Can someone (ideally a midwife) talk me through what I can expect from midwives?

[Mushroo]

FTM and a bit clueless…

I’ve done lots of research on labour itself and I understand the process, and what to expect there.

What I dont have any insight into is what I can expect from the hospital / midwives. Can anyone advise on the following? I’m hoping to use a midwife led unit at a hospital.

1. I know I stay home until I’m in established labour. When I arrive at the hospital, will I go straight to a delivery room? I really don’t want to labour on a ward if I can help it.
2. How do they guarantee birthing suites are available? What if 10 women are giving birth at the same time?
3. How much interaction do I get from midwives? It says online the babies heart rate should be checked every 15 mins. Do I need to push for this to happen or are the processes followed?
4. When do the 15 min checks start? (As I’ll be at home until contractions are established).
5. When do I get a dedicated one to one midwife? Is it the pushing phase? Or the entire time I’m in the delivery room?
6. Can my partner stay with me if I have to go on a ward? (Before and after).
7. If I want an epidural, can I transfer from the midwife led unit? Is that easy to do?

I will ask my midwife as well, but the appointments always seem a bit rushed and I don’t have one for another month or so.

Thank you!

A lot of those questions will depend on the particular hospital you're in. You should get a tour at some point where you'll get answers. A lot also depends,I'm afraid, on how busy it is when you go into labour. They do their best to plan, but childbirth is unpredictable.

You get your own room to give birth in

If they are full up then you will be asked to go to the nearest available birthing unit with a free room at the nearest hospital

Everyone gets a midwife

The wards are for after you've given birth. You can pay for a private room which is what I did. It cost £50 a few years ago now

You never know what can go wrong so always give birth in a hospital with access to surgery as you may need an emergency caesarean etc etc

The anaesthetist does your epidural in your birthing room.

You need to let them know asap once you're in labour and are dilated enough for them to even let you onto the ward and have your contractions close enough because they may be too busy to do one or you might have missed your window.

You don't just randomly ask for one when you feel like it and they come immediately running

It's not like the movies

I guess different hospitals and trusts have different set up so you need to talk to your local hospital

I wouldn't count on any of those things, considering my experience of the NHS in the last 2 years.

@PetersSpecialCheese what parts specifically? This is why I’m trying to understand what is supposed to happen, so at least I know what best practice looks like.

In my experience... (Hospital can be different though)

You get a delivery room once in established labour. If you arrive before that and they say to stay you be on a ward until then.

They don't guarantee a room, if they are full you have to go to the nearest available hospital.

Once in established labour it is their process to check every 15 minutes. Midwife didn't leave me once in established labour and did the checks without me thinking about it. 2nd midwife joined when birth was close.

I think most places now you can have your partner during visiting times. Ours was about 10-8 I think (although went with home birth in the end). My first was born during covid so no partners at all.

If birthing center is joined to the hospital it is easy to transfer. Not sure how it would work if it's seperate from the hospital. Maybe ambulance?

You should speak to your midwife when you next see them to get accurate advice and you will feel more prepared but hope this helps.

^ this.
I didn't get a dedicated one to one midwife the first time. She was that busy running between me and another woman. And this was twenty years ago.

Hi, when is the baby due? Quite a few of the later appointments are dedicated to talking about how it will work at the hospital etc.

If you are feeling rushed at your appointments - don't these appointments are there specifically so you can ask all of these questions.

To help with one question and this wasn't on your list - once you think you are in labour - call your hospital. You might want you to come in or based on some questions stay home.

If during early labour at home, you have been told not to come in till you are at the magic 3 contractions in 10 mins but something doesn't feel right - you call back again. Don't wait.

Lastly typically when you go in before you are admitted you go to a triage bay (partner can stay) where you are accessed and then from there they will determine where to go. First my first I wanted to be in the midwife unit but once I was in labour and in triage there were some concerns so I went to the labour ward instead.

Once on the labour ward I then had 1:1 care.

Hi OP,

Most of the answers to these questions will vary depending on the hospital trust you go to. No one on here will be able to give you rock solid answers because it’s all so circumstantial. And all of this could easily change if you’re induced, if a planned caesarean is recommended or an emergency caesarean is necessary, or if for any reason you or baby are considered high risk.

I’ve had two births, one closely monitored as I was induced, another mid-wife-led unit, spontaneous labour. Both totally different. The commonality is that the midwives in the delivery were all amazing. It’s common for FTMs to come into labour ward when they’re only 0-2cm dilated and to be turned away.

If you manage to judge it right and you’re in established langur and you’re taken straight to the delivery ward, you will get 1:1 mid-wife care, assuming they have enough space and assuming there are no high risk/emergency deliveries that will take precedence. At that stage, it’s likely that you won’t be paying attention to what’s going on around you, so I wouldn’t hone in on details. Time is very blurry during late stage labour!

Instead of focusing on the mid-wife stuff, it’s better to be prepare yourself for the possibility of different eventualities. Mid-wives know what they’re doing!

Good luck! 😊

Not a midwife. But in my experience (and everyone’s will be different):

1. I know I stay home until I’m in established labour. When I arrive at the hospital, will I go straight to a delivery room? I really don’t want to labour on a ward if I can help it. Unlikely, they’ll probably want to do a VE first. But if you’re in established labour they’ll move you quickly or send you home.
2. How do they guarantee birthing suites are available? What if 10 women are giving birth at the same time? This is partly why you ring ahead, I was induced and they wouldn’t start my induction because they only had one “free” midwife for anyone coming in in established labour. I know of people being sent to a different hospital.
3. How much interaction do I get from midwives? It says online the babies heart rate should be checked every 15 mins. Do I need to push for this to happen or are the processes followed? They will follow the guidelines.
4. When do the 15 min checks start? (As I’ll be at home until contractions are established). Once you’re in the delivery room.
5. When do I get a dedicated one to one midwife? Is it the pushing phase? Or the entire time I’m in the delivery room? All the time you’re in the delivery room. You may have a change over if there’s a shift change. There will be more people around during pushing (no idea how many, I was kind of distracted)
6. Can my partner stay with me if I have to go on a ward? (Before and after). In my trust: before yes and after for 1 night, any additional nights at the discretion of the ward. FWIW shit having loads of people on the ward after you’ve given birth and feeling vulnerable. During visiting hours it was like a bloody crèche.
7. If I want an epidural, can I transfer from the midwife led unit? Is that easy to do? If you think you want an epidural, don’t choose to birth in the midwife led unit. You want to have it put in earlier rather than later; don’t spend 80% of your labour in pain just because you want to “see how it goes”. If you get to the point where you want/need one (I left it too late with my second, and it failed so they couldn’t redo it), you won’t be moving anywhere. My second labour I went from 8cm to delivered in less than 15 minutes.

*they’ll send you home if not in established labour

@PurBal @TurkeyLurkey4 @lifehappens12 thank you, this is all super helpful and gives me a much better idea of what to expect.

Im due 30 December so have lots of time, but also may have Xmas staffing to contend with 😬

Not a midwife but a mum of 2 little ones.

• I know I stay home until I’m in established labour. When I arrive at the hospital, will I go straight to a delivery room? I really don’t want to labour on a ward if I can help it.

Depends on how far along you are. If you're having 3 contractions in 10 minutes then you may well be in established labour but it's not a definite!

• How do they guarantee birthing suites are available? What if 10 women are giving birth at the same time?

You may go to labour ward.

• How much interaction do I get from midwives? It says online the babies heart rate should be checked every 15 mins. Do I need to push for this to happen or are the processes followed?

When you're in established labour, a
midwife should be with you at all times.

• When do the 15 min checks start? (As I’ll be at home until contractions are established).

You'll be examined (with your consent) upon arrival). Within 3 minutes of arriving during my second, I had the midwife rooting around telling me I was 9cm.

• When do I get a dedicated one to one midwife? Is it the pushing phase? Or the entire time I’m in the delivery room?

See above. It should be when you're in established labour.

• Can my partner stay with me if I have to go on a ward? (Before and after).

Depends on the time. Before, yes. Baby 1 for me was lockdown so he was gone straight after my emcs. Baby 2 was born very late in the evening and by the time I was ready for the ward after my next emcs at 1am, he was asked to leave.

• If I want an epidural, can I transfer from the midwife led unit? Is that easy to do?

You'll likely just be given it wherever you are birthing. Be aware that the epidural is based on anaesthetist availability. I waited 2 hours with baby 1.

Labour is magical and is usually very unpredictable. With my second, I didn't even bother to write a birth plan. Trust your body, listen to your instincts and expect the unexpected. Labour can be very quick or take days!

You’re so welcome @Mushroo ! I only just remembered, when I was pregnant with my first, I read The Happy Birth Book at least a couple of times. It’s so detailed and has birth stories of all different types of births from multiple women. I found it so reassuring. I also did NCT and hypnobirthing to help me prepare. The thing that’s so helpful about hypnobirthing is that it helps you feel that you can mentally manage any eventuality. 😊

Oh just remembered a really good book I read pre baby - positive birth book by milli hill. It's not about breathing but loss of good information and how it all works

Thank you all so much - exactly what I was looking for and feel a lot more prepared to have a more detailed chat with my midwife :)

Our MLU is in the hospital, the process was that if deemed as low risk by my midwife at 36 weeks, then I could try and get on the MLU. They gave me the number to call when labour started, I phoned the wrong number and ended up in labour ward reception, waiting for someone to decide if they wanted the last room on MLU, thankfully they didn't and I got it.

When I got onto the birthing unit a midwife met me at the door and took me to a room to examine me, confirmed I was 5cm and went off to run the pool in what was the birthing room.

She said that they examine every four hours if wanted. She regularly checked the babies heartbeat and would be in and out of the room, as they were also tending to mother's on the ward. Once I was pushing, she stayed with us the whole time until DD was born.

My husband was allowed to stay until 10pm I think, however with DD2 had I gone onto the ward he would have been sent straight home and asked to do standard visiting hours 10-2 and 6-8 I think.

I had DD2 on labour ward as was induced. When I asked for an epidural I had to wait for the anesthesist as he was doing other epidurals, by the time he got to me I was 10cm and pushing.

hi midwife here,

1. I know I stay home until I’m in established labour. When I arrive at the hospital, will I go straight to a delivery room? I really don’t want to labour on a ward if I can help it.

depends on the set up, some MLU you attend straight away and may go to a room to be assessed, this may be your labour room or an assessment area. Some units you may go to a centralised triage area. When in active labour you will have your own room, if admitted in early labour may be in a bay.

1. How do they guarantee birthing suites are available? What if 10 women are giving birth at the same time?

it’s never guaranteed, occasionally units close and women are directed to other units with availability, but most of the time there will be space.

1. How much interaction do I get from midwives? It says online the babies heart rate should be checked every 15 mins. Do I need to push for this to happen or are the processes followed? Fetal heart monitoring is every 15mins in active labour, so when you’re contracting regularly, and cervix is 5cm… ish. At home obviously you won’t get this, and in early labour if you’re admitted this won’t happen either. Midwives follow national and local guidelines.

1. When do the 15 min checks start? (As I’ll be at home until contractions are established).

see a over answer.

1. When do I get a dedicated one to one midwife? Is it the pushing phase? Or the entire time I’m in the delivery room?

when you’re in active labour.

1. Can my partner stay with me if I have to go on a ward? (Before and after).

This is trust dependent

1. If I want an epidural, can I transfer from the midwife led unit? Is that easy to do?

yes if you would like an epidural you would be transferred to delivery suite as the monitoring changes. And it is easy to do.

hope this helps

Not a midwife but gave birth recently.

Alot of what's been said already it is trust dependent.

When you're in established labour the last thing you'll be thinking is whether the baby is being monitored. You have so many things going on. Breathing, whether to have pain relief, finding a comfortable position and then there's the contractions.

In my experience, I had to have interventions and they were discussed with me prior except for the episiotomy during birth one which my husband consented to for me. I was out of it.

The midwives and consultants were amazing and on hand. Both my babies had raised heart rates or erratic rates and they kept me informed, and positioned correctly, told me when they were adding the monitor to babies head etc.

The mood is light but business like and they know their stuff. In the hospital I was at as it started to get dark they dimmed the lights and put fairy lights out for a calmer atmosphere. There was a blue tooth speaker for music available as well. Tea and toast (coffee for me) brought in as soon as you can manage it.

I was able to shower after my waters broke (was monitored and checked out first) and had a shower before being transferred to the ward. I was given the choice of a wheelchair or to walk. I walked. Both times. I really needed those showers.

In my trust the side rooms (private rooms - I had for both) the first time around because had such a traumatic birth they put me in one without asking or charging ( i would have gladly paid) this time around I definitely wanted another but you could no longer request or pay as they are kept for ladies who are covid positive. I asked if there was one available and lucky for me there was so given it free of charge again.

H could have stayed the first night with me but I sent him home both times. I needed him to be rested to help out especially this time with another child at home. In my trust the visiting hours are 9am til 9pm. Hs/Ps are not allowed to spend the night on the ward or use the facilities, they have to go to the normal toilets in the main part of the hospital.

I spent 5 days in hospital the first time and 3 the second (baby was unwell) the food was hideous, H was able to bring me food in and was able to drop things at reception out of visiting hours.

I would say though if you're planning on breastfeeding, bring a pump with you just in case. Where I was they didn't have one available.

Oh and speak up for yourself, ask as many questions to your midwife as you want. They are there to guide you.

Good luck and congratulations.

All depends on the hospital. I arrived at hospital 5cm dilated and very much in established labour yet had to be sent to a waiting area while they 'got a room ready for me'. The waiting area was the same one as everyone getting their scans so it was hard trying to discretely survive strong contractions while being surrounded by women in the early stages of pregnancy and young children!

Also worth checking hospital policy. At mine it was a strict no to the birthing centre if you'd had any more than the 2 routine scans, even if the scan turned out to be for no reason / everything was fine.

Thanks everyone, really helpful :)