Am going to see head of midwifery at hospital about being allowed in mw-led unit - some advice please

[dinny]

my mw is arranging it so we can discuss me being allowed in there when I turn up to hospital as I have a previous SD

any hints? should I be forceful about being allowed in there and request that obs are on stand-by? not really sure of my feelings (except that I can't bear the thought of being in a traditional delivery suite with the high bed)

thanks (sorry, what a waffling post!)

I had this negoatiation although I had it with my consultant and she then wrote a letter to the mlu saying that she had no problem with me labouring and delivering there.

I took each of the "issues" which I thought might worry them and explained why they weren't a problem. Don't know if it's any help but in my case they were:

previous pph - in one out of 3 deliveries and it was prob because I'd been racing between the ward and SCBU

GBS - neonatal issue not intra-partum. I'd previously been fine with the venflon and abs.

anaemia - only slightly anaemic and not symptomatic.

The labour ward was a corridor away from the mlu so the logistics were easy.

hth. good luck

by the way, when I was really stressing about it my lovely doula very gently pointed out that it was just a room and she'd be with me wherever I delivered, and the labour ward had bigger rooms with more space for moving around. That helped me to get some perspective on it.

I can't imagine why a midwife would bother arranging discussion if it wasn't possible for you. Terrible word, "allowed." Health issues excepted you are allowed to do anything you want, really.

be calm, rational and have a list of bullet points and research if necessary.

at the end of the day, it is your birth , and you don;t have to have permission , and AIMS can be a great resource to help you

if you go in and firmly say you are making an informed decision and you are fully aware of potential risks, then not really a whole lot that can be done

also, the beds in delivery suite should be the ones that can be raised and lowered and adjusted electronically, so that you can use the bed to lean on/ sit on , not just lie on...

thanks for the posts

Lulumama - do you think it is more of a risk being in birthing suite (down the corridor from delivery suite)?

TD, but it is possibly a "health issue", isn't it?

if you are down the corridor from the delivery suite, then i don;t think so, the first port of call to resolve SD is Mcroberts, which can be done in an MLU or CLU. it ultimately comes down to what you think and what you feel comfortable doing. and where you feel you will be better looked after and more chance of getting the birth you want.

If they can see you're really anxious about the prospect of being in a hospital environment this might sway their decision?

I met with the head of the home from home unit at St Thomas's this week as my planned homebirth has gone out the window due to excess fluid and the consultant really wanted me on the 'proper birth centre', but after a good chat with the head midwife I've been accepted at the home from home as a compromise.

She knew I was anxious about being in hospital and was keen to try and make the birth as trauma-free as possible for us. I didn't need to be forceful, or visibly upset in order to get what I wanted, it was all very relaxed, hope it is for you too.

Where there things which may have been factors in the SD such as your position? Talk about how this time you intend not to be flat on your back for the birth (if thats how you wer elast time).

As her what what happen in the M/W unit if someone with no risk factors had an unexpected SD? How would they deal with that? I'm sure any they've had in the M/w unit they've successfully resolved. M/Ws are generally very good at sorting out an SD before the Drs get there.

hi all.

I had my last baby in a mw-led unit (different hospital as we have since moved house) and had a really good labour - 4 hours, stood up, no drugs, then delivered kneeling up on floor, against bed

which makes me more worriedm really - feel it was an optimum labour and still had SD

it was resolved with McRoberts by mws though

You can't go to a midwife-led unit, and request that obstetricians are on stand-by. A midwife-led unit is just that, midwife-led. If you need obstetricians, then you need to go to a consultant led unit.

In response to what some other have said, you aren't "allowed" to do whatever you want. The NHS is obliged to provide you with care, but in the same way you can't demand they give you an MRI for a headache, you can't demand they let you into a midwife-led unit if you don't meet the criteria that allows them to provide you with safe care.

This isn't to say that they won't offer to care for you in the midwife-led unit, but depending on your history, they may have very valid reasons for declining to.

Crouchingdragon - the mlu is in the hospital, next door to the clu

anyone could have problems in the mlu and need obs care - same as if you have to be transferred in from a home birth to hospital

dinny - if your discussion does not go well, remember that you can ask to speak to the Supervisor of midwives at the hospital who can help you achieve the care you want.

Since the MLU is attached to the CMU I cannot see the problem. Obstetricians would attend in an emergency

HELLO Mears - how nice to see you!

I think that's who my mw is arranging for me to see, the head or supervisor...

I thought that must be the case re the mlu being in the hospital

do you personally think it is an OK idea (mlu with prev sd)? thanks, Dinny x

Yes, to be honest I cannot see a problem with it as the CLU is part of the hospital.

oh good - fingers crossed

thanks