and they wanted me to go home without him.

@Helporhindrance07 actually the delivery suite at my second closest hospital has brought in something like this, they've had a midwife start there who used to work on the MLU of my closest hospital. This has been done using only a box of LED lights, flameless candles and a light projector. People could always do this themselves and take the items with them for the birth if they feel that strongly that they want it need it. My comment was more relating to the double beds and birth pools - the rooms would need to be larger if they are expected to accommodate these plus the usual equipment on a delivery suite.

What a silly comment. This is not the case at all, you can choose where to birth your baby.

I had a long traumatic birth with my first born, in an small room, in an old maternity hospital.. I wasn't a high risk for my second child born three years later, but she was born on the back seat of our car, that was full of dog hairs, that our dog had been jumping around on the previous day, I don't do fancy !!

In my trust the CLU had the fancier facilities - I had my post birth shower in the fanciest room. The MLU on the hospital site was dingy and dark and miserable compared with the new and light CLU post natal area.

At my unit the MLU isalways closed due to staffing. Hasn’t been open in months so everyone goes to labour ward. Once there, staffing levels are dangerously low so no one really gets the care they need.
Maternity is so underfunded and understaffed. If men had to experience the woeful care, it would have been sorted by now.
Please write to MPs and explain the poor care, lack of facilities etc.

DS1 was a last minute EMCS after a long labour. I was transferred for observations in the pushing stages and had a horrid phase of being beached up on my back, desperate and unable to move as the fug of pethadine wore off. I'd barely been able to stand due to SPD anyway and wasn't offered help to get into a more comfortable position and that was one of the more lucid moments in the patchy memory mosaic of things spiralling out of control.

DS2 was automatically a high-risk birth as a VBAC and it seemed that by default it would have to put me back into the moment I often flashbacked to.
Fortunately I ended up seeking help and got good antenatal support and a good MW for DS2's birth. We managed to combine the monitoring with rearranging the furniture to make space for a birthing ball and mat to get more comfortable. As it was, I ended up in theatre for the actual delivery, but my memories of labour are much more positive through a bit of effort to get more comfortable. We'd also made it to the MP3 era and got the hypnobirthing tracks looping which also helped... the MW too... she said after that it kept her calm as we reached the panic moment Despite another difficult emergency delivery (rough forceps) it was not a traumatic birth because the MW kept talking to me quietly so I understood what was unfolding, and because she did her best in accommodating things that made me comfortable and gave some autonomy.

What's really frustrating is that there is often equipment such as wireless monitoring but the availability of it functioning or free to use is a lottery and pretty poor odds on getting lucky.

Not all high risk labours are equal and it doesn't take much adjustment or expense to create a calmer atmosphere which can make a difference in a labour going smoothly and can certainly affect the mental processing of birth.

In our hospital the MLU is downstairs next to the entrance whereas the labour ward is two floors up, which I've always found a bit odd for the poor women having to shlep up there in labour. The MLU seems almost permanently empty though, as the entrance criteria is so harsh most women are not allowed to even try their facilities.

I was gutted when I had a bleed and had to go to the Labour ward to be induced, rather than give birth in the lovely midwife-led unit. I cried when I went up to the ward alone afterwards and had a horrendous night alone while a woman in the bed opposite had a (female) visitor all night who snored in the chair and their baby kept crying, waking my newborn up. Instead of the double bed in a private room in the MLU where my husband could have stayed too.

@mummyh2016

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.

But a lot of ‘high risk’ births sort of aren’t - like in my previous example, a woman with previous straightforward births has a much better chance of another one even if she has (for example) gestational diabetes, than a first time mum in an MLU.

If the first time mum is more likely to need intervention I don’t see why she goes to the MLU, while the second or third time mum with better odds of a straightforward birth goes to the CDU?

Even if the delivery bit needs to be a bit clinical, I can't see why they can't make post natal a bit more like the birthing units - better decor, double beds etc.

The bedside medical equipment is pretty minimal in part natal anyway, and can be hid in a cupboard.

I can imagine a community fundraiser to decorate the post natal rooms to make them more comfortable, would actually do quite well given its used by the whole community.

There shouldn't be a choice between attractive facilities and safe facilities.

The outrageous thing is that money’s spent on fairy lights and double beds and not more midwives. It

I see what you’re saying. But if you’re hight risk, then it’s probably best to go to the hospital and come home alive and with a baby. You could always buy fairy light for your bedroom if you like them.
If it’s any consolation, i didnt enjoy any of the nice extras as I was only admitted at the last minute!

@Outfoxedbyrabbits

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?

The whole thing makes no sense to me. The main issue around maternity seems to be a lack of funds, but MLUs seem to hardly let anyone through their doors, and the mothers they do take have a 50% ish transfer rate if they’re a first time mum. My friend went to a stand-alone MLU for her first baby, and had to wait over an hour during the pushing stage for an ambulance transfer to CDU which was a 30 minute journey. That can’t have been cheap.

I also know a stand-alone MLU which has recently shut down due to lack of use, it seems such a waste that it was staffed by midwives 24 hours a day for little purpose.