Anyone managed to get a midwife unit led high risk birth?

[Toadsrevisited]

I had a blissful midwife unit birth a few years ago- gas, water birth etc- and then sadly had a really stuck placenta so had epidural and surgery. Now pregnant with number 2, and have been refused to register to have birth at MLU. Am threatening home birth but consultant said although it's my responsibility to right, it's risky and I would be better in a big obstetric unit hospital. Anyone managed to negotiate an MLU birth when high risk?

[Lj8893]

Of course midwives are qualified to deliver the ops baby!! kimmy what do you think a midwife is qualified to do??

[NannyOggsKnickers]

Here’s the thing. You are trying to mitigate the risk by controlling some aspect of your birth. But the truth is that if you need those interventions then you’ll have them.

No one, not even your consultant, can predict now how your labour will go. You have to accept that you have not control. Looking at risks and statistics isn’t helpful.

Go to the place where you can get the quickest, best care for yourself and your baby. Do you really want a 30 minute ambulance transfer if something goes wrong?

[KimmySchmidt1]

MLUs have lower intervention rates precisely because they only accept low risk births In the first place FFS!

Obviously labour wards, which only see higher risk cases, and are transferred MLU cases in order to intervene, have higher rates of intervention.

Duh!

[ChesterBelloc]

"midwives are not qualified to deliver your baby "

Kimmy, what on earth are you talking about? Of course midwives are 'qualified' to deliver babies! It's their job!

[Bue]

OP I find that people often get such a hard time on MN when they post about wanting care outside what is recommended (and a lot of really inaccurate/irrelevant replies too ).

I think it is probably likely that the MLU won't have you because it is freestanding. But not necessarily. Our freestanding MLU has taken women in the past with previous retained placenta/pph especially if it is likely that the factors that led to it the first time won't recur. Have they gone over your notes to determine what happened last time?

The other in-hospital MLU is a good bet I think and you may get further with that route. Ours quite often takes women who are considered high risk. Have you also considered contacting hour Trust's Professional Midwifery advocate? They are the new name for Supervisors of Midwives and should be able to help.

[Toadsrevisited]

Or do you just need to RTFT?

[Toadsrevisited]

kimmy what are you saying exactly? It will be midwife led but of course if something goes wrong, a doctor will come in and do what needs doing. Baffled?

[EssentialHummus]

That sounds like a good outcome OP, all the best!

[KimmySchmidt1]

You can’t force unqualified people to treat you in afraid - midwives are not qualified to deliver your baby and so you need to go where the qualified people work.

Or just don’t register at all and seek no help just doing it at home on your own? Incredibly stupid but fairer than ruining someone’s career and livelihood by trying to force them to treat you unqualified.

[CotswoldStrife]

Good work OP, that sounds a fab plan - hope things go smoothly on the day for you.

[christinarossetti]

Thanks for the update OP. Hope that it all goes well.

Sounds like the hospital have been very responsive to your needs and requirements thus far, which bodes well.

[welshweasel]

Brilliant! Sounds like a great compromise, hope it all goes smoothly x

[Toadsrevisited]

Just in case anyone wondered what happened next... DH and I decided against home birth for risks, and other hospital M impractical due to distance sadly, but managed to get big scary hospital H to give me a special tour and debrief and planning session. They have promised a midwife led birth in their normal private delivery room but doctors will be outside if needed. Probably taking a doula with me.

[SleveMcDichael]

I'm surprised to see so many people on here rubbishing the impact of a traumatic birth experience. FWIW, I don't think the OP's idea is a good one, but I can see why she feels she has no good options.

The MLU attached to a hospital sounds like a good compromise, OP. I am not sure whether an hour's drive is too much - I assume you won't be driving yourself? Have your previous labours been quick? Is the route reliable, not likely to be clogged with traffic at certain times of day? That would influence my assessment. Good luck with the second MLU. (You may get further if you explain to them the full reason for not wanting to go to the closer hospital. I get that you don't want to here, but that information might help your case with them.)

[FlawlessFuckup]

OP, if you have a PPH at home and suffer death/serious injury, who will you/your family hold responsible?
Because the healthcare professionals involved are trying to stop this from happening

[Bobbiepin]

@bellamuerte I didn't get to see the MLU (it was down the hall from the delivery suite) but from the pictures online I think I would actually prefer the delivery suite! I know not everyone and every hospital is the same but my experience there was very positive and I'm sure that was down to feeling safe and looked after by professionals. Even though I had one midwife I knew doctors etc were only a page away.

[Bellamuerte]

@Bobbiepin Your hospital sounds great. But so many hospitals have built lovely brand new midwife centres with all mod cons which contrast sharply with the outdated wards where they send high-risk patients. It's unsurprising that women want to give birth in the posh new midwife centre and get upset when they're told they can't.

[IsaSchmisa]

Tough position you're in OP. I'll be honest, I don't think you stand a realistic chance of getting the standalone MLU to take you. They have such incredibly strict risking out policies, they kind of have to and that's why the stats are so good. They really do send elsewhere at the first sign of trouble. And they don't have wiggle room. Much as I can see why you don't want the drive to the hospital MLU, I do think that's likely what I'd be planning, just because you're unlikely to get your way.

That's really shit about the lack of tours as well.

[sycamore54321]

An MLU 30 minutes from a hospital with onlu 2 births a day doesn't sound safe for anybody, even the lowest risk. The low rate of births risks providers becoming unskilled.

If you have retained placenta and PPH, what you need is access to a blood bank and to a surgical theatre, as well as the obstetricians and anaesthetists that can make this happen. In that regard, there is little difference in your home and a standalone MLU. Both are woefully under equipped and unqualified to deal with such a risk.

I really am sorry that your previous experiences have had a negative impact on you. However I would strongly urge you put your energies not into fighting MLU policies but rather into seeing if you can process those previous experiences, perhaps with the help of some counselling, in such a way that you can come to terms with needing a hospital delivery.

I also would entirely disregard any cheerleading home-birth private midwife, who has the most obvious conflict of interests in talking up homebirth.

Best wishes OP.

[iBiscuit]

Scrap "minimal intervention, natural birth" actually and replace with "good birth".

Which for me would be one from which both baby and mother come out as unscathed as possible.

[iBiscuit]

things like epidurals do impact on a baby but I bet plenty of women ignore that because they want the pain relief

Yeah, the selfish cows

Statements like that do not help the case for minimal intervention, natural birth. Quite the opposite, IMO.

I find it interesting also that professionals dealing with caseloads where complications are overrepresented are accused of having skewed opinions, whereas those whose caseloads are less complex have more balanced views. Both sets of experiences are going to effect opinion, surely?

FWIW op I think you've been given a bit of a hard time on this thread, although I understand some posters' kneejerk reactions. I genuinely hope you can find a sensible solution that works for you

[pigshavecurlytails]

I have met many CMs and independent midwives who felt that anyone could have a home birth regardless of risk. They were terrifying individuals who were on an anti obstetric crusade and had no regard for the safety of their patient.

[Mummyme87]

Yes high risk women can labour and birth on MLU. You need to speak to your professional midwifery advocates atyour unit. I see women everyday who are high risk for various reasons and use MLU. They will discuss the risks, benefits, negatives etc and come up with a plan.. this is between MLU manager, professional midwifery advocate and consultant. Good luck in whatever you choose to do

[Frazzled2207]

First birth I was in MLU but transferred later on to obs-led delivery suite for interventions

Second birth I was advised to go straight to the delivery suite which I did but had much more pleasant experience with two midwives, no intervention, and didn't see a doctor the whole time I was there. But given what happened the first time (severe pph) I was very glad that they were nearby just in case