Can I insist on an induction? All advice welcome.

[JaquelineHyde]

Right my NHS trust has today decided to turn my local maternity unit into a midwife led unit only and is going to be sending all consultant led care patients 20 miles away to another hospital, a journey which will take 40mins in an ambulance and could be a lot longer in a car.

They plan to introduce this change in the next 6-8 weeks.

I am under consultant led care and am due in 6 weeks!

I have 3 other children at home and I drive but my husband doesn't, so if I go full term and need to travel I suspect we will have to call an ambulance.

Because this is all up in the air we have no idea exactly when this will begin from so one day we could be 2 mins down the road the next miles away. This makes childcare and travel a bloody nightmare. God knows what we would do if the baby needed to stay in hospital.

So I am due to see my midwife on Monday for a normal check up and will then see my consultant next week. Does anyone have any idea what if anything they might suggest and if they don't see any of it as a problem have I got the right to insist on an induction or will I be laughed out of the hospital

I'm just so fed up this is not what anyone needs to be worrying about in the last few weeks of pg but don't have a clue what to do about it.

Actually I am hoping the midwife will say the changes won't happen until 8 weeks and then all of this means nothing and I can continue on blissfully ignorant

Local hospital is walking distance or a £2.50 taxi fare, a journey of about 1-2mins depending on traffic lights.

Definitely would not be phoning an ambulance! In my area consultant led care is a 40 minute drive so those from my area and indeed much further out all have to arrange their transport accordingly - if all of those people without a car phoned an ambulance to take them to hospital it would be a terrible drain on the service. Many of these areas are very socially deprived yet I've never heard of anyone phoning an ambulance for their convenience so I'm assuming they arrange or pay for an alternative and plan for this.! I understand you are in a difficult situation and admittedly I don't have this problem as my dh and several family members would be able to take me but I feel strongly about using the 999 service for this purpose. It's rotten that they're making these changed at such a late stage for you and I do hope things go smoothly! With the nhs it always takes them longer to implement changes so hopefully you'll be ok!

Could you borrow 30 for a taxi from someone if you don't have it?

I could have guessed which hospitals you meant before you mentioned the seaside towns.

My DSis gave birth in Eastbourne at the end of Jan and thankfully there were drs about to see her when she got in a bit of trouble after the birth, it's a long transfer to Hastings.

I don't have any practical advice rather than make your displeasure at the forced change in your plans made very plain to your mw (I've heard this is only a temporary change subject to how to successful it is).
Have you considered Brighton as an alternative? Slightly better transport links if you need them?

Our local hospital us midwife led only so nearest consultant led care are both 25/30 miles away so everyone within roughly 60 mile radius has to somehow get to the hospital. My dc3 is transverse and I am worried what if h go into labour whilst walking school run cord prolapse? I'd prob need to call an ambulance but what if it's taking another pregnant woman who won 't pay for a taxi? You've got six weeks put a fiver away a week if you have to

Oops if you have to budget that should say.

Pay for a driving lesson for OH at the time of labour? ;-) Likely less than the 30GBP taxi and he'll get an extra 20mins practice whilst you get settled in the hospital.

More seriously though if you can afford to run a car you can afford the cab fare. Find one small luxury you're prepared/having to due to baby (coffee? wine? manicure? hair cut?) to 'give up' for a short while to save the money.

And have a lovely birth - good luck!

'if you can afford to run a car you can afford the cab fare' -- I can't afford to run a car, it's a mobility car.

Of course I will bloody try and save up the money needed to pay for a taxi I'm not a complete wanker, an ambulance transfer is the last thing I want.

But if the NHS trust didn't want to cause this kind of problem then maybe they should have consulted of these measures before passing them through. They were only announced as a consideration at the begining of the week and were passed today at a public meeting.

I shall just wait and see what my midwife says Monday as her and my consultant are the only ones who can really know what I am expected to do and I suspect she might not have any answers for a while as they will be ironing out the details, so I shall just carry on regardless until I hear any different

JH I was wondering if the decision would go that way for your local unit. I hope on Monday they can put you at ease and still be able to provide your care there.

Induction maybe tricksy, I think you'd have more luck from the SPD aspect than transport arrangements, sorry to say. In many cases induction is no problem and labour kicks in fine, but quite a few lead to further interventions, which we usually hear more about.

My MLU is a 3 minute walk, almost backs onto our garden. But I shall be going to the CLU at the big hospital which is 30-45 minutes dependant on traffic (or 90 minutes with snow) am lucky DH drives, but if he is working it'll be a taxi for me, also same rate. I contacted local taxi firm last time to check details, they do it all the time, so weren't too worried. Just need to make sure i have the cash on me, just in case. :)

I have my fingers crossed that Monday they'll give you a good plan of action and appease your worries.

DH just reminded me we are due a cheque in the post for a crash I was in a few months ago.

It should be here early April, so if I go full term and need to travel it should have had time to clear so we can pay for the taxi. Hurrah for DH's memory

So fingers crossed that's that worry ticked off the list, now for the other billion worries and concerns this ridiculous decision has bought about!

Jaqueline thanks so much for giving me the heads up on this. What bad timing for us, and awful news for our town in general.

I'm due in 5 weeks, so if I go over it could affect me. Hopefully though our babies will be on time, it'll be longer than 6 weeks and we'll both be OK! I wonder if the quality of care on the unit might suffer if everyone's demoralised as it's about to shut? Although my nurse friend says everyone's demoralised normally anyway so it shouldn't make much difference

I'm not under a consultant now AFAIK. But last time I was augmented (induced to hurry things up once labour had started) and it's not clear whether they are going to do this again this time. My usual midwife has assumed they will, but I got a different midwife last week who said they won't, so I'm confused on that one.

If they are to induce me I want to know I have access to an epidural!

Oh I'm really annoyed about this.

In the hospital I gave birth to DS in, you had to chose between midwife led or more medical approach. I was high-risk so wasn't allowed near the midwife led unit. The medical using didn't have pools, balls or any of that stuff. What I liked about our local hospital was that it was medical and had pools and balls etc available.

Also at NCT, the woman who led the classes was singing the praises of our hospital. She said they have a dedicated obstetrics surgery team, so if you end up having a CS you are under the best care. They stitch every layer of skin when sewing you up, for example rather than every other layer, which is what happens in hospitals which don't have dedicated obstetrics units. (Only very experienced teams can do this in the time available apparently, but it leads to better healing not unsurprisingly.)

I have lots of questions now. Our hospital uses Propess (a pessary to induce). They've only started doing this very recently after the hospital the other way down the coast used it successfully for a year. Does the hospital they want to move us to use it? I really want to avoid the drip if at all possible.

What happens in a midwife led unit if you decide you need an epidural, do they have to transfer you down to the other hospital (in screaming agony?!) What about if you become high-risk or need a C-section? What about emergency C-sections? Do they still happen in the same hospital?

What a spanner in the works.

It'll make it much harder for DP to pop home when I'm in hospital and we have DS to think about. We may have to rethink our arrangements for DS being looked after when we're in hospital.

Also, DP also has an operation coming up which will be affected by the other units being closed at the hospital. He can't drive home afterwards, so will have to pay a cab between towns which will cost a bloody fortune! The downgrading of our hospital is going to make life difficult for so many people here.

I asked for induction on Dd she was late and we had a holiday planed that was booked before knowing I was expecting her. I asked for induction and they wasn't keen on the grounds of a holiday but I explained My concerns that I wanted Dd to be over 15 days old on going for My peace of mind ( had a Dd who went to heaven at 15 day old) . The consultant was very understand and helpful . As it was I was glad to be in hospital when I went into labour as it was only half hour. I would never of made it there from home in that time.
if you explain your concerns hopeful if they will listen to you.
As for the ambulance issue I had one called for My by the Dr when I was in labour with ds4 . We were snowed in and not much traffic could get through. He didn't say to find someone with a suitable car (4*4) he called the ambulance. Labour can be an emergency if there are problems including being unable to get to the hospital. As it was they turned up just as I was delivering ds so we never made it to the hospital.
Good luck op hope things go your way. X

I was induced due to childcare issues. But I was due to be induced at 41 weeks anyway, and they just started the induction a day earlier than planned, because the hildcare I had in place for my older child had changed its mind about helping. They used the term 'induced for social reasons'. Good luck.

jacqueline this sounds really stressful for you, definitely ask the mw about induction, no harm in keeping your options open. Don't want to stress you out more but I wouldn't actually rely on ambulance service to be around to deliver the baby as opposed to taking a taxi, not because of reasons others are saying on here as a women in labour is definitely as much an emergency as anything else, but actually my husband worked a bit with the ambulance service and he told me that because there are so many different things to train for medically they find it hard to cover everything as much as they would like so a lot of ambulance crew probably wouldn't know more about delivering a baby then anyone who's read up on how to do an emergency delivery because they are trained in so many things and deliver babies so rarely.
Hope this information is helpful to you and everything goes according to plan. Just remember when you're talking to the midwife that everyone finds it hard to say no to a pregnant woman in tears ...seriously though good luck and look forward to hearing from you over on april 2013 thread

JH, I'm at the same hospital as you and due on April 5th. Which would make it fine if I were to go into labour around then, but obviously if I go overdue I may just meet the 6 week cut off point.

My MW explained to me that if that were to happen, I would begin my induction at EDGH, and then be transferred (by them, in non emergency patient transport) to the conquest. From what I could gather, they are very much taking the responsibility of transferring EDGH patients to consultant led units if needs be.

A pain in the bum and a total faff, but I hope that's a little bit reassuring.