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 had one of each. Induction is what caused my issues, but they tried to suggest an unnecessary intervention without even considering my lack of consent (I had made it clear I wanted anything tried before this one thing) and it was not needed.
MLU was a great experience but it was above the labour ward in the hospital so didn't really need to concern myself with transfers etc.
I would not give birth at home due to the ambulance delays these days, and I wouldn't use a MLU if it was not in the main obstetrics hospital for the same reason.

Excellent experiences of a midwife led unit within a hospital, although wish that I'd been brave enough to have home births.

I gave birth to one of my children at the same hospital a whilst back and even then my husband had to advocate for me because they were short staffed and just left me on the ward, it was only after he intervened that they moved me to the labour ward. They missed that he had a VSD (hole in the heart) even though it was a loud murmur. I really hoped things would have improved by now, sadly doesn’t look that way.

@Shopaholic100 Do you mean you were moved from a midwife unit to a labour ward, which was understaffed?
There's no doubt that midwifery services are stretched and that goes for both MLU and hospital labour wards. I had a very long wait to get into a suite as none were available (baby boom year!) and after one birth I was discharged within 4hrs of giving birth (straightforward delivery obv) - which was probably due to the conveyor belt of others coming in but it was exactly what I wanted at the time.
I stayed in for a few nights with my first as there were a few health concerns and I felt very unsupported actually. It does feel like a lottery unfortunately, which is exactly why the midwives i know have left the job.

This was before the hospital had a midwife led unit, it was just the regular maternity ward with the curtains closed, not nice experience at all. I was released within a few hours of giving birth, which I was fine with but I felt that in the rush to release me they didn’t check things properly, hence missing his hole in the heart.

I chose labour ward and if I’m ever lucky enough to have another then I’d pick the same again.
My hopes for labour and delivery were to have it as intervention and pain relief free as possible - BUT I wanted all options to be there if my baby or myself needed.

I know many women choose home birth or midwife led unit as they feel more relaxed not being in the clinical environment but that couldn’t be further from my feelings 😅 Give me somewhere where I know almost any situation can be dealt with there and then 👍🏻☺️

Across my 3 births - all with epidurals - only my first needed interventions (episiotomy and ventouse), even though my last birth was an induction. With that one I didn’t even need stitches!

That said, I found pushing tough. I don’t know whether that was partly down to the epidurals 🤷‍♀️

But overall, no regrets.

And in answer to the question, either Labour ward or MLU attached to a Labour ward. I think it’s important to have fast access to doctors if needed

Hi I have had both and personally only went with a midwifery led unit second time round because it’s in the same building as the delivery suite / theatres if I needed to be moved or needed intervention. Both my labours were super quick (under 2 hrs) so this escalated for me rapidly and I was left with little options for pain relief other than gas and air. I think if you opt for a midwifery led unit I think choosing one that’s pretty much close by to a delivery suite is a safer option in case you require any intervention. My birth in the midwifery led unit was much calmer and I felt more relaxed even though I was high on gas and air I couldn’t take in my surroundings much during labour. I found afterwards I wasn’t being rushed off to the postnatal ward and could be discharged six hours after delivery if things were fine with all our checks. If I had my choice again I’d still only choose a midwife led unit that was in the same building as a labour / delivery suite so I had options if things progressed and I needed more intervention. You would also want to consider the pain relief options for a midwife led unit as most only offer gas and air and pethidine. Good luck with whatever you choose

Midwife led unit ONLY if it was attached to a hospital like mine was. I started in MLU and then transferred over to Labour ward. Baby was distressed and I had a crash section. Baby would have died in a home birth or if I was miles from a surgery theatre

Obviously this was the right choice for you because that's where you felt safest but for anyone who is tempted to plan a home birth it's important to know that a labour ward is no safer for the baby and actually much less safe for the mother (assuming a healthy pregnancy, reasonably accessible hospital transfer if required etc).
There is good evidence on this from a meta-analysis published in the lancet around 2020 looking at approximately half a million planned home births.
At the end of the day though, labor ward, MLU and home are all reasonably safe options for most women and therefore it makes sense to decide based on what feels good rather than what's statistically the safest.

Just be aware you can't always get what you want. They pushed water births and I was looking forward to that, but when I got there they were too busy so no chance.

Go take your hippy shit elsewhere 😂😂 id rather drugs and a healthy baby than a homebirth that might resulting death

This doesn’t make sense really - it’s not like the choice is between loads of drugs or a home birth with nothing? I had a safe birth in hospital without taking fentanyl (as many people do).

I chose a stand alone midwife led until for dd1. It was lovely: pool, soft lights, a pull down double bed for after the birth, a little garden area which the rooms opened up onto. After hours of intense labour the midwife broke my waters and out gushed a load of meconium then I had an awful ambulance ride to the hospital. Retained placenta too.

Dd2 I went To the midwife centre attached to the hospital and that felt like a nice compromise. Calm and relaxed but right next to the maternity unit if needed, they can wheel you across on a bed.

There's nothing unsafe about home birth with a trained midwife.
But anyone who wants the epidural/opioids/gas and air should have it, unless there's a specific contraindication.

and some women have safe births in hospitals with fentanyl. Choice is important.

I'd had two two hour births so chose a midwife led unit. My third was back to back. A low lying placenta made it worse. It was the worst pain imaginable and all I got was gas and air. Hours of labour like I'd never experienced before. I never had another baby.

@SouthLondonMum22 @NibliaBiblia I quite agree, but the previous poster equated not having fentanyl with a dangerous home birth, and also suggested you’d be more likely to have a healthy baby with fentanyl, neither of which makes any sense.