It can be a daunting task for a Mum-to-be to choose what type of birth they would like to experience and where to give birth. So I hope I can make it a little easier, by providing the necessary information you and your partner need to consider when choosing the best location and the type of delivery for you and your family.  In my last blog I looked at Home Births, and now let’s consider Midwifery Units, which are also known as Birth Centres (or birth centres) and Hospital.

Midwifery Units or Birth Centres

Such a location tends to be more comfortable and homely than a hospital maternity unit.  They can be:

  • Part of a hospital maternity unit, where Mum-to-be can expect to receive, if required,  pregnancy (obstetric), newborn (neonatal) and anaesthetic care
  • Away from the hospital but without immediate access to the above

Advantages:

  • Being in surroundings that will make Mum feel more at ease, relaxed and better able to cope with labour and delivery.
  • Greater chance of being looked after by the same midwife Mum got to know during her pregnancy.
  • These units have the potential of being closer to home, therefore granting easy access for family and friends to visit.
  • Less risk of having an intervention such as forceps or ventouse (I will be discussing types of delivery in a later blog) than Mums delivering in hospital.

Considerations:

  • Should complications arise Mum may need to be transferred to a hospital.  One Birthplace study found that approximately 4 in 10 first-time Mums were transferred, compared with approximately 1 in 10 having a second or subsequent baby.
  • Due to the unit being completely separate from a hospital certain types of pain relief won’t be available e.g. an epidural.  So Mum needs to check with her midwife whether the unit or centre is part of a hospital or not.
  • Your HCP (doctor or midwife) may advise that it is safer for Mum to deliver in a hospital.
  • Check with your midwife if there are other units or centres within your location that you can view as there may be others if Mum is prepared to travel.

Hospital Birth

Most Mums choose to deliver in an NHS hospital maternity unit.  So if Mum does decide to give birth in hospital she will be looked after by midwives and doctors will be available should the need arise.  However, this being said, Mum still has choices she can make about the care she wants. Your midwife or doctor will provide the necessary information about what your chosen hospital can offer.

Advantages:

  • If Mum’s labour becomes complicated then she will have direct access to obstetricians.
  • The same applies to anaesthetists, who administer epidurals and other general anaesthetics such as gas & air.
  • Should complications arise with your baby there will be on-site specialists in newborn care available (neonatologists,) as well as a special care baby unit.

Considerations:

  • After baby’s delivery Mum may go home directly or she may be moved to a postnatal ward.
  • Mum-to-be may well receive a different midwife to the one who took care of her during pregnancy.
  • Mums delivering in a hospital tend to have more epidurals, episiotomy or a forceps or ventouse delivery.

If planning a hospital birth the midwife can help Mum to decide which hospital feels right for her. If there is more than one hospital to choose from it is worth visiting each one to get a feel for which one suits you best.

Useful birth questions to ask your HCP (Health Care Provider):

  • Are tours of all maternity facilities available before the birth?
  • When is the best time to discuss my birth plan?
  • For pain relief, are TENS machines available for hire?
  • What birthing equipment is available e.g. mats, birthing chair or bean bags?
  • Does the unit/centre and  hospital have a birthing pool?
  • When in the delivery room are fathers, close relatives or friends allowed in?
  • If yes, are they ever asked to leave the room, and why?
  • Am I allowed to move around in labour so that I can find the best position for birthing?
  • What is the unit/centre and hospital’s policy on inductions, pain relief and routine monitoring?
  • Epidural – is this available?
  • When can I expect to go home after the birth?
  • If my baby is premature or sick, what services are available?
  • Who will help me to breastfeed my baby?
  • If I decided not to breastfeed, who will help me to choose the formula feed?
  • Do babies stay with Mum all the time or is there a separate nursery?
  • Are there any special visiting rules?
  • What is the time expectancy if I need to be transferred from a unit/centre to a hospital?
  • Which one will I be transferred to?
  • Will the midwife remain with me the whole time?

It is Your Decision

This is your pregnancy, and in most cases, it is your choice where you give birth. Of course some Mums-to-be have to choose a hospital birth if there are complications in the pregnancy.

But remember, wherever you decide to give birth – home, midwifery unit/birth centre or hospital – you are perfectly entitled to change your mind at any stage during your pregnancy.

If you have any questions, doubts (no matter how small) or just unsure then talk to your midwife. They would have undoubtedly come across them all before and will have the necessary experience, understanding and support to deal with them. They can thereby empower you to feel in control and comfortable with your choices.

Want to Know More?

For further information why not pop over to the following great links:

www.which.co.uk/birth-choice can help you think about the right birth place for you.

http://www.healthtalk.org/Pregnancy_children/Pregnancy/Topic/1716 contains women’s experiences, especially if you are a first-time Mum or you want a different perspective if you are going around the baby block again.

I also have two really useful NHS guides.  One is for Mums having their first and one for those Mums on their second or subsequent one. These two guides will explain in more detail what choices are open to you and the research that can help you make the right decision for you.

Next time I will be taking a look at the types of deliveries a Mum-to-be can expect.

Happy Mum, Happy Birth, Happy Baby!

References: NHS.UK