Preparing for the arrival of your baby can be a wonderful experience. It can also be filled with daunting decisions. Where to have my baby? Do I want pain relief? Injections, feeding, sleeping arrangements. Lots to think about.
Where are you going to give birth to this baby? There are some great options in Northern Ireland to choose from. Most expectant parents in Northern Ireland will have three options – hospital birth with care led by doctors, hospital birth with care led by midwives and home birth with care from midwives.
“My doctor/midwife said I have to go to . . . “ do I really have a choice? YES! You absolutely have a choice, where you choose to give birth is your decision.
Let us look at what is available:
Your house! Birth at home is an option for all expectant parents in Northern Ireland. For more information on home birth you can read the RQIA Guideline for Planning to Birth at Home in Northern Ireland. There are also local Facebook groups for those interested in Home Birth – NI Home Birth Forum, and the Northern Ireland Home Birthers and Hopefuls parents group.
Belfast Area
Royal Jubilee Maternity Hospital delivery suite
Active Birth Centre at the Royal Jubilee Maternity Hospital**
Midwife Led Unit at the Mater Hospital^ (currently closed due to Covid arrangements)
The Labour Ward at the Ulster Hospital
Ulster Hospital Home From Home**
Antrim
The Delivery Suite at the Causeway Hospital
The Labour Ward at Antrim Area Hospital
Lisburn
Lagan Valley Hospital Midwife Led Unit^
Downpatrick
Downe Hospital Midwife Led Unit^ (Currently closed for births)
Newry
Daisy Hill Hospital Midwife Led Unit**
Craigavon
Delivery Suite in Craigavon Area Hospital
Craigavon Area Hospital Midwife Led Unit**
Enniskillen
The Delivery Suite in South Western Acute Hospital
South Western Acute Hospital Midwife Led Unit**
Derry/Londonderry
The Delivery Suite in Altnagelvin Area Hospital
Altnagelvin Midwife Led Unit**
**Alongside Midwifery Led Unit – A unit located in a hospital alongside an obstetric unit (delivery suite or labour ward).
^Stand Alone Midwifery Led Unit – A unit that is separate from a hospital with an obstetric unit.
What are the differences?
The clinical environment: Home from home units and midwife-led units limit the clinical feel of the environment. Delivery suites often have more equipment around the room and less ‘home comfort’. And well, home is home so you decide what the environment looks like. The environment is important because our birthing hormones are affected by our surroundings (more on that in another blog).
Interventions available: Delivery suites will have more interventions available (forceps, vacuum, cesarean, epidural, remifentanil). Midwife-led units and home birth have very similar interventions available (gas and air, bath, shower, pethidine/diamorphine, TENS). Current research available tends to agree that choosing to give birth in a midwife-led unit or at home actually reduces your need for any of the interventions often needed in the hospital!
Who is leading on your care: On the delivery suite you will be supported by a midwife through your labour, but often the key decisions around your care will be made by doctors. With midwife-led units and home birth, as the first suggests midwives take the lead.
Are they all safe?
Birth is generally safe. The BirthPlace Study looked at women making decisions on where to give birth and the outcomes they had; and found benefits in choosing Midwife Led Units or Home Birth. If pregnancy becomes complicated you may want to discuss where you feel is best to give birth, for example, if you know your baby may have some difficulties at birth then the hospital is likely to be the obvious choice.
Some useful links:
Guidelines for accessing Midwife Led Units in Northern Ireland
Planning a home birth in Northern Ireland
Self-referral to maternity services:
