“Sorry, you’re not allowed.”
Is that the response you received when you asked if you could birth in the midwife-led unit or birth centre, because you’ve had a caesarean?
You’re not alone. It’s a hot topic in our online support group for women planning birth after caesarean locally. Here’s some advice from women who’ve walked this path before…
Talk to the person in charge of the midwife-led unit (MLU) or birth centre (BC). Arrange a meeting with the Consultant Midwife or Head of Midwifery at your hospital.
Read the hospital’s VBAC guidelines (ask your midwife for a copy). Remember: hospital guidelines are recommendations, you DO have choices. (If you’re local to Cambridge UK you’ll find them here.)
Ask if your hospital has a ‘Labour Care Pathway’ for VBAC births outside the obstetric unit? (There’s an example of one on this page.)
You could submit a freedom of information request to your hospital to find out if there have been any VBAC births on the MLU/BC.
Think about your reasons for wanting to give birth in the MLU or birth centre. Listen to your instincts; where will you and baby feel safe, supported and cared for, so your oxytocin flows. When you close your eyes and imagine your birth, where are you? who is with you? Talk things through with your birth partner.
Consider hiring a doula to give you and your birth partner extra support during your VBAC pregnancy and birth. Evidence shows that continuous support in labour increased the chance of a spontaneous vaginal birth, had no harm, and women were more satisfied.
Consider any alternatives, for example, some hospitals have a home-from-home room with a pool in the obstetric unit, ask if yours does.
When you meet the Consultant Midwife or Head of Midwifery she/he will want to know you have listened, considered the risks and you are making a fully informed choice.
For local women booked with The Rosie, here is confirmation about the process for women to arrange a HBAC at home or VBAC in the Rosie Birth Centre from the CEO of Cambridge University Hospitals NHS Foundation Trust.
If the answer is still “not allowed”, here’s a few more things to consider:
The Association for Improvement in the Maternity Services (AIMS), says: “A birth centre (BC), or midwife led unit (MLU), will have guidelines restricting which women will be able to use their services; usually this will only allow those who are judged to be low risk to give birth there. You cannot insist on booking in to an MLU/BC if you do not fit the criteria, although it is still worth trying to negotiate. You do have a right to choose a home birth, and sometimes you may find that opting for a home birth may cause the guidelines for the MLU/BC to be interpreted more flexibly.” One determined Cambridge VBAC Friend said she’d birth in the corridor if they wouldn’t let her in the birth centre! (read her birth story)
Here is a statement from Birthrights, the human rights in childbirth charity, in essence it says the hospital must consider your individual request and give you valid reasons, a blanket ‘not allowed’ policy is not considering you as an individual.
This piece of research may give you some ideas or inspiration: “She can’t come here!” Ethics and the case of birth centre admission policy in the UK. The full paper can be obtained from Dr Mandi Scamell.
Have you found this blog useful? Have you any tips or experiences to share? Please comment! And if you have a VBAC birth in an MLU or birth centre please consider sharing your story (in comments below, link to your blog, email or tweet us) to inform, inspire and empower others. Thank you.
Cambridge VBAC Friends is a peer support group for women planning birth after caesarean in Cambridge (UK). Find out more about what we do.
“No Entry. This Way!” Image © Rachel James 2015