Being in Bromley we are very fortunate to have a midwife led unit (MLU) as part of the PRUH. When you’re pregnant, you have several choices when it comes to where to give birth. We don’t have a local stand alone birthing center but we do have the Oasis suite MLU. You also have the option of giving birth on labour ward, or at home, but what are the risks and benefits of your birth place options?
In Autumn last year, a study was published which analysed a massive 500,000 births. This is a much larger analysis than the birthplace cohort study of 2011 (which looked at almost 17,000 births), and found that risk of complications were the same for second time mums whether giving birth at home, in an obstetric unit or midwife led unit. They were marginally higher at home for first time mums (9.3 adverse outcomes out of 1000 births at home vs 5.3 out of 1000 in obstetric units, or 0.93% vs 0.53%) although you should note that both statistics show this is a small chance in either setting, meaning birth is generally very safe for the majority of women.
Both studies showed that home birth, when attended by a trained midwife, is not only as safe as a hospital setting for low risk women, but has better perinatal outcomes. Along with home birth, midwife led units and stand alone birthing centers meant a reduced chance of instrumental delivery, episiotomy, epidural and c-section, and a higher chance of a natural delivery. A breakdown of these statistics is below.
It’s worthwhile discussing your birth place choices with your midwife, particularly if you’re interested in using the Oasis suite. 2 of the larger of the 6 rooms in the Oasis suite have a birthing pool, and the largest of the remaining 4 has an inflatable birthing pool. All rooms have an en-suite shower room so you can still benefit from warm water as a natural pain relief option. Although currently during the pandemic, tours of the labour ward and Oasis suite are not available, you can view what the rooms look like and the equipment available in this video (which also provides a great demonstration of the numerous birthing positions available to you). https://youtu.be/7gkj2f84X74
You can read the results of the birthplace cohort study here: https://www.npeu.ox.ac.uk/birthplace/results
The results of the larger meta-analysis of birthplaces is available here: https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(19)30119-1/fulltext