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 started off in a stand alone MLU with DD- the midwives are rightly very very cautious and the first hint of a problem they will transfer you.

I had been having contractions for about five hours and the midwife wasn’t happy with the speed I was progressing, so opted to transfer me to the big hospital about a seven minute drive away.

I had DD 12 hours later with just two midwives and no intervention at the big hospital.

The worst part was the ambulance transfer- I’m my gas&air haze I was really embarrassed and every bump in the road was agony. I’m pregnant again and I’ve chosen to go to another hospital with an attached MLU just to avoid the possibility of another ambulance taxi!

People I know who used a MLU 40min from the nearest CLU hospital said the midwives were very quick to transfer you just in case, so it was almost as if they planned for women to labour in the MLU and birth elsewhere.
Luckily I had a hospital MLU and got to stay in it much longer than if I'd been in a separate MLU. By late pregnancy I was pretty sure my birth wouldn't be 100% straightforward (very bad SPD) so declined the offered homebirth.

I was a low risk pregnancy and had planned for a waterbirth in the MLU, which is actually attached to the deliviery suite within the hospital. I had practiced hypnobirthing for months, and was very clear about how I wanted my birth to be.

On the day, the MLU had no beds, so I ended up in the hospital delivery suite. The team were amazing, and fully respected all my wishes. I still felt like it was all very calm, private etc. We had low lighting, music, LED candles, scented oils etc.

In the end, I ended up with an emergency c-section, but even that was a positive experience.

I think what I’m trying to say is that you may not end up in your ideal environment, but there are lots of things you can do to try and have the best possible experience. Hypnobirthing was key for me, and a really clear list of birth ‘wishes’ that could be given to all the staff.

Consider the situation of needing an emergency transfer because your life, or that of your baby is threatened. It’s alteady a 45 minute drive, but add to that the wait for an ambulance and you could double that. A MLU is considered a place of safety by the ambulance service so you would be lower priority than other urgent calls to people at home e.g. chest pain, difficulty breathing etc. Personally I would not put myself in that position. You’d be safer delivering at home. I have seen a couple of horrific outcomes from rural MLUs recently - in fact, they are considering closing one of them as a result.

Another vote here for the big hospital. Birth is serious business and, as PPs have said, it can all change very quickly. Easy pregnancy does not necessarily equal easy birth.

My neighbour is a GP and she has had all 3 in fully staffed NHS hospitals (2 here, first in London) despite popping them out like kittens and coming home less than 6hrs later to put on the washing and cook a roast (Ok I exaggerate slightly but it's been that easy for her)

I live in the south on the edge of a cathedral city (but no cheese ) and had both of mine at the county hospital here. The first was a long labour followed by a C-section because DD1 was at the wrong angle. I would have torn badly and she could have had permanent nerve damage to her neck/shoulder. It was all as pleasant as it could have been. The second time, I did it the old fashioned way - VBAC. The birth itself was straightforward, induction at 9am, drip until noon, DD2 at 3:57pm. BUT less than 30min after her birth, I nearly bled out from placental adhesion despite being only a few rooms away from several theatres. There would not even have been time for me to be blue-lighted from home.

Go to the hospital. With any luck you'll only ever see midwives and can have candles and music. Best wishes and enjoy your LO.

With my first, I ended up going from the MLU attached to the hospital (basically through one set of doors) to the Labour ward and then for an emcs when it became obvious that dc1 wasn't going anywhere despite being fully dilated.

One of my friend's had an identical situation only she was in a standalone MLU a 45/50 minute drive from the hospital. Her experience was much scarier than mine.

Based on that and the fact that it's your first, I'd take the Birthing Unit attached the hospital personally.