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Where’s the best place to give birth in Bristol?

So, by the time you find this blog post I’m sure you’ll already have had your booking appointment with your community midwife – yes, the long one where they ask you all about your medical and social history, take loads of bloods, blow your mind with far more info than you can take in and give you your ‘yellow’ notes! (If you’re not from Bristol/the South West then your maternity notes may well be a different colour, but this article will still be really useful!). It may have come as a huge surprise that one of the very first questions you were asked when you booked in for your maternity care is ‘where would you like to have your baby’?!

Like the VAST majority of newly expectant people, you probably hadn’t realised there would be a choice about this….and giving birth probably felt like a bit of a distant thing on the horizon – not something you would have researched before your very first appointment! Still, the question was asked & you had to make a snap decision on which hospital to receive care from during your pregnancy….most likely you went for the closest one geographically without knowing too much about it. The good news is that in Bristol, expectant parents are extremely lucky as we have two incredible maternity units, which are pretty evenly matched!

However, what isn’t always made clear is that whatever decision you made at that first appointment, you can change your mind at any time! As a former community midwife (now hospital-based), it can be a bit of an undertaking to swap your paperwork & care from one Trust to another but, it can definitely be done…and is your right to choose.

Knowing your options is the key to everything in your maternity care, and where to give birth is no exception. What feels right & where feels most comfortable will be different for everyone, so hopefully the info that follows will help you weigh up what’s best for you & your baby.

1. Obstetric Unit (Central Delivery Suite/Labour Ward)

Delivery suite bed

Bristol has two Obstetric Units, one at Southmead Hospital and one at St Michael’s Hospital. These are large Consultant-Led Delivery Suites that have not just labour rooms with midwives, but also a team of obstetricians, anaesthetists, obstetric theatres & theatre staff, Neonatal (baby) doctors, clerical & support staff.

If you have any pre-existing medical conditions, have experienced anything out of the ordinary in a previous pregnancy, or if specific risks present themselves during your pregnancy/labour you are likely to be advised to give birth on a consultant-led unit. Depending on your particular circumstances, this may be because these are the only units where babies can be continuously monitored throughout labour (using a CTG machine), or it may be to have assistance close to hand as certain risk factors may increase the likelihood of assistance being needed.

Things that are important to know about obstetric units:

  • They often have a pool room available! Both Southmead & St Michael’s CDS have a pool room as well as all the regular labour rooms

  • All pain relief options are available on obstetric units

  • You will still be cared for by a midwife, but medical professionals are close at hand if they are needed (if they are not needed then you may not even see one!)

  • They can be quite busy, bustling & potentially noisy places

  • Labour rooms here can feel more clinical as usually there is more medical & ‘just in case’ equipment around and less focus on having a ‘homely’ environment – however, I’m a huge believer that you can create the kind of environment you need & want in any room! We chat in great depth on our hypnobirthing courses about how it’s possible to influence your birth space & how it feels, and the types of things you can adapt, bring and do to encourage all the right hormones to flow during labour – wherever you are labouring. Keep your eyes peeled for a future blog post on this….or grab a place on one of our upcoming courses!

  • Prominent research has shown that for women experiencing an uncomplicated or ‘low risk’ pregnancy, choosing an obstetric unit for labour/birth dramatically increases the chances of experiencing intervention (including assisted birth & caesarean section), but makes very little difference to outcomes for babies. It might surprise you to know that actually poor outcomes for babies in ‘low risk’ pregnancies are incredibly rare overall, regardless of where you give birth! You can read more about the findings of this research on The Birthplace in England Research Programme website

  • If an obstetric unit turns out to be the right place for you, then you need to know that it is absolutely possible to have a wonderful, positive birth experience there – I know, because I had a truly magical one myself! Your chances of this happening will be infinitely higher though if your birth preparation includes ways to overcome some of the challenges of the environment and provides you with practical techniques to stack the odds in your favour – have I mentioned that our courses have this covered?!

2. Midwife-Led Unit (MLU/Birth Centre/Birth Suite)

Bristol Birth Centre Room with floor mat, birth ball and birth pool

Both St Michael’s Hospital and Southmead have options for attending a co-located MLU (i.e. on the same site as the obstetric unit), or a free-standing birth suite (located away from the main maternity hospital). At St Michael’s there is a lovely MLU located on Level E, two floors up from the obstetric unit…and Ashcombe free-standing birth suite available in Weston-Super-Mare. Likewise, Southmead can offer the Mendip Birth Suite, directly adjacent to the Central Delivery Suite & beautiful Cossham Birth Centre 25 mins away in Kingswood (although at the time of writing this blog, Cossham is temporarily closed due to difficulties with maintaining safe staffing levels).

These MLU’s are designed to be a stepping stone between home & hospital and are staffed & run exclusively by midwives. If you are not seeing a Consultant for any reason in your pregnancy, do not require any additional plans or precautions put in place for labour/birth, but do like the idea of still being in a birth unit then these will be good options to explore! They each have rooms available with birth pools, floor mats, birthing stools and other aids to help you remain active, mobile & comfortable during labour. You can check out the specific facilities of each unit by using these links:

St Michaels MLU

Ashcombe Birth Centre

Mendip Birth Centre

Cossham Birth Centre

Things that are important to know about MLU's:

  • These environments are designed to promote the physiology of labour, with the active birth equipment available & a less medicalised atmosphere

  • During labour the midwife looking after you on an MLU will listen in to your baby’s heart rate regularly using a handheld device (these are waterproof so can also be used unobtrusively in the pool). The same monitoring is used at home births too

  • Oral drugs for pain relief as well as pethidine injections and gas & air (Entonox) are readily available on MLU’s. The only method of pain relief that isn’t possible here is epidural which requires an anaesthetist to administer it & continuous monitoring of baby for the rest of labour, and that would mean a transfer to the CDS

  • MLU’s have life-saving emergency equipment & drugs on site and the midwives there receive the exact same training in emergency measures & procedures as those on the CDS (or at home births!). However, to access further care & expertise in the case of an emergency, a transfer is required to the obstetric unit where the obstetricians, anaesthetists & theatres are located

  • The MLU’s are aimed at those experiencing uncomplicated pregnancies, and as such they have certain criteria that you must fulfil to be able to birth there – you can check with your community midwife if you would be a suitable candidate for the MLU. Hospital Trusts are able to refuse to accept you onto the MLU if you have risk factors that fall outside of their criteria, and if those risk factors make it too difficult to look after you & your baby safely without obstetric support

  • The Birthplace in England Research Programme highlighted that ‘low risk’ women choosing to give birth in a midwife-led setting (either an MLU or at home) are more likely to have a straightforward vaginal birth. They also concluded that an MLU was the safest place to give birth for low risk, first-time mums

3. Home

Bristol Home Birth

You can’t find anywhere on earth that feels as familiar and relaxing as home! Not only that, but you can take control of every aspect of your environment, creating exactly what you want…And that all adds up to an incredible place to give birth as those things are a massive boost to our natural feel-good, birthing hormones that keep labour on track and as comfortable as possible. Winner!

If you are interested in home birth then discuss this with your community midwife! She will usually arrange to see you at home for your 36 week routine appointment so that she can go through everything with you and assess things like access, suitability of your space and advise you on the practicalities & how to call the midwives once you’re in labour. When you are in labour a midwife will typically come out to care for you, bringing everything that she needs with her and when the birth is more imminent, she will call a second midwife to attend as an extra pair of hands…

Things that are important to know about Home Birth:

  • It is much easier to plan a home birth with your midwives and then change your mind, than it is to plan for a hospital birth & then try to arrange a home birth at the last minute! Nothing in your birth plan needs to be set in stone…if you decide at any point (later in pregnancy, or even once in labour) that you’d prefer to be in the hospital, then you can phone the hospital and head on in!

  • You can hire or buy a birth pool to use at home for comfort & relaxation and many women will hire/borrow a TENS machine. The midwife will also be able to bring gas & air with her, and in some Trusts home birth midwives also carry pethidine – check with your community midwife exactly what will be available

  • If you need to transfer to the obstetric unit once in labour, either for stronger pain relief or if circumstances change that require medical assistance, then the midwife will arrange for an ambulance. The midwife looking after you will be extremely vigilant for anything out of the ordinary, will bring essential emergency equipment with her and is well-trained to handle special circumstances should they arise

  • The vast majority of transfers from home to the obstetric unit are not whirlwind emergencies. True obstetric emergencies at home are extremely rare, however you shouldn’t ignore the fact that they can happen. The most common reason for transfer is that labour has slowed down or progress has stalled – so by its very nature this is not exactly urgent!

  • Home birth is actually not as messy as most people think! If you take some common-sense precautions with floor/sofa coverings then in my experience, us midwives will usually leave you tucked up in bed with your partner and your baby, with the house looking as if nothing much has happened!!

  • Birthing at home is an option for everyone. It isn’t always advisable for everyone, and for some they may be very strongly recommended not to give birth at home due to certain risk factors in their medical history or circumstances – but it’s important to know that you do have the autonomy to make that decision for yourself. If you are considering a home birth ‘against medical advice’ it is vital that you make an informed decision, which involves listening very carefully to the concerns and advice of your care-providers/consultant but may also involve researching your own individual risk factors more deeply. Some good, objective places to seek support with this kind of decision are AIMS and Birthrights

  • There are some amazing resources out there for anyone thinking about planning a homebirth:

    Bristol Home Birth Group - Monthly meetings with discussion of a variety of topics, support from a range of birth professionals & midwives plus new parents sharing their experiences of home birth

    Why Home Birth Matters - an essential read for exploring the realities of home birth

Best place to give birth in Bristol infographic

There are no rights or wrongs with this & only you can know where feels like the best place for you to give birth. People will always view pros and cons very differently and what seems like an advantage to one couple, could seem a disadvantage to another. So, my advice would be:

  • a)

    Have a good read up on all your options, use the links in this blog to find out more & explore what feels to you like the best place to give birth in Bristol (or elsewhere!), talk it all through with your birth partner, jot down all the things you’d like to discuss with your midwife before you make any decisions

  • b)

    Grab a cuppa and spend a bit of time reading through all the wonderful birth stories that some of my clients have kindly shared on my website. You will find inspirational tales of the obstetric unit, MLU births and home births that will give you a far better and more REAL idea of what birth can be like in those places than relying on all those scenes from TV/movies that are probably foremost in your mind…

  • c)

    Think about booking onto a Little Passengers antenatal & hypnobirthing course and know that wherever you choose to/need to give birth, you will feel completely prepared, empowered & ready for anything! Find out more & book online now...

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