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!

@Glassofshloer

Of course *@JoborPlay*

But there seems to be a real cascade of intervention - one (reasonably minor) condition, let’s say marginally high blood pressure or asthma, leads to CDU. Which means no pool & time pressures. Which means more likely to need a theatre/instrumental delivery. Which means more likely to have PND or birth injuries. Which means more likely a repeat c-section etc. An on it goes.

Of course any woman that requests a c section should have one, I don’t think they should need to make a case for it as long as they understand the risks.

But looking back, had I been sent to the MLU after having my waters broken (or been given the same treatment as an MLU mum rather), there’s every chance I would’ve had a much better birth and taken up less NHS resources in the process.

Despite making normal and good labour progress, they decided to put me on a syntocin drip. Looking back it’s plainly obvious that they did it to speed me up because they wanted the room back (it was so busy I had to wait 3 days on the induction ward for a room to begin with!!). But the drip meant I needed an epidural, which meant I had to lie on the bed & couldn’t feel to push, a very long second stage, huge tearing where I had been forcing it, an infection, further doctor time and antibiotics to treat it etc.

Of course that may have happened had they put me in a pool and left me to it, but the facts suggest being upright & in water reduce the length of second stage and tearing etc.

The current system seems to benefit nobody, not mothers, not NHS staff and not the taxpayer.

Argh sorry, thinking back it annoys me so much!! 😆

I had the opposite experience to you, I was high risk due placenta placement but down graded to low risk after a late scan. I had a very hands off, in the pool labour and absolutely hated it. I'd done all the birth preparation, hypnobirthing stuff and was really in to having a natural delivery etc. But when it came to it, all I wanted was people telling me what to do and when! I wanted a drip, I wanted medical intervention. I felt the MLU was basically abandoning me (they weren't, they just let you get on with it and quietly observe). It was actually an extremely traumatic experience for me. With my second I opted for the most medicalised birth I could - a c section. And it was amazing!

Sorry to ask again but presumably medical staff feel they can deal with medical emergencies in MLUs just fine?

Hi OP , sorry I was working.

I am not a doctor/ midwife so dont know exactly what emergencies they can and cant deal with.

But I do know its akin to emergency 'first aid' - the same as a midwife would do at a home birth while the ambulance comes or if in an adjoining MLU before/when you get wheeled to the adjoining labour ward.

Their are no doctors, no anaesthetists, no neonatal intensive care etc.

You can only have gas and air and opiates - no epidurals etc.

It would be interesting to know what the private birthing suites for high risk women are like. Do they offer all the emergency care equipment in the suite - so a combination of an MLU birthing suite and a treatment room.

Or are they just private MLUs and if shit hits the fan they transfer you to a hospital?

@Glassofshloer

I would hazard a guess that your birth likely cost the NHS more than mine did.

Exactly. Good facilities and lowering the chance of intervention is in everyone’s best interests in terms of cost.

I hugely doubt that being on there played any part in the cost of my birth - except maybe I would've had an epidural on the delivery suite which I obviously couldn't have on the MLU. The birthing pool did next to nothing for me, and I didn't have a double bed that you've been banging on about. But hey that doesn't suit your narrative does it

It would be interesting to know what the private birthing suites for high risk women are like. Do they offer all the emergency care equipment in the suite - so a combination of an MLU birthing suite and a treatment room.

I've given birth at two private hospitals under consultant-led care. Both were c-sections, one emergent after spontaneous labour and one planned. I have been classed as high risk in all of my pregnanices.

In the private hospital, the emergency care equipment is present but tucked away -- think wall port hidden behind paintings, machines in fitted cupboards, etc. There were hospital style beds, more adjustable than the NHS one but that really IS down to lottery I think. Aromatherapy options were available, the lights were controlled by a touch pad on the bed and only the lights the consultant used for examination were fluorescent. Those were only on during active examinations. Birthing balls, bands, and supports were all provided on request but admittedly I asked for an epidural quite early with my first! Private bathroom but as I wasn't going to be getting anywhere near a birthing pool at any time I did not have that suite (I don't know if they assign that particular one in high risk cases.) There was a sofa that converted to a bed for DH and several comfortable chairs, different styles, probably to help figure out the best nursing positions. The physical surroundings could not have been more different than the NHS high-risk labour room.

After the surgery DH and I were provided with a "celebratory meal for two" with champagne. I think we ordered chicken piccata. Both private hospitals had lactation consultants who came around and the first time we actually extended our hospital stay by a day to get an extra day to work with her. (I don't know if this is the case in the NHS hospital -- DS2 was in the SCBU and I was on the ward alone.) The first hospital also provided "mum's services" so post-natal massage, mani and pedi were provided.

And yes, a lot of that is "fluff", but it is fluff that is provided regardless of risk. Manicures and champagne are great but the real things I remember are not being stuck in a tiny, fluorescent lit room with no access to birthing aids during labour and then after the birth, sitting upright in a hard plastic chair in the SCBU to try to nurse a situation that made it very, very difficult to even hold my son, let alone sort out breast feeding. Having to recover on a ward is fine, but I could barely get out of bed and there was no one to even wheel me down to the SCBU to see my son. Couldn't get a breast pump. I wound up walking myself it took hours and I bled everywhere, but I was going to hold my baby. I suffered from PND quite badly with DS2, needed medication and on balance I think it changed me profoundly as a person -- things have never been quite the same since.

And I don't think it had to be that way,.

@GemmaRuby

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.

My exact experience. I spent most of MLU time with a blanket over my head so really was not appreciating the ambience and then screamed for epidural snd they moved me down to labour ward... honestly post natal facilities bothered me more. That was hell. Especially as we couldn't get out for 5 days.

@gwenneh

Thanks for your insight. The private rooms sound lovely!

Sorry to hear about your experiences with DC2.

I am actually pregnant at the moment and have picked the MLU attached to the hospital. I actually designed those suites so will be interesting to test them out and I hope it all goes smoothly. I am very aware nearly 50% of FTM end up being transferred and its slightly terrifying we will be there without doctors. But equally its probably partly the doctors who rush to medicalise IYSWIM. Fingers crossed.