High Risk and midwife led units

[artyfartymack]

Hi,

I am a little put out by my chosen hospital (Basildon) as I have been told I cannot deliver in Willow Ward (The midwife led unit) as I am high risk.

My last baby was born at 32+6 I was fortunate enough to have a fabulous natural delivery with great midwifes but as he was early understandably had to be monitored during the birth.

I have said to my midwife that I totally understand needing to deliver on the labour ward should I go into pre-term labour again but that surely if I reach 37 weeks and have no other health issues there is no reason why I should be denied the opportunity to deliver in Willow Ward but they are sticking to their decision.

I thought it was every womens right to deliver their baby where they chose as long as no health issues put themselves or their baby at risk?

Do you have any advice as to how I might overcome this situation? My other alternative would obviously be a homebirth but my husband is very, very anti.

[Jenn]

Are you being seen by a consultant as well. I was because William was prem too.

I went to see them last week at just before 35weeks. And was told that because baby was basically almost term then they would sign me off back over to community midwife care and therefore no need to be monitored throughout the whole birth. Therefore allowing me to go in the not so clinical labour rooms?

It was just a wait and see for me. MAybe it will be the same for you?

[BirthAffinity]

Hmm tricky one this, as I agree that if you get to 37 weeks and all else is normal, then there would appear to be no reason why you shouldn't birth on a midwifery led unit. However, it does depend a little bit on the reason behind your premature labour last time. For example, if you had an infection, such as group b strep, that led to the premature labour, this could possibly present a problem with a future labour and birth, even if it did go to term. You are about 15 weeks at the moment, so there is plenty of time to discuss this further with your Midwife and Consultant (I am assuming that as you had a previous early labour, you have been referred for a consultants appointment at some stage during this pregnancy). It is a good idea to mention at the consultants appointment that you wish to birth in the midwifery led unit and, if they are in agreemnet that once you reach term it wont be a problem, get them to document this in your notes - it will help your case the next time you see the Midwife. Another line of enquiry is via the birth unit manager or head of midwifery. Your community midwife may be able to approach them on your behalf, or you can also phone / write to them directly.
It may be as you progress through pregnancy that they become more positive about the prospect of using the birth unit anyway, but don't want to get your hopes up by saying yes this early on, only to have to retract if you again labour early.
In short, I think that there is a good chance that you will be able to negotiate your way into the birth unit, but you may have to wait until much closer to your due date to get a definately yes. I would be interested to hear the rationale behind their refusal and it is probably a good idea to get them to clarify this for you too.
Hope this helps, and keep me up to date with developments!

[artyfartymack]

both valid points thanks Ladies. I have a consultant appointment in a couple of weeks so will broach the subject then. I had a SRM and no reason was documented although it is my suspicion that I had pre-eclampsia as I had high blood pressure and severe Odema.

[BirthAffinity]

It may be the high blood pressure that they are concerned about, more so than the previous early labour. Although pre eclampsia does tend to recur in subsequent pregnancies, it tends to be to a lesser degree and tends to happen later in the pregnancy. However, even if your bp, oedema and urine remain normal during pregnancy, you still have a higher chance of your blood pressure rising during the labour itself. If this happened on a birth unit, you would need to be transferred to the labour ward for closer monitoring. This is definitely a point you need clarifying at your consultants appointment, did you or didn't you have pre eclampsia, as it is a potentially complicating issue from your previous preterm labour that should be borne in mind when thinking about where to birth your baby.

[artyfartymack]

Nobody said I had pre-eclampsia and my blood pressure was fine during delivery it was just high in the 3 weeks leading up to the birth. My notes just say, unexplained pre-term delivery

[BirthAffinity]

As I said, get them to clarify reasons / justifications for not going on birth unit and ask them specifics for you as an individual case, not as a generalisation (ie "we don't allow any previous preterm here" - well that doesn't account for the wide variation in reasons behind prem births, and therefore variation in risk for individuals, nor does it look at the details of your particular experience - you want to know what the perceived risks are to you / your baby as a unique case.) speak to the consultant - they will have access to your full medical hospital notes, including previous antenatal, and so should have the full picture, & I'm sure that all being well, you will be where you want to for the birth xx

[artyfartymack]

fingers crossed

[BrandonsMum08]

I know this isnt advisable in the slightest, but a bit of stubborness goes a long way to getting what you want with regards to giving birth.
I was told earlier in my pregnancy with Ruby that under no circumstances should i have a homebirth. Kept asking reasons etc, and was only ever told one thing, which is a risk to to all woman with a BMI over 36 (i think, possible 35 or 37, cant remember now), but after researching it myself, found that they hadnt taken my SPD into account, which lessened the risk mentioned to me. My blood pressure and everything excluding the spd and general aches and pains, was fine. I stuck to my guns and got a perfect homebirth. Couldnt have asked for an easier, more relaxed birth (i only pushed for 1min!!)

Also, with Brandon, i wanted to give birth at a different hospital, and was actually told to go there. I went there first and ended up transferred in ambulance to the other. Labour was fine up to this point. I got to Queens where there was no beds despite being told at other hosp that there was. Andy then asked the midwife what would have happened if we had refused to leave other hospital and she said i would have just got on with it and given birth there. I had a lovely midwife at the first one, but at queens the new one was useless. My labour went tits up from the moment i got there despite it being fine for the first 6 hours.

My point is, if they give you no specific reasons, you go to term, and you have a complication free pregnancy, no high BP or anything, no serious infections etc, then just be stubborn when you get there and basically tell them if they dont let you give birth where you want to, then you will just give birth on their corridoor floor instead - they will soon put you where you want because any birthing room is safer than the corridoor! BUT this is ONLY if everything is fine in pregnancy and you are term. You are less likely to have complications if you birth where you want to because you will be comfortable. Not being comfortable and relaxed (as much as you can be in labour lol) can affect the contractions/dilating - i completely stopped dilating once i was transfered to queens despite full on contractions.

[artyfartymack]

thanks for your support hun, i will do whatever is best for my baby obviously but agree that stubbborness will play a key part LOL!