Where to give birth? Advice please!

[Nolagerformethanks]

Hi all,

I am expecting my first child and I'm 21 weeks pregnant, in my area I have the choice of giving birth at a MLU or a large hospital with a dedicated birthing centre. To give birth at the MLU you must be low risk, they can't induce there either. It is a 15 minute drive north from my house, they have no consultants or doctors there and are not able to offer an epidural. If in the event of any emergency during labour or after labour (baby having troubles or me having a serious tear) I would be sent by ambulance on blue lights to the large hospital previously mentioned which is a 45 minute car journey. All my pre natal care has and will take place at this unit. If I went into labour naturally there is a very good chance I will be the only woman delivering there at the time with 2 midwives to myself.

The birthing centre at the large hospital can obviously offer anything needed in case of emergency, my midwife care has not come from them therefore it would be a totally new environment with me not knowing even 1 of the midwives there. It is a 50 minute drive south from my house.

My pregnancy is low risk, again this is my first child I'm just so torn between the 2 choices, I know I have a while to decide yet but I'd rather come to a decision soon. Any advice/reccomendations would be greatly appreciated

I can only share my experience. I went from low risk to higher risk to being rolled into surgery for an emergency csection very quickly while in labour. I did manage to deliver her without the section but lost quite a bit of blood.
In my situation we couldn't have waited the 45 min.
But my situation was unusual and was a culmination of various issues at the end. Statically the likelihood of it happening are incredibly low.

Sorry to confirm I started out in a MLU but luckily in a hospital and then had to get transferred at pace to the labour ward and then to theatre.

Personally I wouldn't risk a MLU and didn't BUT my mam had an horrendous time delivering my sister when I was 14 and it terrified me.

I was low risk with my first, very healthy too young and still needed doctors assistance.

Too balance those statement out my DSis and one of my close friends have both given birth for the first time this year, neither with complications.

Sounds identical to my situation. MLU 15 mins away, big hospital 45 mins. As it was the decision was removed from me as I was high risk and then I was induced. Before I was pregnant I was adamant I would use the MLU but it concerned me that at the slightest hint of a problem, I would be blue lighted (with DH following in the car). In my trust, I could come back to the MLU to recover which I did, and was the only woman there. I personally would choose the bigger hospital but that’s probably because of my experience

I would definitely go MLU. Had one in hospital which was a horrible experience and one at Home Which was lovely. MLU seems in between.

I experienced similar. DC1 we were transferred to Big Hosp in an ambulance with blue lights etc. A 45 min drive is a lot shorter in the middle of the night in a shiny ambulance. Turned out to be not quite so dramatic, but needed their care for repairs afterwards anyway. Not having been there before was fine (I'd never given birth before or looked after a baby before so it was all new anyway!)

DC2 was born much more quickly in the MLU but also much more painfully and I think if I had a DC3 (nope) then I'd voluntarily go to the Big Hosp and have an epidural!

Do whatever makes you feel most comfortable. take the epidural

Are you in the North @cakesandphotos? Don't feel the need to answer that if you would rather not! Thank you all so far for your experiences/advice, I had convinced myself I would go MLU but I'm really starting to think about the trauma I may go through in the event of something not going to plan! It's a very hard decision, not to mention I'm due in the depths of winter and live in the country so I have also convinced myself we will be 6 foot deep with snow 🙈 must stop worrying! I do imagine though as this is my first child there is a high chance I will have to be induced anyway...

Hospital. MLUs that are not in the same building as a delivery suite are dangerous. If you get a cord prolapse at the last minute youter baby's brain won't survive that journey intact.

Ha @Nolagerformethanks yes I am. Is your MLU in a town starting with H?

Having had two smooth, uncomplicated and low risk pregnancies that resulted in complicated births needing emergency medical intervention I would always recommend a birthing centre with doctors and theatre on site. I honestly don't know why stand-alone MLUs exist, nor do I understand why women would opt for them.

Birth is unpredictable and can go from smooth sailing to flat out emergency, room full of doctors and rushing to theatre in a matter of minutes, as I have experienced personally.

I am sure everything will be fine with your birth and I don't want to scare you but with a 45 minute drive to the nearest birthing unit, I would not be risking it at the MLU. Sorry.

I had my first in the MLU and it was fantastic! Saying that it was attached to the hospital and a transfer would have been a ride in the lift. With a first, in your situation I would probably go hospital too. A lot can happen in 45 minutes.

@cakesandphotos no it begins with an A but seems we are definitely in the same trust as I know yours rhymes with a tinned meat thanks all for the advice and experiences, I am thinking the hospital will definitely be the way to go, will just have to grin and bare the 50 minutes in the car in labour

@cakesandphotos just as a side note my local MLU doesn't allow people to go back and recover there now, they don't staff it through the night unless a patient comes in in labour then on call midwives are brought in!

What about a home birth? If you have two midwives, you will have the same level of care. If you need extra help, then you go to the hospital.

Very few things happen unexpectantly.

If you want zero risk and are willing to accept minor complications (such as episiotomy), go straight to hospital.

I had the choice to go to a local smaller unit or the main hospital. Even though everything went smoothly I'm glad I was up there incase something happened. The last thing I'd want was to be blue lighted up. X

@Nolagerformethanks tinned meat? Now I’m intrigued! 😂

Babies can die or be severely disabled in a 45 minute transfer. Personally I think MLU should be attached to a hospital only.

I would go MLU as you haven’t even listed home as an option, but I had 2/3 births at home. (One being the first)
I drove home from holiday in my last labour after my waters had gone about an hours journey from home so a 50 minute car ride is doable.
Not all births are traumatic and horrific. The pain is not unbearable and you can prepare yourself for lots of eventualities.
You don’t have to be induced if you don’t want.
A change of team and a journey may slow your labour down and could lead to interventions if you drive to the hospital.
If you stay low risk I would go MLU.

@cakesandphotos Spam? I say meat but I'm not sure what it is really 😂 thanks I'm really interested in all the suggestions, I hadn't even though of a home birth! A lot to take into consideration

This was literally me last summer. Liked the idea of MLU but the fear of the unknown was too much for me. I couldn't cope with the worry of needing to be ambulanced 45 minutes to hospital whilst in labour/immediately after giving birth, or the idea of not being able to have an epidural when I didn't know how I'd cope with the pain of childbirth.

I decided to go to the hospital but as it happened I had to be induced, so I would have had to go to the hospital anyway. However, looking back, I am glad I went to hospital. I'm pregnant with DC2 and will go back to the same hospital.

I had a straightforward birth, no epidural or intervention and just a few stitches for a 2nd degree tear, home 24hrs later. The consultant was called in to see how things were progressing and as babies heart rate had dropped he said I would need ventouse if he wasn't out on the next push. I just have listened because with the next push he was out, but that goes to show that even a straightforward birth can be moments away from needing intervention and I was so glad to be in the right place if necessary.

I had my care at my local hospital, so neither the MLU or the hospital I gave birth in. Once things kick off you won't know where you are or who your midwife is, so I wouldn't worry about that!
M

I had my first in a MLU unit in the hospital which was the floor below the consultant led unit so best of both worlds.
Didn't want a epidural had a straightforward pregnancy and when I went to triage in early labour they just sent me there. Baby was born 6am was discharged 8pm that night probably would have been sooner but had to check babies blood group and give me anti-d.
First births can be unpredictable and I'm not sure if I would liked to be that far away from a consultant led unit.

Hospital for me! Luckily, in my area you can have the local mlu (10mins) or the mlu at the hospital (30mins) or the delivery suite at the same hospital (30mins). I went for mlu at hospital and luckily I did as ds needed resuscitation and the alarm button was pressed at drs came from upstairs. Ds would probably have been fine with midwives resuscitating him but in the end (several hours later) we also needed NICU so would have been bluelighted after birth anyway, even though labour was very straight forward and I was encouraged to go for the local mlu.

Perhaps you could ask for an idea of numbers of women who transfer, to give you some perspective.
Generally midwifery led births are less likely to need interventions. If your risk changes towards the end of pregnancy from low, you will be able to change your choices 💚

Yes, usually much less intervention with Home births and MLU. This may be due to there being less high risk in first place. I do think they can be quick to intervene at hospital and when I gave birth at home I was so much more relaxed so was sooo much better.

I was in an almost identical situation with my first (I'm in the South) but in my case there was local MLU (5 mins away) and also a smaller hospital that was closer at around 20 mins (but was consultant-led only), and then a bigger hospital that was 45-60 mins away (with standalone MLU in the hospital too). I chatted to my midwife about the concerns I had about being transferred and she was very reassuring that at ANY sign of complications they will transfer ASAP, rather than waiting until it becomes a potential emergency. I also toured the birthing and recovery rooms in the MLU and I knew then in my heart of hearts it was what I wanted.

It totally didn't go to plan for various reasons, as my blood results had some abnormalities, so in the end I agreed to go to the local hospital 20 mins away. Then I needed induction anyway as my waters broke and labour didn't start within 24 hrs... so regardless I would have ended up in hospital.

This time my situation is slightly different as ONLY the big hospital has consultants, the smaller local one is now midwife-led only. I've thought about it carefully and I have decided that (assuming I stay low risk) I want to try again for a birth at the MLU that's 5 minutes away. I did also consider a home birth though, so I'm not concerned about transfer as I trust the midwives will take no unnecessary risks.

I'd recommend you talk your your midwife about concerns regarding transfer and also look into their birth statistics - which will tell you about transfer rates vs births at the centre. This will allow you to make a fully informed decision that's right for you.