Midwifery led unit (MLU) or home birth…

Following! In the same situation, currently 31weeks with my first and starting to investigate home birth options more seriously. Did she say why they choose to go into hospital - would love to know people’s experiences of this, and whether it’s for pain relief or things not going as planned. I’m 20-30mins from our hospital, whereas the MLU is alongside, which is the only thing that puts me off homebirth

My friend has had 2 out of 3 of her children as homebirth. She had an easy first labour which is why she chose it for her subsequent children but she always says that she would highly recommend it. She also only lives 15 minutes from the hospital which helps if things go wrong. I would be a little unsure about doing it for a first baby though because you just don’t know what to expect. When I had an emergency C-section the woman next to me in recovery was there because her baby had got stuck during a home birth so had to rushed in. I think you just have to make sure you’re fully educated and you know the process if things do go wrong.

I’m going for a MLU and my midwife has said that I just need to let her know which one I want to go to at my 36wk birth plan appointment so that they can make sure that the MLU has access to all my notes and blood results etc. a lot of them you can contact and go for a tour around. Me and my partner viewed one last weekend and we found it really helped to see it in person and chat with the midwives there about all our options and have our questions answered. Some have online tours if they are attached to hospitals usually. But definitely give a couple a call to get a better feel for them before your birth plan appointment

Hey! I’m currently planning on having a home birth (first time mum too). The transfers to hospital are usually due to wanting more pain relief rather than emergency transfers so I’m told. I’m not sure how much you know about the birth process yet but if you do some research into the “transition period”, basically you get a spike of adrenaline before you start pushing and for some people it makes them panic and feel the need to transfer to the hospital too <3

Is the MLU attached to the hospital or would you still have to travel if needed? I think as long as you don’t live too far from a hospital, the team say it’s ok to do and you’re comfortable with the pros and cons and are fully informed then do what’s best for you!

I am currently 32 weeks with my first and planning a homebirth. I am a five minute drive from the hospital and I’m currently low risk which are big contributing factors for me. You can always plan a home birth and then go into the hospital, but if you’re not planning a home birth and you decide you want to stay at home to labour and birth then the midwives will not be prepared. So if you are unsure, I think it’s always best to choose home birth and then you aren’t limiting your choices. Good luck with whatever you decide! X

I’m also a first time mum and we’re probably going to go for a home birth. My approach was to think about where I feel most relaxed, safe and comfortable but also informed of what the process would be if there was an issue. For example, there’s only an MLU in my town, so even if I went there (second option) and something meant I had to transfer, that transfer time is the same as if I went from home. In my area, if you’re interested in a home birth they put in a referral for the consultant midwife who can talk you through everything and answer any questions- might be worth asking about that to get a better idea of what they do in your area? Also, I’ve been told repeatedly that even if I say home birth now I don’t have to stick to it when I go into labour - they just want you comfortable wherever you are!

All I’m gonna say is, my mum would be dead if she had a home birth with my brother 🫣 For me, there’s nothing safer than already been in the hospital, but that’s just my own experience and opinion x

@Jess probably not the best thing to say to women planning homebirths.

My hospital has a birthing unit which is MLU BUT should drs be needed they are within reach. I’m having a home birth with my third, I’ve been doing research on pain management. I will use gas and air though l never used it with my first it made me feel sick if anything.

@Shannon it’s true though and it’s definitely a risk to be aware of. For my son I was transported from the MLU to the main hospital which took a few minutes since it was just upstairs. It wasn’t a great experience but it would have been 100x worse to have been waiting for an ambulance, ambulance ride and transfer - we don’t know what would have happened if it had of been.

The birth place study from 2012 has some good research and stats on home birth vs alongside MLU vs freestanding MLU if anyone’s interested 🤗 Home birth unfortunately isn’t an option for me but it has played into my decision between alongside and freestanding MLUs

I haven’t had a home birth or planned one but from the experience I had with my first baby I would suggest MLU as you just never know, even with all the checks there could be something wrong with the pregnancy & you don’t have the reassurance that your body has done it before & all has been fine. I had a textbook pregnancy, absolutely fine at every appointment never even had morning sickness. I even had growth scans (fundal height was high) which reassured me of size. Declined sweeps went into labour at 40+5 got to the hospital at 4cm thinking wow my body is doing amazing. Nope. My placenta was failing my baby had undiagnosed FGR & couldn’t cope with contractions he was born on the 0.7th percentile via EMCS with a severe brain injury and it’s ruined my life.

@Louise this woman is asking for advice about homebirths and midwifery led care units. It is not necessary to comment about women dying. Walking across the road is a risk to be aware of, it’s not relevant or helpful to Ceri to post negative birth stories that aren’t related to homebirths or midwifery led units 🤯

These two *eClinicalMedicine* meta-analyses provide a comprehensive comparison of planned home versus hospital births among low-risk women. The **2019 study** (Hutton et al.) found **no significant difference in perinatal or neonatal mortality** between the two settings, provided the healthcare system was well-integrated. The **2020 study** (Reitsma et al.) focused on maternal outcomes and found that planned home births were associated with **significantly fewer medical interventions**, including lower rates of caesarean sections, epidurals, assisted vaginal births, and maternal infections. However, findings on postpartum haemorrhage were mixed. Together, these studies suggest that for low-risk pregnancies in well-supported healthcare systems, **home birth may offer maternal benefits without increasing infant mortality risks**.

I’m planning on a homebirth in a well integrated system and I live very close to a hospital, so basically like being in an MLU. These papers are well regarded Lancet reviews. Hope they help reassure about HB! If they had an MLU close to me, next to a hospital, I may prefer that. But honestly my proximity and the support you get at home here means I may as well be, so feeling good about decision. To people sharing scary stories, respectfully, please keep them to yourself and allow people to do their own informed research to make their choices 🙏 fear isn’t helpful here, particularly when well regarded statistics speak for themselves.

@Shannon it is relevant though, it’s a huge factor - if not the main factor in many peoples decisions. It’s important to be informed and aware for any decision.

@Louise exactly, it’s not all straight forward sunshine and rainbows, doesn’t mean something bad will happen to you but it’s good to be aware

Right sorry but my son being severely brain damaged is not a ‘scary story’…it’s real life for me. My son is blind, he has seizures and cerebral palsy, he will never walk or talk or live to be a teenager. I wouldn’t wish this life on my worst enemy, so how could I not share my experience when I found out the hard way that being classed as ‘low risk’ doesn’t mean they are right or you won’t have complications

Wow.. thank you all for your comments. All are very helpful 🙏🏻 I appreciate the research and hearing people’s experiences - whether positive or not so good, it all matters and is relevant. For me.. I think I’m leaning towards MLU now as it is attached to the hospital/ next door to the labour unit and also the hospital is about a 30 min drive away. I also am thinking why not start with home birth & can transfer to hospital if/when needed…as my midwife said if I do decide on a home birth, the community midwife’s will be on call with me from when I hit 37 weeks - I find this quite comforting and reassuring in a way!

@Anna well regarded statistics speak for themselves but there was no clear finding in relation to post partum haemorrhage...

@Ruth It’s likely just that the studies didn’t have enough accurate data to make a clear comparison. The injection they give after birth can help reduce the risk of PPH, though not entirely. Fewer interventions *can* sometimes be linked to a lower risk, as things like inductions or assisted births can increase the chance of PPH, but it’s worth remembering that PPH can still happen even in straightforward births. When more interventions are needed, you’d usually already be in hospital, as home births and MLUs tend to use minimal intervention. It’s such a personal choice, and you can always start in one place and change plans if it feels right for you! If you’re thinking about your options, your midwife can talk through your personal risk factors in more detail and help you weigh up what feels best for you. ☺️ (PS – not a medical professional, I just research a lot!)

@Eve I’m really sorry—I hadn’t seen your message before I wrote mine. I completely understand that this isn’t a ‘scary story’ for you, it’s your reality. I can’t imagine how hard that must be, and I really appreciate you sharing your experience. You’re absolutely right that being classed as ‘low risk’ doesn’t mean everything will go smoothly. 🙏

@Ceri that sounds like a great approach 🎉 the important thing is that anyone feels safe and supported wherever you choose, home, MLU, hospital or otherwise!

I'm 35wks +2 with my 3rd child and hoping to have a home birth. Really looking forward to it actually. Not the birth of course, but being relaxed and at home. I have a large corner bath too so hoping to just pop him out in there. Although midwife said she can bring a pop up pool if I wanted.