DM putting me off going to an MLU

[Nic165]

Currently I'm booked in to give birth in a hospital about 30 mins away from my house. But recently I've been thinking about moving to a midwife led unit which is only 10 mins away. This is my 2nd pregnancy and low risk. I mentioned to DM that I was thinking of transferring to the MLU instead of the hospital which is equipped with the necessary to deal with emergencies. DM was quite taken aback that I would even consider moving and said why would I not want to be somewhere that had everything I needed available in an emergency. I said the MLU would transfer me in an emergency or if I wasn't progressing etc but the main reason I want to move is that it seems much calmer and quieter in the MLU, I can stay as long as I need, no restrictions on visiting times and DP can stay overnight. Now I'm second guessing thinking I'm not doing the right thing by my child if I choose MLU over hospital and something went wrong. Anyone have any recommendations over one or the other or any advice?

I'd go MLU in a heartbeat. Low risk 2nd? You'll have a much nicer birth experience in the smaller, quieter midwife led unit. Also, 10 mins is better for a second, faster labour surely?

That's what I was thinking. Last time I didn't really have the experience I hoped for (lying on my back the whole time, off my head on remifentanil), I just felt like I wasn't fully "there" for it. And the MLU just seems so much more geared towards active birthing and I would like to be more aware this time round and manage the pain in different ways that mean I am still aware of what's going on. I'm just doubting it now if something were to go wrong (I was so excited about it prior to telling my DM!)

It's entirely up to you. Personally when my mum gives opinions on things I can't help but take it into my overall consideration. I take a lot that she says as gospel. Although I always decide for myself. I value what she says a lot. If you are similar then I can understand why you might feel like that. Hopefully though you don't feel like it because you feel like she would go on at you otherwise.

I had 2 low risk pregnancies. First birth long but straightforward (no intervention and no tears). Second birth much the same (although MUCH faster) until about 10 mins from the end when the shit hit the fan. Baby's heart rate dropped so low that the room was flooded with doctors. I was out of it but DH says they were everywhere and even brought in one of those emergency baby cots with heat lamps etc. Thankfully all was ok and I got her our with no intervention but I am SO glad I wasn't MLU.

I'm pregnant again and have been considering MLU for the same reasons as you but after last time I have major reservations.

There's no reason you'll have problems of course and you should decide based solely on what makes you most comfortable.

If it makes you feel better OP I'm aiming for a home birth, you could always float that one to your mum, then the MLU will seem eminently reasonable!

Don't let her put you off. I went to one for DC4 and it was my most positive birth experience.

I had my son in an MLU and I had to actively appeal to be allowed to do so as my bmi is higher and I'm an older mum. It was the best thing I did. It was relaxed and easy. I had wanted a water birth and laboured in the bath with just gas and air. But I got out to be examined and my son decided he was in a hurry so popped out on a bean bag! No stitches only a slight tear. It was a great experience and I was walking around, feeding my son and receiving visitors within a couple of hours.

However - my mlu is within a hospital so any transfer was 5 mins in a lift which was very reassuring.

My sister started in a mlu and after 17.5 hrs had to experience a 40 minute transfer by ambulance to the hospital- she says never again - straight to hospital for her next time.

You just have to weigh things up and do what you're comfortable with.

As a low risk 2nd time mum, research shows giving birth in an MLU leads to less interventions and no difference in the outcome for the baby thsnkf you went to the hospital. Show your DM the birthplace study.

People tried to put me off my home-birth - luckily they didn't, and I've since had 2.
With my hb, I felt really well cared for and monitored - much better care than my first hospital birth, where midwives were too busy and stretched.

Ha, yes tell her you'd like a HB and suddenly an MLU will seem like a much better option for her!

I'm having a second HB but if that wasn't available I'd want MLU. Hopspital is for risky pregnancies

The thing is what she is saying is true. If there is an emergency, the full range of support and expertise and equipment won't be right at hand, as it would be in a hospital. So of course you hope that you won't have an emergency. But if there is one, it will take longer to get you or your baby the help you need. There may be advantages to the MLU that mean a lot to you and that you are willing to balance the risks. But that doesn't make what your mother has said untrue and it's up to you to make an informed choice.

What is the time from the MLU to hospital? Is it in the same direction as your home, or the opposite? There is a big difference in 20 and 40 minutes. (Although for me personally, even 5 minutes would be too much. But it's for each person to decide. )

What is it that attracts you to the MLU that you can't have in the hospital?

Best wishes with your choice, and for your birth.

Thank you for all your replies and sharing experiences. What attracts me to the MLU is that it seems much quieter than the hospital, a lot calmer, and the midwives can spend more time with you. It's the type of experience I hoped for last time round. They also let partners stay with you the whole time, and no restrictions on visiting times. They also don't kick you out after so long. All in all it just seems more relaxed which would make me more calm and feel more in control. If only I had a crystal ball! Because of course if it became an emergency I would kick myself for not choosing the hospital where everything is available whatever the situation. Decisions, decisions! I have a while yet to decide and hopefully will come to the right choice

Hi Nic I would go for the MLU because I think it would be a calmer and better birth experience (especially with a second) I am hoping to birth at home this time around (as no access to mlu) and have a 20 min hospital transfer. However my midwife explained that things don’t suddenly go wrong and at any point we can transfer, there are warning signs they are looking out for (not to mention better quality of care eg two midwives dedicated to your care). You have to make the decision that is best for you and puts you in the best frame of mind to give birth

A midwife who says things don't suddenly go wrong should not be practicing. Things that can suddenly go wrong in childbirth, off the top of my head: PPH, retained placenta, amniotic fluid embolism, cord prolapse, cord accidents, shoulder dystocia, placenta abruption, uterine rupture, baby born unresponsive, baby born with undiagnosed condition requiring immediate treatment. These are all thankfully rare but they can happen in any delivery within seconds and don't have clear advance warning signs.

By all means, make a free choice between the different options. But that should be an informed choice.

I gave birth twice in an mlu and had ambulance transfer after birth both times (not an emergency). Excellent experience, and the thing I note is the level of experience and confidence of midwives working in that environment, as they are with you all of the time from when established labour starts, they can monitor so much more effectively and aren’t relying on traces and physical examinations like an intermittent midwife would in a hospital. During my second birth, the midwives were really just observers apart from bringing gas and air and filling the pool, I had no examinations and they still knew exactly what was happening better than I did (at one point they shared a look, in retrospect it was clear they knew I’d reached transition even though I didn’t, baby was born a few mins later but I thought I still had ages). Clearly the pps who have mentioned that there are things that can happen in childbirth that don’t have warning signs are correct, but very rare and all is a balance of risks. You are more likely if you were in a hospital situation to need intervention that may lead to an emergency c section, so the risk is not all one way.

Yes to everything tfoot has said and it has to be your choice ultimately and what you are comfortable with but I just wanted to pop back on and just alert you to the alarming comments of sycamore who keeps popping up on all of these threads and scaremongering. From what I can grasp, she has some sort of agenda and is very anti midwife so I’m guessing something must have happened to her in the past. She’s been messaging over a prolonged period of time and doesn’t appear to be pregnant, just stalking these boards as a hobby. Sycamore, as always, I urge you to get some therapy if you’ve had a bad experience but please let people make their own decisions. Most midwives are I imagine very knowledgeable and good at their jobs, mine certainly is and I don’t appreciate you commenting negatively on here without the full picture, please get some professional help and perhaps come off these boards for a while. I’m considering reporting you for many of the damaging things I’ve seen you say that may be very scary to women who are not in a position to know that you are a bit angry and affected

A midwife who does not know that things can suddenly go wrong in childbirth is not a fit person to take advice from.

Oh sycamore- stop being such a weirdo. It would be ok if it was a one-off comment but stop trawling the boards trying to scare first time mothers, you aren’t even pregnant and you’re here daily. Ps my midwife said they can see things go wrong, things rarely suddenly go wrong, for instance there’s pulse rate changes and all sorts. And just so you know, intervention rate for home births (and mlus) are much lower than obstetric wards!

Your midwife is wrong.

Personal insults are unnecessary.

You call it personal insults, I’ve had enough. You actually scared me when I was learning with your one sided flippant comments. Now I see you on here most days scaring others. It’s unacceptable. People are impressionable and a lot of what you say can be very scary and intimidating. Please be careful of what you are saying to those of us who are actually pregnant, it can be damaging.

yes sycamore things can go wrong and women can die in childbirth so can babies and all sorts of things can happen... they can happen in hospital and at home and in an ambulance...
What you actually have to go on is the statistics and facts you are presented with in each individual case however.
Not just bung everyone in hospital with every machine available to man and think that is going to be the best option.
I had a hospital birth and it was horrendous BECAUSE OF every machine available to man being there.... an absolute cascade of intervention. I genuinely wish id never been convinced to go to the hospital. There were no medical issue with me or the baby but I found the whole experience traumatic because of the drugs and the environment. As a result my labour took an extremely long time and a I developed PND.

Hospital is not always the best choice.

OP talk it over with your midwives. If you are low risk and you think you would be more relaxed in a MLU then that seems like a good option. Id go with what your midwives tell you and not what your mother thinks.

Any chance your hospital has a low risk birthing unit in addition to the general labour ward? Ours does now, it’s essentially the same as an MLU but on the same site, down the corridor in case of an emergency. It’s where I would choose for another birth but don’t think they’d let me (previous emcs). My only experience of birth is a very frightening one so I find it hard to get my head round the idea of a non-hospital birth while others who’ve had great MLU / Home birth experiences often can’t understand why I could never give birth outside of a hospital.

I tried to give birth in what is an MLU here in Germany, but when crunch time came DD wouldn't come out, despite my midwife's best efforts. So they moved me to the nearest hospital 20 minutes away by ambulance. At the hospital she was born after another 5 hours, with epidural after ventouse (having been prepared for c section I think).

Despite this 'huge ' distance, this particular MLU is very popular and they don't get many transfers like me.

My guess is that with, say, 5 min transfer time they're more likely to wait longer than with 20 min, when they're less likely to just try something (as they could've tried the ventouse where I was) in case it goes wrong.

If the MLU is what you want, then take that. It'll only make you calmer. 10 min is not long.

Midwife here.

Your mum is correct in that hospitals are better equipped to deal with complications, however, there are barely any emergency situations which occur with no prior warning signs. At the MLU you'd be cared for by highly trained midwives who would be vigilant for these potentially developing complications, and would certainly prefer a timely ambulance transfer to an emergency with no back up! You also have to remember: we can resuscitate babies and mums. We know how to deal with bleeds. We've got smaller hands than our usually male obstetric colleagues, so are better for breech/shoulder dystocia manoeuvres. We do episiotomies if needed, and can repair all but the most severe tears.

You'd be in very safe hands at a MLU

Great post from moofeatures.

OP- I had a few similar comments from people when I booked to give birth in a stand alone MLU with my first baby over 20 years ago.

Bottom line is- MLUs would not be in existence if they weren’t safe. The stats show that they are extremely safe (unless of course you have very specific reasons why if wouldn’t be for you personally.)

FWIW I’ve also had a csection (in hospital, obviously!) and a VBAC - again, in hospital with consultant-led care, because I was now deemed a higher risk.)

The MLU first time round was fab. I’d say the main difference (having had hospital birth so being able to compare) is that the midwives had so much more time. They were fully able to utilise their expert skills (ie delivering babies) without an overly medicalised atmosphere, and without lots of interventions. The midwife who delivered my baby told me she had previously worked in big hospitals and found far more job satisfaction in the MLU, being able to support women right through labour with minimal distractions, having to dash around checking on other labouring mums etc

If you are keen for a low tech birth, you want to avoid epidural and possible cascade of intervention, I would go for MLU like a shot

Whenever there's an article about infertility the same old ill-thought-out comments are made by people who, I'm guessing, have never experienced the pain of infertility and yet feel like they can lecture those who have.
The comments are usually along the following lines:

1. It's selfish.

Yes but so are lots of things that we humans do. For example, having children 'naturally' is selfish. Taking medicine so you don't die when you get ill is selfish. When you really think about it, even wanting to live at all is selfish compared to the alternative of altruistically topping yourself so you don't keep using up the earth's resources and breathing out all that evil carbon dioxide. All of these things are selfish but are an accepted part of what it is to be human. Why is having children with medical help particularly worthy of criticism?

1. You should adopt instead.

Adoption may well be an option for some, I certainly considered it when I thought I may never have children. But adoption is not for everyone. It is a wonderful thing to do but it is difficult and not everyone can do it. Also, children needing adoption are not simply substitutes for the babies you can't have yourself - it's a lot more complicated than that. For a start you'll probably need to grieve for the biological children that you wont be able to have and some people might not be able to do that. Adoption just is not the simple answer to infertility that some people seem to think it is. Moreover, why should those who need medical help to conceive be the ones who should adopt as opposed to those who can conceive 'naturally'? I don't see why those afflicted with infertility should bear the social responsibility for adoption any more than those who intend to start a family but don't need medical help to do so.

1. The world is over populated.

This may be true, but again why shouldn't those who conceive naturally have to think about this too? Or is it that infertility is the mechanism by which god / mother nature / the flying spaghetti monster selects those who will bear the burden of keeping the population down and we just shouldn't mess with it? It seems to me a rather barbaric approach, but hey - why not? Let's also shut down all the hospitals and let mother nature take its course - infertility, infant mortality and slashed life expectancy for all will soon sort that pesky population problem out. Of course we could take a more civilised approach and treat those with fertility problems and perhaps do something else about the global population crisis like, umm I don't know, improvements in women's education and family planning for example?

1. It's mother-nature's way of telling you something.

Telling you what? That you don't deserve children? That it's just 'not meant to be'? Some causes of fertility are actually quite easy to overcome - for example your tubes might be blocked because of some surgery you might have had previously. I suppose instead of an operation or a round of IVF to circumvent that particular obstacle you should just accept your lot because 'mother-nature' it telling you your whole reproductive system is a write-off?

1. You just want what other people have, you're just jealous.

Correct - but we're not talking about wanting some else's nice new handbag here. Yes, when you are consumed with grief over not having your own child then it does sting when you see others with their kids. It's not pretty, but jealousy is sometimes inescapable. A little bit of compassion would go a long way here, these people are in a lot of pain. Nobody chooses to be consumed with sadness and jealousy and it's not the same thing as being unable, or unwilling, to be happy for others. If you could feel even a fraction of the self-loathing that is felt by a person who finds them self bitter and jealous when they would otherwise be so so happy for those others with babies then you would know how cruel it is to make such thoughtless comments.