Birthing centre vs labour ward

[lilyb84]

I'm sure there have been plenty of threads about this so sorry if I'm duplicating.

I'm due in January and at some point need to decide between the midwife-led birth centre or the labour ward (not considering a home birth).

Many of my friends and family have planned for the former but ended up giving birth on a ward due to various complications so part of me thinks there's not really any point going for the birth centre as it probably won't happen anyway! I also wonder what it's like in one of the units as my hospital doesn't offer tours - I can't imagine not having all the hospital equipment around if that makes sense (but have maybe watched too much TV).

Just wondering if anyone here has actually given birth in a midwife-led centre and has any experience to offer?

And what are others going for (I realise options are different depending on the area)?

FWIW I'm at King's College Hospital.

I'm hoping to use the birthing centre at my local hospital. Meanwhile, fingers crossed, have no reason not to. If you go into labour on your own (without being induced) and there's no reason not to, you can start in the birthing centre and if you feel you need more pain relief etc, they will always transfer you anyway.

Due with my first in a couple of weeks so can't share my experience yet, but a couple of friends have used the birthing centre and would definitely recommend it...

Good luck with your decision; and you're right about keeping your options flexible anyway!

Thanks ava! I mostly just want to be practical so might just have to see how the pregnancy progresses and how I feel further down the line!

Good luck with your imminent arrival!

i gave birth at chelsea and westminster birth centre - the midwives were amazing! I found the whole setting much more relaxed and you would forget you are in a hospital. I couldn't recommend the experience more highly - fingers crossed you can go to one!

I managed to get in the birth centre and it was a great experience. I had a lovely big room with a pool in one corner, big mats on the floor and bean bags. Mood lighting, music, a kettle and an ensuite shower room.

My midwife was lovely, and the only intervention was using the doppler to check the heartbeat regularly when I was pushing. I didn't have pain relief as didn't want to be moved off there down to labour ward, you can have gas and air and also pethadine on the birthing unit though if you want something.

It was a very calming environment.

You can still opt for the birthing unit, even if you just start off on there it is worth it.

Is it your first baby? You're more likely to have a long labour with complications first time around. I started at a birth centre but was transferred. It was lovely for the time I was there but they will not keep you unless everything is very normal and if you labour too long you'll be out!

I had my first at our local midwife-led unit and the experience was as lovely as labour can be, although I did have to transfer to the hospital afterwards due to a haemorrhage, so if you choose the MLU then make sure transferring is an outcome you're happy with if you have any complications. You also have to be happy with the idea that the transfer will delay any treatment/surgery you need.

The MLU itself was very nice but still a medical setting, so not majorly different to the rooms at the big hospital - same floors, curtains, everything wipe-clean, same bathrooms, etc.. It did have a big pool, soft lighting and less traffic, so I was the only person in labour there and had the attention of 3 midwives. I did wish there had been a bed in the room as the most comfortable position for me to labour in was actually sitting down and it was hard to get comfortable on the (wipe clean, surgical looking) floor cushions.

Good luck with whatever you choose

Thanks all for your comments and experiences! Yes it's my first (hence my being totally clueless) but I'm under no illusion that things will go to 'plan' even if I make one

I may opt for the birthing suite as some of you have suggested but will be more than open to being transferred during or after the birth.

I had my first in MLU and it was great - although I made sure there was the option of the full labour ward just down the corridor in case needed, not least as I'd always been a complete wuss with pain. Happily I didn't need it and had a really positive birth, very private, used pool and had midwife there pretty much throughout. Had 2nd degree year which mw repaired while I was on the bed enjoying tea and toast (slightly surreal) and an ensuite which was great. Was able to stay in room for 4 hours before transferring to postnatal ward tho could have gone home had I wished (I opted to stay overnight just in case). Would thoroughly recommend - now pg with Dc4 and really pleased that consultant has agreed to MLU (not a given as am now over 40) - last two were home births so I wasn't too sure of going for labour ward. But again, good to have the back up there.

Good luck!

For my first I was in the mlu but transferred late on. Second time on labour ward only due to complications first time but there actually weren't any second time.
Although there is a lot more equipment in the labour ward I didn't actually find the experiences that different- mw care was excellent in both. As is usually the case there are far more pain relief options available in the labour ward.
At our hospitals there is a pool available in both but I know in many places pools are in MLU only which may swing it for you.
When I went in both times I was initially in triage and they were very flexible as to which ward I wanted to go to so you may not need to make a decision in advance.

If you have the option, I would go for the birthing centre. We have had 2 DC. First had to be hospital because waters broke early, so we were considered medium risk. 2nd DC was at the birthing centre and it was much more pleasant and calm. We ran into problems with the afterbirth which resulted in a blue light transfer to hospital/ theatre (10mins by ambulance), but given the choice, I would still opt for a birthing centre over hospital.

In case it is relevant to your decision making, I should add that I am DH (and birthing partner), but I am reasonably confident that DW would be of the same opinion.

I recently gave birth in our local MLU and it was fab, it was next door to the main delivery ward though and due to a very long second stage the midwifes had to inform the senior midwife / doctor next door who came through - so i suspect that if it had been a standalone MLU then i would have been transferred and also that MLU's do have some emergency equipment to hand.

We Recently did the tour of the midwife birthing unit and delivery unit at my local hospital.
The midwife doing the tour said that all women will be triaged upon arrival at the hospital and those who have had a midwife led uncomplicated pregnancy will be offered the midwife birthing unit whilst everyone else will be moved to the delivery suite. Both the midwife unit and the delivery suite are in the same building so if complications arise for those on the midwife unit they just move them over to the delivery suite.
It reassured me to know that I could use the midwife birthing unit without having to worry about specialist help and equipment being too far away if it became required.

To add: your choice of pain relief might dictate where you give birth as there are limited options available on the midwife unit.

I want to go into the MLC as the atmosphere is so much nicer, you don't need all the hospital monitoring equipment unless there is a problem, in which case you're just transferred to the ward anyway - which at my local hospital is next door to the MLC.

I am currently low risk so am hoping for MLC, but you never know what might happen so I'm trying not to get too hung up on it.

Is your local birth centre in a different place to the labour ward?

Personally I would recommend going for birth centre and if you need to they will transfer you over. The more comfortable and calm you can be during labour the more likely you are to have less interventions and a quicker birth. Usually a birth centre is more homely and there are more pools, balls etc to help you get comfy!

I had DD1 in a birth centre in water and I would definitely recommend it (especially water! The relief as I got in the pool was incredible). The birth centre was just one floor up from the labour ward though so i knew I didn't have far to go if I ran into problems. In fact I ended up in theatre after the birth for a haematoma and the transfer was just a case of being wheeled to the lift and then to theatre.

Now expecting DD2 and planning a home birth in water but only cos I had a quick labour last time so am worried about making it to the birth centre!

I had a straightforward pregnancy, no complications, and therefore presumed I'd have a straightforward birth. I was wrong!

I opted for the water pool in a MLU but ended up being transferred to the consultant led unit. It was a five minute walk if that, just down a couple of corridors, (and I was on a trolley so not walking anyway!) but the transfer was hideous - having to stop the gas and air while I was in indescribable pain, having to get some clothes on, having to gather all our stuff while being terrified about the worsening condition of my baby, etc.

I don't know what I'm going to do this time. I quite liked the pool and the MLU but if I'd known I was going to be transferred I'd have NEVER started off there. I knew there was a chance I'd be transferred, but I never really thought about the logistics of it, and the hassle/pain involved, if that makes sense.

If I could do my first labour again I'd start off in the consultant led unit, both because of my experience and also because I don't know of any friends - home birth or MLU to start with - who didn't end up giving birth in the consultant led unit.

A big factor to consider for you will be the distance between the two units in your area, and also if you have any indication at all that your labour may be anything but completely straightforward. Good luck in whatever you choose.

Wow, thanks for all the advice and experiences you're all sharing, it's so helpful!

The MLU at King's is, as far as I know, on the same floor etc as the labour ward so a transfer would be quick if needed. I'm probably going to opt for no/minimal pain relief if only to see if I can do it but want the option to change my mind....

running I'm sorry to hear you had such a horrible experience being transferred. I suppose you just never know what will happen but it's helpful to hear from your point of view and to know that the transfer, even if quick, won't necessarily be easy. I hope you have a better experience next time.

And trapper thanks for your opinion, my DH is leaving this decision totally up to me (and not sure he's going to be great in any hospital situation tbh) so it's good to hear from the husband/birthing partner's point of view (although your poor DW - the drama sounds terrifying!).

I started on MLU but was transferred v to the labour ward. In terms of the rooms and care there was no difference.

However, at my hospital birthing pools are only in the MLU and you can't have an epidural in the MLU

OP - a friend of mine ditched her DH and took her mother instead, such was her concern about him not being able to cope! Completely agree that it should be your decision. The other thing that may be with looking at is what the differences in after-birth care are like. You may find you get a private room and more flexible visiting rules at a birthing centre.