Birthplace options - just can’t decide

[swiftt]

I always thought I wanted to birth in my hospital, so I was close to doctors and drugs should I need them. But I’m low risk so far, would like access to a birthing pool and would like to minimise the chances of needing intervention. To be clear, I’m completely open to changing plans and will accept whatever is needed during the actual labour - but I am trying to establish my preferences for now.

My options are:

1. Home birth
2. Freestanding MLU
3. MLU on hospital site

I live around 20 minutes from hospital, quicker with blue lights. I like the thought of having all of my creature comforts at home, a dedicated midwife, no worrying about whether a pool will be free. But I worry about the mess, the noise and if anything were to go wrong.

The freestanding MLU is the same distance from hospital, and offers the same pain relief etc as I could access at home - so this option feels a bit pointless, other than not worrying about the mess or noise as I wouldn’t be in my own home. But it’s around a half hour drive from where I live.

The MLU on site at hospital is a stones throw from the labour ward, so maybe I’d feel more at ease knowing how close drugs and doctors were - but would I be more likely to end up wanting these if they were so close? This is probably a busier unit as it services a larger city and area, and I’d have less chance of getting a pool.

It’s my first baby so I know that many home births for first time mums do end up in transferral anyway. Likewise, if anything were to happen at the freestanding MLU, I would be transferred anyway.

Can I hear some experiences of anyone who wasn’t sure which option to choose, and how their birth panned out eventually?

I was low risk all the way to my 40 week midwife appointment, then I wasn't, ended up induced which was the furthest away from what I had wanted originally but was actually really glad to be in the medical environment in the end.

For next DC I would love to have another go at getting into the MLU as was intended previously but I like the fact the labour ward is only down the corridor should it be needed. I can't think of anything worse than an emergency ambulance transfer, we are half an hour away from hospital with an ambulance station at the top of our road. Many other people will have positive home birth stories but for me the MLU gives a good halfway option. I knew my birth plan had to be fluid but the induction was a late curve ball so my advice would be to consider all eventualities and be guided by any medical advice offered- I could have said no to the induction but I took the view they wouldn't be suggesting it if it wasn't the 'best' option based on the info they had.

I had a home birth with my first. I didn’t want to have to move when in labour and preferred the idea of a dedicated mw and being able to get in the birthing pool when I wanted. But I was always sure that I wanted a home birth, was not at all anxious or worried about the prospect of giving birth and wasn’t bothered about pain relief (they offer gas and air, but I didn’t like it so just went without - the birthing pool helped massively anyway). It went absolutely fine! Great in fact. And I’m glad I chose that option. Mess and noise not really an issue. DH cleaned up afterwards while I recovered in bed with baby. Noise - meh. We lived in a block of flats at the time and I believe I woke up the neighbours. But they were very good natured about it.

Hi OP.
I was in a similar position to you in terms of distance except the MLU was closer to my house, about 15m.
I was very frightened about labour and I looked into all the options carefully be visited both the freestanding MLU, hospital MLU and delivery suite.
I really liked the atmosphere at the freestanding MLU and that was ultimately my main reason for choosing it.
I laboured at home for about 12 hours ( no idea how long really) and arrived at the MLU at about 10pm on the Friday night. I laboured there with my OH all through the night and had gas and air and a shot of pethidine at one point so I could have a sleep. It was a lovely atmosphere and I was standing or squatting the whole time which made the pain totally bearable.
At around 5 the next evening when I was 10cm dilated I tried getting in the pool but I got too hot (so it was unsafe) and they got me out and cooled me down. By that point my contractions had stopped and they got my consent for a transfer to delivery suite.
Even though it was a weekend and not busy the transfer took an hour. I had gas and air in the ambulance but I didn't need it was no contractions. When I arrived the shift was only an hour away from changing so nothing happened.
Then people started arriving and I was put on the drip.
I did not like being at the hospital, there were bright lights and they strapped monitors to me which were forever beeping and people fiddling with me. They did let me squat on the floor but they clearly weren't happy about it. No way was I lying down at that point after 36 hours labour !
Contractions started up again and I had DC after about 2-3hours pushing. I had a huge bleed after and they gave me something for that.
The end part in the hospital was not nice at all but it made me even more glad that I chose the MLU as the atmosphere was so much better for labouring. I had 4 different midwives being in labour so long and the MLU ones had an approach I preferred. The hospital was busy and the staff were stressed, people kept coming in and out. I think that's partly because it was the second stage of labor though.

With our 1st I was low risk but at my last mw app my BP was high so they admitted me to hospital and induced. I'm glad she was born at hospital because she ended up with her cord round neck and needed assistance. Her hb was monitored throughout established labor so distress noticed immediately, wouldn't have had that at home.
Our 2nd was very large and had polyhydramnios so I was classed as high risk. 3rd was the same but slightly smaller. 4&5 were twins so higher risk. Previous cesarean and large baby over 4.5kg instantly has me labeled as high risk now so they will always recommend a hospital birth for me.

I wanted to be on site where there was access to strong drugs (if I wanted them), and (more importantly) doctors if I needed them. So my options were either the hospital MLU or delivery suite. I had a slight preference for the MLU, but wasn't too bothered where I gave birth. I just didn't want to see my colleagues in theatre!

In the end, pre-eclampsia was picked up at my 36 week midwife appointment, which automatically meant I could only deliver on the delivery suite. As I needed the drip to kick start labour, the pool was also out. Fortunately I had decided long before to not be too attached to the idea of a water birth (due date at the busiest time of the year). In the end I had a regular vaginal birth with no need to go to theatre, so I got what I wanted in the end! 😂

so maybe I’d feel more at ease knowing how close drugs and doctors were - but would I be more likely to end up wanting these if they were so close?

Does that matter? Sounds like a good thing really, if you do feel suring labour that you would rather transfer tgen you have the option without a long waiting time. It might actually help you relax more knowing that its there?

I don't see the point of option 2 really.

I wasn't in the same position because I was high risk but even then the birth absolutely didn't go as they planned either, but it was fine really. I ended up with an emergency c section but it all went really calm and she was born quickly and healthy. No horror stories about recovery either. Its a day that I would be very happy to repeat really, even if it didn't go as I/we planned.

The only reason I’m including the freestanding MLU as an option is because it’s usually quieter than the one attached to hospital. I go there for all of my community midwife appointments so know it well, the midwives are all lovely and if I didn’t need to be transferred then I’m sure it would be fine. I’ve never been to the one attached to hospital. I doubt they’ll allow visitors etc at the moment to check it out. I’ll discuss it with my midwife at my next appointment and see what she thinks. She noted the freestanding MLU as my birthplace preference way back at my booking app without really asking me about it, it was just assumed that I would want to birth there. Again, totally aware that I could end up high risk and have the option taken away from me, but until that point I need to decide a preference.

I was low risk the whole way through pregnancy. Was in the MLU which was located in a hospital. All fine all the way through labour, then after pushing for over 90 minutes it was clear DS was stuck in the birthing canal, so I was taken over to the labour ward, given a spinal block and prepped for a potential EMCS. In the end didn't need one and just needed assistance, but I don't know how I would have coped with being moved at that point if I hadn't already been on site. I fully intended on doing the whole thing in the MLU and in the birthing pool, but my experience really brought it home that you have no control over what happens during labour, and so I'd always chose the MLU in a hospital in the future.

Being a first baby I would try and go for a water birth knowing that the labour ward is close.
No one can't ever explain the pain of birth 😂, my first was 32 hours of torture. At the time there was no pools for a water birth. However the pain and the length of time was a total shocker 😂.
My next 2 were water births . As far as births can be they were lovely! The water is amazing! Really helps with pain.
Now I'm pregnant with 4th, I would prob try for a water birth but have no one to look after the kids 🤦🏼‍♀️, so going to try for a home birth. But will miss the pool (dh won't let me have one at home as he will have to clean it and isn't good with blood). I'm a bit nervous about doing it with out a pool. Lol

I would opt for the mlu at the hospital in your circumstances, you don't really know how your body will react the first time. In retrospect I would have been completely fine with a home birth as I didn't have any pain relief of stitches but I'm aware my situation is unusual! Your age might be a factor too, apparently giving birth is easier in your 20's (which I was) though it's not that clear why.

I had the same options (3rd baby but low risk), I’m chosen the hospital with MLU attached just for my own peace of mind.

I’m planning a home birth for my first, like the PP I’ve always wanted to have my babies at home and the idea doesn’t scare me. I’m pretty relaxed about the idea of giving birth and have confidence in my body and the team around me.

Does your trust have a dedicated home birth team? It’s worth finding out if they do. My area does and it means that the midwives who attend you are very experienced in home births and their hospital transfer rates are a lot lower than the national average because of their learning and experience.