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Original poster

What's your opinion of stand alone midwife led units?

27 replies

Seasidedolly · 06/10/2014 21:10

Hi all

I just wondered if anyone had any opinions or experiences of midwife led units?

I've been offered Cossham Birthing Centre in Kingswood, Bristol, and also Southmead hospital.

I'm swaying towards Cossham because its new, each room has pools, double beds for DH to stay over, aromatheraphy etc, but my main concern is if there's a complication, an ambulance transfer to Southmead is required.

Southmead wouldn't take long in the dead of night but rush hour could take up to 45 minutes.

I am hoping for a natural birth (first child!!) but I am concerned about putting my child potentially at risk if I do need to be transfered and it takes a long time.

Anyone been in, or currently in, a similar situation?

OP posts:

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LikeASoulWithoutAMind · 06/10/2014 21:18

I had 2 of my 3 dc in a standalone mw unit (had the other one at home)

It would have taken us 45mins to drive to hospital in rush hour but the mws assured me an ambulance could get me there in 12-15mins blue light. They also said it is fairly unusual for complications to arise all of a sudden and they are very cautious and will transfer you if they even slightly suspect an issue (esp with a 1st time mum)

I had a really fab experience, it was great. The mws were all really experienced and of course they stay with you all the time if you want them to. I'd also met most of them beforehand, which I found very reassuring. It was also a really supportive atmosphere in terms of establishing bfing.

Sheddie · 06/10/2014 21:26

Hi Seasidedolly. I went to a birthing centre to have my DD (she was my first..and only at the moment). I really liked the thought of not being in a busy hospital. At first it all seemed great because we were the only people there when I turned up in labour. We had a huge room with a pool and I felt relaxed (as you can be when you're in labour) there.

However after several hours of pushing the midwife decided I might need help to deliver so I had a 25 minute ambulance journey to hospital. This experience was not particularly nice as I was told to stop pushing and just had to lie on the trolley. I definitely would not like to repeat the experience.

Once at the hospital things moved quickly and I didn't need help after all. In hindsight I probably would have chosen to just go there in the first place to save the hassle! I went home within three hours of giving birth. I know for those who have to stay overnight hospitals are not always great so I may have felt differently if that was the case.

It's a difficult decision. I know people who did manage to have their babies at the birthing centre and they loved it. Good luck!

skyra13 · 07/10/2014 08:48

I have the same issue in a different area, it is my first and I am quite big so if any goes wrong, I think I'd rather be at the hospital already! x

Gen35 · 07/10/2014 09:23

You'd have to be very unlucky for the transfer time to make a critical difference - can you talk to your mw some more about transfer situations and outcomes? It would likely be very scary, although ok in the end, I had a friend requiring a transfer and while they found it traumatic, there were no terrible outcomes. Personally I'd not risk it for a first dc but only because I had a PPH with dc1 and although I'd probably have been ok, 45 mins might have meant I was in even worse shape after.

Imbimba · 07/10/2014 10:16

I had 2 dcs in a stand alone unit in nw London. Transfer time to hospital was 12 minutes, but I figured that because i was guaranteed constant one on one midwife care throughout labour, any problems would be picked up very early on. I was also told that sometimes they call an ambulance and then it turns out they're not needed - they are very cautious and don't take chances.
I had 2 very positive experiences in this birth centre. For no 3 (due next month) I'm going to the midwife led unit in the hospital instead...have had some complications this pregnancy and, although they'd let ne go to the stand alone centre, i just don't want to this time.

canweseethebunnies · 07/10/2014 10:47

I am going for an moly with a hospital 30 mins away. Have you asked about ambulance transfer times? I'm sure they get there quicker than you think. I understand why you're concerned as that route across Bristol is a traffic nightmare!

Remember, the mlu's are very cautious. They don't wait until it's an emergency, they transfer at the first hint of a problem.

canweseethebunnies · 07/10/2014 10:55

By the way, this is my second baby and I opted for the mlu last time, and ended up in the hospital, so I'm speaking from experience!

canweseethebunnies · 07/10/2014 10:56

*mlu not moly

katiegee · 07/10/2014 11:50

My first baby is due in December, I am going to the maternity unit in a nearby hospital. There is one standalone MLU nearby and blue light transfer to the nearest hospital is less than ten minutes. I've had friends who have given birth in the MLU and have raved about it. Two had to be transferred to the hospital but this was done quickly and at the first sign of any problem rather than it becoming an emergency situation.

Me, I'm a worrier. I have no reason to think anything might go wrong, and I know i would be in the best hands if something did happen, I would rather be in a hospital. I hope there is no need for a doctor to be anywhere near me during my labour and delivery (and afterwards) but I will feel a lot calmer knowing there is one down the hall should the need arise. But like I said, I am a ridiculous worrier.

Do what feels right for you, whatever that might be. :)

stargirl1701 · 07/10/2014 12:00

I have had both DDs in our local MLU. DD1 in the pool and DD2 on a birth mat with my birth ball (she came too quickly for the pool - it was still filling up). I stayed in for 5 days afterwards with both which, if you are allowed, I would highly recommend.

Tbh, I would like to live at the MLU for the first 3 months! Warm, clean, good food and lots of advice on hand. I go to the bf group there on a Monday. Love it!

Roxie85 · 07/10/2014 13:07

I had my first on Xmas eve last year at a stand alone mlu and it was fab. I was concerned as a first timer but after a tour of both there and the hospital I knew exactly where I would feel more comfortable. The more relaxed you can be the better.
I had a tear so was transferred to hospital afterwards (I think this is where a some of the transfer figures come from as well as when people decide they want epidurals as my mlu couldn't offer them)
They always transfer before an emergency arrises if they can, they are always cautious. My friend had a pph in the pool at the mlu so was blue lighted to hospital 20mins away and all was fine.
Go and look round and ask about the resus bits. I did and they showed me the resus units they have for mum and baby and they are trained to use them. My mlu told me the resus stuff they have is the same as the hospital which made me feel better. I'd happily go there again as I had a dedicated mw who never left my side.

workingtitle · 07/10/2014 13:21

IIRC from last year, Cossham had high transfer stats because they were new and bedding in, but they have been working to reduce them. If you go to visit and ask, they will be able to give your their recent stats and discuss transfers with you. Southmead delivery suite are great, postnatal care less so.

RetroHippy · 07/10/2014 15:59

Like katiegee, I have a choice of the local standalone mlu or the birthing centre at the same hospital as the labour ward. They are about 15 minutes drive apart.

While the stand alone unit is meant to be amazing, I'm going for the centre with attached labour ward just in case. It's DC1, so I've no idea what's coming, and I'd rather be wheeled down a corridor than blue lighted, even if it is only a few minutes.

claraschu · 07/10/2014 16:05

I had my first two in hospital in the US, with epidurals (which were great, though not exactly what I had wanted of course).

I had my third in a small midwife-led unit in the UK, and it was a much better experience in every way. I think I would have been anxious if it had been my first child, but I knew I wouldn't need the epidural if I didn't have to deal with all the hospital palaver.

babykonitsway · 07/10/2014 16:46

I would use a unit like this if it was attached to a hospital. Maybe I am just a negative Nancy but if there was a serious emergency ie haemorrhage, baby very distressed etc would you get to the hospital in time? 45 minutes in rush hour traffic is one thing but what if ambulance was far away or queued up?

I get that birth is an experience but at the end of the day for me, getting the baby out healthy is the most important factor. If something terrible happened that could have been prevented could you forgive yourself. I know its un-likely but no one ever thinks it will happen to them.

not so important is pain factor. As its your first what if you cant manage, some women just cant. Do you want to be transferred to hospital in agony, probably wouldn't get blue lighted either as it wouldn't be an emergency.

Its a tough decision, only you can make.

Binglesplodge · 07/10/2014 17:00

It's such a difficult decision - I'm facing the same choice in Oxfordshire, between the Cotswold Maternity Unit and the JR hospital and at 39 weeks I still haven't managed to come to a conclusion! The atmosphere in the midwife unit is so relaxed, friendly and cheerful and the Spires at the JR don't offer tours so I haven't even been able to see what it would be like.

I'm hoping once I go into labour instinct will take over and I'll know whether I feel I need somewhere relaxed or somewhere very medical...

DanyStormborn · 07/10/2014 17:35

This is my first. I am choosing a stand-alone midwife led unit, it is 10 miles to the nearest obstetrics unit, around 10-20 minutes transfer depending on ambulance availability. I will be assessed at 36 weeks to check I am definitely low risk, if they deem me not to be then I will have to go to a hospital. I like the sound of the stand-alone unit as it is quiet and relaxed (the midwife unit attached to the local hospital and on the same site as an obstetrics ward is relaxed but always very busy so you might not get the pool room and might get less midwife time etc.) I also like that it falls somewhere between a hospital birth and homebirth which is a nice compromise for me as I would love a home birth but don't feel comfortable doing that for my first baby. I know there is a fairly high chance of me getting transferred to the hospital (30% for first time mums compared with just 10% for second or third babies) but I don't mind if that happens as I will have had some of the labour in that environment and I'll know I tried it. I'm not worried as I know the midwives don't want an emergency situation arising so do try very hard to hard to spot things early enough for a comfortable transfer and if a real emergency does arise they are trained to deal with it. I know three first time mums who tried to have their babies there, two had just the type of birth they wanted there (one was a water birth) and the third got transferred to the hospital in early labour due to there being meconium in her amniotic fluid (possible sign baby is in distress), that fits in with the 30% statistic.

Kth1981 · 07/10/2014 17:38

I had my second child at a maternity unit (my first in hospital) and have to say it was a much more calm and relaxed experience. I had 2 midwives who was there the whole time. In hospital I felt they were under staffed and my partner had to go and find the midwife on a few occasions. If given the choice I would definitely choose the maternity unit again

IamHelenaJustina · 07/10/2014 17:43

I think that if the transfer time is very short - shorter than from your home - yes it's a good option. However if by using a MLU you are prolonging your transfer time then I really don't see the point. You might as well have one to one care in your own home.

IamHelenaJustina · 07/10/2014 17:50

Also important to note that a lot of people have said effectively the midwives are trained to deal with an emergency - and that's true they are. BUT there is a limit to what training can do ' in the field'. There are some childbirth emergencies - very severe pph being one - in which training only gets them so far and you need very rapid access to major medical support. It's all about the transfer times for me. Doesn't matter how lovely the place is if it's too far away.

tigerlily1405 · 07/10/2014 17:52

OP a friend of mine was transferred from Cossham to Southmead, it didn't take too long and the midwives called for the ambulance at the very first sign of a problem. I had my DS at RUH Bath
because of locality but next time I will definitely choose Cossham, apparently its really nice! But from what my friend had said the transfer to Southmead doesn't put me off.

Original poster

Seasidedolly · 07/10/2014 20:07

Thank you all for your replies! They've given me some more points to think about, I'm only 14 weeks but I do think about it alot, my friend is a few weeks ahead of me and she's going for a tour of the MLU at the weekend so I've armed her with questions.

I think I'd rather wait a bit longer before I do the tours because at the moment, labour doesn't really feel real yet! I'll wait till its sunk in then do the tours :)

The real worry is the transfer time and as OP has mentioned above, I wouldn't want to regret my decision if something suddenly went very wrong, at least at Southmead MLU there are doctors just down the hall, there's just a reduced chance of getting a pool birth.

Thanks all again :)

OP posts:

frazzeled · 07/10/2014 22:37

I am married to a doctor, and several of our good friends are anaesthetist and obstetric consultants. Interestingly none are in any way encouraging of being at a stand alone unit when it came to their own/my births. They all have far too many experiences of what can happen if you do have an emergency, and although they are rare I can never understand why you would want medical help further away. I note that most of the positive comments are from people who have had a good experience, and that is great for them, but why take any risk?

workingtitle · 08/10/2014 03:30

But, frazzeled, those working in obstetrics have a rather skewed perspective. As you say, the genuine emergencies are rare--giving birth is a pretty safe thing to do. Of course that's not to say bad things never happen, but the best idea is surely to evaluate your own risk based on evidence, and see what you're comfortable with.
There are also risks to giving birth in hospital that don't exist in freestanding mlus, like higher risk of hospital acquired infection (much more conmon than birth related serious morbidity/mortality) and greater risk of instrumental birth/or a 'cascade' of interventions that can result in morbidity for mums and babies.

Midwives are highly trained and do count as 'medical help'(!) In mlus they get to enhance their skills. The aim is for a birth that is above all else safe - they are very cautious and will have a low threshold for transfer.

The best available evidence (place of birth study) says that for both first and subsequent babies, mlus are as safe as hospital for low risk births.

Mashedupbanana · 08/10/2014 09:11

I had my second baby at Cossham last month and it was fantastic. As I understand it they transfer at very early signs of a problem so there is very little risk but having said that, I had my first at Southmead and it was fine (Cossham hadn't been built then).

It would be lovely having your partner staying with you over night as they have at Cossham.

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