Natural Childbirth at the Whittington

[NBD]

Hi-

I'm an American, just moved to Highbury, and am going to deliver my first baby at the Whittington. I'm hoping to be able to give birth without an epidural, episiotomy, etc. I've read the excellent "Stand and Deliver" by Emma Mahoney, and it suggests getting a copy of the hospital's protocols so you know what to expect and can make a birth plan accordingly. Well, I went yesterday and the consultant said he wasn't sure there were any, and no one had ever asked him. He did assure me that whatever the labouring woman wants (within reason), she gets.

I am curious what experiences women have had at the Whittington. Can you walk around? Do they want you to lie down to deliver the baby or are they ok with letting you be in any position that's comfortable (Squatting, standing, in water)? Do they dissuade you from water birth? Are they ok with doulas? Do they do routine episiotomies? Do they induce a lot, and if so, do they let you decide if you want to or just really strongarm you into it after a certain period of time? And I know post-natal there is horrid, but how long do you typically stay?

I really appreciate your feedback. I've yet to take a tour, but have been to appointments there and have been seen pretty quickly. I hear mixed things about all hospitals but on the whole, but there seems to be a lot of positive things said about the midwives in the labour ward.

Also, just as a side noteit's incredible how midwife-led this country is. In the states, you're "weird" if you go with a midwife, and home birth, water birth, hypnobirth, standing, etc. are, on the whole, all considered fruity. So as daunting as it is to navigate the NHS I still don't quite get it -- it's great to have all these options.

i was encouraged to walk during my labours at the Whittington (2000, 2003) but in the end I had caesareans for both of my births.

I told the midwife what kind of pain relief I did/didn't want and she (for the most part - not the woman on the ante-natal ward!) respected my wishes.

I made an informed choice re: the sections both times (though the second was a crash one, much hairier, but felt in safe hands)

routine episitomies were given across the UK in the bad old days - I've not heard of them recently.

You can be discharged quite quickly within 6 hrs iirc, if there are no contraindications.

I stayed for 4, then 3 days post-section (and would advise you to at least know the basics of c/s and any other interventions in case they do come up as options for you - forearmed is forewarned)

good luck!

IME it very much depends on the pregnancy you've had and the midwife you get on the day.

On the whole most of the midwives are very enlightened - they are highly unlikely to ask you to lie down and they don't do routine episiotomies - only if they have to do an instrumental delivery because your baby is in distress or something.

Normally they are keen to get you out afterwards! If there are no complications it could be the same day - if you have a c-section then it's normally 3 days. If you do have to stay for some reason you can request and pay for a private room which makes the stay a lot more bearable.

If you have a complicated pregnancy for some reason and require monitoring or induction then obviously some things will be different as you may be a bit restricted by the monitor - but they are still pretty flexible I found.

Do go to their tour and take their free antenatal classes - it will answer a lot of your questions.

It sounds like you may actually really enjoy using the birth centre at UCH? I had my baby there and they were fantastic and the good thing is that it's just across the corridor from labour ward, so if you do need any 'help' everyone is just there. If you don't, then it's just you and the midwives +/- birth pool and you can do what you like! It's a home from home environment.

Is that the Elizabeth Garrett Anderson unit TYAGN?

All I would say is that it's very worth looking at the stats, vs the facilities. There are lots of places that have shiny birth centres but pretty bad intervention rates - for example, according to Dr Foster, you have a much better chance of having an unassisted vaginal delivery at the Whittington - 60% there, vs only 40% at the Elizabeth Garrett Anderson.

And Caesaraan rates are 25% at the Whittington vs 30% at the EGA.

Dr Foster is worth a look actually - have a look here

It gives you the facilities and statistics for things like % of women who knew their midwife in labour, % of assisted deliveries, % of vaginal births etc.

It tells you a lot more about a hospital than the facilities - for eg the Whittington has a birth pool - but according to Dr Foster only 72 women last year actually used it for birth (that's out of more than 3500 who gave birth there!). Which suggests that they are pretty useless about supporting water births. However EGA isn't much better - they had only 84 women who used the pool.

It's interesting to look up the stats before you go on the ward tours as it gives you an idea of what to ask - for eg if a water birth is important to you, you might want to ask how many midwives are trained in water birth, under what circumstances would they advise against using the pool, how many pools are there, is it possible to request a room with a pool when you call up in labour etc, etc.

But, one reason why the stats might look like that is that UCLH/EGA specialise in high risk pregnancies/births so are therefore more likely to carry out CS and other interventions. The bloomsbury birth centre at UCLH/EGA seems ok, i had a homebirth using their midwives though so don't have direct experience...

That's very true, but all the major London hospitals use that argument - they all have higher than average high-risk pregnancy stats and most of them have specialist clinics for various high-risk conditions.

However I'm not trying to run down UCH or anything - I'm sure it's lovely! I'm just saying it pays to look at more than the decor when you are deciding. It's equally about where you feel comfortable and what's easiest for you to get to (a big consideration when you are schlepping across London the size of a house on public transport!)

Also many hospitals won't offer you a homebirth if you are outside their catchment area so if that's something you're interested in, it's worth finding out who covers your area.

UCH is the main teaching hospital in the UK and as such does see more of the 'complicated' cases and yes that will alter their stats.

The Bloomsbury Birth Centre is currently in the Elizabeth Garrett Anderson Hospital (part of UCH) which is their maternity wing.

The unit is old but clean, so no flash decor currently! They are moving in to their new wing in October (I think) this year and are currently trying to decide how to best spend their budget on the new birth centre.

You need to physically visit somewhere that you're considering and you will either feel comfortable with it or you won't - I would go with that personally. I liked the birth centre because all the options were just there BUT I would labour in peace and 'au naturel' unless the midwives decided that I needed medical help, rather than being surrounded by a barrage of consultants and registrars from the off. Each to their own .

"the main teaching hospital"? I may be wrong abotu this (happy to be corrected if I am!) but I don't think there is a single main teaching hospital for the UK? All the universities use different hospitals - and the University of London uses a number of hospitals including UCLH but also The Whittington, The Royal Free, Kings, Guys and St Thomas', Queen Mary's and lots more.

Anyway this is all a bit beside the point as I presume NBD is already booked into the Whittington and (from what you've said NBD?) it doesn't sound like she has any plans to change - she just wanted feedback on what it was like.

Good luck anyway NBD, I'm sure you'll have a great delivery - they are really nice at the Whittington whatever you decide in the end.

Whittington has a great (free?) accupuncturist (James Mutkin i think his name is) who can help with all manner of pregnancy related probs, including bringing on labour to try to avoid being induced.

A friend booked a homebirth through the Whittington and was prepared for it to be extremely natural - water, no drugs etc. She said the midwives were fab, all the way to the point she transferred in for a c-section . They were still great after that, apparently...just not what she wanted.

And I agree with your point about the US. Was talking to a friend who teaches ante-natal classes in San Francisco the other day - she is amazed that midwife-led care is the norm here, she thinks the ob-gyn industry out there is trying to outlaw midwives.

I had a homebirth (about to have second) using Whittington midwives and they are lovely. I live very close to the Whit and the feedback I get (I am involved with NCT so meet lots of mums) is that the birth experience is good, but the postnatal care/ ward can be a bit crap.

The Whittington, I believe was one of the first hospitals in London to start "allowing" women to labour and give birth in any position they chose. The Active Birth Centre is nearby (if you're interested in classes) and I believe the Whit and the ABC have had a relationship since the 80's in giving women the choice to birth naturally. If there was any reason I couldn't have a home birth, I'd be happy to give birth at the Whittington. The wards look really quite tired and depressing, but I don't suppose I'd notice in labour.

As I said, I've always found the staff lovely. I was quite overdue last time round and even the consultants were good. Very reasonable. Didn't try to push me to have an induction and were happy for me to book it for when I was 42+3 to give me as much chance as possible to give birth at home. (I had home birth at 41+5 in the end.) They were very on board with low-intervention birth and when I was scared sh'tless and really disappointed at the thought of being induced, they were very kind and said they tried to do inductions as gently as possible.

I know it's not actual experience, but hope that helps a bit.

Yes they allow you to walk around.

Yes you can be in the positions that you want to be in.

They do have a birthing pool and you can ask to use it. Best to ask when you call to go in and to ask again on arrival.

They're fine with doulas. I've been there many times and have a good relationship with the mws and consultants.

No routine episiotomies.

It is up to you whether or not you allow induction.

Postnatal ward much like any other London hospital. If you give birth normally you can ask for a short notice discharge (6hrs).

I love the Whit. They have reflexologists available and as to protocols, don't believe any consultant who says that they don't have one. They do!

I have a client due twins at the Whit soon and they have got the best, least intrusive twin policy of any London hospital (and I've seen most of them). I gave birth to 4 of mine there. Love the Whit.

And acupuncturists and I think they're introducing homeopathy (well I know one Consultant who is working to implement it).

You've been in my mind for days 12yg. Really looking forward to seeing you soon (but not too soon iykwim)

NBD - I gave birth in the Whittington a year ago.
Was induced. (Did feel a bit of pressure to be induced).
Was encouraged to walk and encouraged to be in any position most comfortable for me.
No episotomy (sp?)
Finally succumbed to their repeated requests for me to have an epidural "just in case" (they thought I would end up having a C-section)
In the end, delivered vaginally with the help of a ventouse and a brilliant doctor who listened to me and narked off a anaesthetist (sp?) in the process by prioritising my labour.
Post-natal care was okay for me and although the place isn't spanking new, it is clean.

They only have two rooms with birthing pools which you are available if free - you cannot book.
If you have a complicated birth (ie C-section) you have a private room, otherwise you can pay (I think £150 for a private room if available. Again, you cannot book).

If you want to know about protocols, I'd recommend their free Parentcraft classes - they do a separate ones for waterbirths. During my labour, I was told you weren't allowed to use the pool unless you've done the course.

hth
oh, btw - wish I'd have done a course at Active Birth Centre as well as Whittington's Parentcraft classes

Channel 4 did a film, for their current affairs strand Dispatches, called Undercover Mother with a local mum who was giving birth there anyway. You can download most dispatches and watch them on your pc if you google them.

Prob not your ideal thing to watch but would give you the hard side too...

To answer teh OP.

I gave birth to both of my children at the Whittington. I had an espisiotomy with my first and got by on gas and air with both.

Also gave birth whilst squatting/kneeling for both. I never felt under any pressure to do it any other way.

My dc are 7 and 4 btw.

I went to the Whittington and the midwife was great. The parentcraft class was very focused on positions and breathing etc which helped to get a feel for the place although was otherwise useless.

The labour itself was straightforward, but had to be on monitoring for a bit. I decided at one point I had to go to the loo i.e. get up and go for a walk. One of the MWs told me I was being a bit silly but the senior one came with me and rubbed my back every time there was a contraction which was great. DD born naturally with only gas and air [proud emoticon!]. They also offer acupuncture for pain relief and getting labour started which I liked. They do have some water pools but apparently they take forever to fill and are not positioned very helpfully for leaning etc hence the lack of use.

Downsides, the postnatal ward is horrific. I was discharged within 6 hours which helped but screwed up breast feeding a bit.

As far as I know, they are happy with doulas.

Also, one valid but non-medical point! It is a hell of a lot easier to drive to the Whittington and find somewhere to park when you are in labour than it is at UCH and the traffic is slightly less likely to be critical!

Thanks to all for your advice. I had no idea I had to take the parentcraft course to be guaranteed water birth if I wanted it. So I'm now trying to figure out when it is!

And I plan on taking a tour with my husband--it's possible he'll go for a home birth after seeing the ward, but I also feel more safe this go round in a hospital. I think. Still too early to tell.

And that's wonderful to hear about the Whit's record and history with natural birth...

Im due to give birth there in Nov and they don't do a spearate class for water relief anymore. In any case the pool are just for pain relief not to give birth in it. There is just three antenatal workshops + one for breastfeeding (I have yet to go ).
I have heard lots of very good comments/experience about the whittington so I'm quite confident I'll have the birth I want (barring any potential problems/contr-indications).

I even know someone who had on her birth plan she wanted the most natural birth as poss but at one point when she asked for an epidural the mw recommended she didn?t have one bc she estimated my friend had only an other hour to push and the epidural would not kick in early enough anyway. My friend was surprised at first, but looking back was very happy with the mw recommendation.

NBD - I was told that I had to have taken the waterbirth class (which is separate to the parentcraft classes) before being allowed in pool. Bit skeptical whether this is true because how did they know whether I had or not? (BTW - I had taken class). TBH I think it was a way of putting me off the pool, which wasn't available when I went into labour ward anyway.

BTW - after seeing labour ward, I wanted to have home birth or go private because I thought it looked a bit decrepit. Couldn't in the end because I was induced, and to be honest, when you're in labour you really don't notice your surroundings (at least I didn't)

Good luck!

I've never had a client refused a waterbirth because they hadn't taken a class. Maybe it's my amazing wit and charm!

I had my first baby at the Whittington 10 years ago and the experience was so good (lovely, hands-off but present midwives; I spent most of the time in the pool, but got out to push) that I had my second at home.

But I agree with other posters that the postnatal care wasn't great.

HTH

i had michael my first son at the whittington too (15 years ago)! they were lovely!