Birth centre vs hospital - first pregnancy (long)

[MossletoeAndWine]

Firstly apologies in advance. I feel like I've hijacked everyone else's threads about this and have even gone on about it in the bar, on my ante natal thread, goodness knows where else.

Secondly apologies again. This is going to be a bit post and run I'm afraid. I'm off to get ready for work in a mo and won't be able to post again until lunch time or thereabouts.

All that out of the way, I basically need a bit of a hand.

It's my first pgcy, I'm due in March, and I have two options. The hospital I've chosen to give birth in has a midwife-led birthing centre, and obviously a hospital too.

Before I knew anything about birth, I was actually thinking of asking for a c-section because I had heard so many horror stories about vaginal birth. Then I heard of an epidural, and thought, well, I'll go for that.

But now I'm thinking of doing it relatively naturally.

I want to know: really, just how painful is it? I mean, what is the pain like? As bad as breaking a bone for example? Or much worse?

I have had a few recommendations for books (and have bought Sheila Kitzinger & plan to buy Ina May's guide to childbirth) but if you had a natural birth, what helped you get through it?

How likely is it that I could even have a natural birth, I mean, how often do people get the birth they want?

Am I being silly? Should I just go with the epidural in the hospital and leave the birth centre well alone?

As dh will be my main birth partner, what sort of things does he need to know if I have a natural birth?

Thanks everyone, and I also promise that after this thread I will make a decision and stop boring people about it.

If the birthing centre is in a hospital so that you can get transferred easily and quickly to a mainstream maternity unit in case of complications, it sounds like a good option for a first birth. It is perfectly possible to get through birth with no pain relief or just gas & air (which I think is available at most birthing centres but you should check on what you can have at yours...)

Sometimes people don't have the birth experience they want so I think it is a good idea to be prepared to be flexible and not have your heart set on anything in particular - remember at the end of the day the important thing is the health of the baby.

I think it is important to prepare physically for the birth as it can be tiring if you have a long labour, so keep doing gentle exercise during your pregnancy (maybe aquanatal classes) and I found yoga good too for improving suppleness as well as teaching relaxation techniques.

I have heard the books by Gowri Motha recommended also to give you tips to prepare for a natural bith.

hth

I'd echo the ante-natal classes - yoga was a godsend for me. Having had an epdural first time round I was keen to avoid it with second labour and did: ante-natal yoga, hypnobirthing and also had a homeopathic kit and used TENS in the early stages.
Made an enormous difference.

I'd also say it's practically impossible to compare the pain that one person might feel with another's. Also remember asking my mother if labour was worse than root canal, and she said "different". But it's one of those things that is impossible to describe.

Moss--- this is a really big decision...so don;t apologise or push yourself into making a decision......!!

how likely is it you could have a natural birth? very !!! you are designed to give birth vaginally......not everyone gets the birth they want, but with some preparation, you can make it more likely IMO,

Epidurals can slow and even stop labour, a mobile epidural, that allows you to move is a better option, but not widely available.

Being active in labour, being able to move as you need to and listen to your body is a big factor in getting a good birth experience...

the pain is not comparable to anything else , and as has been said is different for everyone....

it does hurt,.and it isnlt called labour for nothing..it is hard work !! BUT- the pain is a positive one, Ina May calls the contractions 'an interesting sensation that requre all of your attention" which is a great way to look at it..and at the end of it...you get a baby !!! no other pain has such a positive outcome..the adrenalin rush you get when the baby is delivered is amazing and makes it all worth it....

it is hard to believe it now, where you just imagining what it will be like and you do tend to get told all the horror stories, when you are pregnant..but there are some really positive birth stories around !

having had an emergency c.s first time after a failed induction, complete with epidural, ARM , syntocinon drip and a natural, spontaneous labour, with my waters going with a bang (!) , lots of gas & air and some pethididne................i know how i would do it again !

the sheila kitzinger and Ina May books are great at inspiring you to believe you can do this...!

the birth centre with midwifery led care is a good option as midwives are experts in vaginal delivery, whereas in the hospital, you will be under obstetric led care which might lead to more intervention.....

DH just needs to be there.......support you, and do what ever you need him to do, whether that is rub your back or leave you alone ! you won;t really know until you are in labour if you want to be touched or held or not !!

hope you get the birth you want, regardless of where it is ! xxxxx

obviously natural spontaneous labour was the second time !!

Different people feel different pain. I did the whole ante-natal yoga, reading Kitzinger, booked into a birth centre bit and ended up pleading for an epidural (I had back to back labour to be fair) and an emergency c-section. The most important thing is not that you sign up to anyone's particular theory, or their version of what you should do, but that you keep an open mind and do what you need to do at the time. There are no medals or brownie points for skipping pain relief if you need it. Just go with whatever you need to do for you and your baby and remember that it is a small part of the whole being a mum experience.

I hope it goes well for you

I'm surprised lulumama hasn't mentioned that hiring a doula or having another female companion experienced in birth can reduce your risk of intervention

Just to throw another idea into the ring - what about homebirth? It's as safe as giving birth in hospital, you reduce your risk of a cesarean by HALF just by planning one (obviously if you give birth at home you have no risk of cs at all ) At home you are likely to experience less pain because you are in your own surroundings. Obviously if you are totally against the idea then go for the birth centre, but you could have a look at homebirth website and DEFINITELY get the Ina May book - very inspirational and inspiring.

You ask about pain - and labour and childbirth is hugely painful. But there is one thing worse then pain and that's fear. Fear is what traumatises women during childbirth - whether they have an epidural, CS or natural birth.

I found the way to ally my fears about childbirth was to gather as much information as possible,and give birth in a place where I felt comfortable and looked after, with people who knew me and trusted me.

I had realistic expectations about the length of labour, my own pain threshold and I kept a very open mind with regards to how my baby would be born. Added to this, I was lucky to have a reasonably straightforward first time birth.

I would recommend you speak to your midwives and visit the birth centre and hospital, and if possible talk other women who have given birth in these places.

I've had two totally natural births. More painful then I could ever possible imagine, but afterwards something strange happens : you forget the pain. Yesterday, I burnt my finger on the oven. Far more painful then I remember childbirth being.

Hi Moss! Everyone is different with labour, I hate the thought of an epidural...having a wire in my back and no control of my legs possibly! I always specifically say I don't want one!

TENS...some people find it great...I hate it! When I tried it I couldn't get it off quick enough!

Hugging/touch...some people really need that but I can't bare to be touched in labour!

I need to BREATH concentrate and focus with no distractions and then in between contractions I need someone to chat about rubbish to...dh being ideal for that!

Last two times I had nothing, gas and air being shoved in my mouth when pushing so I just bit on it. I hear it is great though and I might get the hang of it this time.

I had pethidine type drug for ds1 and even that wasn't helpful as I was all dopey and had to be shaken to push. Also first time I was really scared and tensed up which didn't help.

I actually think that if you are relaxed, confident and there are no complications then totally natural is the best way to do it.
Its like vomiting almost, your body takes over and supplies amazing natural endorphins which are FANTASTIC better than anything the hospital can give you!
I'd definately go for midwifey comfy place!
Then if there are any problems it'll be great to know that the hospital is nearby for a safe delivery one way or another.

Would personally go for mid-wife led unit in hosp - easy to swap units if you need to. (Is what I did for ds and am about to do for ds2b 2.)
My plan was actually to have no plan and just go with the flow (felt a bit odd explaining this to the midwife). If I needed drugs I'd ask for them (though didn't) and when I needed to go for a walk / space / to change position I said so and they supported me in that. Meant I didn't stress at all in labour with ds and felt in control and believe that that is why the birth was so easy. Dh was a bit shocked by how straight-forward it all was (lots of scare stories from friends from ante-natal class by then). Sincerely hope nr 2 is the same!
Should add that I did plenty of yoga beforehand (and dh also big on being mindful of your breathing) and found that really gave me something to focus on and distracted me from the pain.

Cannot emphasise enough waht an enormous difference it made having a good breathing technique. With dd I think I kept holding my breath whenever had a contraction and that was completely counter-productive. With ds, I breathed as had learned in yoga, in for three out for six (or 2/4 or 4/8 whatever) all the way through the contractions and I felt calm and in control.

Hi Moss

Don't apologise for asking people's opinions. It is such an important decision that you need to get as much info as possible before you make a choice.

Before you decide on home birth / midwife led unit/ hospital, I think it is worth considering what kind of a person you are. Would you feel reassured by having your own things around you and labouring with DH in familiar surroundings or do you find the idea of having immediate medical back up for emergencies a great comfort? For my first baby, I knew that I was too much of a worry pot to be at home even though I could have got to hosp under blue light in about 15 mins. However, the people I know who have had home births have raved about them and all of them have done them at least twice now.

For me, the MW centre would be a good place as you have all the back up there in the same building. I had planned for DD to go to the MW led unit and do it on gas and air or in the pool if possible. As you could go to the drug bit at any point, I felt that I had the best of both worlds and could see how I coped on the day. As it turned out, I was induced so never got near the MW led bit anyway!

I was very frightened of the pain but as someone said your body is designed for this! Many more people give birth vaginally than by CS. I would agree with finding out as much as poss in advance and learning to breathe. On the day, just take it as it comes. You may well find that you manage brilliantly without epidurals etc. If OTOH you feel you need one, you can have one. I think you just need to be flexible. THe main aim is to have a healthy baby and a healthy you at the end of it. How you get there becomes less important once the baby has arrived.

As you know from the March thread, my first labour wasn't great but I got DD at the end, and am doing it again so can't have been that put off! Definitely would recommend finding out more about the doula idea - you could ask Kitty or Fox on the other thread more about this.

HTH
XXXX

The way I look at it is this (and I've only read the OP).

If you are inclined for whatever reason to try for as natural a birth as possible, then that is not an irrevocable decision. You can start in the birth centre and then if things become too much, or if there is a problem, you can always be transferred. This happened to me. I laboured for a long time at home very comfortably, but due to a previous medical treatment I just wasn't dilating, so went into hospital and had ds and was back home within four hours. I ended up with a mobile epidural, and the whole experience was great.

The opposite is not true. If you are induced/have an epidural, then that has knock on effects that mean that the whole experience of labour will be affected (not always adversely).

Natural can become medical. The converse is not the case.

I'd encourage you to give a natural birth a go. In terms of pain, pain is such a subjective thing that it is impossible to tell you accurately how you will experience it: descriptions range from period type pains to the worst pain ever experienced. However, I strongly feel that fear exacerbates pain levels exponentially: choose the kind of environment in which you will feel comfortable and relaxed (that might be a hospital btw). I would advise you to expect a long labour (it might not be, but often is first time)....if you're expecting it to be days, you might be pleasantly surprised. I'm talking about days of doom laden pain by the way, but first births often take a long time (mine was nearly 3 days).

The last thing I would say about labour pain from my own point of view, is that it is nothing like any other pain in that, once you have given birth it is just gone....not only that, but there is a surge of emotion and adrenaline that made me feel fantastic.

Think about your ideal birth, write it down, let everyone know what you want, but EXPECT to have to be flexible, as it is actually your baby that rules the roost in terms of labour, not you!!!

Good luck, I wish you a fantastic experience....it really can be!

OH GOD: I"m NOT NOT NOT talking about days of doom laden pain!!!! sorry that was a mistake......

just agreeing with daisymoo - if you can afford it, i would sooooo recommend having a doula. Ours cost £500 but a trainee might be cheaper and it was the best £500 i ever spent (we don't have a whole lot of money either and saved for it). Or you might have a great relative or friend who could do it for free
I'm not a hardnut and don't like pain much and yes it does hurt loads, but am so glad i managed to have natural birth even after epic 27 hour labour. Belgo is so right, it is fear that can determine your labour - i had a homebirth but I wouldn't have managed without the wisdom and patience and reassurance of the doula - dh was AMAZING but had never witnessed a birth before (?!) so it helped him a lot too. Whatever happens, be flexible and don't beat yourself up if your plan goes pear-shaped! Just have confidence in your body as the wise Lulumama says (and listen to her advice, she is ace!)

I had independent midwives btw, and they made a huge difference so I would second looking at having a doula/indep midwife.

Moss
I've broken 44 bones in my body, had an ectopic pregnancy, appendicitis and bone surgery without General anaesthetic.
I have also had two babies without pain relief.

Birth is a very different effort altogether
for oen thing I felt in control and very sure of what I wanted.
FWIW you are more likely to get the natural birth in the birth centre - I had my 1st in natural birth unit. Same as you just thought I wanted a decent birth had no clue how I would get it or whether I would, but knew where I was most likely to be supported.
Get to good ante natal classes, think about finding a doula to help support you and your dh during the lead up and birth of your baby.
I had my mum with my 1st and she knew exactly what I wanted and spoke for em when I couldn't.

trainee doulas are only allowed to charge a maximum of £150........and are just as passionate and committed, think i have given you these links before , Moss , but here they are again,,

train & place doulas nationwide

doula uk can also put you in touch with a local doula

Mossy, the most important thing about preparing yourself for the possibility of a natural birth is to get your head round things. Do not go into birth with fear and anxiety as these are your 2 worst enemies. If you are clammed up with fear and uncertainty then it doesn't matter where you actually give birth.

Giving birth is SO much about what is going on in your head and I cannot emphasise the importance of this enough. It in no way guarantees an easy or uncomplicated birth, but it goes a hell of a long way in getting you there. You need either a private midwife or a doula. If you feel informed and supported then you will relax and feel more confident about the whole process.
Forget about the pain Mossy, it hurts to give birth, but your perception of the pain is what really counts. If you understand deep within you during a contraction that it hurts but is not a bad pain and will be over and if you can breathe through it calmly then you will not be frightened of it and the fact it hurts will not be an issue. Does that make sense?
If you want to email me about it or even want a chat on the phone please do. I'll send you my number

I have just skimmed the replies so apologies if I repeat what others have said

I had an 18 hr labour with DS which started at 6pm so I was pretty tired. It was mostly "natural" I had pethidine but I didn't have an epidural

What worked for me

• tens machine - if you try this you should put it on at the beginning apparently for max effect
• massage from DH
• keeping mobile
• breathing

The contractions, for me, were waves of discomfort. It wasn't a constant pain
Remember labour doesn't last forever it will end