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The Midwifery-led Birth Unit (MLBU) has been developed to offer
another safe birth option of place of birth to low-risk women.
The MLBU is situated on level 2 of The Rosie Hospital, on Christine
Ward.
What is a Midwifery-led Birth Unit?
An MLBU:
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is organised and managed by midwives
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offers midwifery-led care for women throughout the labour,
birth and immediate post-natal period who have no significant
medical or obstetric problems
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has an identity separate from the established delivery unit
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has a senior midwife responsible for service operation
Philosophy of care
The philosophy of care at the MLBU is to provide midwifery care
to low-risk women in a comfortable designated home-from-home environment.
Women will be able to make informed choices regarding their care
and be encouraged to have a normal physiological birth without
the need for intervention. The unit offers a relaxed environment,
which has been shown to facilitate normal labour and birth. You
will often spend no more than two to six hours in the unit following
the birth.
Who can choose to birth in the MLBU?
A discussion on all birth options will take place with your
community midwife during pregnancy. An assessment of you and your
baby’s health will contribute to deciding what is appropriate
for you. The midwife can help you decide on the type of care that
will be suitable for your individual needs and wishes. On admission
to the MLBU, a midwife will take a full health and needs assessment
and review all your pregnancy care and any scan and blood results.
Following this initial assessment, it may be that the MLBU is
not the appropriate place for your labour and birth. The MLBU
midwife will then organise your transfer to the delivery unit
on the 3rd level of the Rosie, where your care will be continued
by the Delivery Unit team.
Advantages
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You are likely to receive one-to-one care in labour
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This option may suit women who do not want a homebirth but
do not feel comfortable with a hospital environment
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The emphasis will be to support and encourage physiological
birth without interference using birthing balls, birthing stools,
support bar on the wall, support rope to hold onto, birthing/labour
pool, massage, music and positions
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There is an area to make simple refreshments in labour
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There is room to walk around in labour
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The MLBU is in the hospital, therefore, if you need medical
assistance to birth your baby and you can be transferred to
the Delivery Unit on level 3 of the Rosie quickly.
Disadvantages
There is no epidural service on the MLBU. If you decide you
want an epidural in labour, you will need to be transferred to
the delivery unit midwifery team on the 3rd floor of the Rosie
Hospital.
What about safety on an MLBU?
MLBUs (or birth centres as they are also called) have been shown
to be a safe option for ‘low-risk women’, that is
women without significant medical or/and obstetric conditions.
International studies have demonstrated their safety in terms
of maternal and neonatal mortality (death rates) and morbidity
(long- and short-term illnesses). The studies have found that
the outcomes are equal to or better for low-risk women when cared
for on MLBUs. It is argued that this effect is in part due to
the increased availability of one-to-one care in labour and birth.
Monitoring during your labour
This will be similar to checks carried out in a homebirth situation.
If during your stay in the MLBU there becomes a need for medical
review, transfer to the obstetric delivery unit on level 3 of
the Rosie can easily take place.
Transfers from the MLBU to Delivery Unit
Transfer from the MLBU to the Delivery Unit is occasionally
required for the safety of either mother or baby. Transfer rates
vary and range from 6.5% to 16% nationally. Most transfers occur
within the first hour of admission following the midwife’s
full admission examination.
Who does the examination of my baby?
Either specially trained midwives on the MLBU or a paediatrician
can perform these examinations before you leave the hospital.
Several of the midwives in the community are able to do this initial
examination; it is worth asking your community midwife if this
service is available in your area. This examination is recommended
anytime in the first week of life.
How do I prepare to use the MLBU?
Preparation will not differ from standard pregnancy care and
your community midwife can answer any questions during the birth-plan
discussion. This will take place at around 34 to 37 weeks of the
pregnancy.
Can my family and friends visit me on the MLBU?
Following the birth of your baby, the plan is to ensure transfer
home as soon as possible to the care of your community midwife,
this is usually within two to six hours. While on the MLBU, close
family members and friends can visit you as long as this does
not inconvenience or compromise the care and comfort of other
women and families on the MLBU at the time.
Can I visit the MLBU while I am pregnant?
The midwives working on the MLBU hold a weekly session. This
is a ‘drop- in’ session, often on a weekend afternoon,
to look round the unit and meet some of the midwives and staff.
Ask your community midwife for details of the next available session.
What to do when labour begins?
When you are in labour or/and your waters have broken, after
you are 37 weeks pregnant, and the midwife has confirmed that
you are suitable for care on the MLBU then call: 01223 217 003
There is a midwife 24-hours a day who will do a telephone assessment
before you come to the MLBU.
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