Is the concept of "choice" of where to give birth a load of cr*p?

[mum295]

From the NHS website: "Wherever you decide to give birth, you can change your mind at any stage of pregnancy. Talk to your midwife if there's anything you're not sure about, or you want to know more."

Am currently 10 weeks pg with DC2 and as have not yet had 12-week scan don't want to discuss this with friends who know the hospitals involved, so please excuse rant on here but I would appreciate hearing your thoughts and experiences!

With DD (now 2.5) I was originally booked into Hospital 'A', closest one to us, but after finding out they didn't offer tours for mums-to-be (only an online video) and talking to our Doula, we opted for a midwife-led unit at Hospital 'C'. It was a bit further away but overall, I had quite a positive experience there and appreciated being able to go and have a look around beforehand, so it wasn't so scary when I was admitted.

We have since moved house, not too far away but far enough that Hospital 'C' isn't an option this time around. Saw the GP to report my pregnancy and asked her about hospital choices. She was a locum and looked at me blankly, said to speak to the midwife and went ahead and filled in forms for Hospital 'A', still the closest one to us.

I've had the booking appointment with the midwife today and am feeling a bit deflated and . It was basically a form-filling/blood-taking exercise. She was pleasant enough, but not exactly listening to me, IYKWIM.

I mentioned to the midwife that we might not end up having the baby at her hospital, Hospital 'A', and wanted to take a look at Hospital 'B', not that much further away. She all-but put her pen down, made a comment that was a very thinly-veiled version of "well I'll stop what I'm doing now then, this is a waste of my time" and told me to go and see the GP if I wanted to go somewhere else. I then had to talk her round, persuade her that I probably would have baby at Hospital 'A' and that as friends had had babies there, I was sure it would be okay.

The fact is that Hospital 'A' had a dodgy reputation until a few years ago and has had a lot of money thrown at it recently to improve the birth stats. Friends have definitely reported 50:50 good:bad experiences. Also, we know one of the obstetricians there socially and neither of us fancy him seeing me in that context, IYKWIM! Happened to some friends of ours and they definitely feel awkward about it, although he's a good doc and v.professional.

Will still be investigating Hospital 'B' but was just a bit dismayed by the midwife's attitude and how defensive she got. I went into the appointment so excited (we took a year to conceive this time) and she completely burst my bubble!

What are your experiences of hospital choice? Have GPs and midwives been helpful and supportive or not?

Sorry this is so long. I feel better now!

So you were assigned your midwife based on the hospital choice that your GP made?
I think that's standard, but yes, if you don't want to go to A then you have every right to decide that and stick to it.

Would you consider a home birth?

not.

I had DD at hospital A, and had a terrible experience. I am having this baby (am 40+1!) at hospital B but have had to see MWs from hospital A for some appointments because Hospital B doesn't send any MWs to my GPs.

they've been arsey with me every time.

I couldn't have a HB unless I registered with hospital A and therefore ran the risk of having to go there should anything go wrong, so again, lack of choice.

Nickel yes, around here you have appointments with midwife from your assigned hospital.

Am not overly worried at this stage as switched hospital at around 30 weeks last time and managed to get re-booked fine.

I have considered a home birth but DH not keen. Also we now have DD and no local family for her to stay with, so she would have to be at home whilst I was in labour. She is a sensitive little soul, gets upset enough when I'm sick (morning sickness) so don't want to risk it. Will have my Mum stay at our house with her whilst we go to hospital.

I've had no problems swapping hospitals. But you do usually need to book in again with a second set of midwives.. which is annoying. They all like to have their own set of notes in their own style basically!

Don't take the risk of a hospital you're not happy with - you don't have to.

i apologise if i'm out of touch with latest rules, but i had ds1 in a hospital nowhere near where i lived, 10 years ago the rule was any NHS hosp had to take you if they had space, and i booked in very early.

ds2 and dd i had at my nearest hospital which happens to be not within my local authority as we live right on the border, but again i booked in very early and was told you can go to any NHS hospital you like (though clearly if its 100 miles away they might suggest you're being unwise)

That sounds rubbish! You should switch if you want to, you're perfectly entitled to. I was automatically offered a choice of 3 hospitals (one midwife-led) or a home birth with no pressure in any direction. It might make a difference that we have care with our community midwives wherever we give birth, so I guess it's no hassle for them.

You can register at whatever hospital, you can later change to a different hospital - but walk your notes across, yourself, don't rely on the internal system getting them across complete and on time - and you can even turn up in labour at a third completely different hospital or stay at home. As lOng as everything is normal (wrt the pregnancy, I mean) only jobsworths make any fuss.

But it is like any pregnancy-related plan: there are no guarantees that things will continue the way you planned.

I've been reading up on Hospitals 'A' and 'B' online and am still keener on 'B', so will try to go and have a look round. I had to go there for something else a year ago and was impressed with the cleanliness and medical care.

I switched hospitals during last pregnancy so know the drill with notes and so on. Even so, I might just wait until after 20-week scan before I switch. Last time I was re-scanned by the new hospital anyway due to large heads running in DH's family and their concern about complications. They just copied all the notes into their book/folder and appeared to be happy I'd chosen them.

Am looking forward to getting 12-week scan done so that, assuming all is well, I can talk with friends about their experiences, as many have now been back to Hospital 'A' for second birth.

the hospital they chose for me is the closest to the Dr's surgery I use, and the midwives that cover the surgery are based at that hospital. You get to see both midwives and either one would be at your birth.

I understand their logic and I do think thats nice, but I had to say I didnt want Hospital B, I wanted A. They seemed a little put out but understood my reasons (Hospital A 3 miles from my work, and I spent too much time in Hospital B as a child to want to give birth there, however amazing it is!)

Anyway, when I give birth, I dont care who does it, just get it out as quick as possible :)

Thanks Loopy and everyone for your support, I'm feeling better about things this morning.

Last labour/birth was reasonably straightforward and quite quick (12 hours start to finish), so I would prefer MLU, which Hospital 'A' doesn't have but 'B' does.

Had a chat with DH last night and he agrees we should go to 'B', so I think that is the decision made.

I took the plaster off my arm where MW took blood yesterday and she has left me with a huge bruise as a souvenir of our encounter...nice!

I'm not going to make a complaint because she was superficially nice, but it was superficial, and she dropped the act quite quickly when I mentioned Hospital 'B'. She wasn't the regular MW so hopefully the next appointment will be better.

Hmmm, I'm pg with my first at the moment and my experience with my GP couldn't have been more different. He was fabulous. After congratulating me and saying how fab it all was he sat me down and asked if I'd thought about where I wanted to have the baby.

I decided on the hospital closest as it's stats are much of a muchness and neither DP nor I drive. It's a 10-minute walk. He agreed but made clear that if I wasn't pleased with it I was free to swap at any time. He also said he could hold off booking me in if I wanted time to decide.

As it happens I'm happy with my choice but I also feel that I could change me mind at any time without it being a problem. In this day and age a GP really shouldn't assume a woman hasn't got somewhere in mind when it comes to birth.

Oops my mind!

Hospital choice was freely open to me in both pregs. I was based in one county miles away from London but wanted my consultant apts and delivery in a central London hospital. GP sent letter to London hospital and they took me on. It could be because I have a difficult obstetric history and so were more sympathetic.

In 1st pg, I also switched hospital on due date.

I was told I could change my mind about which hospital I had chosen when I went to get my refferal from my GP, mainly because I wasn't sure which that just picking the one closest to my house was the right decision (turns out it was but for other reasons).

Also in my area they have standardised maternity notes that are used across all the maternity hospitals which would make switching easier.

I guess maybe the midwife was just a bit insulted and acting quite unprofessionally as a result.

Well, I have taken the first step towards switching to Hospital 'B'. Phoned their ante-natal line earlier and left a message.

They called me back not long ago and were soooo friendly! So nice after yesterday's experience!

Unlike Hospital 'A' they do offer tours, so am going to go and have a nose around as soon as I can, just to make sure I'm happy with their facilities.

The lady I spoke to advised waiting until after my first scan and blood tests had all come back okay, then said they'd be more than happy to have me. I have the option to self-refer so that I fill in the forms and notify the GP/original midwife after the event.

I remembered that with first pregnancy, GP (different GP) said he didn't blame me for switching from Hospital 'A' as 'C' was so much nicer and was where his wife had had their kids.

Feeling really now!

Intrigued - there is no choice where I live!

Hi,
I asked my midwife at my first appointment if she could tell me about my choices and what i should base the decision on, and she told me she could not advice or persuade and it was up to me (not very helpful but not fussed either) so i went away and did my research on the Dr Foster website. This website gives lots of useful stats like no. of unplanned c-sections, and no. of private rooms with bathrooms as well as no. of women who gave birth there last year. I used this to decide on the hospital 2nd nearest to me. The midwife accepted this as its in the same PCT trust, i think the probelms arise if its a different PCT area. Apparently you are not as welcome if they are really busy and you are from out of the area, though they still have to admit you if you turn up in labour. Good luck choosing and stick to what is best for you x

Loopy - yup I am in the south of the UK but this is my 3rd DC and I have never been offered a choice! A choice would involve compulsory public transport (ie short ferry crossing) so I guess that's why ;)

I find the whole idea of being given a choice to be very stressful. I am glad I have none! Well it's either hospital or home - no birthing centres either.