Choosing where to have your baby

Birth centre, home or in hospital?

All women, including first time mothers are entitled to choose the setting where their baby is born. Most women can be re assured that they can leave the final decision about where to give birth until the last month of pregnancy when there will be a discussion with the midwife about the most suitable setting for a woman’s individual circumstances.

Women who live in the Ashford & St Peters (ASPH) catchment area and receive care from ASPH Foundation Trust will automatically be provided with labour, birth and postnatal care.

Women who live outside of the ASPH maternity services’ catchment area can choose to have pregnancy and birth care on an out of area basis. Unfortunately we cannot offer a home birth in this situation.

Pregnancy and birth are an exciting time. As this experience unfolds your maternity team will give advice and help you make decisions for your labour and birth.

The three options for labour and birth will be discussed generally in this leaflet. Further information or for an in depth discussions please contact your community midwife.

Evidence about place of birth

The Birth Centre

Leading the way for normal birth the Abbey Birth Centre has been purpose built and aims to offer an individualized service, in an environment that allows women and their families to experience low risk birth in a supportive and safe place.

The Birth Centre Philosophy

Our birth centre midwives encompass those values all women should expect throughout their birth experience –

• Providing excellent and evidence based care throughout women’s childbirth experience
• Prioritizing the safety of women and their babies
• A deep understanding of the process of normal birth and how to support that process and meet the individual needs of women and their families using our service
• Delivering excellence, working in partnership with women to ensure their requirements are met with kindness, compassion, respect and understanding
• Providing high standards of care to women and their families.

As you are approaching the end of your pregnancy, your midwife will make a plan with you about where you will have your baby. Your midwife will talk to you about your options at ASPH. All women with low risk pregnancies* will be booked to have their babies in the Abbey Birth Centre.

*a low risk pregnancy means that you have had no complications and that you are not under the care of a consultant obstetrician or receiving specialist care.

At your 34 week routine appointment, together with your midwife, it will be decided if you meet the criteria to have your baby in the birth centre.

If your situation has changed it may be safer for you to have your baby at in the consultant led unit at St Peters.

You will have the opportunity to discuss this with your midwife throughout your pregnancy but the final decision will be made between 34-36 weeks of pregnancy.

Home Birth

You do not have to decide straight away if you want to have your baby at home, however deciding by your 36 week appointment is helpful. Once you have decided, your community midwives will discuss this with you at home and make arrangements to be available to you from 37 to 42 weeks of pregnancy.

You do not need any special equipment to have your baby at home, but useful items may be suggested by your community midwife.

You will be cared for by community midwives who look after women with uncomplicated pregnancies. They will support you during Labour and continually make assessments of your and your baby; If the midwife is concerned about anything she will discuss this with you and arrange your transfer to the Consultant led Unit at the hospital.

Benefits

Women who choose to give birth in their own home are more likely to feel in control and more likely to have a normal birth. You will have familiar things around you and you can wander around freely.

Birth at home may be right for you if:

• If you want to avoid monitoring and drips
• You do not like hospitals
• You want the privacy that your own home can provide
• You do not want to be away from other children overnight
• You would like to have a number of birth supporters with you in labour
• Only you know the kinds of things that will help you feel relaxed. Some women feel that home is the right place to be. Some women will choose the birth centre or hospital.
• Midwives are highly trained to observe the well-being of mothers and babies during labour and will transfer you to St Peters if they believe either of you are not coping with labour; They will provide emergency treatment as necessary until you arrive at hospital.

Disadvantages

Our birth figures show that:

• In pregnancy around 13 out of every 100 women who plan a home birth are advised to change to a hospital birth. The usual reasons are problems with blood pressure in pregnancy or concerns about the baby’s growth and wellbeing.
• First time mothers: women having their first baby are more likely to transfer in to hospital.
• Occasionally women need to transfer into hospital after the birth for more intensive monitoring of the mother and or baby.
• Emergency transfers; midwives are fully trained to provide first line emergency treatment and care during transfer by paramedic ambulance.

Hospital Birth on Labour Ward

You will be cared for in the labour ward by midwives. Doctors are available should you need them.

Benefits

These rooms are suitable for women and babies who may have more complex needs and so are closer to the emergency birth facilities.

You will be cared for in these rooms if you are having consultant care –

• You need an epidural
• There are problems with your blood pressure
• You need closer monitoring of the baby during labour
• You need drugs to speed up labour
• You have a medical condition e.g. diabetes
• You are being induced
• You are having twins
• You are in premature labour

What to do when you think labour has started

You can call the Triage number on Labour Ward 24 hours a day, for advice at any time that you are concerned about yourself or your baby not just when you are in Labour.

The number to call is : Triage 01932 722835

If you are booked for the Abbey Birth centre or to have a Home Birth please contact the Abbey Birth centre, number below, when you think you may be in labour i.e

• Your waters break and/or
• You are having contractions or pain

The birth Centre Telephone Triage number – to be used after 36 weeks of pregnancy-once it has been decided that you will have your baby at home or in the Birth Centre:

Birth Centre 01932723761

Remember you can phone this number for advice at any time after 37 completed weeks of pregnancy

See the front of your hand held notes for support groups and helpful numbers.