Birth centre or hospital?

[Eleano]

Has anyone got experience of giving birth at a birth centre and what was it like?

I’m considering it however, my nearest one (Crowborough) is a 40 minute drive from home and a 20 minute (ambulance) drive from Pembury hospital (in case of complications).

I’m low risk so I’ll probably pass the assessment but I’d love to hear thoughts from someone who’s used one before as I'm a bit nervous about it not being closer to the hospital and about my own body's reaction to labour since it's my first time.

My main reason for looking into birth centres is the better birthing environment, better midwife to mother ratio and the ability to use upward birthing positions rather than lying down (which is meant to be the likeliest position to cause complications). Also a study across 68,000 low-risk pregnant women, showed that the birthing practices used there halve the chance of intervention compared to hospital births.

I gave birth second time in the birth centre attached to the maternity unit so it doesn't apply. The midwife mother ratio was the same as the staff were pooled and pulled to different areas (mine was called from on call, no midwives free when I arriveed, the lead midwife did my check in.)

However, without even asking, first time round (when there was a local birth centre without clinical back up) everyone diswaded me from using it. A colleague needed to be bluelighted due to haemorrhage (first birth). Someone in my NCT had her first birth in the birth centre, baby went to nicu. In the end, I didn't have a choice as I went into labour before 37 weeks, but I'd decided labour ward.

My labour ward delivery was ok. It's private rooms so you can do what you can to make them a better birthing environment, projector, essential oils defuser etc.

Important thing is there is no reason a labour ward birth is automatically lying down. They mostly have ensuite bathrooms and bean bags and pools, although they are less likely to be free than in a birth centre. There are bars on the walls to hold onto for an active birth.

Personally I would either have a home birth or a midwife led birth in the hospital. I can't see what benefit the birth centre has - and actually may end up less safe than being at home if there were complications as you'd be viewed as being in a place of safety by the ambulance dispatch team, so you'd be lower priority than someone at home. Ambulance response times nationwide are pretty horrendous at the moment so I would want to be in hospital.

No reason you can't birth in whatever position you want, wherever you choose to labour!

I work in a stand-alone birth centre. The point above about a slower ambulance response is just not true. We have cat 1 for emergencies (approx 8 minutes) and cat 2 for all other transfers (approx 15 minutes). Regardless of the reason for transfer, a midwife from the unit goes in the ambulance along with the paramedic so that you're well looked after throughout the transfer and the handover at the other end is smooth.

I think if you're considering a birth centre, then phone them and go visit, and find out more for yourself. We offer tours at any gestation so people can come and look around, meet the team, get a feel for the place, and ask questions, then we offer an appointment at about 34-36 weeks to discuss things more in depth and do a risk assessment. By then you've had all your scans and bloods, to identify if you have any risk factors or if baby has any growth issues that would make hospital a safer place to be.

The other thing you don't mention is postnatal care. Most maternity units get low ratings for postnatal care - the staffing ratio is just not enough for women to feel supported and cared for in very many cases. I know that where I work it is clean, calm and relaxed. Staff are very accessible for support as the ratio is so much better, and there's less waiting around for paperwork etc when you're ready to go home as we're not going to have 9 women to do checks and discharges for....