Natural Birth with UCLH?

[mimsy35]

Hi,

I am 34 weeks pregnant with my first baby and I am booked to give birth with UCLH. My pregnancy has been really smooth so far and I really want a natural birth. I've intended to use the birth centre at the EGA wing. I've recently read a lot of horror stories about how the midwives in UCLH move people to the labor ward if birth is taking too long. There also seem to be alot of mysterious "last minute emergency interventions" during natural births. I'm now terrified that this will happen to me and my otherwise healthy baby. I'm scared I will be forced to have an epidural or c section.
Would it be safer for me to have a home birth instead of going to the hospital? Has anyone had a positive experience of natural birth at UCLH?
I'm really becoming quite anxious about it and don't know what to do for the best. Any advice? Any positive success stories?

Thanks!

I'm a bit surprised by the bad stories you've heard, it's unfortunate as I and the majority of my friends (at least 4 or 5 in the last 2 years) all gave birth at UCH with fantastic experiences. So at least from our end, all good!

I gave birth nearly a year ago in the birth centre. They were very much leaning on the side of anti-intervention, from antenatal through to the labour itself. If you opt for the birth centre they encourage you to go for as much as you can without G&A, then to wait a bit before the pool, avoid the use of drugs etc. They really want to avoid epidural as that means a transfer to the labour ward. They have a lot of equipment and I found they were keen to stick to my plan as much as possible whilst offering helpful ideas to keep things going. They have much more staff in the birth centre than is available on the labour ward, so they encouraged women whilst antenatal to opt for the birth centre whilst I was there.

In terms of my birth, they held out as long as possible. I was in the pool room, I used G&A from around 4cm (I needed it! Never got around to the pool because labour progressed faster than originally expected - about 6 hours from 3cm to 10cm) but I was pretty much left to get on with things in the way I felt comfortable with, they helped me with breathing, offered different tips and equipment (eg birthing ball, positions to be in). When it was time to push things slowed down, so they helped me with different positions on my knees and then suggested the birthing stool. I pushed for 2 hours but it was actually alright, not horribly painful (!), contractions had moved to 5mins apart hence the time it took plus DS has quite a big head and struggled to move over the 'bump' in the birth canal (no idea what that's actually called).

They said that once you get to 2 hours of pushing they have to seriously consider intervention, to avoid complications/distress, they were worried about needing to intervene in our case but they really encouraged me with pushing and breathing and just before 2 hours DS suddenly came shooting out (only way I can describe it!). They immediately had me reclined, G&A, breathing techniques to slow down and limit tearing. Baby delivered onto stomach and they focused on getting us both well and happy, I had torn and he was a little pale. Frankly they were brilliant. I had 2nd degree perineal tear which was expertly stitched, just a bit swollen after, plus an 'unusual' (according to MW) vaginal tear, also well-stitched but had some problems after due to me overexerting but it still healed up and fine within 1-2 weeks.

It was only the other day that DH told me that I was very close to requiring serious intervention, eg EMCS I remember them regularly looking at the clock and saying, "Let's give it 10mins more, come on delasi, I want you to take a deep breath, really bare down..." etc, so I think they really did their best to avoid intervention and it worked.

I would definitely go back for future DC if I can.

Sorry that was very long

PS no one can 'force' you to do anything you don't want to. I found that the medical staff at UCH were very good, so if it reached a point where they said it would be necessary to intervene I would have trusted their judgement, but I wasn't up for an epidural for pain management and would only have gone with it if an EMCS was necessary and they actively discouraged epidurals in the antenatal class as being not so helpful in labour in terms of time it takes and having other interventions during the labour.

I had a natural birth, in the pool, no intervention, brilliant midwives at UCLH in 2011. Wouldn't hesitate to go back again.

I gave birth at UCLH 3 years ago (first DC) and had a similarly positive experience, only this time in the labour ward where they were very supportive of my desire for a natural birth. Went into labour early, wasn't sure where to ring so rang labour ward first and was asked to come in to be checked out as my waters had broken, this revealed high blood pressure so they said I'd need to come back to the labour ward when things had progressed further rather than the birthing centre.

Things progressed at home very quickly so we were back within a couple of hours 9cm dilated. The only issue we had was that they didn't believe I was so far advanced so I nearly gave birth in waiting room in front of poor teenage boy! Eventually DH found some staff, a bit of a panic when they realised I was already 9cm, but things really slowed down after that at the pushing stage. I had typed up my birth plan in advance. This was read by the midwife as soon as she came in and she did take it all in and managed the birth in accordance with what I'd suggested in the birth plan (but making suggestions gently when they needed to progress things).

My pushing stage took absolutely ages - seemed like 3-4 hours though I'm not sure they would have let it go so long. However I am pretty sure that the midwife did allow it go on for some period longer than normal the basis that I was keen to avoid intervention and baby's heartbeat (which she checked regularly) was strong and healthy.

She offered a few times to speed things up with drugs but I asked if we could give it a bit longer. Eventually she said that they would need now to do something to speed things along and asked me which I'd prefer of syntocin or an episiotomy. I therefore still felt that I had an element of control and that she was respecting my preferences.

She did a brilliant episiotomy (my home midwife raved about it) which never gave me any pain afterwards. DS was born a couple of seconds later. She delivered DS onto my tummy (it felt very much like she threw him at me!) and we had skin to skin for a good long while before they towelled him off, then they left me, DH and DS alone to bond for about 5 hours in the delivery room before I was taken to the post-natal ward.

I may just have been lucky - they were busy so I was dealt with by a senior midwife and I certainly got the impression that the labour ward mainly deals with caesareans (mine was the only natural birth that the medical student, who was also with me, had seen and it was her last night on the labour ward). I am sure these things do vary hugely depending on who you see. But certainly there is scope for it to go very well

My experience was in 2005 so a while ago, but was the opposite of what you describe. I had a straightforward but long labour - went to hospital at 11pm on Sun at 5cm dilated and went to the natural birth unit. Transferred to the labour ward at 2pm on Mon for an epidural at 8cm dilated - my choice entirely. Gave birth naturally at 8pm Sun.

So although I made very slow progress (3cm in 15 hours - the rule of thumb is 1cm per hour) no one suggested intervention of any kind.

Even though I had an epidural which I was hoping to avoid, it was still a very positive birth experience for me - largely because I felt in control of my decisions and not pressured at all.

Not a great experience at the birth centre in 2011 (DC1).

They told me to stay at home until my contractions were a certain time apart, but they never got very close together. The pain got too much so we went in away, at which point I was 7cm. However they didn't have enough midwives on and I wasn't checked on very often - maybe once after the arrival check. DH had to go and find someone when I had to push, and I remember begging the midwife not to leave...

Also, the midwife didn't read my birth plan and cut the cord immediately which I didn't want - presumably to speed the process up due to staffing issues. I was too out of it to know what was happening and DH didn't intervene.

I was pressured into transferring to the labour ward on arrival due to a high blood pressure reading - no wonder after a stressful taxi transfer to a strange place and being greeted by a surly midwife who I struggled to understand. I refused as I had never had blood pressure issues and sure enough it soon returned to normal.

For DC2 I had a home birth, but all antenatal care at UCLH. The home birth was so much better. I felt I got much better care - two midwives to stay with me throughout active labour. The community midwives who attend home births from UCLH are generally great and very lovely.

If you feel able you could opt for a home birth, but there is absolutely nothing to stop you transferring to the birthing unit at any time if you want. A home birth is not for everyone though.

Thanks for your replies!

It sounds very much like "time" will be an issue. From what I can gather I'll be given up to 2 hours to "push" and if my baby hasn't arrived by then, I'll be transferred to the medical ward - even if there's no danger to the baby. I guess I'll just have to stand my ground fiercely. I'm toying with the idea of home birth - though it's my first pregnancy so the thoughts of being home alone with a midwife I've never met before is scary too. I can't afford £2K for a private midwife. What to do!

I've been reading information on medical procedures during labour and I know that I definately DO NOT want continuous electronic fetal monitoring. It seems to be the cause of a lot of unwarranted alarm resulting in a cascade of intervention - it's like the least little thing causes intervention - just like Poosnu's passing high blood pressure.

Oh it's all so confusing!

If only I could feel confident and guaranteed that I'll be left in peace to deliver naturally - then I'd be delighted to be giving birth a UCLH because it seems like a good place otherwise... instead I'm still highly suspicious that my wishes won't be respected! I can't help thinking it shouldn't be this way!! :(

Sorry you still feel that way mimsy - to be fair to UCLH, only one of the responses on this thread backed up your doubts. Good luck, I really hope you get the birth experience you want

If you do go the homebirth route, I can't speak highly enough of the community midwife team at UCLH. I had a great hb (1st baby) with them earlier this year.

I second what CityDweller says. All the community midwives were just lovely and I very quickly felt comfortable with them. Really really lovely. I wouldn't let the thought of having a strange midwife put you off planning for a home birth if you are considering it. Two of the team will visit your home at 37 weeks to drop off the drugs, gas, etc so you can meet several of them then.

You would most likely also have a strange midwife in the birthing centre / labour ward. It's unusual to have someone you have met before. You may even get a locum midwife in hospital. That location would be more stressful.

I understand that UCLH is really excellent for complex births but you don't seem to be high risk at all? The community midwives at UCLH are very supportive of home births and remember you can transfer into hospital at any time; if there is a medical reason or even if you change your mind.

There are loss of threads about home births on here. It does tend to reduce the risk of intervention.

Hi all, I am going to give birth at UCLH too. What really scares me and I don't want under any conditions whatsoever are forceps and ventouse. I will definitely write it in my birth plan and discuss it with a MW at next appointment (I am now 30 weeks), but I am scared they won't follow my plan. I want to write very clearly I would go for a cs instead of assisted delivery. I can't believe those medieval instruments are still allowed!

My 9 month old was born in the labour ward. My experience was fantastic. Midwife appeared surly and uncommunicative, in fact listened to my concerns and went outside to the doctorsand fought my corner, plus gave me the sweep to end all sweeps, so that I was clearly in full blown labour in 10 mins flat. (Went in to be induced. I suspected I was in labour or just about to be so didn't want pessary, just drip. Doctors not happy about sweep, wanted to crack on.)

In fact, when I told them I had a slow amniotic leak the day before, they believed me, although they couldn't see it. They really trusted my judgement and acted on it. Fab, fab, fab.

Sorry, one further thought. Baby was being monitored with me. I have had two high risk deliveries. Baby was in some distress at the pushing stage but all that resulted in was an additional person in the room, lots of shouting at me to push and a little bit of telling me off for too much gas and air. But no intervention.

And that was in the labour ward.

Had two babies at UCH, 2008 an 2009 so a while ago, but the midwives in the labour ward were totally amazing. The second time we got an immediate change in midwife as the one who met us was a bit new and couldn't quite handle the pace! (both times, I had precipitate, I.e. fast, and a bit complicated labours) Post-natal care after DC1 was pretty awful (but that's not a UCH-specific problem) but was amazing with DC2. She was born at 36 weeks though so I got a bit of extra care because they had to check her a lot. All fine though! Would definitely choose UCH again - thought they were amazing.

So no experience of the natural birth bit but the midwives change around anyway, I think.

Hi Mimsy. I very much hope you get the natural birth you want, in whichever surroundings you choose and it all goes brilliantly for you and little one.
Please try to keep a bit of an open mind about things though. No one will (or indeed can) force you to accept any treatment you don't want, but you don't actually know how your labour is going to go or how you will cope with it. There are many many different variations and a straight forward pregnancy (or otherwise) is not necessarily a good guide to how labour will be. Please, if things don't go as you hope and visualise, don't be disappointed in yourself or with your body. A healthy mum and baby is the name of the game and unfortunately Mother Nature isn't always entirely on side.
It is true that monitoring and intervention isn't necessarily nice or ideal, but it has it's appropriate place. As do other interventions such as forceps and ventouse. They aren't done for fun or staffing issues, they are done to try to get the best outcome with the information available at the time. A late stage urgent or emergency Caesarean section (which is hardly un 'medieval' in it's barbaric-ness if you think about it) can be a damn sight more dangerous for mother and or child. Not always but sometimes.
There are always options, they change with the situation and although having a good idea of what you would/would not like to happen is a good plan, please be prepared for your mind to change or the situation to strongly suggest a course if action that you hadn't really wanted. Sometimes alarmingly quickly.
As I said, I hope it all goes really well and you get what you'd like, but labour and delivery is not something you can really 'plan', or have much control over. Your body and baby will do what they will do, at best you can react to it.