How do hospital births work then?

[MotherPanda]

Hello, I'm 33 weeks pregnant and up untill last week I was certain that I wanted a home birth, as I wanted to be in control and have a fear of hospitals (i think it's the smell).

However, from this week i'm having serious doubts - and am starting to think that maybe a water birth at the hospital would be ok, so long as i don't have to stay for long afterwards etc.

I think i'm already too tired to fuss with sorting out everything with the midwife, and not sure its worth the expense to hire my own pool and buy all the bits and pieces. As it's my first baby theres a good chance i might have to transfer anyway.. I don't like the idea of having to clean up afterwards and of having stitches done in my bedroom either.

so - do you have to stay overnight in a ward if everything goes ok - or can you nip off home a few hours after the birth?

As soon as you go into hospital, do you get put into your own room to see out the contractions, or do you get put on a ward whilst you dilate?

I would hate to be apart from my DH, so don't want to ever be left alone while there - is this possible?

AHHHH! I need to have made my mind up by next wednesday, as this is when I have to book in a homebirth/hospital birth at the latest.

You won't go into a ward until you have had your baby. You'll be in your own room and of course your DH can stay with you the whole time. Generally they send you home if you aren't very dilated, or not in full labour.

I don't think many people are keen on hospitals particularly, but generally the maternity section has a very different 'feel' to the cancer wards or A&E, for example. I felt much more relaxed about the thought of a hospital birth - I didn't want to have a big pool of water sitting in my living room for a couple of weeks, and have to clean everything at home and make it as spotless as a birthing room at a hospital. Plus I didn't fancy the possibility of a scary, uncomfortable transfer to hospital. You may have to wait as long for intervention if you are already at hospital, but at least you can wait in bed and not have a bumpy ride in an ambulance.

I know what you mean about the smell though - maybe take some nice room spray with you to disguise it a bit.

How long you stay in depends on you and the baby. Some people go home the same day, some have to stay a while to recover. It's ok though, lots of friendly people and help with feeding, bathing etc. And hospital food's not that bad!!

Right to try and answer your questions:

Pools - yes hospitals have them but whether you get to use it or not depends on how many there are and how many babies they are delivering. Some midwife led units are significantly quieter with more pools whereas some hospital site units maybe only have 1 or 2 and have more people in delivering (if that makes sense.) Have you had a tour of the unit? If not see if you can get one.

Stitches - you may not have to have them but if you do the midwives bring sterile kit with them to home or unpack it in hospital - you get exactly the same treatment. The air in your bedroom is actually probably cleaner than the hospital air.

Transfers - well who can say? I reckon had I had homebirths for dd2 and dd3 I would have ended up going in anyway after the birth - dd2 had meconium in the waters and was a bit distressed. dd3 was ok but I had bled quite a bit afterwards. There's just no way to know this so don't make a descision on the asumption that a transfer is inevitable.

Discharge - if you have a straightforward birth you can discharge after 6 hours BUT with your first baby it is often a good idea to hang about for a bit to ensure that you are getting feeding established. Of course that assumes that the hospital midwives are helpful. If you have feeding support for you at home - doula, experienced freinds or sisters who can come and help you out - then you're probably as well at home.

Admission - on admission you will be examined (assuming you consent to that - you don't have to have a vaginal examination) and then if you are considered to be in established labour you go to delivery with dh. If you aren't then you can either get sent home to contract some more (joy) or you can go to the ward and if it's after visiting hours dh will very likely be sent home. You can avoid this situation by hanging on at home for absolutely as long as feels safe. If you are having good lengthy and frequent contractions then chances are they are doing some dilating work.

sadly, the answer to most of your questions is 'it depends'

if you're in established labour when you arrive at hospital, you'll probably go straight to the labour ward into a private delivery room, assuming one is available. DH can stay with you in the delivery room.

once baby arrives, you and baby will be checked over and any stitches etc done in the delivery room. once a bed is available on the post natal ward you'll be transferred. as a general rule, DH's can remain with mum and baby on post-natal ward between about 8am and 10pm. if post-natal ward is all individual rooms, they might have a different policy of allowing DH to stay 24 hrs.

absolute minimum discharge time is 4 hrs following a straightforward delivery but both you and baby need to be discharged so if you have baby at night or at the weekend you'll probably have to wait a while before the paediatrician comes to see baby - I'd say be prepared for at least a one night stay just in case

good luck

My DP was with me for the birth (I transferred in from a home birth so wasn't in hospital for the labour) and for a couple of hours afterwards, but once they sent me up to the post-natal ward he had to go. The baby was born at 1am and I went up to the ward at about 4am I think, and DP wasn't allowed back til 9am. That first night was pretty horrible to be honest - I was quite out of it and on my own with this baby, trying not to wake anyone else up! I really want a home birth next time if only to avoid that.

Just in relation to a couple of your points:

• on where you will labour, it really depends on the hospital. If you go in early and don't want to go home, you may be placed on a pre or even post-natal ward for the early stages until you are transferred to your own room.

• if you don't want to be left on your own, check the hospital policy carefully. At my local hospital, on the post natal ward visitors weren't allowed before 7 am and for around 3 hours at lunch time, then had to leave some time in the evening (not sure when - I didn't stay overnight). I think that's pretty common.

-in terms of staying in, no one can make you (unless you're sectioned under the mental health act!). If it's straightforward it seems to be the case by me that, if you deliver in the morning, you can get out the same day relatively easily, ours does a 6 hour discharge if you want it. In the afternoon it gets harder, as they want you to have the baby checked by the paed and, if he/she has done their rounds, you have to kick up a bit of a stink. We did and got checked and home that evening.

Hope that helps a bit.

Re paed checks - dd2 and dd3 were both checked at home by the GP the following in the following day or two. Dd2 was a 4 hour discharge and dd3 was about 12 hours - I stayed in a little bit because of the bleed and went home mid afternoon when everything seemed settled. They originally wanted me to stay overnight but I told them to forget that . That was a Saturday and the GP came on Monday.

Oh yes, thanks NorthernLurker, forgot to say you can ask to have the GP do the checks instead. We just went with loudly saying how much we wanted to go home and the ward manager realised she could free up a bed in a very busy ward by finding a paed!

Thank you everyone for your experiences - I was wondering about the 'paed checks' because if i was going to have a home birth, surely the gp would pop round the next day to carry them out then - so im sure i could ask for that.

Going to have a long chat with my DH tonight and see how he feels.

I did have images of me being tied down to the bed after the birth, forced to stay a night on the maternity ward....

Nobody can force you to stay. If you tried to insist on taking an unwell baby out you'll be up against it but you yourself - well it is your choice if you take your own discharge. If there is cause for concern - say you bleed heavily you can always do what I did and say 'I'll stay till x time and then if I'm ok I'm off'

My local hospital has a weekly 'open house' where you can just turn up and look around. I found it really helpful. The tour was done by a midwife, so you could ask questions.

You should really check with your hospital about all this stuff as I have read all the responses and thought, 'hum well that isn't what happened to me' etc.

Remember you will effectively be transferring to hospital whilst in labour though, you can't avoid that bit by opting for a hospital birth, and you might go in, be told you're not dilated enough and then go home again. I think it really depends on your local hospital - ours apparently has a birthing pool but it's not set up to use, and whether you go straight into a private delivery room depends on how many other women are giving birth at the time, I have friends who have done almost all their labouring on a ward and then been transferred just for the birth. Also the delivery rooms at our hospital are tiny, although they might say they encourage active birth there's no space to walk around so I ended up on the bed most of the time. My experience at hospital last time has made be very keen to go for a home birth this time as I got to 5 cm at home, then arrived at hospital and everything stopped, ended up with failure to progress and induction (and finally an emcs). The consultant said this happens to 60% (failure to progress, not the emcs) of first time mothers in that hospital. I don't know what would have happened if I'd stayed at home but I don't think the transfer at that stage helped. I think it really depends where you feel most comfortable. And of course, you don't have to have a pool at home, not all home births are water births. We hired a birthing pool though, won't fill it until I'm actually in labour so no pools of water sitting around. Plus the midwives clean up after you I'm told!

i planned a homebirth with dc2 managed 32 hrs at home and transferred in for the last 2. There was no panic midwife felt i needed a drip to get me dilating better as everything very slow. Went in our own car & she met us there. We probably wouldn't have gone in much earlier even if we were planning a hospital birth as the contractions had been very manageable up til then. In fact if we'd gone in earlier then we would likely have been sent home and done the journey more often.

If you plan a homebirth you can always change your mind even at the first contraction and go in. If you plan a hospital birth then that'll be your only option. I don't think the midwives leave things so late as to get into emergency situations at home if they are concerned for any reason they'll send you in in plenty of time.

Check out your local hospital and talk to your midwife about how they manage a homebirth. Hopefully that information will help you make a decision about what is best for you. By the way planning a homebirth with number 3 due in 4 weeks wish me luck

I had my first baby 10 days ago and had similar worries to you and originally wanted a home birth. I really didn't want DH to be sent home...really didn't want to stay on a ward etc.

I went in 20 hours into labour and was only 2cm dilated. They tried to keep me in and as it was 1am DH would have been sent home. I told them I wanted to go home and they agreed. I don't think there is much they can do to keep up there unless they're worried in which case you'd be transferred from home anyway.

After I had given birth I told them I wanted to go home ASAP. They said they would keep me in the delivery room initially but then realised that because DD had been born using ventouse they had to keep us in 12 hours, so I was transferred to the ward. I kept telling the midwives I was planning on going home and they were fine about it; we left about 10 hours after I gave birth because they were happy I was confident feeding etc.

So it can be done. Stand your ground and stay calm and confident and you should have no problems, all else being well.

Good luck!

Good luck bumble34!

I think your right - if i plan for a homebirth I can always change my mind and go into hospital if i feel like it, but can't really do it the other way round.

I am still going for a tour of the hospital though (in a couple of weeks) so will be able to check policies and things then.

sigh... I do feel much calmer now. I think my lack of confidence has to do with the impending fear i now have - the realization I actually have to give birth!

Thanks Loopy :)