Midwife-led unit or labour ward for birth: pros, cons and choices

[Shopaholic100]

Midwife led unit or hospital labour ward what are the pros and cons and which did you choose?

I chose labour ward, for two reasons: I wanted an early epidural, and I found being closely monitored and having doctors at hand very reassuring. That’s just my personality and I knew without a doubt that would make me feel safest.

I had an induction at 41 weeks in the end (my request) and I felt very at sea being sent home after the pessary was inserted and told to come back in 24 hours if nothing happened. I was much happier when I was back in, in established labour, and the baby could be monitored!

I would say neither. Home birth 🤎 with a doula.

too many unnecessary interventions going on these days.

You can either go for the midwife led centre, where pain relief is bouncing on a ball and being told to ‘breathe through it’ or actually have a proper pain free birth in a labour ward with an epidural.

The epidural costs the NHS more money which is why they want you to have the ball, and they’ll throw in a bit of gas and air for good ‘breathing’.

An early epidural (not last resort) is the smart choice op.

I've done both, my midwife led unit is still in the hospital and just up from the labour ward. The midwife led was perfect for my first, straightforward birth, good calm experience. Second was labour ward, high risk for age, strep b and excess water, although i was induced and we had issues with her heart rate and the emergency button was pressed several times, i still delivered DD2 without intervention, very supportive midwives with docs on standby. Midwife led unit was definitely a calmer space, but i m glad i was on the labour ward for the second goving the problems that occurred.

I had two quick births so I'm maybe not the best judge. Gas and air with the first with episiotomy. The second I had no time for anything. I was in for a day the y time in the Labour ward and about 12 h with the second on the midwife led unit.

Birth wise there was little difference. The baby comes out one way another. For me the key difference was post birth. The midwife until was far nicer. My hospital gives you your own room if you are in the home from home bit. It was so peaceful. The Labour ward was hell on Earth. 6 women, visitors, partners. No space. No privacy. No sleep. This made such a huge difference with my mental state going home. I didn't sleep but I wasn't nearly as stressed. But this was my second child and I understood what was happening more. First time I did really want to be in Labour ward and felt safer there.

Ther are many unknowns and you never know what will happen or how you will feel at the time though.
go with your gut!

Why do we normalise taking Fentanyl for birth?

It blocks the ability inately communicate with the baby inside you who relies on your hormones for direction.

also it crosses through the placenta

Having had both experiences, I would choose midwife-led again. I just found it a calmer experience and was comforted to know the labour ward was close by if needed. But I knew I didn't want an epidural so it was an easy choice. Also, MLU was much, much quieter so the midwives (pre and post birth) had a lot more time for my care.

Because it enabled me to be awake whilst my son was being delivered via a CS, that was important to me and I would do the same again.

Birth is seen as a natural process but the reality is without intervention many many women and babies would die and have died. There’s a good chance you will have a positive birthing experience but for me the thought that if anything did go wrong I’d sooner the doctors and surgeons be a buzzer pull away than an ambulance ride. So for me it was hospital 💯

Is it a smart choice? It might have been the right choice for you, and for many women, but not every woman.

I specifically chose not to have an epidural and had no expectation of a 'pain free' birth. I also didn't want unnecessary drugs in my body, or my baby's.

I found the gas and air and hot water in the birthing pool ample to deal with labour pains.

I would always choose midwife led but I think it depends how far away the hospital labour unit is from it. For us now it is 50 minutes away so I would choose the labour ward as the transfer would be awful. You win no points for not having the pain relief of your choice so having it as an option via epidural may be important to you which is absolutely fine.

I went with a midwife led unit, but it was in the hospital so they could transfer you if needed. I had two water births, but you don’t know how things will play out - though my mum and my sister had relatively easy births too.

I'm due with my first soon, my personality means I was never going to plan to birth anywhere that didn't have emergency care immediately available, but if that's not such a consideration to you (I think it should be for everyone, but that's just me!) the main things are limited pain relief in midwife led, conversely labour ward is generally accepted to be a more stressful environment overall which can stall labour.

I would be a hell of a lot more stressed personally knowing that if I did want an epidural/need certain interventions/hamorrhage that I needed to be transferred for care, so overall for me it was an easy choice. But I understand people have different risk thresholds.

It's probably worth (if you can) considering/finding out how smoothly your female relative's birthing experiences have been - it's by no means a way to tell how yours might go, but knowing my sister almost died from a postpartum haemorrhage (hospital birth) did make me even more sure about my choice...

Oh and I'm actually hoping for a water birth with gas and air and no epidural, so I sort of want a typical "midwife led" birth in the hospital setting - I'm not choosing it for an epidural. I just really, really want to be as close as possible to emergency care as you never know what's going to happen.

My birth preferences exist, but my "plan" is "get them out safely and keep me alive"

I’m talking about everyday general psychological birth not emergencies.

I had an emergency CS before my VBAC too and medication free birth was 1 million times better

I think it’s very hard to say what is better, because every birth is different and unpredictable. If you have a low risk pregnancy maybe a midwife led unit would be calmer and lead to a better birth. My first birth at hospital was horrible despite the epidural so I may be biased. If the midwife unit is part of the hospital you can be transferred if things go wrong and that’s something you can talk through with your midwife.

Is the midwife led unit in the hospital or is it separate? That would be my deciding factor.

For both my births, I wanted to be in the midwife unit in our hospital, but I ended up in the labour ward. DD1 because the midwife led unit was full, but i had a midwife led style experience on the labour ward (they closed all the curtains, turned down the lights, moved the bed to one side so I could labour and deliver on the floor - it was great). And actually it meant when DD1 starting to struggle a bit, they could get the continuous monitoring going straight away. She needed NICU so actually being in the hospital meant it was easy for me to visit her.

For DD2 i chose labour ward as I wanted an epidural, but she came so fast that I just did gas and air again, so could have been in the midwife unit. But it didnt really matter because I was in the zone and wasnt really bothered by the surroundings.

I wanted the midlife led ward to use the birthing pool and try and minimise intervention. The labour ward was just across the corridor in the event you needed to the transferred/wanted an epidural anyway. Ultimately I didn’t get a choice. I was induced at 41+5 on the induction ward and unbeknownst to me once the pessary was removed went from 2cm to 10cm in a couple of hours and shouted for help once I got the urge to push. I was taken to the midwife led ward where they had a bed. I didn’t even get the birthing pool as it all happened too quickly. I got gas and air while pushing but honestly at that point it didn’t do anything. Sometime you don’t get the choice so don’t put too much pressure on it. Good luck!

Because birth can be - like mine was - painful beyond my wildest imagination of what pain could be. The epidural saved me. It also meant the second part of the birth wasn’t traumatic ( as the first was) and I bonded with my daughter straight away. I adored her the second she was handed over to me. If anything crossed the placenta it did her - and our relationship- no harm whatsoever. A traumatised wreck of a mother would have been so much worse for her.

I had two elective CS after the horrific vaginal birth and the C sections were so, so much better. Horses for courses! You have your preferences, others have theirs. Epidurals are totally normal and there’s no problem with that.

Labour ward because I never had any intentions of having a baby without an epidural asap.

"Because birth can be - like mine was - painful beyond my wildest imagination of what pain could be."

Yep, I gave birth 49 years ago to my only child. There was no pain relief available at the facility at all (long story). Note, I only ever had one child.

First baby had no choice by the time I got to 42 weeks and was admitted for induction

Subsequent babies, home births and if that hadn't been possible would absolutely have gone for midwife led unit

But every pregnancy, mother and birth are different and that the above felt like the right choice for me has no bearing on what is right for you. You can have an intervention free vaginal delivery on a consultant led labour ward- once my first labour started the only intervention I had after that was monitoring of the exact same kind that was done at the home births I had for my other children.

No thanks I'd rather leave it to the professionals why take a chance on your babies life? Watch the movie peices of a woman

My views are probably shaped by the fact neither of my children would have survived birth without intervention, but I would not want to be far from all the medical support should I or the baby need it. So midwife led in a full hospital yes, separate place that requires a transfer to a labour ward no.

You may be technically low risk but if it’s your first baby you really have no idea how your body is going to respond to labour or the various pain reliefs available. Relying on gas and air is all good until you realise it makes you very sick and I can’t remember a single thing from the period of labour I was on it.