At 23 weeks, can I change my mind about where I give birth?

[Miffster]

My GP said to me, when I turned up to say I think I am 5 weeks PG, that the Homerton was 'best because it has a lovely new birthing unit and if you need to get consultant care, that it's got fantastic facilities for dealing with baby emergencies'. So that was that and I was down for the Homerton. I wasn't expecting to have to decide where to have a baby at that stage - I thought the GP would just make me wee in a jar or something.

Since those innocent early days I have been busy finding stuff out. I've since heard beyond awful tales of the post natal ward (bullying or ignoring staff, dirt and squalor, all sorts) and have several times got tearful about the thought of DH being made to leave me there on my own.

So I decided I would rather have a home birth. That way DH and I could be together with our baby son. I also think I would labour better at home than in a hospital, even if the pain relief options are limited. Even though I am scared of the pain, I wanted to try to stay at home as long as possible at any rate. (A big change from pre-pregnancy when I wanted to be hit with a chemical cosh and woken when it was all over.)

Since all the news story kerfuffle about the dangers of home births so many people have told me that I'm mad and of course I must go to hospital that I am feeling very discouraged - worried I'm putting my DC1 at risk by thinking of having him at home.

Then today I read about the Whittington having a lovely MLU and birth suite with water pools etc - and where husbands can stay the night!

This seems to be the answer to my prayers! And the Whittington is only 2 miles away, whereas the Homerton is almost 5 miles away!

I can't understand why my GP didn't suggest the Whittington to me in the first place, at least as an option. Perhaps she thought it was going to close. Maybe it's cos the midwives I see at the GP surgery seem to be based at Homerton.

I don't really understand the system. I see different midwives each time and have only had 2 appointments anyway so I don't have a particular bond with any of them. I've also had 2 GP appointments. I think they call it 'shared care?' I've had 3 scans at the Homerton and they have been great. But that's the sonographers, not the consultants or midwives, and the sonographers won;t be delivering DC1.

What's important to me at the moment is to have a safe labour with supportive midwives, (preferably women whom I have met before I am 4cm dilated), and to have my husband with me during and after, holding my hand, and to have medical care on hand if there is a medical emergency but otherwise to go at my own pace and not have interventions and be induced and epiduraled and so on,

But like I said, I don't know how the NHS maternity system works. I don't normally have anything to do with hospitals and I go to the doctor maybe once a year, if that.

How do I go about finding out if I can visit the Homerton and Whittington and look at the facilities. I've not written a birth plan yet but would like to, do you think the midwife or GP will be funny with me if I say, I don't know WHERE I want to give birth yet, I just know HOW I want to give birth - please help me find local facilities that will work with my plans?

I feel I'm supposed to be with the Homerton but I had no idea when I walked into the surgery and said I was pregnant that I would be expected to know all about how and where I wanted to have the baby months later! I've not had a letter from them saying I am having a baby there or anything.

It's all very confusing and this is a very long post. Sorry.

I changed to the Whittington at 32 weeks! And I live nearer to the RFH (where I was booked it). It wasn't a problem to change. i can't recommend the Whittington MLU enough.

And DS2 was born in the MLU and it was totally fab. As good as private.

This is what to do:

Go to Whittington website, and self refer.

link

Fill out the form, and email it to them.
Thats it! Wait for them to call - you'll have to have another booking in appointment though.

Even though we already had 12 and 20 week scans at RFH we got a 36 weeks scan at the whittington as they wanted us to have one there too.

You need to book into the MLU as well before 36 weeks. Once they have set you up a hospital number you can make the appointment to book into the MLU.

They have a tour on a saturday, I didn't bother because I had good recommendations.

Ok, the Whit is good IMO, but you will hear horror stories of it and any other hospital in London.

IME you would be lucky to meet your MW before giving birth at the Whit. The community midwives do sometimes work in the hospital, but only one of my friends had a community MW deliver her baby and it happened to be the one MW she'd met who she disliked! It is, also, pretty normal to see someone different each time and then, if you needed an emcs for example, for a totally different team to show up for that. If you gave birth in the birth centre your DH could stay as long as your stay didn't exceed iirc 12 hours. For a first baby you might want to stay longer to establish feeding, for example; for that you'd be on the post natal ward and your DH could not stay there.

So if you still do want to change hospitals you should do it asap. Hospitals get booked up and then you would not be able to change. You would transfer by speaking to your GP to ask her to refer you to the Whit.

IMHO hospital facilities, shiny new pools etc, are less important than the quality of medical care available, so looking at the facilities wouldn't make a vast difference to me (although I did draw the line at the ancient North Mid). If you've been having ok care at the Homerton it might be worth persevering, but you could call and ask to speak to a MW so you can ask any questions you have.

...or self-refer. Good tip there, MumNWLondon!

Oh great, thanks for the tip Mum NWLondon !

Haliborange, it's not smart shiny facilities I'm keen on, I wouldn't mind if the Whitt had small dingy individual rooms, it is the fact that I am terrified of being on a shared post natal ward completely alone, in pain, having just had a first baby, aged 40, with night staff shouting at me, unable to BF, and having my husband sent home that I am worried about.

If I self-refer to the Whit will that cock up all my antenatal appointments before 36 weeks though? will I drop out of the GP/Homerton midwives system and re-emerge into the Whittington MLU system at 36 weeks?

Miffster - the RF didn't know I'd transferred out so I just went to all my RF appointments that were already set up until the new Whittington ones were set up. ie I went to the RF 34 week check with community midwifes and then at 35 weeks had Whit booking in appointment.

DS2 was born at 7am, we'd got there at 4am. We stayed in the room (which is lovely and shiny, double bed is great as we all slept as we'd been up all night) stayed in until 9pm that night - we could have stayed longer had we wanted. They have 4 rooms with pools and a smaller room without pool that we could have moved into if we'd wanted to stay overnight.

The midwifes waited on us hand and foot all day, and were lovely. We probably could have gone a bit earlier had we wanted but it was so lovely we were not in a rush. At the MLU they pride themselves on the aftercare.

As I said on the other thread we did not see or hear any other patients (although I know they were full when we arrived! I didn't need help BFing as it was DC3 so can't comment on that.

You can change, but you may need different paper notes sorted - different hospitals sometimes have their own way of doing things and their own colour of notes to easily tell them apart. You may need to change some appointments, but that's a not deal in the larger scheme of things.

Wherever you go, you may well have never met the midwife that attends you in labour. Even if you have a home birth. So don't get too hung up on this. If it really worries you, hiring a doula may help so that you have a professional advocate you'll have met before to help you deal with the medical staff.

I'm hoping for a home birth. The NHS and midwifery college responded to that recent study and the consensus seemed to be "not applicable to the UK". I've looked at the evidence and personally I'm happy.

I still think the most important person in this process is your baby,and if you've been told one place in particular has the best set up for dealing with babies if there is a problem, maybe it is worth biting the bullet and putting up with one grim night.

Also you do know the Homerton has private rooms? I think for £80 (may be less)you can book one when you arrive in labour.

Good luck whichever you choose!

As far as I can tell the facilities at the Whit are fine, and the main reason for being recommended the Hoemrton by GP is because there's an antenatal clinic at the GP surgery featuring Homerton midwives, which has been very convenient so far.

However, the Homerton ISN'T convenient at all, it's over 5 miles from my flat, hard to get to and the Whit is only 2 miles and easy to get to.

It therefore makes sense to transfer for the last part of pregnancy because I don't want to have a homebirth which transfers to a hospital 5 miles away, with poor aftercare - I want to transfer to a hospital 2 miles away, with good aftercare.

Moving to the Whit means I can plan for a home birth but know, if I need to transfer, the hosital is less than 10 mins away. That's very important for the safety of the baby, as well as my own safety.

Putting me and a distressed half-born baby in an ambulance and driving over 5 miles through north east London pre-Christmastime traffic is not safe.

I think the Whit is the safest option because it's closer. And I feel much more relaxed about going there - that's also safer for the baby - a confident labouring mum is less likely to have baby-distressing episodes which require intervention and drama. And post-natally, the happier I am, the happier baby will be, I should think.

Anyway, thanks very much everyone for the info on this thread, and the thread in Childbirth which prompted it!

Miffster

Chiming in with the others that

a) that recent American home birth study is not hugely applicable to the UK since various of its conclusion (like 2 MWs) are the standard here anyway. It was also greatly (and inaccurately) hyped, but I still understand your concern.

b) I understand your wish for continuity of care, however that is pretty unlikely wherever you give birth: home, hopsital, MLU etc because of rotas and staffing patterns as explained. eg comm MWs generally don't also work in the hospital. If you have a HB then you will be delivered by Comm MW who you have a greater chance of having met before.

c) if you go to a MLU you will receive the same pain relief as you would at home (eg no epidurals at either), so in terms of pain management, that is neutral

d) privacy. You should labour in a private room and if you are nice and advanced when you turn up that should happen. DH will be allowed to stay for as long as you are in labour/immediate recovery, which is often for a couple of hours or more after the immedaite birth. Many hospitals have private rooms for later recovery either for a cost or if you ask v v nicely. However, my understanding is that even in the private rooms, DH will be required to respect visiting hours (generally). If you want DH there constantly, then HB is the only surefire way to make that happen.