Where to be born? Birth Place Choices Project. Your choice, naturally

Transcription

1 Where to be born? Birth Place Choices Project Your choice, naturally

2 Choosing where to have your baby In this area women have a number of different birthplaces to choose from. When the time comes for you to have your baby, you will want to be in a place where you feel relaxed, comfortable, confident and secure, and for everything to go smoothly. Where you have your baby will be an individual choice for you, so it is important to talk it through with your midwife or doctor. Remember, it is your choice and you can change your mind at any time.

3 What are the options? Home Birth Birth Centres Consultant-led Units Home Birth Every woman can choose to have her baby at home. Research has found that home birth is as safe as hospital birth for healthy women having a straightforward pregnancy, and that women who plan to have their baby at home are less likely to have a caesarean or interventions such as forceps or an episiotomy. If this is your first My midwife was so good I never felt worried about the home birth as it was obvious she knew what she was doing and if the case arose that she needed help during the birth, I know she wouldn t mess about. baby, you can still have a home birth. There is no evidence to suggest it is unwise. Birth Centres If you have thought about a home birth, but feel you would be more relaxed being in a different environment away from home, a birth centre may be the right choice for you. Some are co-located in the same building as consultant-led maternity units, while others are not. With thanks to the staff at the birth centre and the excellent support of my midwife throughout the pregnancy, labour and birth, I could not have asked for anything more.

4 Stand Alone Birth Centres Even if they are in community hospitals, stand-alone birth centres do not offer the same facilities as the consultant-led units, for example there are no doctors, special baby units or operating theatres. Instead these birth centres are run by small teams of midwives and health care support workers, providing a home-like, friendly I was in a small room with one midwife and my husband. It was very calm and intimate and the midwife I had was great. The whole experience was wonderful. atmosphere, and are specifically designed for women who are having a healthy pregnancy and are expected to have a normal birth. If you require extra facilities or help you will need to be transferred to a consultant-led unit. Co-located Birth Centres Co-located birth centres are based within the same My labour building as consultant-led experience this time around was excellent maternity units. They tend and very relaxed. to be on a different floor I actually enjoyed to the consultant-led unit this experience and and are suitable for would recommend women wishing to have a your unit to anyone. natural birth in a home-like, friendly atmosphere, but who may not live near enough to a stand-alone birth centre. As with the stand-alone birth centres, you would need to transfer to the consultant-led unit if a problem were to develop. Consultant-led Units These are based in the main maternity hospital and are primarily for women with medical, pregnancy or labour complications or for women planning to have an epidural for labour. However, anybody can choose to have their baby there if they wish. Exceptional care provided throughout labour and birth. Despite a difficult labour, complicated by having diabetes and epilepsy, everyone was very professional but at the same time very caring.

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6 What do I need to know? Guideline Research If Problems Occur Transfer One to One Postnatal Care Guideline Local health professionals have a guideline that enables them to help you make an informed choice about where to have your baby. This guideline includes the following recommendations: All parents to be given up to date information and all the options regarding birth choices. All parents to be given time to make their decisions regarding their birthplace choice, and be assured they can change their minds at any time. Home birth and birth centre care are options that should be promoted whenever possible. Please ask your midwife or doctor if you would like a copy of the full guideline. Research The research on and around birthplace choices has its limitations, but shows: The Choices Home Birth/ Birth Centre Consultant-led maternity unit Advantages Increased satisfaction, more relaxed and in control. (Both home and Birth Centre) Less chance of a caesarean section and more chance of shorter labour. (home) Less interventions, e.g. forceps and ventouse and increased chance of successful breastfeeding. (home) Less likely to have a drip to speed up contractions and less likely to have pain relief for labour. (Birth Centre) You can choose to have an epidural. You won t need to transfer if there are problems. Onsite access to emergency support including obstetric, anaesthetic and neonatal services. Disadvantages No onsite access to doctors or neonatal services. You may have to transfer to hospital. You cannot have an epidural. (Apply to both home and Birth Centre) You are more likely to have a drip and electronic fetal monitoring, and therefore more likely to be confined to bed during labour. You are more likely to have an episiotomy. References Rooks et al Spitzer Saunders et al David et al Feldman and Hurst Olsen and Jewell Saunders et al Rooks et al David et al Spitzer Hodnett Olsen and Jewell 2004.

7 If Problems Occur Home birth and birth centre care are similar in terms of resources available, for example basic resuscitation equipment. Midwives are trained to quickly detect the onset of problems and, in the rare event that you or your baby need emergency treatment, midwives are able to provide first level emergency care, for example oxygen and suction. If further aid is needed you will be transferred in an ambulance to the consultant-led unit for specialist care. Transfer Midwives are skilled in recognising any complications of pregnancy or labour. If it is thought to be in the best interest of you and your baby, arrangements will be made to transfer you from home or a birth centre to a consultant-led unit (see insert on your local birth centre for transfer rates and times). Transfer can be upsetting but you can be reassured that procedures are in place for when Having planned a home birth and having to proceed to hospital, I felt that my midwife explained every scenario properly and supported us well as she knew the last thing we wanted was to be in hospital. She continued to be a great support throughout. transfer to hospital is necessary and the safety of you and your baby is always the top priority.

8 One To One Care In Labour If you have your baby at home or in a birth centre, you are more likely to have care from a midwife you know and to have a midwife stay with you throughout labour. One to one constant support throughout labour has been found to have a positive effect on the outcome of labour, including fewer instrumental deliveries, Excellent labour due to the privacy of the birthing rooms. Also my own midwife was there which made me feel relaxed, confident and happy as she was aware of any problems and fears. fewer caesareans and slightly shorter labours. Midwives caring for women at home or in a birth centre will have the support of a second midwife for the birth and It was immediate postnatal period. wonderful having my midwife from the Birth Centre with me throughout my labour and birth. Postnatal Care If you have your baby in a consultant-led unit, you can transfer to any birth centre for postnatal care prior to going home. This may just be for additional rest or for support with breastfeeding. The birth centres also provide postnatal support groups for new mothers and babies. I had 3 days in the birth centre as part of my postnatal care. This gave me much more confidence and knowledge and enabled me to cope better once I went home with my new baby.

9 Helpful Contacts Home Birth Support Group National Childbirth Trust (NCT) Supervisors of Midwives Southampton Portsmouth extn 3649 Association for Improvements in the Maternity Service (AIMS) Birth Choices UK Vaginal Birth After Caesarean (VBAC) Active Birth References David et al, 1999 Perinatal outcome in hospital and birth centre obstetric care. International Journal Gynaecology and Obstetrics, 65(2): Feldman E, Hurst M 1987 Outcomes and procedures in low risk birth: a comparison of hospital and birth centre settings. Birth, 1:18-24 Hodnett ED 2003 Home-like versus conventional institutional settings for birth (Cochrane Review) The Cochrane Library, Issue 2, Chichester, UK: John Wiley and Sons, Ltd Olsen O, Jewel MD Home versus hospital birth (Cochrane review) The Cochrane Library, Issue 3, Chichester, UK: John Wiley and Sons, Ltd Rooks J, Wetherby N, Ernst R et al The National Birth Centre Study. Part II Intrapartum and immediate postpartum and neonatal care. Journal of Nurse Midwifery 37(5): Saunders D, Boulton M, Chapple J, Ratcliffe J, Levitan J 2000 Evaluation of the Edgware Birth Centre. Barnet Health Authority, London. Spitzer MC 1995 Birth Centres. Economy, safety and empowerment. Journal of Nurse-Midwifery 40:4, pp

10 Where are your local birth centres? Broadlands Birth Centre Princess Anne Hospital Coxford Road, Southampton Tel: M3 Blackbrook Birth Centre Blackbrook Maternity Home Blackbrook House Drive, Fareham Tel: Hythe Birth Centre Beaulieu Road, Hythe Tel: Lymington Birth Centre Kings Road, Lymington Tel: Romsey Birth Centre Mile Hill Winchester Road, Romsey Tel: Romsey M27 Southampton Hythe Lymington Hampshire M27 Fareham Gosport IOW Petersfield A3(M) Portsmouth Mary Rose Birth Centre St Mary s Hospital, Portsmouth Tel: Grange Birth Centre Petersfield Hospital Swan Street, Petersfield Tel: Blake Birth Centre Gosport War Memorial Hospital Bury Road, Gosport Tel: Birth Place Choices Project Babies are such a nice way to start people (Don Herold ) Black & White Design