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The basic options

Spend some time thinking about the following options. Discuss them before you come to a decision.

 

In hospital

For the last 30 years most babies have been born in hospital. Many hospitals have tried hard to meet parents’ wishes and to make labour and delivery as private and special as possible. All over the country maternity care staff are working even harder to make sure that women get kind, sympathetic and sensitive care. Hospital maternity units should become friendlier, more comfortable places, where you will be able to get to know the people who are caring for you. You will probably be asked many questions about your wishes so you should feel more in control over what’s happening to you.

 

If there is more than one hospital in your district, and you can choose which to go to, try to find out about the practice in each so that you can decide which will suit you best. Team midwifery may be in operation which means that you will see a midwife from the same team each time you visit the hospital, including at the delivery of your baby. Or there may be a Domino Scheme which means that your midwife will attend you at home in labour, accompany you to hospital to deliver your baby, and then accompany you home after the delivery (usually six hours later). Midwifery care will then continue to be provided as necessary for10 to 28 days.

Use the checklist as a guide to the sort of questions to ask. Talk to your doctor or midwife.

 

It’s also a good idea to talk to other mothers who have recently had babies and ask them about their experiences at local hospitals. You can contact other mothers through your local branch of the National Childbirth Trust, your local Community Health Council and AIMS (the Association for Improvements in the Maternity Services).

At home

  • Some women want to have their babies at home because:
  • they feel they will be happier and better able to cope in a place they know and with their family around them;
  • if they have other young children, there will be no need to leave them to go into hospital;
  • they will have more privacy;
  • they will be able to relax more and will not have to fit into a hospital routine;
  • they are more likely to get to know the midwife who will be with them during the delivery.
  • One or two midwives will stay with you while you’re in labour and, if any help is needed or labour is not progressing as well as it should, will summon a doctor or transfer you to hospital by ambulance.

 

How to arrange for a home delivery
If you are considering a home delivery, first talk to your midwife and GP. Some people think that women should not have home births because they argue that they are unsafe. In fact, research suggests that a home delivery is as safe as a hospital delivery for women who have uncomplicated pregnancies. You have the right to choose to have your baby at home. Your doctor or midwife may advise against this if they think that you are at risk of complications during labour. However, this may be difficult to judge if this is your first baby.

 

Find out whether your own GP will be prepared to care for you during your pregnancy and a home delivery. If he or she cannot help, there may be another in the district who can. You can then register with this GP just for your maternity care and continue to see your own GP for any other medical treatment.

The local supervisor of midwives or Local Health Authority can give you the names of GP's with a special interest in pregnancy and childbirth.

 

Alternatively, it is possible to arrange for maternity care to be led by a team of midwives. Contact the local supervisor of midwives at your nearest hospital who will arrange for a midwife to visit you at home to discuss home delivery. The midwife may also be able to provide most or all of your antenatal care at home. You can contact her directly when labour starts and she will stay with you during labour and the birth of your baby.

 

In a GP or midwife unit

This may be part of the hospital’s ordinary maternity wards or a separate unit. Your baby can be delivered here by your community midwife, who has been involved in your antenatal care, and your GP (or sometimes by a hospital midwife). Some areas operate a team midwifery system, so you may get to know who will deliver your baby.

 

Care in a GP or midwife unit can be more personal since you will usually be looked after by people you know. If the unit is part of the main hospital, then emergency facilities are there, should an unforeseen problem arise. This type of unit is generally used for women who are likely to have a normal delivery. The length of time you will remain in the unit after the birth depends on how well you and your baby are.

 

You can also ask for information on your options from:

  • any other health professional, particularly your midwife or health visitor – your GP or the Child Health Clinic can put you in touch with them;
  • the local supervisor of midwives, who is also usually a senior midwife at the local maternity or district general hospital – you can get in touch through your health authority or hospital and the addresses and telephone numbers will be in your local phone book;
  • your local Community Health Council in Northern Ireland your local Health and Social Services Council;
  • your local branch of the National Childbirth Trust.
  • the Association for Improvements in the Maternity Services (AIMS)

These are the kinds of questions you may wish to ask about a hospital.

  • Would I go to the hospital antenatal clinic for all or just some of my antenatal care appointments?

  • Does the antenatal clinic run an appointments system?

  • Does the hospital run antenatal classes?

  •  Does the hospital offer team midwifery care or the Domino Scheme for delivery?

  • Will I be shown round the labour and postnatal wards before the birth?

  • Is there a chance for me to discuss and work out a birth plan?

  • Can I be seen by a woman doctor if I prefer?

About labour and delivery
Are fathers, close relatives or friends welcome in the delivery room?

  • Are they ever asked to leave the room, and why?

  • Does the hospital encourage women to move around in labour and find their own position for

  • the birth, if that is what they want?

  • What is the hospital policy on induction, pain relief, routine monitoring, diet or any other aspect of labour that concerns me?

Afterwards

  • Are babies usually put to their mother’s breast immediately after birth?

  • What services are provided for sick babies?

  • Are babies with their mothers all the time or is there a separate nursery? 

  • Will the hospital encourage (and help) me to feed my baby ‘on demand’ if this is what I want to do? 

  • Who will help me breastfeed my baby?

  • Will I get help if I choose to bottle feed?

  • What is the normal length of stay? 

  • What are visiting hours?

  • Are there any special rules about visiting?

Are babies usually put to their mother’s breast immediately after birth?

 

Information provided by Health Promotion England.