Early pregnancy - do I get to choose my midwife?

[Audrey2013]

Hello ladies,

I am sooo happy to be 7 weeks pregnant but am absolutely new to all this?
So the first question - about midwives.

• Can I choose any hospital/center/midwife or are the choices limited to the postcode area I live in?
• If I can choose, any tips or advice anyone? Would you recommend it to be a hospital team or a smaller birth centre, etc?
• Should I even consider going private? Has anyone tried both options (NHS and private)? Are there any advantages? (For now I am only talking about the consultations throughout the pregnancy, not giving birth).

Thanks in advance for any advice! xx

I'm afraid you don't get to choose your midwife as such, but you do get to choose which hospital or midwife led unit you wish to birth at. My advice is that unless somewhere has awful reviews opt for the unit/hospital that is easiest for you to get to. Midwife appointments tend to be on specific days and they are not flexible with times, so being able to get there quickly and easily is useful.

As for hospital v midwife led unit that's personal. I've opted for hospital as it is my first, I am a bit older than average, and the midwife led unit has a 38% onward referral rate anyway. If there are any problems at all, and problems include a slow first stage (not uncommon with a first baby) they send you to hospital anyway. The actual number of births in the unit is very low. I guess they have to be cautious as they are no doctors on site, and the hospital is 40 minutes away.

Outside of London it is possible to have a private midwife, and private scans (based on the very poor care I've had I'd go for this option in future), but nearly impossible to have a private birth. I'm in the SE, and there are no private obstetric units near me.

Your community MW will be determined by who covers pregnancies for your GP practice. Normally you have a booking appointment at 8-10 weeks and you'll be asked your preferences on where you want to give birth, though you can change your mind later on. That will determine where you go for scans and, if you are considered high risk, obstetrician apps. In the NHS, unless you have a home birth, when you'll be looked after by the community MW team (but not necessarily YOUR MW) then you're likely to get a stranger in a MW unit or hospital. It hasn't been a problem for me, I like my community MW and the hospital ones have all been great. If it was v important to have someone known to you then you might want to look into having an independent MW or doula with you.
I gave birth in a MW unit attached to the labour wards at the hospital. Best of both worlds for me, lovely hands off natural birth and all the blue lights and bells only seconds away when it went badly wrong following arrival of DS2.
At least book with community MW and see how you get on, you can discuss options and change plans from there if necessary.

Forgot to say I've opted to have private OSCAR scan(nuchal translucency and bloods at 12 weeks) and Group B strep test in late pregnancy as not offered on NHS in my area. No problem with going private for certain bits.

Thank you both for your replies, much appreciated!!!

My GP told me to refer myself to a hospital nearby, I guess that's what I will do first thing tomorrow...

Bakingtins, a "MW unit attached to the labour wards at the hospital" sounds great, will definitely look into that! Thanks again!

I would second midwife-led unit in hospital. I had a long, slow labour with DS and a long pushing stage but there was no pressure for any intervention at all. They were really keen to let it happen naturally.

I chose my hospital based on proximity to work (easier for appointments) and good reports from friends. Some of the online reviews weren't so good so I would maybe take into consideration that people are more likely to go online and post a review if they're unhappy than if they're happy.

I have chosen to give birth at a hospital outside the area, so my antenatal care has come from the community midwife team local to me who are not very familiar with either my hospital notes or any of the facilities, procedures, classes etc available at the hospital. I found I had missed out on quite a lot of information. So if you do go out of area, get in touch with the hospital and ask what they offer in the way of tours, classes, etc.

Ladies, thank you very much for your replies!

Am I right thinking that it is quite common to be seen my a local midwife throughout the pregnancy and then, if I decide to go private for birth, get to the hospital when already in labour?

Yes. If you are classed as low risk you would only be seen at the hospital for 12 and 20 week scans and then probably offered a tour of the labour wards towards the end of pregnancy. If you choose a hospital birth then you contact them once you are in established labour and go in.
I'm not sure what you mean by "go private for birth" as in most areas (outside London) that's not an option. I guess if you book into a private hospital you'd have some contact with their obstetrician before you went into labour.

I don't really know anything about it either, but to be honest I don't know why you'd want to pay for a private birth or even if there's much provision out there. Ask friends where they went and what their experiences are like, and go with the good reports.

The other thing to consider is that an NHS hospital will also have provision for you to receive emergency care at any point during the pregnancy - things like needing to be seen due to reduced fetal movement (happened in my last pregnancy and I was scanned), bleeds (have had these both pregnancies) and a whole raft of other issues that can come up. For example my baby is currently lying transverse at 37 weeks so I'm being scanned next week with the possibility of the consultant turning her. If you went private for all this stuff it could end up costing you a fortune. I don't want to scare you by the way - these babies can just be bloody awkward at times and you need to know where you'd go if you need extra help.