Place of birth
Every hospital will have different options for place of birth depending on the services they offer. The safest place for you to give birth to your baby will depend on your ‘risk’ factors in pregnancy or in labour. Your midwife can discuss this further with you.
Advantages – There are many advantages to giving birth at home; you are more comfortable in your own environment and the midwives will come to you. Once you birth your baby, the midwives clean everything up, tuck you up in your own bed and leave when all is well! You will be seen at home that day or the next day for your usual postnatal visits.
Pain relief available – You can use all the natural methods of pain relief – breathing, hypnobirthing, reflexology, acupuncture, TENS machine, massage, movement and water – this maybe your bath, shower or hired birthing pool. Your midwife will bring gas and air cylinders. If you think you might like to use Diamorphine/Pethidine, this will need to be arranged beforehand. Speak to your midwife about this.
Staff – You will have a midwife present with you once you are in established labour. As you progress in labour, a second midwife will be requested to attend. Most hospitals are teaching hospitals so a student midwife may also be present.
Why you might be asked to transfer to hospital – People often worry about having a homebirth, especially if they are having their first baby. However, most of the emergencies we worry about don’t tend to happen at home. There are usually tell-tale signs of problems, such as your labour not progressing as normal or concerns about your baby’s heartbeat. Your midwife will discuss any concerns they have with you. Other reasons for going to hospital could be because you decide that you would like further pain relief, such as an epidural. In all these cases, transport to hospital is usually by ambulance.
These can either be standalone units which means they are not attached to a hospital, or co-located units which are in a hospital, usually near the labour ward.
Advantages – Birth centres are the ‘home from home’ alternative to having a low risk birth in hospital. The rooms usually have a birthing pool, birthing balls, mats and the options of low lighting. Some may have TV’s or docking stations for your music.
Staff – As this is a low risk area, the birth centre will be staffed by midwives, healthcare assistants or midwifery support workers. There may be student midwives or medical students present.
Pain relief available – You can use all the natural methods of pain relief – breathing, hypnobirthing, reflexology, acupuncture, TENS machine, massage, movement plus use of the birthing pool, gas and air and Diamorphine/Pethidine (mainly used in early labour).
Why you might be asked to transfer to the labour ward – Transfer to the labour ward will be discussed with you if your labour isn’t progressing as normal, if there are any concerns about your baby’s heartbeat or if you would like further pain relief such as an epidural.
This is where most of the ‘high risk’ mothers will have their babies. It has more equipment for mothers and babies that need closer monitoring. Sometimes women may need to go to the labour ward because the birth centre is full. This doesn’t mean that you can’t achieve a normal birth. The labour rooms can be made to feel less technical through simple things like moving the bed and dimming the lights. Some labour wards may have birthing pools and telemetry (wireless) fetal monitors meaning all women, including ‘high’ risk women, can mobilise and use the pool.
Pain relief available – You can use all the earlier mentioned methods of pain relief. The labour ward is the only place where you can have an epidural.
Staffing – The labour ward will have lots of staff – midwives, obstetricians, anaesthetists, nurses, theatre staff and healthcare assistants. There may also be student midwives and medical students.
Most hospitals will have an online tour of their unit so you can see what their places of birth look like. It is always a good idea to think about where you would like to birth your baby and write it in your birth plan (see my blog on writing a birth plan!).
If your preferred place of birth falls outside of hospital guidelines (perphaps due to your ‘risk’ factors), then speak to the midwives and obstetricians caring for you to reach a compromise that you are happy with and which maintains safety for you and your baby. If you are still not happy and want extra support, ask to speak to a Supervisor of Midwives. For more information on this, look at your hospital’s website for details on how to contact them. For further information on the role of Supervisors of Midwives, please see http://www.lsamoforumuk.scot.nhs.uk
In my antenatal classes, places of birth are discussed in more detail. For more information on my classes or to book, please see Antenatal Classes.