I don't want to give birth in the MLU feel like a failure

[laurG]

I am 35 weeks pregnant with Baby 1. I am not scared of birth but for me I have no real desire to do it all naturally. I can't control what is going to happen obviously, but if things go at a normal pace I want to labour at home for as long as it takes and then have an epidural. I totally understand that epidurals increase the need for medical interventions, tearing and that I will need to be in a more clinical environment. But I find the idea of being in the hospital bit very reassuring. I am anxious about becoming a parent and the thought of being in a lot of pain really mind blowing. I just don't want to feel it longer than I have to. I also don't want my partner seeing me in pain.

The thing is I feel like a total failure. Ive been trying to do hypnobirthing techniques to get me through whatever fate chucks at me. But mainly to get through early labour before I can get to the hospital. However, the book I am reading (although it pretends to be neutral) very much focuses on natural birth as the first choice and interventions as an unfortunate but necessary back up. I stated antenatal classes the other day and the labour ward was very much marketed as a hell hole, where women loose their dignity and only really necessary in an emergency - with some acknowledgement that pain relief is ok if you have been labouring for a long time. .
I came home crying and feeling judged.

My midwife says that I have to start birth in the MLU regardless but can get a transfer and epidural but I don't believe her. I don't want to be in the MLU at all. It is really upsetting me. What can I do?

Read a different book? Every author is going to have their own stance on what the ideal birth involves and how best to achieve that. Even if you agree that a 'natural' birth is what you want, different authors will suggest different ways of achieving that.

We don't have a mlu in my area, so I never faced this exact quandary but I think it's nonsense that you have to start there against your will. Seek clarification from the supervisor of midwives on that.

I would also find out, if you don't already know, how late in the proceedings they are realistically able to perform an epidural. If you start off at home and try to remain there as long as possible there is the chance that by the time you get to the hospital, go through triage, get into a delivery suite and wait for an anaesthetist that your labour would be too far advanced for an epidural anyway. I didn't want one, but this certainly would have been true for me.

Make it plain on your birth plan that you want an early epidural so as not to take this risk. It's your body, your birth and your decision to make. Don't let anyone tell you otherwise.

Re failure, you can't fail at something you never set out to achieve. If you don't want to give birth naturally, and you've understood the implications of requesting pain relief, that is entirely your call. Stop comparing yourself to other women's standards.

Maybe think of it like this. If your friend was on a strict diet, yet ate a huge piece of cake she would be justified in feeling she had failed at the diet. If you're not dieting, or otherwise restricting your food intake, you're free to eat cake should you wish and no one should be assuming you're on the same diet as your friend.

You cannot "fail" at giving birth. Everyone simply does their best to get through it in one piece emotionally and physically...and even then nothing is guaranteed. It isn't a competition, an exam or a league table. Your experience has literally nothing to do with any other woman's experience, so comparisons are pointless.

My obstetric consultant told me that there are no prizes for not having pain relief. He was correct. I also detest the idea that having pain relief means your birth is not "natural".

Put down the hypnobirthing books, they are not helping you. You seem very clear on what you want, and how you will cope with things as they progress. You have done the relevant medical/clinical reading.

There should be boxes on the front of your notes that specify where you plan to give birth- tick the delivery suite box. Put it in your birth plan & remember that your community midwife is unlikely to be the midwife on shift the day you give birth.

I had no desire to deliver in a MLU and just nodded along with midwife talking about it and would just say at the end that I was more comfortable with the labour ward. I wanted to be sure I’d have access to pain relief if needs be. No reason to feel like a failure. Nothing wrong with natural birth (I actually didn’t need an epidural and laboured to 10cm without it) but nothing wrong with wanting to minimise your pain either. We offer pain relief for gallstones, kidney stones, tooth extractions without a second thought!

I was the same. I felt more secure in the hospital labour ward, knowing I could have help if I needed it. Due to medical reasons I wasnt allowed any pain relief other than gas and air and pethedine but I just felt safer in the hospital. I have had 3 hospital births.
If I was allowed to have an epidural, I 100% would gave had one. There is no shame in having pain relief.

OP my birth plan had only one word on it: epidural

Your notes need to say it, your midwife needs to be in no doubt and your DP needs to have your back on it.

I was exactly the same as you, without the MLU part. Can you raise it at your next ante natal, maybe with DP or your mum there to get your wishes clear?

And I completely echo Bobbie in that no one is going to tell me that the way I delivered my baby was any “less” than the way they delivered theirs.

Why do you have to start in the mlu? Is it hospital policy? If so maybe another hospital would be a better fit for you.

Please note the pp saying that if you stay at home long enough you might be too late for an epidural. You don't yet know how fast or slow your labour will be or if you will find the contractions manageable.

When they start again with what a hellhole hospital is, ask them if they weren't just telling you it's crucial that the mum is feeling safe? They will say yes. You feel the safest when you're giving birth at a hospital that is equipped to handle everything. End of discussion.

Thanks for your kind words. I just don't feel like the midwives are listening to me. I've brought the issue up twice before and both have said 'You'll be amazed at what your body can do" and "all labours must start in the MLU". The latter point doesn't seem to be true as the hospital website clearly states that you DO have a choice. I will try again at the 36 week appointment next week. ARGHHH I've just found the email address for the head of the midwife team. I think I will drop her a note.

I also find hospitals reassuring. Our MLU was in the hospital and you had to start there if you were low risk. I told them as soon as I arrived at 4cm that I wanted an epidural so I went straight to the labour ward. It was the best place for me and the same is true for many others. You should be able to choose the birth you want.

No, don't try at your appointment, you need to tell them that is what is happening full stop. Is your DH or birth partner good at backing you up and can they come with you?

You need to feel safe, it will help labour progress and it's better for your mental health.

Absolutely NOT a failure.

You have nurtured and grown your baby to his/her current size. That's not a failure...that's amazing. How he or she is born is largely immaterial. I've been a midwife and can talk natural birth like a pro if that's what the woman wants to achieve. But I was equally happy to support the woman who said "no thanks...not for me". Having your baby is a success no matter how he/she arrives. Only you have got the baby this far and only you can birth your baby. The midwives and obstetricians can help if needed but the bulk of birth is done by you and that's a huge success and to be celebrated.

Print off the web page that says you have a choice and take it with to your midwife appointment.

Be prepared to advocate for yourself & get your birthing partner on board.

Remember - you are the one giving birth & they must listen to your choices, even if things change on the day.

NICE guidelines state you should have a choice in where you have birth. I wonder if they’re trying to bump MLU numbers up? Are they at risk of being closed? They shouldn’t be putting pressure on you like this. They should be listening to you.

I did hypnobirthing classes and wanted to try labour without an epidural. Unfortunately given some complications (which I won't go into as I don't think that would be helpful to you), I ended up being strongly advised to have one. With DC2 I made a conscious decision to have an epidural relatively early when I felt the pain increasing to more than I could cope with. The labour went in a similar way but I was much calmer and in control this time and I really wonder why and for what I put myself through the mill before. There is no shame in having the labour you choose, whatever that is. I wish I had not felt pressured to do the things I was told were the "best way". The best way, for me, was an epidural.

So they are lying to you.

You totally do have a choice! It's awful they are pressuring you. Women should labour where they feel most comfortable.

Agree with previous replies - there aren't any prizes for giving birth with fewer interventions.

You need to at least start off having the labour YOU want, spell it out at all your remaining antenatal appointments and make sure your birth partner is fully briefed on what you are and aren't comfortable with. They may need to speak up on your behalf when you are in labour as you'll be in pain and it's hard to think.

They aren't realising the depth of your fear and therefore aren't realising that your fixation on one solution is something you are doing to manage your fear. And thus that having that option seem out of reach is causing you extreme anxiety.

All of us are terrified of labour so they probably think you just have normal levels of fear and are handling you as per normal.

Let them understand that your fear is abnormally strong and that you feel you can only manage the fear if you know you are in easy reach of an epidural.

They may well organise to show you how the transfer works if you do need an epidural to reassure you or simply agree that going into the ward is best for you. They might have other resources to help you.

Feeling like a failure already is a bit of a red flag for PND so it is probably a good idea to really let them know how strongly you feel.

I had exactly the same throughout my pregnancy. I kept being told I couldn’t go to labour ward as I was low-risk and had to go to MLU or homebirth. It make no difference to my otherwise supportive midwife, who despite knowing about my anxiety and depression, she refused to budge. It made no difference in the end as due to a complication I ended up on labour ward and the MLU couldn’t take me.
I recommend going to the Birthrights website as they have a fact sheet on there stating that it is your right to choose where you wish to give birth.

They absolutely can't force you to go to the MLU. It's not going to help your labour if you feel stressed before you even start, surely they should understand that!

Sounds worthy of a complaint!

You do not have to give birth in the mlu if you don't want to. Women should be listened to and their choices respected, whatever those choices may be.

I would encourage you to stand your ground with your midwife, and tell not ask her that you will be giving birth on the labour ward. On the day of your labour, go to the labour ward and refuse to go to the mlu if they tell you too (which personally I doubt they will).

This is your body, and women should feel empowered to chose the birth that is right for them (and this is coming from someone who had a planned home birth)