Kingston- midwifery led unit or the 'medical' side?

[micegg]

I am only 15 weeks preg with num 2 but already nervous about the birth. I will try and keep this to the point. Bascially we lived in a different are when i had DD1 and after getting to 5cms I could not stop pushing and was in agony so had an epidural. No regrets about this as the birth was a good experience. But as I have not actually experienced the full on drug free version of childbirth I dont really know how I will cope. This may not matter but the hospital I am booked in for baby 2 is Kingston which seem to have 2 sides to their delivery unit. The midwifery led side and the medical side (obvioulsy they dont call it this but not sure what to name it). The mid led side sounds lovely. Home from home, stay in the same room after the birth (I believe), promotes active birh and pool, blah blah blah etc. I like the IDEA of this. However, apparently you cant transfer to the med side for an epidural. Part if me wants the opportunity to try the whole natural, active birth approach with a pool, etc but the other part of me wants the choice of an epidural. I have visions of myself going on the med side and being pushed into this high tech type birth when I could have been alright on the mid led side. Or going on the mid led side and deeply regretting not haveing an epdidural. Given that I dont really know what the full on version will be like I am scared by the whole idea of commiting to either side. Has anyone had experience of this set up? It just seems odd to me. Why cant they have the home from home thing going on in all the rooms with a choice to have an epidural and medical support if you need it. Suspect much of this anxiety is about the birth itself than which side I go on but just bare with me!

micegg, I haven't given birth in a hospital like you describe, but a similar experience in that when I gave birth to dc1, I had the choice of midwife-led unit (very low tech, def no epidural available) or a large hospital about 20 miles away. I went to NCT classes and much of the group discusion centred on exactly your point - no one could decide where to book in, because although we all agreed that the unit sounded much nicer and in tune with the kind of births we wanted, most people wanted the option of an epidural if the pain became too great! I decided on the small unit and it was the best decision I made. (And I know what the comparison is like, because dd2 was a c-section in the large hospital and dc3 a VBAC in the large hospital - I was by now classed as 'high risk' so wasn't allowed the lovely unit.) It sounds as if a big issue for you is anxiety levels - you know you want a natural birth but you've lost the confidence that you can do it. I would say that a postitive natural birth could be a great experience of empowerment for you, after a very medicalised first birth. I think all women get to the point in labour of thinking 'I just can't do this any more' but then you find the energy from somewhere. You make an interesting point about why can't epidurals still be available even in a midwife unit. I suspect there are lots of reasons to do with staffing/having anaesthetists on hand etc. But for myself, I was glad in retrospect that i hadn't even had the option. DC1 was a long hard labour, and I can imagine that if an epi had been a possibility then I might well have given into it. The whole birth would then have been very different - statistically, epidural leads to more interventions such as forceps/ventouse. I know I wouldn't have felt the same about it. I had such a powerful feeling that this had been 'my birth', that I had done it which was amazing. So, sorry for the long post, but I would say def go for the midwife side.

I'm booked in Kingston (for an elective CS though)and what they say on the video (you can't visit the actual ward) you can transfer from midwife led unit for an epidural to the "medical unit". Anyway maybe the best route would be to ask for an appointment with a hospital midwife to clarify all your doubts?

I had dd at Kingston almost 3 years ago and certainly at that time you could transfer from the Malden suite to the delivery unit if you wanted an epidural. After all, if you had issues during labour and needed further assistance they would transfer you.

However, when I was looking into it and booking in they pointed out that if you went in the normal medical unit, it didn't mean you couldn't have a natural delivery with only midwife help just that everything was on hand if you needed it. What swung it for me at that point (not that I would have had a choice when it came to it but thats another story) was that the normal delivery rooms had ensuite bathrooms, the malden suite didn't. Of course, this may have changed.

Good luck with whichever you choose !

i was booked into the malden suite (the midwife-led suite) but they wouldn't take me because i had problems with blood pressure.

i think the policy is that you can't have an epidural in the malden, but you can start off there and transfer (i.e. pop down the corridor) if you need medical support. you don't have to commit to one or the other (and the choice may be made for you as it was for me).

so i ended up in the "medical" bit but still got a midwife-led delivery. even though i ended up with an epidural, i wasn't pushed towards a high tech approach. the doctors' involvement was minimal, with the midwife topping up the epidural, and encouraging me to be as active as possible in the circs. i was really pleased with the care i got.

hth

cross posted, sort of

the malden rooms do have ensuite bathrooms now

ooh Jura - if you see this, quick hijack but did you get my CAT.

Sorry if you have and youre just busy/ don't want to reply but just wondered. Am not mad stalker honest, just saw a post of yours regarding a school which I think your children are at and wanted your thoughts if you didn't mind.

Haven't read all the post (must do some house work!) I booked the Malden suite three years ago. When the time came they didn't have the a room available. Planned a natural birth with a little help from Tens machine all went very well. Good medical staff gave me options. Write out a birth plan of what you think you want. Add a few what if's keep one for yourself make sure your birth partner understands your requests. The room I had in the end was bigger and a view which was lovely. They brought extra pillows out for me. Don't worry be happy

That's great - thanks. Sorry to nag, whenever its convenient for you to reply would be fab - I just wanted to check you'd got it ! Look forward to hearing from you as and when.

There isn't really much difference (or wasn't three years ago, but at that point they didn't have pools in the Malden unit either). The two "sides" are literally paces from each other, and the rooms are virtually identical (I think "home-from-home" would be overstating it slightly). And in the not-Malden side you're unlikely to see anyone other than a midwife anyway unless you are high risk or develop problems (or are having an epidural, obviously). They may have redecorated since then and made the Malden suite rooms extra-homey (or possibly installed scary killer cyborgs in the other rooms to make them less homey ) but honestly, at the time if someone blindfolded you and put you in one of the rooms you wouldn't have known which it was (although, again at that time, the Malden rooms didn't have private ensuite bathrooms whereas the others did -- as lulu says, they do now).

By the time I was in labour with DS I was classed as "high risk" so not allowed to go for the Malden. Last time I checked (am pregnant again, going for Kingston again but still won't be allowed to go for the Malden as I'm having a VBAC, so it's not as if I checked in detail, but I did read through that bit) they did let you transfer if you wanted an epidural, assuming there was a delivery room available.

So if you particularly want to use the pool for labour or water birth I'd go for the Malden. It'll be easy enough to transfer if you want to. But if for whatever reason you end up not being able to use the Malden the alternative isn't radically different.

Haven't read them all I'm afraid. I was booked in Malden Suite but there was no room when I arrvived. Had a very supportive m/w on medical side who let me have a natural (ish) birth. DS got stuck and after 2hrs had to go to theatre for ventouse. IME, then, book into Malden Suite because you can change your mind when you get there! Also, if you do end up medically then they are great.

p.s. do the New Malden active birth class and then you'll be ready for anything!

Gave birth to DD1 in the medical side, and DD2 in the Malden suite and would say the main difference was a more relaxed approach in the Malden suite; DH and I were largely left to our own devices and were actively encouraged to go out for a walk, get a coffee, whatever. Of course this may have had more to do with the fact that it was our second baby and we felt more confident ourselves, than it being policy, but it was generally a calmer, more relaxed experience. Saying that, I felt very well supported in the decisions I made for both deliveries, and certainly didn't feel pressured into any medical intervention for my first birth, the midwives were great for both.

I did prefer the rooms in the Malden suite (and was lucky enough to get one of the two with a birthing pool, though dd2 ended up arriving too quickly for them to fill it in time ); I think because they contained less medical paraphernalia. Agree with lemonaid that 'home from home' is not an entirely accurate description though! But both sides seemed clean and bright and had ensuite bathrooms.

As lemonaid said, the two sides are literally just opposite sides of the reception area, so I can't see how it wouldn't be possible for you to get an epidural if you needed one, they just don't encourage you to book the Malden Suite if you're pretty sure you will want one. Fingers crossed you won't, most second deliveries seem to be much quicker!

One word of caution - Kingston is an extremely busy maternity unit. So even if you do express a preference for one side or the other, there's no guarantee that's what will be available on the day. Bearing that in mind, I would imagine (but am only assuming) that an anaesthetist (sp??) may be available more quickly if you were already in the 'medical' side, (but you may still have to wait a while for one).

Hope this helps, don't mind answering any specific questions you might have.

I had my daughter in the Malden suite, found it excellent. Would be v happy to answer any specific questions. You can't stay in the same room after birth, though, you have to go to another room. But you will only share with a maximum of one other person and the bathrooms are lovely and clean and close. I have no complaints at all about the care that I got!

Thanks everyone for your replies. I am going to check out the active birth classes and book the malden. Sounds like it doesnt matter much as where I go will depend on availability on the day and also sounds like I can transfer for the epidural if I need one. I have heard some horror stories about Kingston so its good to hear some positive stories. Only 20 weeks before I find out!

Hi, I work at wexham park and we have a wonderful birth centre and separate labour ward. Women on the birth centre can transfer to the labour ward if they want an epidural (although most don't as they enjoy the experience of the birth centre).

I'd say just double check that point because sure as heck, they'd take you to the ward if you experienced complications so I can't understand that they would not transfer for an epidural - sounds a bit draconian if they don't...

Its actually a bit contradictory. In the hospital pamphlet it says you can transfer for an epidural but in the types up midwife info it says "transfers for an epidural" are not normally allowed ot words to that effect. Sounds from these potsings it wont be a problem on the day. TBH I will just crawl to the other side of need be