Midwife led unit

[JE87]

I'm 19 weeks with my first child so a while to go yet but my midwife was discussing where I will be giving birth. They are advising me to go to a midwife led unit, I'd have my own room in a quieter, small hospital and it does seem a much nicer environment than a ward. However, there are no doctors there and if there is any sort of emergency you get sent to hospital via ambulance.

Just wondering if many people gave birth in midwife only unit and what your experience was like? I've spoken with a few friends and they all ended up needed a doctor at some point which has really put me off the midwife only unit.

Hi,
I’ve had both my girls in midwife led units (know friends that have done the same). I never had any problems and the midwives were amazing. But I think it depends on what your pain relief options are.. you’ll only be offered gas and air at MLU no epidurals etc... are you a long distance from the doctor led hospital? X

Dear god no. I would never ever give birth in a stand-alone unit with no doctors on site. Never ever and I wouldn’t recommend it either. Sorry.

I have birth in an MLU and it was fantastic. Care was top notch, got a pool both times, found it relaxing. But...and it's a big one... my MLU was attached to the big hospital and so all the doctors etc in case of emergency were a ride in a lift away and not an ambulance ride away. X

I personally wouldn’t.

I loved the midwife unit BUT our local one is attached to the labour suite where all the doctors are, plus it's a massive hospital with neonatal unit on site - I wouldn't chance it without backup, except maybe a second pregnancy following an uneventful first.

I'm planning to birth in the mwu but as some others have said it's attached to the hospital - downstairs is where the keep the good stuff.

Last time I ended up on syntocin (sp?) Drip,had an epidural (would do that again), an episiotomy and almost foreceps.

I'd want to know I had immediate access to that again.

The questions to ask are about your specific risk level, the transfer time to the obstetric unit, the BBA rate for transfers and and delay in transfers from MLU to obstetric unit as well as the number of transfers.

Only with that information can you make an informed choice. Statistically outcomes for MLU are better than for obstetric units for lower risk deliveries ......but that is not necessarily the same as a personal outcome.

Hi, I feel quite strongly about this as had a horrendous birth- which would’ve been avoided if I’d stayed in the ‘normal’ labour ward.
I won’t go through the whole ordeal, but for a first time mum I’d say play if safe. Labour will be completely different to how you imagine it, not so much the pain but the intensity - you really won’t be that aware of you’re surroundings, and have mood lighting and music playing is worth it for the risk.
At the time I had my ds1, our local hospital had just opened a birthing centre so i was adamant I wanted to use it- but my son would have been born at least 12 hours earlier on the normal ward!
The vital things they miss- such as baby heart rate monitoring, mothers heart rate monitoring, positional scanning - could all save you from risk.
Even this like examinations, I was pushing for 4 hours with no success- when I got onto the labour ward the doctors said I wasn’t fully dilated - the midwife hadn’t picked up on this and had told me to push (my baby was back to back so I fet the urge to push, on the labour ward they would’ve have known this and prevented me pushing for so long- which then caused a haemorrhage).
Lucky for me our birth centre was upstairs to the normal labour ward, I was taken to theatre after being examined. Had I haemorrhage in the labour ward they wouldn’t have had the equipment to stop the bleeding and save my life.
I know this sounds really dramatic but honestly don’t take the risk.
If you have a straight forward birth, then look at these options for baby number 2.
These units have great stats because they can only intake low risk women.

Only have the one but needed episotomy due to quick fetal distress and told me they needed her out now. Followed by a quick check over by the resuss team who'd came in at some point unbeknownst to me 😂 thankfully not necessary and she was peachy!

So from my own experience, if I was to have another one it would have to be where doctor/consultant was for that safety net.

Midwives were great but im very thankful there were other healthcare professionals there on hand!

My unit was midwife led but you could have an epidural between 9 & 5 Monday to Friday. It was great I got to stay for three days, I could have left earlier but I was new to it all and it was nice to be looked after for a while. My closed maternity hospital has you discharged within hours and has large shared wards. I absolutely would give birth in that environment given the alternative was a small unit with small rooms of only two people. Or your own if you were especially in need.

I gave birth in a midwife led unit that was attached to the main hospital. Would much prefer a quick trip down the corridor rather than a quick trip in an ambulance. I was perfectly fine anyway and was not in need of any intervention, extra drugs or anything like that.

Thanks for sharing everyone. I think this has definitely made up my mind! If it was attached or next to the main hospital then it would be different but it's quite a significant journey away.

I'm a doctor. Myself and none of my colleague friends have or would give birth in an MLU. We have seen the other side!

Meant to stay a standalone MLU. Linked to a hospital absolutely fine!

I'm due in 3 weeks and have the option of a stand alone MLU about a 25 min ambulance trip away from main hospital, or an attached MLU - I'm going for the latter. I really don't fancy an ambulance transfer if things don't go to plan and the midwives in the stand alone have a relatively low threshold for transferring women (quite understandably- better safe than sorry) x

I did, it was absolutely amazing. Birth too fast to contemplate epidural, so decision was out of my hands, but it was a lovely unit, wonderful midwives, and we got a private room overnight! I had friends on wards who didnt have such a great time. But- big but - the ward was right across the corridor. I'm not sure how I'd have felt having to transfer by ambulance. Then again, its something they must do all the time so I wouldnt worry about safety, more a convenience factor for you!

Like other posters my first two births were at a midwife led unit attached to a main hospital. I needed a forceps delivery eventually for DC1 so needed a last minute epidural, doctor intervention etc. The atmosphere at the midwife led unit, plus birthing pool etc was fantastic but I would be wary of needing a transfer during labour. Most transfers occurr for non emergency reasons, for example to have stronger pain relief/ epidural. However there is a lot of evidence that the transfer itself can cause labour to stall, necessitating further interventions.

To be honest, in your situation I think I would have chosen the midwife led option but it might not have been the best choice!

My cousin was in a similar situation to you with DC1 and needed the transfer in the end - it didn't phase her at all and has just given birth to DC 2 in midwife led unit. Ultimately it's your decision - I would ask myself how I'd feel about needing a transfer and base my decision on that. The chances of an emergency occurring at the unit is quite small since, as a previous poster said, the threshold for transfer is really low. But for a first time mother the chances of transfer are quite high.

I would choose MLU over labour ward in hospital. This time I'm having a home birth. The stats I've seen show lower risk of interventions including unplanned c-sections at MLU/home. This is my second child however, and I would have felt more comfortable at either a hospital or attached MLU with my first.

I have used an attached MLU twice. First birth went really well and I was able to use the pool. Second went very wrong, very quickly as I had a massive PPH and was very glad that when they pulled the red cord there were a roomfull of people there in seconds - I needed surgery and transfusion. Third time round I was deemed high risk and not allowed to use MLU but had a good experience of hospital birth, was able to stay upright and active and give birth kneeling (my preference) and MW stayed hands off. I would want to be in the right place for intervention quickly should it be needed, you can still aim for the more peaceful low intervention birth you want if you are clear in your birth plan, but don't get too hung up on it going a particular way, it's unpredictable and outside your control. If there is any option to transfer postpartum that would be when I'd really appreciate a quieter MLU - the one near us is like a hotel, partners can stay overnight, there is more help to establish BF....

I'm surprised they would even offer this with your first pregnancy and labour!

@Cantthinkofausername1990 I was offered this too at my midwife booking appointment. It's my first baby. Midwife asked me if I considered where I wanted to give birth, I said hospital. She told me that there's evidence that MLUs have better outcomes for low risk mothers. I shrugged and still said hospital. Turns out I had to go on medication which upped my risk factor anyway so it was a pointless conversation.

I’m not allowed to as consultant led (19+1), but I definitely want an epidural so even if not consultant led I’d not.
The local MLU to me is fantastic and has a brilliant reputation but it’s not for me-its 20 miles from the hospital so just too far.
There are MLU’s attached to the 2 main hospitals so think they are a better bet as transfer is immediate if required. But regardless I’ll be in the main labour ward.

Gave birth in a midwife led unit attached to a hospital. Had to be transferred to the consultant-led birthing centre in the end and am very happy it involved an elevator rather than an ambulance ride.

I would choose MLU hands down over hospital. I was gutted I ended up in the hospital for my first. I strongly feel that if I'd been in my local MLU I would've had proper attention instead of being left to labour on my own in the antenatal ward until 10 cm and pushing without proper monitoring of the baby or access to pain relief. Obviously everyone's perception of risk is different but the idea that you're unquestionably putting yourself at risk of you don't have a doctor in the building is a cultural belief not an objective one.

I had both DSs in a stand-alone MLU. Both straightforward water births after low risk pregnancies. When I went for a look round prior to DS1 being born the midwives were quick to reassure that if they noted anything that concerned them they would recommend transfer to the local hospital 25 minutes away.
Weighing up the risks and benefits it was a choice I was comfortable making.