What if complications occur and we need to get to a consultant-led unit?
As all the midwives working at the County Hospital are senior and experienced, they will make every effort to ensure that, should your risk status change during your antenatal care or during labour, you will be transferred to the consultant unit as quickly as possible. This is because there are no obstetricians at the County site to provide care in labour, should complications arise. Should you require an urgent transfer to a consultant-led unit, an ambulance will take you to Royal Stoke (on rare occasions this may be to a different hospital). You will always be accompanied by a midwife during this process.
How long will a transfer to a consultant-led unit take?
Should you or your baby require ambulance transfer to Royal Stoke, it is anticipated that the quickest time this can be done is 47 minutes in emergency situations. In less urgent cases, the transfer time can be significantly longer. External factors, such as traffic and road works, will impact on the transfer time. You will always be accompanied by a midwife and if you are in labour, your birth partner will be asked to follow separately in transport arranged by them. If your baby requires transfer they will be escorted with a midwife in an ambulance. You will be transferred in a separate ambulance accompanied by either a midwife or maternity support worker to be reunited with your baby.
The risk of being transferred while giving birth in the FMBU is no greater and no less than if you choose to have your baby at home. The midwives will care for you in exactly the same way as they would if you choose to birth at home. The national average transfer rate of women from FMBUs to obstetric units is 9-13 per cent for women who have had one or more babies and 36-40 per cent for women who have never had a baby. Source: Birthplace in England Programme
Is having my baby at an FMBU as safe as a consultant unit/ hospital birth?
The Birthplace in England Programme says:
"Giving birth is generally very safe for healthy women with a straightforward ('low-risk') pregnancy. 'Adverse outcomes' for babies are rare regardless of where mothers plan to give birth, occurring overall, in just 4 to 5 births in every 1,000. These adverse outcomes are serious or potentially serious events, but thankfully they are rare."
What facilities are available at the FMBU?
You will be encouraged to mobilise during your labour and the midwives will support you with relaxation and breathing techniques. Birthing balls, floor mats and fully adjustable beds are available to help you find the most comfortable position at each stage of labour and delivery in upright positions is promoted. The following methods of pain relief are available:
- Entonox (gas and air)
- Pethidine (injection)
The choice of a water birth is also available on the unit. The use of warm water for labour and birth has been practiced for centuries as it can aid relaxation and ease pain.
It provides a calm and gentle transition for the baby and can increase a woman's overall satisfaction with the experience of having a baby.
In the FMBU midwives are unable to provide an epidural for pain relief. If an epidural is something you wish to consider, please discuss this with your midwife as it will be necessary to deliver in an obstetric unit.
You are very welcome to visit the centre and talk to the midwives there before making your decision. You can do this by contacting the FMBU directly on 01785 230059.
Are planned midwife-led unit births as safe as births planned for a hospital obstetric unit?
The Birthplace study cannot prove with absolute certainty that there are no differences in safety between the settings but overall, it found that the proportion of babies with an adverse outcome was similar in births planned in midwifery units (both alongside and freestanding) compared with births planned in obstetric units.
For women who did not have complications when they presented for care in labour, outcomes were almost identical in births planned in midwifery-led units and obstetric units (3.1 adverse perinatal outcomes per 1,000 births for births planned in an obstetric unit, compared with 3.2 per 1,000 births in freestanding midwifery units and 3.4 per 1,000 births in alongside midwifery units).
Midwifery-led units were also safe for the mother and women who planned birth in a midwifery unit were significantly more likely to have a 'normal birth', i.e. without medical interventions. They were less likely to have their baby delivered by caesarean section, forceps or ventouse (vacuum). For example, more than three quarters of all women in the planned home and midwifery unit groups had a 'normal birth' without medical interventions, compared with 58 per cent of women in the obstetric unit group (the latter group of course includes higher risk women).