MLU or hospital birth?

[Downbytheocean]

Am 22 wks pregnant with second dc and originally planned to give birth at same hospital as first ds, RVI newcastle. I had an epidural and ventouse delivery, after diamorphine and in the midwifes words was 'clearly one of this who wouldn't cope well with the pain', hence the epidural. I had wanted a waterbirth but was refused due to staffing issues. This really knocked me and I felt out of control for most of the 10 hours labouring in hospital. I have moved and am closer to the MLU now, lovely newly renovated unit and I don't think there would be the same issue with staff shortages so I hopefully will get to use the pool. I am worried that given that I 'clearly couldn't cope' last time, I am daft to consider the MLU and should be going to the main hospital where an epidural would be a possibility. I could transfer by ambulance if I really wanted an epidural but it's unlikely I would go that far. I've signed up for two natal hypnotherapy workshops and hope I can change my frame of mind about the birth but a friend has asked why on earth I would put this pressure on myself, and surely I would want the crash team on hand and security of the hospital. Given all this is the MLU the best place for me?

You know what, midwives do not have magic skills and your midwife did not have the first clue that you "would not cope well with the pain". They may be able to tell that you are not coping (in the present tense) but they are not able to see the future. So I would take that out the equation if I was you.

With DD1 I was told I had a low pain threshold. Like fuck do I. I had DD2 with not even gas and air. Turns out I'm just one of those people for whom the latent stage is most painful. Pushing, crowning, transition, all totally fine for me.

In terms of the crash team, the recent place of birth study shows that babies born in MLUs have outcomes just as good as those in CLUs. So proximity to all that lovely technology is not what gives the good outcome - the general hypothesis is that probably MLUs and home births give better care, so problems are picked up early, whilst there is still plenty of time to transfer.

The decision about where to give birth is totally yours, but take all that judgemental stuff out of the equation.

Or have a home birth. Then you would 100% know you would have a pool .

Just the sort if positive advice I have been missing NYRevolution. Thanks.

You're welcome. Honestly, after DD1 I really doubted myself for DD2. I did some hypnotherapy, plus some other exercises with my doula and had an amazing home birth. I thought I was a complete wimp and couldn't cope, but turns out I'm hard as nails .

Seriously though, second time is easier. Even if it's just as objectively hard, you feel more familiar with everything and therefore hopefully less scared. Personally I would never give birth in a CLU again, unless I was high risk for some reason (when I would thank my lucky stars that they existed for those situations).

If you feel most comfortable in a CLU, then go for it. You need to be where you are comfortable. However, if you feel like you might like the MLU (or even a homebirth) then I would definitely go for it. The only thing that would put me off a MLU is all the rules (you can't go more overdue than X, you must be Y cms to get in the pool) - I like to labour on my own terms, so home was right for me. If I had my time again, I'd have had my first at the MLU (except it hadn't opened then!).

ps I had forceps for DD1, instrumental is much less likely to be needed with a second baby and no epidural.

Second birth is likely to be shorter and easier than first

Hypnobirthing plus a homebirth with a pool. Or if not then MLU .

Like the sound of this being shorter and easier. I'm only 22wks so plenty of time to focus on the MLU. I would be terrified of a home birth, panicking about organisation, it's just not for me but I am really set on a waterbirth. Thanks for the positive encouragement, I needed it.

Good luck!

Homebirth was just a thought if you were stressed about the pool being available.

Hope all goes well.

I've been having a similar dilemma as 10 mins away there is a lovely MLU with a really high MW:patient ratio; you have a private room & DP can stay overnight; everything has really positive things to say about it. Or there is the labour ward at the hospital 45 mins away where I gave birth last time as I was induced.
I would love to give birth at the MLU but, after a lot of thought, am going to go with the labour ward. I had an epidural with DD and whilst the need for that was possibly due to being induced, it may be that I have a low pain threshold. DD's head was off the charts size wise so she was dragged out with forceps in theatre. That is the bit which really concerns me & was my deciding factor. Second babies tend to be bigger so this one could have a bigger head. The reason for the forceps being done in theatre last time was that they weren't sure it would work so wanted to be able to go to a C section. Presumably, if DC2 has a bigger head, forceps are less likely to work so I am more likely to need a c section. DD's AGPAR was only 4 but rose to 10 within a few minutes so they decided she didn't need to go to SCBU...what if that hadnt been the case? Would I want to risk her being blue lighted?
I raise these points so that you can think about similar things. Why did you have the ventouse? Where was it done? What was the effect on your DC1?
I think that NYRev raises some very valid points & I totally agree with her & lots of my friends who have had significantly easier second labours and have said similar things. However, I tend to be someone whose head dictates over their heart and so will be going to the labour ward as I think that, medically (and therefore sensibly) its the right decision. If the hospital would just open a MLU on site so you could just be wheeled into the labour ward "proper", I would be sorted. Sadly, I'm not sure that will ever happen & it certainly won't in the next 12 weeks!

I've just spent the night with a woman who had epidural last time ("Low pain threshold") who gave birth to a bigger baby this time in a pool in her living room. Length of labour similar this time. The (large) head took its time but slowly, slowly, no stitches needed. Oh and she had no pain relief at all. At one point, around 9cm, she looked up and said "could I have some paracetemol?". Gas and air was available?.

Murtette - I agree with a lot of what you've said, although I always think 'low pain threshold' is a nasty phrase (particularly to use about yourself .) Someone said to me a while back - if you feel you are in more pain, you are in more pain, it's not a low threshold.' Pain is a subjective thing - it's not like saying you are tall or short. Feeling more pain = more pain. I thought that was a good way of putting it!

I can see why you felt that you wanted a CLU, and totally respect that. Just wanted to add that for me, my homebirth was a 'head' decision too. I knew that being in a hospital and the interventions they pushed on me (ARM completely stopped my contractions, as one example) was a big part in having an awful time. It was a very rational and logical decision for me to avoid the hospital, rather than just being an emotional one. I think after a bad first birth logic can push you in either direction,paradoxically with both being equally logical!

p.s My second baby was nearly a pound smaller than my first, but same size head!!

Research shows that Midwifery led care for women without complications is the safest care. Women who plan to birth at home or in a midwifery led unit are less likely to require intervention.

However, there is absolutely nothing wrong with starting out in an MLU and then asking to transfer because of the need for an epidural, because your labour needs some help.

Murtette you have also made valid points, which have given me more food for thought. I know these are my DH's concerns, although fully supportive of any decision I make, my ds was ventouse as he was stuck and i wasn't able to push him out, I don't know the technical reason, to be honest it's all a blur. A lot of people came into the room and they talked about taking me for an emcs. Ds was blue and lifeless and the paediatrician was on hand to take him but he came to me within minutes. I think without the epidural things would have been very different, but could I have coped without the epidural? If the next birth is shorter, I know what to expect, I can focus and not be scared, I feel reassured and confident with the mw care then maybe i won't be looking for an epidural and the MLU sounds like the place for this. I think I have convinced myself. I am also doing a relax and breathe for labour course and may talk about a doula with the trainer. I think a big concern for me is that i won't want to cause a fuss and ask for that transfer if i couldn't cope. Still 17 wks or so of umm-ing and arr-ing ahead!