Where will I have my baby? Singleton Hospital, Swansea Midwifery Led Unit 01792 285212 Antenatal Assessment Unit 01792 286111 Princess of Wales Hospital, Bridgend Labour Ward 01656 752383 / 752387 Neath Port Talbot Hospital, Port Talbot The Birth Centre 01639 862117 / 862103
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During your pregnancy you will be asked to make lots of decisions. This leaflet is intended to help you consider the choices available to you regarding the place of birth for your baby. As birth is generally very safe for both yourself and baby (Birth Place Study, 2011 (BPS,2011)), we offer you the choice of planning your birth: at home in the Birth Centre at Neath Port Talbot Hospital in the Midwifery Led Unit, Singleton Hospital in the Consultant Led Unit at either Singleton Hospital or Princess of Wales Hospital Regardless of where you decide to give birth, you will be cared for during your pregnancy and after the baby is born by a named midwife who is a member of a Team. We are proud to inform you that within ABMU Health Board, women always receive one-to-one care from a midwife during labour. 3
What is best for me and how do I choose? You may not be aware that you have a choice about where to give birth. Most pregnant women, particularly those who are pregnant for the first time, think they must have their baby in hospital under the care of a Consultant. Recent reports have suggested that it is just as safe for a woman who is healthy and experiencing an uncomplicated pregnancy to give birth outside a Consultant Led Unit. However, if you experience problems during your pregnancy, need a Caesarean Section or you are offered an induction of labour, you will be advised to attend either Singleton Hospital or Princess of Wales Hospital for the birth of your baby. If you are having an uncomplicated pregnancy you will be cared for following the All Wales Clinical Pathway for Normal Labour. This Pathway aids the midwife on the care you receive during your labour. If complications arise or progression is slow, then you will be transferred from Midwifery to Consultant care. More information about the Pathway is available from your midwife. Home assessment Healthy women with uncomplicated pregnancies have the option of a midwife to support them at home in early labour. Home assessments are offered as many women experience a latent phase of labour. This is when your body is getting ready for labour but not quite established. You may have heard it called niggling or slow labour. If we can support you to remain at home you are more likely to carry on eating and drinking normally and continue with normal life. You will not need to come into hospital until labour is established. Research tells us that, with appropriate support, the best place for a woman in the latent phase is her own environment. 4
Home birth Some women choose to give birth at home because they want to have their baby in a familiar environment with their family around them. According to the Birth Place Study (BPS), 2011, birth is safe for women and babies at home if it is their second or more baby. However, there is a slight increase in risk to first babies being born at home. If you are pregnant with your first baby and you are planning a home birth, please discuss your birth plan with your midwife. If you start your labour at home you are more likely to have a normal birth. This is because you: have more control during the birth and therefore may feel more relaxed be able to move around your home, watch TV or listen to music may use less drugs for pain relief are less likely to need stitches can have whoever you want with you during the birth eat and drink what you like If you request an epidural or any problems occur you will need to be transferred to hospital. Who will look after me? If you choose a home birth you will be cared for by a midwife from your Team with a second person attending for the birth. As midwives are experts in normal birth, no doctors will need to be present. The midwife will stay with you for up to two hours after the birth of your baby. You will be visited by another midwife within 12 hours. Whenever possible a midwife will carry out your baby s first examination. What about the equipment needed for the birth? Your midwife will bring all the equipment necessary, including gas & air and Pethidine for pain relief. If you would like a water birth at home you can make your own arrangements for the hire of a birthing pool. 5
What happens if there is a problem? Midwives are trained to deal with a range of problems should they occur. If necessary, a midwife will call for an ambulance to take you or your baby to the nearest hospital for additional care. The time this will take is dependent on where you live. Your midwife will explain to you and your partner why you need to be transferred and what will happen during the transfer. A midwife will always travel with you in the ambulance and if possible, stay with you until your baby is born. Home birth key points More relaxed and more control More likely to experience normal birth Can eat and drink as you please Less likely to need stitches No epidural available If problems occur, you may be transferred Use less drugs for pain relief 6
Midwifery Led Unit, Singleton Hospital At Singleton Hospital we have a Midwifery Led Unit where healthy women experiencing uncomplicated pregnancies can give birth. According to BPS, 2011, there are no increased risks for healthy women and their babies who choose to give birth in these areas. The Unit consists of two birthing rooms. It is managed and run by midwives with no doctors present. Many women go home shortly after giving birth. If you want or need to stay longer, we may transfer you to our Postnatal Ward. If there is a problem, your midwife will inform the staff working on the Labour Ward and arrangements will be made to transfer you as soon as possible. Why would I choose the Midwifery Led Unit? If you labour in the Midwifery Led Unit you: are more likely to have a normal birth generally feel that you have more control and are more relaxed may use less drugs for pain relief are less likely to need stitches can have whoever you want with you during labour and the birth generally report a positive birth experience (BPS,2011). If there are any complications or you request an epidural you will be transferred to the Labour Ward. Midwifery Led Unit key points Less likely to need stitches No epidural available No epidural available If problems occur, you may be transferred Use less drugs for pain relief Use less drugs for pain relief 7
Birth Centre, Neath Port Talbot Hospital There are seven single-bedded rooms with en-suite bathroom and teamaking facilities. Double beds are provided in some rooms should your partner wish to stay with you. A pool room is also available for women who choose to labour or birth in water. According to BPS 2011, there are no increased risks for healthy women and their babies who choose to give birth in a Birth Centre. The Birth Centre offers a relaxed and homely environment with flexible visiting times, but we do request that you respect other women who are staying with us. Who will look after me? The Birth Centre is managed and run by midwives, there are no doctors present. In labour you will be cared for by a midwife from your Team with a second person attending for the birth. The midwives are experts in normal birth and no doctors are present. Why would I choose the Birth Centre? If you labour in the Birth Centre you: are more likely to have a normal birth generally feel that you have more control and are more relaxed may use less drugs for pain relief are less likely to need stitches can have whoever you want with you during labour and the birth generally report a positive birth experience However: if there are any complications you will be transferred to the Princess of Wales Hospital, Bridgend as there are no Anaesthetists, if you request an epidural you will need to be transferred On average, 90 out of every 100 women who labour in the Birth Centre achieve a normal birth. 8
What happens if there is a problem? Midwives are trained to act quickly if a problem arises during labour with you or your baby. If there is a problem, your midwife will call for an ambulance to take you or your baby to the most appropriate unit, just as she/he would if you were at home. About 11 out of 100 women who labour at the Birth Centre are transferred. Most women are transferred because their labour does not progress as quickly as we would hope. Less than 1 in 200 women are transferred for a serious clinical event. Your midwife will explain to you and your partner why you need to be transferred and what will happen during the transfer. A midwife will accompany you during your transfer and if possible, will stay with you until your baby is born. From the time the decision is made to transfer, to arriving at the receiving unit, the time is currently an average of 50 minutes. If you give birth in the Princess of Wales Hospital or Singleton Hospital you can transfer to the Birth Centre at Neath Port Talbot Hospital after the birth of your baby where we can provide additional support. If you would like to do this please let the hospital midwives know and they will make the necessary arrangements. You will need to use your own transport to make the transfer. Birth Centre key points (BPS, 2011) Homely environment unrestricted visiting Less likely to need stitches Use less drugs for pain relief If problems occur, you may be transferred More relaxed and more control No epidural available More likely to experience normal birth 9
Consultant Led Unit The Maternity Units at Singleton Hospital and Princess of Wales Hospital are both described as Consultant Led Units because they are run by both Doctors and Midwives. There are reasons why women experiencing an uncomplicated pregnancy may choose a Consultant Led Unit. It could be because: the hospital is close to where you live you are worried that something could go wrong during the birth of your baby you would like the choice of either a Midwife or a Doctor as the Lead Professional you can choose to have epidural pain relief The Birth Place Study, 2011 states that birth for healthy women is as safe in Birth Centres and Midwifery Led Units as in a Consultant Led Unit. In a Consultant Led Unit you: are more likely to have electronic monitoring so will not be able to move around freely will probably receive more drugs for pain relief are more likely to need stitches are less likely to have a normal birth than women who labour at home or in the Midwifery Led Unit or Birth Centre (Ref: NICE, 2007) Consultant Led Units are generally very busy so we would ask that only your partner and one other person be with you during the birth of your baby. We understand that relatives and friends want to visit mum and her new baby as soon as possible, but please think of the women on the ward who may be unwell and need rest. Visiting is restricted to fixed times in some ward areas. We also ask that you do not use your mobile phones, but if you need to make an important call, please consider other people in the area. In the event that one unit is experiencing a high level of activity, it may sometimes be necessary to transfer women to another unit within our Maternity Services. 10
Consultant Led Unit key points Restricted visiting times The hospital is close to where you live Possibly use more drugs for pain relief Possibly feel less control of your birth Choice of midwife or doctor as lead carer epidural available 11
Singleton Hospital, Swansea The Maternity Unit consists of: Labour Ward (Central Delivery Suite) Midwifery Led Unit Ward 19 Antenatal Ward / Antenatal Assessment Unit Ward 18 Postnatal Ward Ward 19 has a dedicated antenatal assessment area which is staffed 24 hours a day, 7 days a week. This area will be your first point of contact if you think you are in labour or you have a concern relating to your pregnancy. Labour Ward has ten individual rooms for women to give birth in. There are also two theatres where Caesarean Sections take place. Following a Caesarean Section women are transferred to the three-bedded low dependency area. There is also a high dependency area for women who require additional care. The Neonatal Intensive Care Unit (NICU) in Singleton Hospital is able to look after babies from 24 weeks gestation. Who will look after me? You will be cared for during your labour and birth by a midwife from the Hospital Team. Following discharge from hospital you will be cared for by a midwife from your Midwifery Team. 12
Princess of Wales Hospital, Bridgend The Maternity Unit consists of: Ward 12 Maternity Ward Labour Ward Bluebell Room The Labour Ward has six individual rooms for women to give birth in. There is a birthing pool for women who would like to use water for pain relief or experience a water birth. There are also two theatres where Caesarean Sections take place. The Special Care Baby Unit (SCBU) in Princess of Wales Hospital is able to look after babies from 32 weeks gestation. The Bluebell Room is a room off the Labour Ward where healthy women experiencing an uncomplicated pregnancy can give birth with a midwife. This room is a homely environment with a double bed and en-suite. If there are complications arrangements will be made to transfer you to the Labour Ward so you can be seen by a Doctor. Who will look after me? If you have a normal pregnancy, you will be cared for during your labour by a midwife from your Team with a second person attending for the birth. If your pregnancy is complicated, you will probably be cared for by a midwife from the Hospital Team. 13
Tips to help you to decide where to give birth Arrange to look around the units. Contact telephone numbers are on the front of this leaflet. Speak to your midwife and have a list of questions to ask. Ask yourself what do you want from your birthing experience: what sort of environment do you want? what pain relief do you want? will you want a natural birth or an epidural? do you want water for labour and/or birth? who will you want with you when you give birth e.g. partner, mother, other people? Attend Antenatal Education Sessions. with your midwife. Write your birth plan with your partner and/or your family and share it Visit our website at www.abm.wales.nhs.uk to view virtual tours of the Maternity Units. Remember, the most important thing is: where do you think you will feel most comfortable and relaxed when having your baby?! Sometimes our units get very busy and we may ask you to give birth in another unit. Please bear this in mind during your pregnancy so that you can tell us what unit you would rather go to. 14
Comments from women who have used our Service I ve had two babies at the Birth Centre and was very happy with the environment, atmosphere and most of all the midwives were very helpful. Thank you all for your hard work and team effort. The care I received was excellent. I shall be forever grateful to you. The Service both times with my two pregnancies was very good. The midwives and staff are all kind, helpful and patient. I started the Antenatal Classes with a very ignorant attitude because I thought I knew it all. By the time we got to the third class I d probably learned, and enjoyed learning, 100 things and that s all down to you. Supervisors of Midwives It is a legal requirement that all Midwifery Services have Supervisors of Midwives whose main role is to protect the mother and her baby. If you would like to contact a Supervisor of Midwives at any time to discuss your chosen place of birth or matters relating to midwifery care, you can do so by contacting the Supervisor of Midwives Office on 0300 062 8049. Support for Parents: how supervision and supervisors of midwives can help you is a publication issued by the NMC which gives further information relating to Supervisors of Midwives and can be accessed via the NMC web-site (www.nmc-uk.org). 15
If you wish to discuss any concerns regarding your care or birth experience, please ring a member of the Midwifery Management Team 01792 285465 or 01656 752307 Putting Our Patients FIRST EB420 052010