Just been refused the use of the birth centre at local hospital!! am gobsmacked!

[stellamel]

Just been for a visit to the Birth Centre at Stepping Hill hopsital. I was literally there 1 minute!

The midwife who went to show me round said I had to have had a straight forward pregnany (which I have). She asked if it was my first baby and I told her it was my second and she asked about that birth and I told her I'd had pre-eclampsia. Where upon she refused to allow me to go any further. Just out right said I wouldn't be able to use the birth centre and would have to give birth in the normal maternity unit - which might I add is only on the floor below, so it's hardly like I'd be a million miles from medical 'help' if required. I did point out that just because I'd had PE before didn't mean I'd get it again, she disagreed and said they wouldn't book me in!

I had a horrible medicalised birth with my dd read here and there is no way on gods green earth I am going into the normal maternity unit. They'll have to drag me there kicking and screaming.

Is this normal? I thought we had the right to give birth where we choose?

Don't know what to do now, seeing MW later, not sure what options I have left now

I can really empathise with you wanting to give birth in the MLU, but unfortunately the fact is that as you had PE in your first pg you are more likely to get it again in this one. PE can develop or worsen quickly during labour or soon afterwards, and can develop into eclampsia. It might help to have a chat with your consultant to see if they can give you some idea of risk based on your last pg, and then discuss the MLU with them.

Yes, let's never complain about anything ever again because people die in Africa

This is highly likely to be a political decision rather than a safety decision. That doesn't mean you will get them to change their mind stellamel, but it's worth fighting it.

ladyteasmaid please try to be a bit more reasoned. I don't think comments about women in Africa are remotely relevant to this issue.

Yes it MAY be safer for the OP to give birth in the main unit but she hasn't been given a single reason why that should be so, just protocol.

It may be that they want her in the main ward because of better equipment and staffing levels and feel that her pregnancy does show a risk of the PE reocurring. In which case fair enough.

On the other hand it may be that the MLU has targets for transferrals and vaginal births and don't want their stats spoiled due to the risk of having to transfer her upstairs if her bp goes up.

Either way, the OP's right to have a conversation about her specific risks and the reasons behind the policy is hardly unreasonable and has nothing to do with maternal mortality rates in Africa.

And there's a big difference between having had a crap birth and being traumatised, not necessarily correlated with the length of level of intervention.

just to echo what most are saying, tell them (I wouldn't ask) that you are having a homebirth, I think they might change their minds then. One floor above? 30 seconds in lift? What difference is that going to make?

What an interesting predicament. I am surprised that the answer would be no based on a first pregnancy ending with PE. I have gone on to have three healthy pregnancies following my first with PE.
There seems to be plenty of great advice on here and I think that I would start with asking for another opinion from someone more senior in the birth-centre.

(Incidentally, how far along are you this time?)

I was refused the MLU because of a previous c-section. As in your case, our MLU was a floor above the labour ward, in the same hospital. I saw two consutants, and a midwife consultant, and none would agree to me being on the MLU, although they did agree to remove some of the standard protocol for a VBAC (ie CFM) In my case, the reason was transfer time to theatre incase of uterine rupture - their argument was, in an emergency, even travelling one floor to get to theatre is an unacceptable time delay. My experience is that they are very strict on their exclusions, unfortunately, and as someone pointed out, part of the reason is to preserve their high "success" rate in terms of straightforward deliveries.

I believe there is a higher risk after a first pre-eclampsia; they certainly monitor you more carefully. I was in the ante-natal ward for weeks before with both labours, and the pre-ecl mums I met in there who had already had children did often seem to have a history of pre-eclampsia in previous pregnancies. This may mean that they will want to monitor you during the labour in a way that they wouldn't in the MLU; and it may also mean they will want you booked with the consultant for regular check-ups before going into labour.

Still, I would see the consultant and see how you get on. It may be that they find you are not that high risk after all.

Also, if you do have to go into the usual unit, do be extra careful with your birth plan, so you can eliminate stress as much as possible.

my sister recently got signed off by her consultant to use the MLU , despite being high risk. ( blood clotting issues and other stuff) she ended up in the CLU as MLU was full, but she had a waterbirth with no interevention.

you can ask for a second opinion, and i firmly believe that the mother's experience of how and where she delivers is vitally important, as of course is the safe arrival of the baby. but the birth is likely to go better and more smoothly when the mother feels suppported, listened to and is at ease

if you develop PE symptoms, then you might be as well to go to the CLU. but if you don't and you are determined and are making an informed decision you can request a consultant to sign you off to give birth in the MLU

and if all esle fails, ask for the supervisor of midwives to intercede and speak to AIMS

FWIW it is sometimes possible to negotiate your way into an MLU when you don't meet the criteria. I was allowed to try for a waterbirth VBAC at my local one after initially being told it was not possible. When I had to transfer (all signs being that the baby needed to come out right away) the only delay was the doctors on the CLU faffing. The transfer itself took 30 seconds. From a safety point of view being on the MLU was fine.

Lady Teasmade it's not about plinky plonk music and mood lighting. With my last birth I listened to the medical advice right down to the last word, because I respected and trusted them. I allowed them to induce me, to foetally monitor me inside and out, to deny me food and water for 48 hrs, to hook me up to a drip, to catheterise me (even tho I begged them not to, and promised I would wee in a jug so they could monitor my output), to give me an epidural for the blood pressure, to behave myself and lie on a bed for the entire procedure. My baby was so stonked out when she was born she wouldn't breast feed and I was no use as I couldn't stand upright due to the crushing headache I ended up with, cos of the hole in my spinal membrane caused by the botched epidural - a headache that lasted 2 weeks.

It took me almost 2 years to find that special bond with my daughter, due to guilt, the sense of failure as a mother, the failure to breast feed, etc My dd might not remember where she was born, but i am damn sure see remembers the fall out from it.

So I do believe that birth is about the mother as well as the baby. I am not trying to put my baby in harms way, my pregnancy has been totally straight forward, I don't see that I am a high risk mother.

BTW, I am 35 weeks.

I have seen a consultant at 16 weeks who said I should give birth where I wanted and that a truamatic birth should be avoided at all costs for the mental health of the mother. She could see no reason why I shouldn't give birth at the MLU.

I have been monitored v. closely during this pregnancy, I've been having 2 weekly MW appointments since 28 weeks, and had a growth scan at 30 weeks (all good).

I saw my MW this afternoon (I never see the same one either!) and she agreed that she couldn't understand why the MLU wouldn't have me. She is booking me in with the senior MW for my next appointment to discuss my options and see what can be done about my giving birth in the MLU. But she did say, in her opinion, that home birth would be bottom of the list, the MLU at Buxton next (because it's a 40 min trip to hospital) and the MLU at the Stepping Hill hospital preferrable.

Thanks for the AIMS link Tangle.

Brilliant advice on here as usual, thanks everyone.

I got turned down by the MLU because I have asthsma. Its a dog allergy. Not relevant particularly to giving birth I would have thought, but they were adamant. I was transfered there the day after I gave birth as DS was jaudiced and I was anemic they wouldnt let us home, but unit was closer to home. The place was bloody empty. I saw one other mother in the 4 days they kept me in. I think they turn down so many, they have bugger all left. And the maternity ward at the hospital was bursting at the seams. its a fear of being sued I think.

As it turned out, I would have ended up at the hospital anyway, but i was so angry with the decision.

Stellamel I'm glad you were able to talk to your midwife about it. It sounds like you will be going into your second birth with a very clear idea of what you want. I know birth plans don't always get followed, but being well-informed (and there's nothing like having been through it all before to 'inform' you!) will make a difference.

Fingers crossed for you.

Oh and my friend who had the lovely 2nd birth had a doula, who she said was fantastic. I think it gave her and her DH the chance to relax because they knew they had someone there to fight for them if needed.

I cried when I heard her (2nd) birth story, it was just so perfect. And yes, part of that was being in the MLU where they turned the lights down, spoke in quiet voices and were deeply respectful of her as a labouring mother.

There is a very active homebirth support group in the area run by a lady with a wealth of experience negociating care specifi to her plans with this particular hospital's team. Email me if you would like to talk to her.....liz haslett 212 at hotmail dot com (no spaces etc...)

How well you are treated by the medical staff makes a big difference to how you manage afterwards. It's still shocking to see that medical staff are so hyperfocused on their own particular little niche that the big picture is obscured.

That being said, I would caution against relying on getting anywhere fast in an emergency if there's a lift involved. You should not take it for granted that a potentially serious hiccup will not happen at that point.

Even if you negotiate and get into the unit, have a backup plan in place in case they transfer you so that you'll get some of what you feel is necessary for your delivery even if the circumstances are not ideal, from your pov. And don't underestimate the potential trauma of the transfer itself if it happens.