Midwife led unit

[daisy2609]

Hello,
I'm 10 weeks pregnant with our 5th child. Had a very awful first birth (long labour, pushed for over 2 hours, got stuck, tried forceps and ventous, resulted in a c-section) but since then have had 3 "textbook" deliveries, no pain relief, stitches or complications.

I had all my babies in a very busy high risk labour ward. I really don't want that again I want to have this one in the midwife led unit attached to the labour ward. It's literally along the corridor from the labour ward. You walk in and turn left for unit, right for ward. I want the pool this time, I want to not be strapped down on my back being monitored for 6 hours. I want to feel relaxed and a bit more in control, I'm fed up of delaying going in as long as possible so I don't feel so panicky through labour.

How do I convince them to let me do it?! For what it's worth I wouldn't consider it if the unit wasn't literally a 20 step walk for doctors in an emergency. I don't want to insist on a home birth but tbh I think I'd actually prefer that to another over medicalised (that a word?) birth. It's not only the birth but also the hospital stay after, last time they constantly wanted to take blood from my baby for EVERYTHING! They must have pricked his heals 20 times, absolutely no exaggeration. The midwife could barely do his heal prick test because I the damage to his feet. Add to that being in a bay with 4 other women and their babies, no sleep, no privacy and being the only one breastfeeding on the ward where everyone else was bottle feeding. I just wanted to go home and they delayed it for over 24 hours. I was in tears by the time we got home. The idea of being in a more homely and private environment is so appealing. I just need to know if I can even "insist" on going to the unit or if they can refuse and make me go to the ward.

Thanks for reading!

Your body, your baby, your choice. Repeat as necessary. That being said, listen to their advice too. It's always a grey area as to them 'letting' you and them following hospital protocol - for example, if they 'let' you despite you having factors against their hospital policies they are opening themselves to all sorts of trouble. I'm intrigued to know why they pricked your baby so much, we only tend to do that for blood sugars (which is important) or very few other reasons so they must've had good reason to do that.

I’m going through this now. I have stated a preference, which has been agreed, for the MLU however in reality they can turn me away on the day (and did first time!) and there is nothing you can really do.

I’ve had a birth planning session with a consultant midwife who was supportive of this and detailed it in my notes. the consultant wasn’t particularly thrilled but didn’t cause any problems either. However, as I say, I am Concerned I’m being placated and have no chance of actually getting on the unit when the time comes

Bear in mind there may be somethings you have rights to whilst a patient/ labouring woman (the right to refuse treatment etc) but you can’t force them to accept you into a part of the hospital if they’re not happy on the day.

Just make it clear you know, understand, and have researched your risks and would still prefer the relaxed atmosphere of the MLU as you feel it would be beneficial for your labour

A compromise is to be on the high risk ward but replicate a MLU birth there- 1:1 with a midwife (refuse doctors visits) keeping mobile (mobile monitors should be available) and potentially a pool (our consultant unit has one- it’s not very used because not many High risk women can use it, so a good chance of availability)

sorry I may of missed this in the original post but what's the reason for you being on a high risk ward apart from awful first labour ?( only share details if you feel comfortable 😊)

I think you really have to stick to your guns on this if it's what you want , you've proven you are able to have textbook births so Im sure with the right midwife/consultant you'll
Be given a chance

The more births you have, the higher risk you are. Plus a previous c-section increases risk. You may also be over 37 or whatever the age is they count as extra risk as well.

Ultimately up to you but they don't have to accept you at the MLU. If you don't want the delivery suite I think the alternative is saying you'll have a home birth in which case I understand often the MLU is offered as a compromise.

I'm preparing for VBAC and facing similar hospital aversion, so you have my sympathies! Going with a doula and a stiff birth plan but who knows. Maybe if you research a bit, you could refuse some of the prick tests and nastier elements of birth?

Thanks for the replies guys, sorry I haven't been back sooner.
I'm 32 so it's not an age thing, definitely understand with the more babies and c-section being higher risk. But I have had no complications in any pregnancy or birth since the first one.

I don't really want a home birth, I do get that I should be within short distance of actual help if needed and of course, if any problem arises during the pregnancy I would be welcoming all the medical stuff with open arms. It's all the stuff that comes with it. I will definitely ask about a meeting to discuss birth options, that sounds a perfect place to start. My community midwives are incredible! It all seems to go so brilliantly until a consultant gets involved. I know they're usually just being over cautious but sometimes I think they worry themselves and me a bit too much! I was having growth scans for the last month of my last pregnancy as they thought the baby was going to be huge, constantly terrifying me with talk of an 11lb baby (only estimated!) he popped out at barely 8lb, exactly the same as 3 of my other babies I'd been panicking about how my lady bits were going to manage it, turns out, perfectly fine.

The tests the baby had last time were mainly for sugars, but also for blood gasses and then for jaundice the second day. Nothing ever came of any of them. I wanted nothing more than to refuse some of the tests, especially as 2 of them had to be repeated because they "lost the samples" i honestly did not think I could refuse them though! That's good to know for next time thank you.

Thanks for all your input, I'll calm down and start talking

Yeah stay calm! The home birth thing is basically a cynical slightly middle class strategy - they don't want you to have a home birth, you don't want to have a home birth but the threat of you going for one would make them say MLU is available to mitigate risk. A bit devious but I've read that a few people go for it. You don't actually have to have a home birth or even want one

Does the MLU allow you to deliver a fifth baby? Ours won't due to the risk of PPH, have you considered refusing the monitoring if everything goes to plan but staying on the consultant led unit with a firm birth plan in place?

Is the MLU in the hospital new? It's just a bit unusual that you weren't in it for your previous births if you had textbook pregnancies.

All you need to do is tell the midwives you want to give birth there, they'll do a risk assessment around 36 weeks to make sure you're a suitable candidate and then you can have your baby there. And if there is some reason why they think you should not, then ask to speak to the unit's Professional Midwifery Advocate (used to be supervisor of midwives) who can help you navigate your choices and advocate for you.