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For most of us, particularly first time parents, when we think about giving birth, we picture a hospital, but there are more options available to you than simply the hospital...
So what is the difference in all these places & how do you choose which is the right place for you?
Obstetric Led Unit
Also known as the "Labour Ward". These units are always situated within a hospital and are led by consultants/doctors; you'll be cared for by midwives but the doctors are on hand should they be required. Giving birth on a labour ward means you'll have direct access to anaesthetists should you request an epidural or if a caesarean is required.
Things to consider if choosing to birth on a hospital labour ward:
You may be more likely to be cared for by a different midwife than the one who you've seen throughout pregnancy
You are more likely to have an epidural, episiotomy, forceps or ventouse delivery
Midwife Led Unit
A Midwife Led Unit or MLU is situated either within a hospital with an obstetric unit or on the same site as a hospital with an obstetric unit. These units are led by midwives and you're more likely to be cared for by a midwife you have met during pregnancy. MLU's tend to feel much more familiar and comfortable than an OLU but they have the benefit of being very close by to doctors should they be required. They often have several birth pools available if you are wanting to use the water during labour.
Things to consider if choosing to birth on an Midwife Led Unit:
You may need to be transferred to the Labour Ward if any complications arise during labour/birth
In some cases, you may need to transfer to the Labour Ward to access an epidural should you want one.
Birth Centre
Sometimes referred to as a Freestanding Midwifery Unit (FMU), birth centre are not attached to or on the site of a hospital with an obstetric unit. This may be a favourable option if you are feeling particularly anxious about being in a hospital setting but maybe don't want a home birth. They are very similar to MLU's in that they aim to create a home from home feel, supporting physiological birth and you are more likely to be supported by a midwife that you have met during pregnancy. These centres can vary in size from just having 1x birthing room to having several.
Things to consider:
For smaller Birth Centres, they sometimes are unable to open due to staffing
You may need to be transferred into hospital should any complications arise
If you wanted some particular pain relief, such an an epidural, you would need to transfer into hospital to have one.
A study found that "Women who planned birth in a midwifery unit (AMU or FMU) had significantly fewer interventions, including substantially fewer intrapartum caesarean sections, and more ‘normal births’ than women who planned birth in an obstetric unit"
Home
This one doesn't need much explaining I'm sure. Yes, people still give birth at home, and more often than not it is a very safe option! Being in a familiar surrounding can hugely help our birthing hormones flow with ease, as we feel safe. If you choose to birth at home, you're more likely to be cared for by the same midwife/midwives throughout your pregnancy & birth, it is worth asking if your local trust has a dedicated home birth team that you can meet with & ask any questions you might have.
Things to consider:
You may need to be transferred into hospital should complications arise
You may be advised against home birth if you are classed as "high risk" at any point in your pregnancy
For first time births there is a slight increase in the risk of serious problems for baby (from 5 in 1000 in hospital to 9 in 1000 at home)
Epidurals aren't available at home
Hopefully this helps you think a little more about what feels like the best place for you to birth your baby but I'd always recommend speaking to your healthcare team & finding out about all the options available in your area. Then, where possible, go for a tour of the various units before you make a final decision.
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