NICE draft guidelines on giving birth - home birth or midwife led unit?

[KatieMumsnet]

Hi All

NICE (the National Institute of Health and Care Excellence) are in the news today with draft guidelines recommending that midwives advise mothers-to-be to opt for a midwifery-led unit (MLU) or a home birth when deciding where to give birth.

What do you think? Would these recommendations work for you? Would you still stick to a traditional hospital ward? Have you had a home birth and loved it? Or did you opt for a home birth or midwife led unit only to find out the resources weren't there?

Would be great to hear your views.

Thanks

MNHQ

(Closer examination of why ELCS are being done, might be beneficial to women who don't want an ELCS too. Why are some hospitals doing them in circumstances that others are not. And how involved / aware are these women about the need / discussion over whether they need an ELCS

It cuts both ways here).

Hi all, I'm only 8 weeks pg with my 1st so I know I will probably sound very naive, but I have to choose where I want to give birth for my booking appt in a week so am interested in this. (Also, the hospitals / units don't give tours until you've chosen and are booked in - bizarre catch-22 I don't understand)
This advice has made me very happy, as I don't want any interventions if it can be helped and I'm scared of trigger happy doctors. The tide of opinion/referrals has always been to hospital in my city (based on acedote) until a mlu was built last year, but it's still under attended which I suspect is due to discouragement by docs or scare stories. My FIL - who for some reason feels he has the right to have strong opinions on birth which he spouts at any opportunity - thinks giving birth outside a hospital is absolute madness, so I am so glad there are some decent stats to support hb/mlu, even for a 1st timer. Previously I had been scared of fighting to get into the one mlu in the whole city and having to justify my choice over and over.
I know a lot of people on here have had awful experiences and that is terrible. I guess I'm just trying to say there are also people around who want a mlu and are prepared to travel further to get it who ALSO are feeling pressured at the moment, but towards hospital, who are really really glad of any indication that the discussion should be kept open towards hb/mlu.
Sorry, rant over

The thing is lizzibt, you can always book the MLU and if there is a problem you will be transferred to the CLU which will be via ambulance.

Surely that has to be better than sticking around at home wondering when to go in, or going in and being sent home again, or leaving it too late and giving birth in the car without any medical support (unlikely with a first, but it could happen.)?

And either tell FIL that rigourous research has proved MLUs to be safer than CLUs for a woman in your position or better still don't tell him at all - let him spout on and on and learn to ignore him if he's like that.

I seriously considered a home birth for my first.

Thank goodness I didn't. Massive PPH. If I had been at home I would almost certainly have died. Maybe I'm the 1 in whatever small number fatalities - but you couldn't have predicted it. I was young, slim, fit, easy pregnancy.

As you can imagine, I'm not really pro home births. When the shit hits the fan I want a doctor and a theatre and a full range of medicine! A huge PPH is terrifying.

But this assumes that the hospital is properly staffed oohdaddy and that the drs aren't already in theatre. You only have to read these threads to see posts about the woeful standards in many hospitals, particularly on postnatal wards - so what if you have a PPH on a badly staffed postnatal ward?

I was on a badly staffed ward. DH had to run for midwife. There is panic button to call and a doctor must have sprinted they got to me so fast.

I will take my chance on a badly staffed ward. A blue light would have been 20 minutes at least. Fuck that!

My friend in my antenatal class was similarly "low" risk. Baby got stuck/distressed and then they became worried as her heart rate was all over the place and was emergency csection. A home birth would have meant 45 minutes in am ambulance. Final friend who did have a home birth had a bloody nightmare. Blue light job in rush hour evening traffic for emergency c section. We were all first time low risks women!

Maybe me and my friends are crap at having babies! But someone has to be - why risk it with your child.

I think MLU are probably good if attached to the labour ward and for second time births onwards when you know what your body does.

For first timers to give birth at home? Utterly bonkers based on my experiences.

Giving women the option is a good thing imo, as long as the scientific evidence is available to them, so that they can make an informed choice. But if you live a long way from the nearest hospital, it will be more risky. So it doesn't help when they close local hospitals.

I don't like the idea of any pressure being put on women to give birth at home, just because it's cheaper/frees up beds in hospitals.

However, a home birth can be such a lovely, relaxed, fulfilling experience - it's good that people are being encouraged to consider it.