Birth Centre/MLU experiences?

[LookingAtMyBhunas]

Hi all! (Have posted on pregnancy but think might get more responses here) Debating between a birthing unit and home birth. The only reservation I have with the birthing unit is it's the next town along (about 25 mins) and I've read that sometimes they can't always be used if there's not enough midwives to open the centre??But honestly aside from that it looks amazing - like a spa day. 😂Its attached to the hospital so no transfer issues should I want to go to the labour ward for epudural etc. We've not had the best care from my local midwife team and my closest hospital is in Requires Improvement.Any experience anyone can give would be so appreciated.

I used a standalone MLU both times. It was close to my home (I walked back after both births) but had no attached hospital and was about 15 mins at blue light speed from our nearest. I was told that because of that my MLU was over cautious and would transfer early if any doubts.
but it was lovely, very focused on me, very positive and not stressful. Plus we had a big room to ourselves and private bathroom. Had a water birth the first time but no time to run it second time around. No Bounty lady but think that’s a bonus tbh.

Oh and yes our local hospital was TERRIFYING which was another reason I opted for the MLU initially. But tbh even friends who didn’t have the best birth were mostly pleased with whatever they had chosen afterwards. As it’s all a bit unknown and you feel very lucky to go home with your brand new baby. Good luck with whatever you decide.

DS1 was supposed to be born at the MLU. We had a lovely room. Unfortunately when they were checking his heart rate it kept dropping after contractions and not coming back up so I had to be wheeled down the corridor to the main maternity ward as they wanted him monitored.
The MW spotted the issue and was able to react so I was in the right place when his heart rate dropped further and his blood oxygen was borderline low before I was fully dilated. Had an EMCS and he was fine.

I wanted to give birth in a free standing MLU but when I went into labour they didn’t have the staff available - I hadn’t been told this could be an issue so just bear that in mind. I gave birth in the MLU attached to the local hospital and it was really wonderful; the less medicalised experience is backed by evidence to lead to fewer interventions and more positive birth experiences and outcomes so read up about it and it may sway you

Thanks so much all.

@saxonisthedrug Totally agree, birth became so medicalised in the 70's/80's and I don't think it's ever really gone back.

If it's in an MLU I take it you don't have your own midwife? Although I doubt I would anyway, haven't even met mine yet and I'm 17 weeks.

With DC1 I was initially taken to the birth centre and it was a literal dream. Huge room, twinkling lights in the ceiling and a birth pool the size of a small swimming pool.

Sadly, just as the birth pool was filling up I was told that there were too many high risk women on the labour ward and they needed to move all midwives there so I did get moved. I was gutted initially but they got me a room on the labour ward with a birth pool and my doula set up fairy lights and got my music playing and I really didn’t really like I missed out on anything.

I’d recommend checking if any of the rooms on the labour ward have a birth pool. It was very important to me and helped massively during labour.

I had 2 of my DC at a MLU which was attached to the hospital about 30 mins from home. I think it is a really good half way house to having a home birth.
It was a compromise for my youngest as I wanted a home birth but there were no ambulances available so they weren't able to offer a homebirth - I knew this was a possibility from a few weeks before birth so sort of planned the MLU in the end. They opened it just for me with my midwife and a support member. I had a complicated history so might have helped them support my MLU over labour ward wish.

The MLU was really relaxing. Pools in all rooms. Some rooms had bed others had floor mat things. A little kitchen area in each room for you to use. Ensuite rooms. All round calmer atmosphere. Comfortable place for DH to sit and sleep - not that we were there long before my 2 arrived (90 min and 45 mins!)
Ours transfer down to labour ward early on any sign of issue so its worth bearing that in mind. Ours also deal with alot more issues than most post birth on the MLU. I had quite bad tears and had the option of the doctor coming up to the MLU to me over going down to labour ward.

I had my own midwife while I was there. One student and one qualified allocated to me. The senior would pop out but wasn't looking after anyone else directly, she was letting the student take charge.

Hi it's labour ward midwife here. Is it your first child? The evidence from a very large study revealed there are more risks to the first baby in home births compared to MLU or traditional labour ward. The risks are the same for the 2nd, 3rd and 4th babies (low risk women only). Women giving birth at home or at the MLU are much less likely to need an emergency Caesarean or instrumental delivery (the link to follow).

The rule regarding a one-to-one care from a midwife does not vary between locations. Women should get their own midwife once they are in established labour (4 cm and over).

I can't comment whether the home births of MLU service would be suspended in case of staff shortages, you should enquire locally.

I hope it helps

Further to the earlier message...

This is the best summary of the study I mentioned earlier

https://kclpure.kcl.ac.uk/portal/en/publications/birth-place-decisions-information-for-women-and-partners-on-plann

I had my first in a MLU attached to a hospital. It had dim lighting, but was nothing special. To be honest, I was in so much pain, I didn’t care. For my second, I would have been in the MLU, but meconium in my waters meant I had to go to the traditional labour ward. That was fine too.

This research also includes unplanned home births so not accurate. OP get an independent midwife if you can afford it. Best money I ever spent.

I am afraid you have the wrong information. There were no unplanned home births in that study, please see the link to the full study below
https://www.bmj.com/content/343/bmj.d7400

Hey! Thanks so much. Yes it's my first 😀

I'm a bit confused though, you say the evidence says 'there are more risks to the first baby in home births compared to MLU or traditional labour ward' but then go on to say 'Women giving birth at home or at the MLU are much less likely to need an emergency Caesarean or instrumental delivery".

Isn't that a contradiction?

I was due to have my first at a small MLU in the town close to me, however it closed due to staffing 3 days before my due date and has never reopened 7 years later. There is still a small MLU in the county which remains open. The MLU was open in the day for support, questions and breastfeeding support, unsure if this is available in your area. I saw my midwife there each time during both pregnancies although it was not open for births. I saw the same midwife each time but knew there was no guarantee she would be available when I gave birth.

First baby I had in the large MLU attached to the hospital in the “big city”. I had pool ran for water birth, no idea which midwives were there and there were lots of doctors at the end as well as I had a PPH but no time to go up to labour ward.

I did walk into the MLU for second as was told it would be fine to have baby there but as soon as they heard I’d had a PPH the taps to the birthing pool were turned off and I went up to labour ward. I did have a room there which wasn’t too different to MLU but had a lot more medical equipment. I only s”had a max of midwives in the room during the whole time and it was very calm and quiet. I think I saw 4 or 5 people in total as was there over shift change.

I had 2 fantastic experiences with our local MLU - also attached to a hospital. The first was born too fast to make use of many of the facilities (we were in and out of hospital in about 8 hours and never left their initial assessment room) but the second was born in the pool under dim twinkly lights and then we spent the first night together in that room with plenty of space, a comfy reclining chair for DH and my own bathroom.

I would say though, out of 7 women in my nct group who planned to give birth in the MLU for our first, I’m the only one who managed to have my baby there. An array of minor complications or requests for more pain relief meant the others all transferred out.

No it means that when they looked at the health outcomes of babies born at home Vs in mlu Vs labour ward, there was a higher rate of poor outcomes for babies of first time mums born at home. This means that they may have benefited from being born by CS/other earlier intervention. Resuscitation is limited for babies born at home- you are relying on the midwives until they can get baby to hospital. Whereas if you are already in a hospital you can get a paediatric team there super quick.

I'm not biased against homebirth at all by the way- I planned a homebirth for my 1st (transferred to labour ward in early labour) and had a homebirth for my 2nd.

I started my labour in a standalone MLU, I didn't want to go to a hospital and our local one isn't well rated anyway.
It was so so nice compared to the hospital, it was comfortable, spacious, private, nice food etc.
I did end up getting transferred because my labour took a very long time basically, but it was mainly because of one midwife pushing for me to be transferred even though I didn't really want to be, over the course of my labour I saw about 6 different midwives on shift at the MLU, this one twice and I didn't like her the first time and I was annoyed when she came back on shift since at that point I'd been told I was close to giving birth and I didn't want it to be her that was there for the birth over all the other much nicer midwives who'd treated me!
I think I'm still going to try again with the standalone MLU because the hospital that has a MLU inside is the same one I got transferred to and its just not a great hospital so I'd rather not go there unless I have to.

No, there's no contradiction.

It was a huge study involving 64 500 women. The study looked at 250 variables. The risks for mums and babies were counted separately.

Unfortunately the study didn't elaborate why low-risk women on the whole were better off in the midwifery-led care.

A systematic review of similar 28 studies worldwide came to the same conclusions (link to follow).

All the studies are free to read, if you wanted to have a look for yourself. They are published in reputable peer-reviewed magazines

Further to the earlier post pubmed.ncbi.nlm.nih.gov/29727829/

This is a good summary. The risks are higher for first babies born at home. Overall risk is still low, please see the Decision making guide. However this is something to bear in mind.

I got you, thank you and thank you @Where2GoNext
I think home birth is not something I'd be 100% comfortable with for my first, MLU is the top option.