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Talk about every stage of pregnancy, from early symptoms to preparing for birth.

Midwife-led birthing suite vs doc-led medical delivery dept - any view/experiences?

17 replies

Chestnut99 · 18/07/2012 14:45

Just wondering if anyone has experience of the differences in quality of care (assuming all is fairly straightforward) in a midwife-led birthing suite as compared to a doctor-led medical delivery dept? Specifically, I'm thinking about St Georges in Tooting (the Carmen Suite), but any experience would be useful. DC2 is due in 6 weeks or so.

I had a fairly grim experience with DC1 who was born in the medical delivery dept, with a very mediocre midwife (co-incidentally a man, although I think he was mainly just poor, regardless of gender). I wasn't allowed any choice of where to give birth first time around because of potential complications but this time I've been given the go-ahead to be in the Carmen Suite.

I have a suspicion that the better midwives are probably going to be in the midwife-led birthing suite, but is this true or just me making things up based on a bad experience? Any thoughts/experiences would be very welcome. I haven't asked the docs/mws on the basis that they probably have to stick to a party line that all are equally good.

Many thanks!

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minipie · 18/07/2012 15:01

Just marking my place as I am interested in the same thing (and same hospital!)

There is one definite advantage I know of with the Carmen Suite which is that you stay on the Carmen Suite for postnatal rather than going to Gwilliam ward, and DHs can stay overnight there whereas they can't in Gwilliam.

(However if this is your DC2 then your DH may need to go home anyway?)

I don't know anything about the relative quality of midwives/general care though, so will be interested to hear any experiences.

jenbird · 18/07/2012 15:22

Can't speak about the specific hospital but I had dc's 1 and 2 at the medical del unit and dc3 at Midwife led. The latter was so much better. The medical unit was more of a cattle market whereas I was the only one on the MW unit. I had my own room and stayed there without ever having to go on a ward. I was also out 7 hrs after I gave birth as the MW was able to discharge me where as with the med unit I had to wait for ages for the dr's to come around. It was altogether a much nicer experience in terms of care.

ArtyJennie · 18/07/2012 16:03

If you are prepared for no pain relief (apart from gas n air/ TENS) then i'd defo go for the MW- led. I'm assuming the mw led doesn't allow epidural/drugs etc?

I had dd1 at the birthing centre in Croydon- it was lovely. Lovely mw all to my self, birthing pool, bouncy ball. DH stayed overnight afterwards, only one other person staying on the ward!

This time (i'm 35 weeks) I'm terrified of going through the pain of birth again so i'm opting for an epidural so i'll have to risk the medical delivery dept. I hope i'm making the right decision! I keep changing my mind!

minipie · 18/07/2012 16:53

Yup Arty MW led unit doesn't have epidural available, but I gather I could transfer if I decided I wanted an epidural half way through.

(Though I wonder whether I might be lower down any "waiting list" for epidurals as a result of having changed my mind last minute rather than having it in my birth plan).

Chestnut99 · 18/07/2012 17:31

I got to 10cm last time on gas and air and a TENs machine (at which point it all went pear shaped and I ended up with a full spinal block Confused, so minimal pain relief doesn't worry me in itself.

I do like the sound of staying there overnight in your own room - the Gwilliam ward is 4 mums and newborns to a room (no suggestion of being allowed into one of the few single rooms last time) so it was a rather noisy night. And my DH is very happy to hear he might get a bed too ...

Any thoughts re the relative quality of the midwives?

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Chestnut99 · 18/07/2012 22:13

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BuffyFairy · 18/07/2012 22:23

The Carmen suite is lovely. My mw stayed with me the whole time and the student midwife too. Had dd in Sept 2011. Unfortunately there was meconium when my waters broke so had to go down to main delivery rooms but same midwives accompanied me.

You still have 4 beds to a room on postnatal in Carmen. My dh could stay until midnight but not the whole night. The advantage is that there are fewer postnatal beds so it's quieter and I think you get more attention from the midwives.

4boyzmum · 18/07/2012 22:38

Hiya. I had DC4 in MLU at my hospital. Cant obviously speak for all hospitals but compared to my first 3 birthing experiences (though none have been eventful so to speak, all very straightforward) it was a billion times better. No intervention from midwife etc whatsoever, i totally did it all by myself and it was brilliant. But didn't feel on my own whatsover, mw and student both on hand at all times. Had a whole 'suite' to ourselves - own bathroom etc, use of birthing pool (which was fab) and to top it all off my DH was able to spend the night with me and baby in the suite instead of being shoo'ed away as happens on the ward. He slept like a baby while me still on a massive high was watching Jeremy Kyle on ITV2 at 4 in the morning!! Expecting DS5 in 7weeks and im devastated that im unable to use the MLU this time - apparently due to the fact that after 4 labours you are deemed more 'at risk' when giving birth. Im very grateful though that i've at least had the chance to use it previously and would completely recommend it to anyone who is able to use one.

warzonemummy · 19/07/2012 12:14

I have my heart totally set on the Carmen suite. In anticipation I have worked so hard and raised my iron levels to safe levels to be allowed there. However, I have been reading that the facilities there are limited and if you go into labour when it is occupaied you are sent off to the other unit - some times they will transfer you into Carmen suite if it becomes available bit not guaranteed. There is no certainty.

minipie · 19/07/2012 12:25

I am also v keen on Carmen warzone and I asked a St George's midwife about that recently. She said it hardly ever happened these days that they had to turn women away from Carmen due to being full. It was more likely however that the birth pools would be full (as they only have 2), but women could still use the Carmen suite without the pools.

Eeek, I didn't know that iron levels could be a reason to be turned away. What do your iron levels need to be to be "safe", do you know?

Of course there are still lots of other reasons why Carmen might not be possible eg breech birth, induction (not sure if induced ladies can use Carmen?), high blood pressure, placenta praevia etc... so I am trying not to set my heart on it tooo much. But it sounds great.

shinyblackgrape · 19/07/2012 13:25

I'm interested to read this. I am currently booked in to the midwife led birth centre at Wythenshawe for first DC. However, am wondering if I would be better in the consultant led ward.

I haven't had any detailed discussions with the midwives I have seen at all. I was assessed as low risk at my booking in appointment so was told that I should go to the midwife led centre. I agreed as I didn't know any better! However, I'm 22 weeks now and thinking of trying to discuss the pros and cons with my midwife at my next appointment.

Londonmrss · 19/07/2012 14:13

Am also interested in this. Particularly in terms of what facilities are available in case etc etc. Eg if baby needs help breathing or needs oxygen, or any other problem which might not present itself in time for a transfer to a medical unit, can a midwife-led unit cope with that?

Hulan · 19/07/2012 14:19

I had DS2 at the Carmen suite and what an amazing birthing experience that was. Even though DS came 1.42 hrs after we arrived, the midwives were soo lovely and I was in full control of my labour and movements. And yes, it is on a 'first come first served' basis, but we had no trouble getting in. I can highly recommend it. Beautiful birthing experience

warzonemummy · 19/07/2012 14:35

My iron level was 9 and I needed to take it up to 9.5 to be able to use Carmen suite.I am on supplements and eating iron rich food and I have managed to bring it up to 9.2 and next week I will get checked again and hopefully it will be 9.5 then. My worry if going overdue as I am pretty sure they won't allow inductions at the Carmen suite.

London, if you are also hoping to use st Georges then you are very close to neo natal and so on anyway. They do swift transfers.

minipie · 19/07/2012 14:41

Thanks warzone mine is 11.something so hopefully ok.

I am also worried about induction. However I know a reflexologist in Balham who has a pretty good track record of bringing on labour in overdue mums... haven't tried her myself but I'm planning to if the need arises! PM me if you want her details.

YokoOhNo · 19/07/2012 16:18

I was supposed to go to the midwife led birth centre unit at Queen Charlottes (W London). The midwives there were excellent, it was much quieter and more friendly and my ante-natal care was done in the birth centre from 32 (i think) weeks. Such a relief after the chaos of the regular ante natal clinic.

In the end, I had a 4 day, hesitant labour, i.e. contractions at 3-4 mins apart, but not dilating at all, so the midwives wouldnt admit me to the birth centre. They gently told me to go to the labour ward to get an epidural and sleep so I had the energy to push, or i would have ended up with a c-section. However, because they liked me I was already on their books, the midwives admitted me back into the birth centre rooms for post-natal care due to my actual delivery being very smooth. T'was lovely.

so what im saying is, go for a birth centre delivery, but you have to be sure you can cope on gas and air and you may well find it doesnt work out on the day

Chestnut99 · 11/01/2013 14:34

Hello - thought I would just follow up with my experience to answer my own question IYSWIM!

I was admitted to the Carmen Suite, as hoped. It was all much calmer than I remember the medical delivery suite being with my DS (although I think it was probably a quieter day, luck of the draw). We were shown to a delivery suite with a "normal" hospital bed in one corner, but a beanbag, a mattress on the floor, a birthing pool, a birthing stool thing with long lengths of fabric to hold onto above it, and a private bathroom en suite. My NCT teacher tried to suggest it would be more like a spa than a hospital - a bit of an exaggeration, but it was a larger, brighter room with much less technical equipment than I remember the delivery room being.

My main concern was to have a more creative midwife who actually helped me, rather than someone who just took readings and measurements and called in the doctors at a certain point, which I what I had last time. I kind of got this. The midwife looking after me for most of the time was an experienced midwife but new to the Carmen Suite, so I was still examined lying on my back (incredibly painful), she called the doctors when we thought the baby might be stuck and she looked a bit blank when it looked as if I might give birth in the birthing pool. BUT the senior midwife in charge was very experienced and helpful and creative and was there at all the critical moments. She basically used her brain and experience to get my DD out (it turned out she was tangled in the cord, not in a dangerous way but so it was difficult to push her out). The senior midwife suggested changes of position, changes of angle to how I was standing, worked out that my very sticky-outy forwards bump meant that I actually needed to be leaning back a bit, not forwards.

Pain relief wise, I did gas and air and TENs again, fine, but the big revelation was the birthing pool which I got into at the end of the dilation phase - AMAZING - genuinely no pain between contractions. I think this really helped psychologically in having a break from dealing with the pain, which for me is stronger during contractions but basically still there in between, once I'm in established labour.

After DD was born, she was put straight on my chest, uncleaned, unmeasured, and we were left undisturbed for about 2 hours (I think there was an emergency going on somewhere else), which was fantastic. DD fed well immediately during that time and we've had no significant BFing problems since. Then we all got cleaned up and the room was wiped down enough for my family to come and see me in the delivery room itself, so this part of the postnatal care was great. DD was born at 2.30pm in the afternoon and I wasn't moved to the postnatal bed until about 9pm that night - lovely and peaceful.

The Carmen Suite postnatal rooms themselves are exactly the same as the Gwillim ward rooms, 4 beds per room, although there are not so many of them and the corridor outside is lighter, wider and this felt nicer. The disadvantage is that there are delivery rooms alongside the postnatal rooms, so the nights can be very noisy ...

Overall, I did have a better and more positive experience and I would definitely recommend it Smile

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