Hello!

I'm Spanish but my partner's British and I should be giving birth in Edimburgh, Scotland. I keep reading about all the "routine" interventions that don't really appeal to me and wonder how much of that actually applies to the UK. I'd appreciate if you ladies could tell me whether these things are normal or not, either from first or second hand experience.

* Are inductions common before 42 weeks, with no obvious problem?
* If you start laboring naturally will they try to get it to go faster by rupturing membranes or giving you oxytocin and such?
* Will they let you walk and adopt postures other than laying down on your back if you feel like it?
* Do they let you eat (within reason) and drink?
* Is it common to have episiotomies (perineal snips) "just in case"?
* Is Electronic Fetal Monitoring (EFM) standard?

How about midwife led units? Will they be similar to a home birth, just not quite at home?

I'll be thankful for any input. It's early but there's so much to consider!!

Hiya,

Sorry in advance that this is sooooooooo long!

I think the important thing to remember is that its your body and they have to ask your permission before doing anything.

If you're worried make sure you ask what theyre doing throughout labour (or put your birthing partner under strict instructions to be your voice and advocate for what you do and dont want).

Its also useful to write in your birth plan that you want all procedures explained to you, just as an extra precaution. In your birth plan you can also put if there is something specific that you DO or DONT want.

At the end of the day this is your birth. Some women go into hospital happy to get on the rollercoaster and do what ever is suggested, but my personal opinion is the more aware you are the more likely you are to be able to feel in control and achieve a birth where you feel happy with what happened.

Midwife Lead units tend to use less intervention. You're right that its similar to a home birth but in a unit (sometimes inside a hospital or outside a hospital) run by midwives. You dont have to pay and its still under the nhs. If you wanted or needed any intervention you would need to be transfered (i.e. c-section, epidural etc), but its important to bear in mind the average waiting time for a c-section, even if your in consultant lead care in hospital, is 20 mins so that they can prep the theatre etc. In a MLU, if that unfortunate circumstance arose, then they would ring ahead to the hospital (if the unit isnt already in the hospital) so they could start prepping the theatre and start prepping you for theatre in the ambulance. Your waiting time may be no different from that of someone sat in hospital.

MLU's often have individual rooms decorated in a more 'homely' way with access to tens machines, birth balls, your own bathroom and often each room has its own birthing pool (of course you would have to check what your MLU has). They also stock gas an air for pain releif. They can administer pethidine, i think (again pain relelif) and theyhave suction, oxygen, ressus equipment at hand incase the baby needs it when its born to help it breathe. They also carry drugs in case of mum haemoraging (very rare this happens) to make your womb contract and stop the bleeding. They can give stitches to tears if you need them.

MLU's tend to have a smaller number of births that occur with intervnentions like epistostamies, ventous, forceps etc than constultant lead care. So if you're looking for a more natural birth with less intervention it might be an option for you.

*inductions - are normally carried out after 42 weeks but again they cant force you, they can just strongly suggest it. I think they would only induce earlier if there was a concern about you or the baby (like the babys size being very large or some other kind of problem). Induction statistically gives you a smaller chance of a natural childbirth.

*membranes and oxytocin - sometimes they do both, for example if your waters have broken and your contractions arnt regular the often try to stimulate a stronger labour. Again you can refuse, its your body. MLU's are probably (im not sure) less likely to do that because theyre more laid back.

*moving about - MLU's this wont be a problem. Hospitals are generally pro you moving about but the rooms might not be set up with birthing balls or alternative comfy places to squat or sit or wander. SOME hospitals can be a bit snotty about this. The main problem you will have is that if you have an induction or an epidural they wont let you move so you will be on your back for the duration of the labour (i think, this is my first baby so this is all things the midwife has told me or ive found out from reading)

Eating and drinking - yes as far as i know but i dont know whether its like a normal hospital ward and you get food at specific times rather than when you need it. I'm sure you can bring food and drink from home - i would suggest thats a good idea because hospital food is notoriously gross! I have been told by friends, so i dont know how true this is, that hsopitals advise against food incase you need a c-section, but you might want to check that info. I have no idea how it works in MLU's. The only thing that might get in the way of you eating and drinking is if the hospital reccomends a procedure that requires Nil by mouth.

Pernineal snips- its more commen for them to be done in hospitals than MLU's but as far as i know its not like america where they are done routinely in some hospitals. If you dont want a perineal snip this is something you can put in your birth plan so they know your wishes.

EFM - this is more common in hospital, i think in MLU's they use dopplers every 15 mins or so when your in active labour to check the baby is ok. Again, for some odd reason, beign on an EFM means youre more likely to need intervention in your birth. Statistics are an odd thing! Maybe its some kind of psychological effect of mum being able to hear the heart beat speed up and slow down with contractions.

I hope this is helpful. I'm not medically trained so all this information is based on reading (alot, im a complete nerd) and having long conversations with my midwife. We have an independant midwife (a midwife we are paying to come to our home birth rather than an nhs midwife) so my appointments are often maybe an hr (or sometimes 2 hrs ) and i get lots of oppertunity to ask questions.

Good luck xxxxx IM me anytime

Thanks a lot for such a comprehensive answer I feel it'll help with talking to the midwife to have an idea of what's "normal" and what will work in my case.

I did get the impression the UK was more on the civilized side, but I raised the subject of episiotomies with my partner and he seemed to have bought the "prevention" aspect of it, and that made me wonder. I then took the time to read on an bit about it and actually found quite a few papers online which basically seemed to say no benefit is proven... (and even that harm may be supported by the evidence) so I figured I definitely want to get well informed and discuss things beforehand. I hope the midwife I get is supportive of a more natural birth.

Cheers!

I'm sure things will be fine and you will have a lovely experience - a MLU might be a good option for you but of course it depends on how you feel about it and if you get any complications further down the line.

Good luck xx

I gave birth in hospital and will do so again probably.

1. in my hospital they normally recomend induction 10-12 days overdue, though most hospitals make you wait the full 14 days. You can refuse to be induced.

2. you don't normally get waters broken or a drip, if this was recommended it would be for a good reason eg in labour for ages and no progress, by helping you along this way the hope is you still have enough energy left to push well and have a natural birth.

3. yes everywhere I have heard of encourages you to be active during labour. (You will be at home for the majority of this part as hospitals usually only admit you when you are quite far on!) My hospital has birthing bouncy balls; I think most do.

4. eating/ drinking- I was already pushing by the time I got to hospital so didn't have "labour" there. I was only allowed sips of water. Obviously this depends what stage of labour you are at- if fully or almost fully dilated/ pushing you won't be allowed anything- this is in case you need c-section. If you are in early labour you would need food for energy.

5. epis- only if necessary, they generally prefer to let you tear as there is the possibility you won't need stitches for a tear, but you definitely will for an epis. If the midwife recommends it you will be asked if you mind having one before they do it. The circumstances in which you require one is if baby's head gets stuck despite you pushing.

6. foetal monitoring- baby's heartrate checked by midwife (doppler/ scan) at every contraction during the pushing stage. During labour you wear a stretchy band with the monitors on it. If the baby is in distress you night need a clip attached to baby's head to keep constant check on baby.

You can refuse any medical treatment but personally I am confident in my midwives and hospital that they won't recommend anything unnecessary. Midwives are very much in favour of minimal intervention. Write out a SUCCINT birth plan if you wish. The midwives will ask you during labour things like - vit K injection for baby? -injection to contract your uterus after birth? In the NHS you won't have someone with you the whole time, just the last bit.

Thanks, mummypeanut!

Thank you, Jenstar, that was also very enlightening. Sounds fairly reasonable, too. It really makes me more confident for when I meet the midwife. And you raised issues I haven't yet thought about (like those injections at the end).
I like to read on and make informed choices, or at least understand what's going on.
Good thing I still have some 7 months!

the reason they do all this is for safety of baby especially induction at 42 weeks as baby is at risk and by 38 weeks everything is fully formed and healthy and completely ready and plus any further than 42 weeks the pressure on you too is bad

they do everything to get your baby here for you x

I know, Jess_smurf, the only thing I think they sometimes can get carried away with safety, and doing "more" isn't always the best thing. About induction, for example, it's quite common for first babies to be later than term by a bit. Yet they are fine. They may be ready, but perhaps you aren't - and so run the risk of an un-needed c-section. Induction also carries risks (I've started reading on such things) and so *when* and *why* they do it is the issue. Clearly it's necessary in *some* cases - I don't dispute that.
To me, an induction because there are clear signs that a problem may be developing is fine, an induction just because I'm a week past just isn't - not without any other signs.

Hence me asking... because it appears some places get rather carried away with "safety". Episiotomy is the one I've read most. I checked online and actually got some medical papers. None of them seemed to show any benefits to either mother or baby, yet some hospitals will do routine episiotomies on things like 40% of mothers... I even heard 70%. That is quite ridiculous, and even more so if there are no clear benefits. So I know my stance on that - none without my consent, and they better have a good reason to give me if they want that.

Much of the stuff I'm still catching up on. I'm not anti-hospital by any means - but I don't trust them blindly, either. At the end of the day it's my body they may be messing up, and babies die after all kinds of procedures, too.

Cheers!

heya,

I'm reading 'Ina Mays - guide to childbirth'. Its got quite a lot of detaisl about different types of pain relief the pros and cons of each and the different interventions etc. I'm reading it at the moment and its written really well - its an easy read and very positive in its views on childbirth. If you want info it might be a good place to find it ) - she is very pro natural childbirth so Its possibly not the best read if your a 'give me all the pain releif you've got' type person - i dont think theres any issue how ever you want to do it


xx

Thank you! I just checked online and my library's got that -yay!- so I'll read it when I'm back (got to spend as little as possible at the moment).

Cheers!