Would you give birth in a midwifery led unit?

[Sophia73]

I voted no for myself but I am totally supportive women choosing where they birth. Unfortunately where I live the birth centre is so difficult to get into!

I wanted to add too that I had a dream "healthy" pregnancy - certainly no risk issues - with lots of preparation - which was followed by an extremely trecharous birth - so I agree with those that said low risk pregnancy does not mean low risk birth.

I was actually booked into a midwife program and birth centre to have my bub and changed to private hospital and obstetrician at the last minute as I had heard a few stories that made me think it wasn't for me. One reason was that the birth centre actually send mums home a few hours after birth - now I know that would suit lots of people to a tee - but for me I really felt like I wanted some after care, help with breastfeeding, and a good rest without the distractions of home.

In the end I was happy with my choice...my obs respected my desire to labour without intervention and my care was mostly by midwives in the hospital. My DDs birth was difficult and I only narrowly avoided a caesarean. The truth of the matter is that she was truly stuck in my pelvis and 100 years ago with out the current medical care we probably both would have died.

As it turns out I really needed that intensive care provided by the private hospital as I could barely walk and needed regular pain relief.

So Yes to choice but No for me personally.

[Julie Doula]

Perinatal stats show that 97% of Victorian women give birth in hospitals under the Obstetric Model. Only 2% give birth in Birth Centres, and experience the Midwifery Model. However, these aren't strictly "midwifery-led units": unlike other countries, they are not independent, free-standing or midwife-led - the midwives do their best but are still bound by obstetric policy.
Only 0.3% of Victorian women experience midwifery-led care, those that choose homebirth. Of the 222 Victorian women who gave birth at home in 2005, 90% had a spontaneous vaginal birth, 80% had an intact perineum, 96% had no pharmaceutical pain relief, 16% transfered to hospital and 4% had a caesarean.

Women who obtain birth centre care, and/or Midwifery Model care, are a tiny, tiny, tiny minority in our current birth culture.

I'm not convinced that 97% of women give birth under the Obstetric Model because 97% of women prefer it. I think that the lack of opportunity, information, options and funding have something to do with it. By contrast - 80% of women in NZ choose one-to-one Midwifery Model care. It's not because they're a big bunch of hippies who love suffering. It might have quite a lot to do with the fact that it is funded in NZ, and because the first person most women see when they get pregnant is a midwife - not a GP.

I've heard from so many women that when making enquiries regarding birth options in early pregnancy, they get told their choice is between private and public. I.e. two versions of the Obstetric Model. Many doctors don't mention birth centres, most don't mention homebirth. ONe of my clients, when she informed her GP of her decision to go through a birth centre, was told, "Have you got any idea how many births they botch up???" I think that very few women are presented with the full menu of birth options. They get the censored, abridged version. That's not informed choice. That's not choice at all. If women really did have a choice, and Midwifery Model choices were as well funded and supported as Obstetric Model choices, I think it is possible that more than 3% of Australian women would choose them.

At any rate, those who are opposed to the Midwifery Model, and those who do not desire it out of personal preference or need, are certainly not in a place of duress or at any risk their preferences will become less accessible or less supported.

[hannahfroodoo]

Whether you would chose obstetric or midwifery care, you'd have to agree that there are really very limited options for the women who choose midwifery care. That's what I think needs to change. Let women choose what they want but provide better options so that we CAN choose....

I had my first DD in a public hospital and didn't see an OB until my tear needed stitching. It was a wonderful and empowering experience that I was looking forward to repeating.

I had my twins in a private hospital with a private OB and I hated the experience. I had arguments during labour with the OB that reduced me to tears and ended up having numerous, unnecessary interventions.

Obviously, based on my experiences, I would choose midwifery led care. It disappoints me that women (myself included) don't know about their options for midwifery care. For example, I never realised that a public hospital would let me bring a private midwife to the birth.

I am not demanding that the government pay for more birth centres or midwifery units - just that the same medicare and private insurance coverage be available for private midwives and private birth centres as for private OBs.

But most importantly, that we are made aware of other options beyond just 'public or private.'