Homebirth or MLU?

[Niavic]

I'm a ftm and super indecisive about where to give birth. I always planned the midwifery unit attached to the hospital (all the freestanding ones are still closed) but I honestly thought the visiting hours would have improved by my due date, now it isn't looking likely. We live 45mins to an hour from the hospital, depending on traffic. Husband waits in the car park while I have to be examined and he can come in if I am over 4cm dilated then he leaves an hour after the birth. He is then allowed to request 1 hour of visiting per day from the midwife on duty. This sounds more like a prison to me and I can have issues with anxiety so I think this could all lead to a very negative birth experience. So I'm now considering a homebirth. Midwife is supportive with whatever I decide. My biggest issue is the distance to the hospital. Does anyone have any advice for either homebirth or lack of support following the birth from your partner? We're always such a team I hate the idea of being separated, and him not being able to bond with the baby. Thanks in advance.

Those visiting hours are awful and I'm sad that anywhere is still doing that.

Even our local delivery suite in hospital has better hours than that and out mlu is 2 birth partners right through.

Can you ask them when they plan to update their policy to see if it's imminent.

I'm opting for mlu which has a half hour transfer time should I need moving across to delivery suite.

In your case I’d probably go for a home birth. It’s awful that they still have those rules in place.

However, be aware that around 50% of first time mums end up being transferred to hospital during a home birth. Not necessarily because of really awful complications but also for things such as demanding an epidural. I think only have a home birth if you’re ok with that prospect and you’re willing to be flexible and it won’t impact you too much

Absolute disgrace partners are still not allowed in unrestricted! But we can all go to primark!!

For your peace of mind, the midwives and staff were superb to me when I was having my baby during Covid. Very sweet, understanding and extra helpful. Also all the mums chat, help each other out which is lovely.

I'm not sure I'd call it a disgrace. Primark isn't full of vulnerable people more likely to die from the virus, but hospitals are. Still, that's a really horrible situation to be in, OP. I hope they relax the visiting before you have to decide.

Thanks for the replies. @Raindropumbrella I am very flexible in the prospect of a transfer in the the hospital, and then at least I know the visitinh once there, but am thinking of trying for the homebirth first.

@Milkand2sugarsplease these are unfortunately the updated rules as on 2 days ago! Before that there was no visiting at all.

@magicmatilda thanks for this, that's good to know if I do have to go in xx

@Niavic to be completely honest, and I say this as someone who had a home birth with my second, I wouldn’t go for one if I lived as far away from the hospital as you do. Having done 25 very uncomfortable minutes in a car to hospital while contracting I found that one of the worst things about my labour.

Given that if all goes well after birth in the MLU they should surely discharge you after a few hours, won’t you be in the same position whether you hb or not? Ie if you are in after the mlu because they need to keep an eye on you or baby, you would have been in even if you’d had a hb?

I had a home birth and obviously my experience biases me but I wouldn’t have one when you live that far from the hospital. I haemorrhaged after DD was born and had to have the ambulance called and sirens on to go to hospital. It was not a pleasant experience.
Like you, I have anxiety issues and that’s why I chose a home birth but it was with full support of my midwife - it was actually her idea.

@foxhasbigsocks thanks for the reply. I'm looking for everyone's honest opinions so I really appreciate hearing all sides. In the MLU I get moved to a ward in the hospital after 1 hour with hubby and baby, that's why hubby has to leave after an hour, it's the wards rules, then with no problems they aim for a 6 hour discharge but it depends on staffing and when the paadiatrician is available to do the check. Hubby can visit for an hour the following day if there are issues which like you say, would happen anyway with a homebirth. So that's our minimum goal if I have to go in. The distance is definitely the thing that's concerning me most.

Nope, that distance could prove fatal to you or baby so would be too much of a risk for me to manage

@Niavic I’m absolutely not against home births, but the only reason I didn’t have one with my first was that they told me it was more than 50% likely in a first birth to have to transfer into hospital from a hb. I thought I would find that hugely stressful. The odds are so much better for hbs with second babies.

@Niavic I am planning a home birth with this baby (#2) but I wouldn't have with my first. The transfer rate is much higher for first babies (though not all for emergency reasons as @Raindropumbrella mentioned) and I think I'd feel more negative if I had the sudden upheaval than if I went in as planned. I know every birth is different but it feels a lot less unknown this time round.

We are 20 minutes from the hospital, less by ambulance. The car journey was awful last time but I would worry about home birthing with a long transfer. It is worth remembering you could transfer at any time and whilst the journey was bad at 6cm it would have been a whole lot worse at 10cm. When I had my home birth assessment the midwife discussed with me the fact there may be a delay in help/intervention if a transfer was needed vs being on a MLU, which I am happy with as we are v close.

For what it's worth, my first was born on the MLU at 1am and I was discharged first thing that morning. I spent less than 12 hours there (including labour/birth/after) and whilst partners didn't have to leave then, it is such a short period in the big scheme of things that I would have been ok. I think hospitals are generally offering fast discharges now (if you are happy with that) because of visiting restrictions.

As @Foxhasbigsocks said, if you had to stay longer than that it would likely be because there was an issue (complex stitches, stronger pain relief, feeding difficulties etc), you would have to transfer in post home birth anyway.

How long until your due date? Will the 21/06 (possible) easing of restrictions change anything?

I've recently been through this. The actual giving birth part didn't go to plan but the midwives were fantastic. My hospital also had the same rules regarding partner only being allowed in from 4cm dilated, but when I got there he was allowed in with me and I was only 2-3cm but they never said anything and let him make up a bed on the floor out of bean bags haha. After the birth he stayed with me for 7 hours whilst I was waiting for a postnatal bed.

The postnatal period was awful though. I ended up staying in for 5 days for a few reasons. I think I would have been fine if I could have gone home the day after, but each day I thought I was coming home and I didn't, and when my partner left each day to go back home on his own to an empty house it broke my heart. He was allowed 90 minutes per day with me and the time went so quick. It felt so claustrophobic being in a small cubicle surrounded by curtains and not seeing daylight. I barely slept for 5 days as my baby wouldn't settle in the crib, by day 4 I broke down into tears and the midwife had to take my baby for a couple of hours so I could get some sleep. In the end they pulled some strings and got me a private side room with a window and air conditioning which did a world of good. I was so depressed when I went home with my baby, I feel sad just thinking about it. I totally understand though that these are covid times and I could tell the midwives really felt for me and know how horrible it all is with all the restrictions.

Part of me thinks I would want a home birth next time because of this, but I know if I have a second child hopefully all these restrictions won't be there and it won't be the same. Also I think I would have been okay if I would have only been kept in the one day. I also lost a lot of blood and had 3 doctors in the room stitching me back up and stopping the bleed so the thought of a home birth does make me nervous in case that happens again.

I think it's a difficult decision to make. I know people that have had a very straight forward home birth and they liked it. Good luck with whatever you choose.

I think you live too far from the hospital to make a home birth a good idea. There’s a 50% chance you’d have to go to hospital so you’d be doing that journey in labour and worst case the delay could be dangerous for you and/or baby. 50% chance you’d have the baby at home and all well, but if you had the baby in the hospital and all was well you’d be out quickly and the shit visiting policy wouldn’t really matter.

Compare the worst case scenarios and make a decision on that basis.

OP, when is your due date?

The rules in my area are similar - partner can be there for the birth but can’t go to the post-natal ward with you. I guess they can stay after you’ve given birth but before you move, although that could be a matter of minutes only, if a bed is available.
We have 1 hour post-natal visiting slots too, and only the birth partner can attend.

It must be really difficult to have to give birth with these kinds of restrictions. I’m not due until December so I suspect I might be able to dodge the restrictions.

I’m a FTM too and I’m not considering a home birth because I’d feel safer in a hospital if anything were to go wrong. If you live 45 minutes from your hospital, I think that’s a huge distance should you or baby need emergency care for any reason.

Equally, I hear what you’re saying about the rules feeling like a prison. If it brings you any comfort, having your baby in hospital means there’ll be others there with you, going through exactly the same worries, alone, without their birth partners.

It’s also important to remember that if you go with the hospital birth and your husband happens to have any signs of COVID or tests positive, he won’t be allowed in at all. Do you have an alternative birth partner just in case?

Hope you manage to come to a decision, it’s really difficult. 😕

I am so sorry that those ridiculous visiting hours are still in place! That's obscene and I'm so frustrated by some of the short term views taken on these things (probably decided by childless men).

I am expecting my 3rd baby in 6 weeks and have been humming and haaing between the community MLU (30 mins away, lovely double rooms all with pools etc) vs the MLU attached to the hospital (1 hour away if no traffic). I ruled out a home birth purely because I want a pool and don't want the hassle/wait of it being put up and then tidied up later.

DC1 was a little complicated but DC2 was very very straight forward water birth. There is no reason to expect that I won't have another straight forward birth but this thread has made me decide I will be going for the hospital MLU.

Main reason is the risk of transfer. The transfer time by ambulance is 25 minutes + the wait time for the ambulance. If anything is wrong during labour then that should be a managable time frame to get to the hospital. But the idea of being transferred in an ambulance, strapped down on my back is horrific. I was continuously monitored with my first and on a drip and not allowed to move off the bed and I hated it. Lying on my back made the pain infinitely worse so an ambulance transfer gives me the fear. I woild genuinely rather be driven in a car at that point but theres no way they'd allow it.

However, my biggest fear is that something unexpected occurs during or just after delivery to me or the baby. That transfer would just be too long in an emergency.

With your first baby I wouldn't be too worried about the time in the car. It will be uncomfortable but doable, but its very very unlikely that baby will just suddenly appear. I'd be spending as much time as possible at home then getting out as soon as I could.

6 hours is generally guidance, if you feel well enough before then you can go. With my last the thing we were waiting for was the paediatric check which you could arrange to do the next day if its going to take a while. Will be a pain but at least you'll all be together.

How long left do you have? Can you get some expectant mums together and write to the hospital? Petition? Unless you are in a hotspot I can't understand why the rules are still so tight. We've been allowed birth partners in Scotland since before end 2020 and that's at every level. I also don't think there are any restrictions on visiting for dads.

(And before anyone starts, I am very respectful of lockdown, of vaccinations, etc. I just don't think that restrictions like these are reasonable anymore when 99% of our most vulnerable have been vaccinated).

Thanks again for all the replies. I'm due on the 30th so not a lot of time left! I've already written to Pals and our local mp and I'm in Wales so the 21st June will not affect us. So now we have the 1 hour slots starting this week if the ward can accommodate it, it's not looking to change again in the near future. Before that it was nothing so I realise I should be grateful but I just still find the idea of being alone in the hospital difficult. I work on the community and we've all gone back to normal with home visits so it's frustrating but there we go. It sounds like the general consensus is the risk of complications and the distance is just too much. I hadn't originally even considered a homebirth but I've had to go to the assessment unit a few times and it wasn't very nice being completely alone behind curtains for hours on end. It's just unfortunate timing I think. But I appreciate all the replies, it's nice to hear the perspective and experiences of others 😁

I had a home birth with my first and will be again with my second at the end of this year. I may be one of the 'lucky' ones, but everything went fine. I went 17 days over my due date so some would consider this high risk. I was also about an hour from hospital but it didnt really worry me. I was so relaxed the whole time and labour was 7hrs from start to baby being here. The placenta wouldnt come out at first and after 3.5hrs of trying, they gave me the injection and it came. Even with that happening they never tried to transfer me. My midwifes had total faith in me which was amazing. Being sat on our sofa after and not having to move at all was just the best.
It's a decision you have to make for yourself, but a tricky one.

Hope you have a lovely birth wherever it happens!

With that transfer time I’d go to the MLU - as others have said if everything is straightforward then its likely you’d be home soon after .

I had my baby in a MLU and the restrictions were as you’ve described, birth partner only in during active labour and for an hour after the birth. It almost felt a bit punitive, like, serves you right having a baby during a pandemic.

In the event though it wasn’t like that, when I arrived they didn’t examine me, they just said, are you in active labour? Ah then come on in both of you.

And then after the birth we stayed in our room in the MLU and my husband stayed, he was going to stay until discharge at 6hrs but then we were kept in overnight due to baby having a heart murmur so he went home to put our toddler to bed.

The midwives did such a great job of making it feel normal and the ‘rules’ were very discretionary but where it was possible they did everything they could to keep us together.

Hi OP, I would urge you to get more in depth details on the statics re transfer to hospital for first time mums, please don’t let this put you off at face value. I’ve had two homebirths 2016/18 (and expecting third) and remember at the time of my first my midwife telling me that a large proportion of the 50% that transfer to hospital are out of choice and rarely emergency. I think it’s worth investigating more before you make up your mind either way. I can understand your concerns post birth in hospital with your partner not being there to support and massively sympathise. The standard of care we had at our home during and after both births was incredible. I felt so safe and that if there were to be any complications the midwives were so present and in tune with me/baby that they would have picked it up straight away and we would have be blue lighted into hospital. Good luck with the birth whichever route you take.

That's a very long way from the hospital if anything goes wrong.

I'd go for MLU as it's safer especially for a FTM. My husband is a paramedic and he's seen things go wrong, it's sadly not uncommon.

It's just so difficult!! I know our mlu is very strict though so I'm not expecting any leeway on the restrictions.

Am also debating between MLU and home birth (baby no. 2). Have done an online positive birth course which has helped greatly to understand the process and have more confidence. I met a mum recently at an antenatal apt who had had her first baby at home and had a wonderful positive birth, she is planning another home birth with 2nd. A close friend also had no. 2 at home and had a good, calm, straightforward birth and found the process easier in a comfortable familiar environment. 50% transfer may not be across the board as I asked the senior midwife at my local MLU regarding the hospital transfer rate, and this is what she said: 20 - 25% are transferred to hospital (from this particular MLU). Most are FTM’s but the vast majority are non urgent transfers - slow progress of labour is the most common, then things like wanting an epidural. Sometimes if baby’s heart rate has changed but they monitor and are well trained to pick up on changes like this early to intervene when needed (whether at home or MLU.) Game changer for me is getting a birth pool set up at home, (bought to ease late pregnancy aches and pains) but it is so wonderfully comfortable, first time in I felt such relief and like ‘yeah, could totally do this at home!’. It was fairly easy to set up, I got a ‘birth pool in a box Eco’ mini size (which is a good size, plenty of room to get in different positions (I would say regular size only needed if you plan to have your birth partner in the pool with you, the bigger ones also take longer to fill up). Also at home no restrictions on your birth partner, how long they can stay etc and I imagine no face mask needed (unless midwife requests this?) I am hopeful no as want to see his face fully. Go with what you feel happiest and most confident in. Would recommend positive birth course for any eventuality, wish had known about it first time round.