Home Birth or Hospital Birth

Transcription

1 Home Birth or Hospital Birth Information for patients Excellent Care with Compassion

2 The aim of this leaflet is to help you decide where you would like to give birth by outlining the options available to you in this area: Home Birth Chorley Birth Centre a stand-alone midwife-led unit Preston Birth Centre a midwife-led unit situated alongside the consultant unit at the Royal Preston Hospital Sharoe Green Obstetric Unit, Royal Preston Hospital provides consultant-led maternity services with midwifery support. Facilities include obstetric theatres and a neonatal intensive care unit When deciding where you would like to give birth you should take account, not only of the facilities available in the different locations, but also of factors such as your medical history and your previous experience of pregnancy and childbirth (see page 3). Sometimes decisions about place of birth made early in pregnancy may need to be revised, for example, if you develop problems in pregnancy such as anaemia or your baby is not in a head-down position at the end of pregnancy. In such situations you would be advised to give birth in the consultant-led unit. More detailed information on each of the options is available from your antenatal clinic or midwife. Home Birth Women often decide that they would like to labour and give birth at home because they feel more relaxed and in control within their own familiar environment where they have the ability to move around freely. This can reduce the need for strong pain killers, although gas and air (Entonox) and aromatherapy can be used. Some women also choose to arrange the hire of a birth pool. If you would like to have your baby at home you will be supported by the midwifery team during your labour and birth. Following the birth of your baby the midwifery team will arrange postnatal care 2

3 as required. Planned home birth is associated with good outcomes when women are healthy and their pregnancies are progressing normally. You should, however, be aware that you will need to transfer to the consultant-led unit if: you want to have an epidural as a method of pain relief in labour. any problems develop during your labour, birth or early postnatal period. The most common reasons for transfer are concerns about the baby s condition or where labour does not appear to be progressing. In 2012, about 1 woman in 3 who planned a homebirth needed to be transferred. Very rarely, the home birth service has to be withdrawn and any women in labour at this time would be transferred to the nearest birth centre for continuing care. The service is only withdrawn if there are insufficient midwives available to provide safe levels of care for you and any other women in labour at the same time. Birth Centres Preston and Chorley Birth Centres are small maternity units which are staffed and run by experienced midwives supported by midwifery care assistants. They offer a comfortable and less clinical environment than the consultant-led unit and are particularly suitable for women expecting an uncomplicated pregnancy and birth. There are no doctors based in the birth centres as midwives are the experts in normal pregnancy and birth. The midwives offer support and advice during your labour, encouraging you to give birth in the best way for your body and baby. They are able to recognise when there is a problem and get the right help for you and your baby. Chorley Birth Centre is situated at Chorley & District General Hospital. It provides maternity services in conjunction with the Sharoe Green Unit at the Royal Preston Hospital. The two hospitals are fourteen miles apart. 3

4 Preston Birth Centre is due to open in July 2014 and is situated on the first floor of the Sharoe Green Unit at the Royal Preston Hospital Facilities in our birth centres include: Modern en-suite birthing rooms each with a birth pool Sitting room and kitchen where you can prepare your own drinks and refreshments Facilities for partners to stay following birth for up to 24 hours Aromatherapy, gas and air and pethidine as pain relief options The birth centres do not have facilities for: Epidural pain relief Continuous fetal monitoring Induction of labour Assisted birth with ventouse (suction) or forceps Caesarean section Medical treatment of newborn babies (other than initial basic resuscitation) Should any of these be required you would be transferred to the consultant-led service based in the Sharoe Green Unit Transferring to the Sharoe Green Obstetric Unit Most babies are born without complications but sometimes problems can occur unexpectedly. If this happens and you are at home or in Chorley Birth Centre, the midwives would provide initial emergency care while arranging a transfer to the Sharoe Green Unit by ambulance. The time taken for the ambulance to get to you will vary according to how busy the service is, traffic conditions and the distance involved, but approximately 75% of ambulances will arrive within 20 minutes. Similarly, the time then taken for your journey to the hospital will depend on traffic conditions and the distance involved; the transfer from Chorley takes approximately 40 minutes. You would be accompanied throughout by one of the midwifery team 4

5 In 2012, only one woman in five needed to be transferred to the Sharoe Green Unit during labour (well below the national average of one in three). The likelihood of needing to be transferred is less if this is not your first baby. Only one mother and baby in ten required transfer for specialised postnatal care. If you are at Preston Birth Centre and problems arise you would be transferred to the consultant obstetric unit in the Sharoe Green Unit. The Delivery Suite is situated on the floor above the Birth Centre and can therefore be reached rapidly via one of three lifts. Sharoe Green Obstetric Unit The Sharoe Green Obstetric Unit at the Royal Preston Hospital is a large maternity unit that provides specialised medical (consultantled) services in addition to the full range of midwifery care. The delivery suite comprises 12 individual en-suite rooms and an obstetric theatre is situated nearby. There is a Neonatal Unit equipped to provide intensive care for premature and ill babies. You will be advised to give birth in the consultant-led unit if you are affected by any of the following: Medical conditions such as diabetes or epilepsy Anaemia (low blood iron) Preterm (before 37 weeks) labour Previous caesarean, forceps or ventouse birth High blood pressure Twin or breech (bottom) birth Body Mass Index (BMI) over 35 Heavy bleeding (haemorrhage) after a previous birth Induction of labour is planned You will also need to give birth in the consultant-led unit if you wish to have epidural analgesia during your labour. The unit provides a full range of pain management options including gas and air, aromatherapy, a birthing pool and pethidine injections. 5

6 Postnatal care is provided on the maternity ward on the first floor of the Sharoe Green Unit. Beds are arranged in four-bedded rooms with en-suite facilities; there are also a limited number of single rooms. Your length of stay would be determined by your individual needs and those of your baby and when you go home your ongoing care is provided by the community midwifery team. Other hospitals This leaflet describes the maternity services offered by Lancashire Teaching Hospitals NHS Foundation Trust, but if you prefer you can give birth in a hospital in a different area. Other nearby hospitals include: Blackburn Birth Centre Blackpool Lancaster Wigan Ormskirk To help you make your choice you can arrange to visit these hospitals using the contact telephone numbers listed. If you decide you would like to give birth in one of these hospitals you will need to ask your GP for a referral letter. Where can I get more information? Your midwife and doctor will provide information and support to enable you make the right choice for you and your baby. You are welcome to visit the birth centres and obstetric unit to help you make your decision. You can arrange this by contacting: Chorley Birth Centre Preston Birth Centre (after July 2014) Sharoe Green Obstetric Unit Consultant Midwife or

7 All women are entitled to reach their own decisions about how and where to give birth, with the benefit of midwifery or medical advice. If you experience any difficulties or need additional support you can contact a Supervisor of Midwives. Supervisors of midwives are experienced midwives who are responsible for monitoring the quality and safety of local maternity care. They can be contacted on or by midwifesupervisors@lthtr.nhs.uk 7

8 Sources of further information Lancashire Teaching Hospitals NHS Foundation Trust is not responsible for the content of external internet sites. Please ask if you would like help in understanding this information. This information can be made available in large print and in other languages. We aim to make the information as up to date and accurate as possible, but please be warned that it is always subject to change. Please, therefore, always check specific advice on the procedure or any concerns you may have with the fertility clinic or your doctor. References Royal College of Midwives, Birth centre resource: a practical guide, 2010 Royal College of Midwives, Evidence-based guidelines for midwifery-led care in labour: Birth environment, May 2008 National Institute for Health and Clinical Excellence, CG55: Intrapartum care, September 2007 Hollowell J, Puddicombe D, Rowe R, Linsell L, Hardy P, Stewart M, et al. (2011) Perinatal and maternal outcomes by planned place of birth for healthy women with low risk pregnancies; The birth place in England national prospective cohort study. BMJ 2011;343:d7400 Division: Specialist Services Directorate: Women s Health Production date: February 2014 Review date: February 2017 LTHTR/Tr/2014feb/62 Excellent Care with Compassion