Birth Place Choices

Information for women

This leaflet can be made available in other formats including large print,

CD and Braille and in languages other than English, upon request.

This leaflet gives you information on the choices of where you can give birth to your baby. You can choose to have your baby in: • your own home.

• the Birthing Centre at the University Hospital of Hartlepool

(Midwife-led care). Women can only choose this option if they live in Hartlepool.

• the Maternity Unit at the University Hospital of North Tees

(Midwife-led care). • the Maternity Unit at the University Hospital of North Tees

(Consultant-led care). • Consultant-led antenatal clinics are provided at the University

Hospitals of North Tees and Hartlepool. • other maternity units in the UK. This leaflet only contains information about maternity services provided by North Tees and Hartlepool NHS Foundation Trust. What do I need to consider when deciding where I want my baby to be born? You need to consider: • your safety.

• the safety of your baby.

• your personal choice.

• where you will feel most comfortable, confident, relaxed and in control of your labour and delivery.

• the care you or your baby may need during or after delivery.

• the advice of your midwife. Your community midwife will assess (check) your needs and advise if you are: • low risk, and will be offered care by a midwife during your

pregnancy and delivery.

• high risk, and will be offered care led by a consultant obstetrician (doctors who specialise in the care of pregnant women) during your pregnancy and delivery.

Your midwife will discuss the reasons why you are low or high risk and explain the choices available to you. Our maternity services provide single sex accommodation and facilities for women and their babies; in addition birth partners are encouraged to be part of the whole experience. This may mean that at times the units have both men and women present within the ward and delivery area.

Can all women have a home delivery?

To ensure the safety of you and your baby we advise that you: • be expecting only one baby that is lying head down. • start labour between 37 weeks and 42 weeks pregnancy. • have had less than 5 previous pregnancies. • have no medical problems or concerns. • have had no problems with this or previous pregnancies or

deliveries. • have good help and support from your family and friends. • have a home that is safe to deliver in.

If you choose a home birth your community midwife will visit you at home to discuss this option when you are 36 weeks pregnant and complete a full assessment of your needs. Research suggests that women having their second or following babies are just as safe having their babies at home as at hospital.1

What are the advantages of a home birth? The advantages of a home birth are: • giving birth in familiar surroundings with family present, if you

wish. • it encourages freedom and comfort. • you may be more active in your labour. • you will be more in control of your delivery. • it reduces the need for pain relief. • you will be relaxed and more comfortable in your own home. • you can arrange visitors to suit you and your family.

What are the disadvantages of a home birth? The disadvantages of a home birth are: • the possibility of complications. These are rare. If any

complications develop during your labour or delivery you may need to be transferred to hospital. This may cause you added discomfort and anxiety, as well as causing a time delay in you receiving medical treatment. The midwives will constantly be monitoring the health of you and your baby and if any complications do happen they would advise you to transfer your care to the hospital as soon as possible. The national average transfer rate for a first time mother is 45 women in every 100 and 12 women in every 100 for a second time mother.1

• if your condition changes and you need to transfer to hospital, an ambulance will be called. The ambulance

transfer time is dependent on the local Ambulance Trust responding to our Emergency call.

What plans need to be made if I want a home birth? Your midwife will discuss this as part of your birth plan. She or he will: • visit you around the 36th week of your pregnancy to develop

your plan of care and to prepare both you, your family and home, for your labour and delivery.

• arrange delivery of equipment to your home, for example, a delivery pack and entonox (gas and air) and oxygen.

• discuss the types of pain relief available.

Your midwife will advise you on the safe storage of entonox/oxygen cylinders, if needed.

Who will deliver my baby? There will be 2 midwives at your delivery; however we cannot guarantee you will know them.

Birthing Centre at the University Hospital of Hartlepool

What is the Birthing Centre? The Birthing Centre offers a family friendly, home from home environment where you and your birthing partner can enjoy the birth of your baby. The Birthing Centre supports normal birth by providing one-to-one care in a place where you feel comfortable and relaxed, allowing you to remain in control of your birthing experience.

Where is the Birthing Centre? The Birthing Centre is at the University Hospital of Hartlepool on the ground floor opposite the Gynaecology Outpatient Department. The Unit is locked for the safety of you and your baby; access is controlled by staff. The Centre is managed by experienced midwives who promote the normal birth process and help women have a good experience during and after delivery.

What facilities are available? There are 4 birthing rooms (1 with a birthing pool). All offer a different birthing experience, including an active birthing room which offers an alternative to the traditional delivery room. The room offers rocking chairs, birthing balls, bean bags, delivery mats and stools, as well as other equipment which encourage mobility during labour. All rooms are en-suite. Pain relief available includes: • birthing pool • TENS machines (provided by yourself) • Entonox • Pethidine or Diamorphine injection.

Can all women have a delivery at the Birthing Centre? To ensure the safety of you and your baby you must: • be expecting only one baby that is lying head down. • start labour between 37 weeks and 42 weeks pregnancy. • have had less than 5 previous pregnancies. • have no medical problems or concerns. • have had no problems with this or previous pregnancies or

deliveries. Please note giving birth at the Birthing Centre is limited to women living in or near Hartlepool. At your booking appointment you will be allocated to the Birthing Team that supports the Birthing Centre. Your midwife will discuss your birth place choices at your booking appointment and will have a further discussion when you are around 36 weeks pregnant.

Who will deliver my baby? All babies born in the Birthing Centre are delivered by midwives from the Birthing Team. Midwives are trained to identify and deal with emergency situations, calling for medical assistance when needed. Nationally 60 - 70 births in every 100 are carried out by midwives.2

If you need to be transferred to the Consultant-led Unit at North Tees, you will be taken by ambulance and a midwife will go with you.

What are the advantages of a Birthing Centre delivery? The advantages of the Birthing Centre are: • a calm and relaxed environment. • one-to-one care in labour (where possible). • a birthing pool available for labour and water birth. • your midwife will accompany you in the event of transfer to

the Consultant-led Unit. • en-suite delivery and postnatal rooms. • your birthing partner can stay with you during your labour and

afterwards if this is what you want.

What are the disadvantages of a Birthing Centre delivery? The disadvantages of the Birthing Centre are:

if a problem arises during labour you will need to be transferred to the Consultant-led Unit at the University Hospital of North Tees. The national average transfer rate for a first time mother is 36 women in every 100 and 9 women in every 100 for a second time mother.1

an epidural service is not available.

if your condition changes and you need to transfer to hospital, an ambulance will be called. Ambulance transfer time is dependent on the local Ambulance Trust responding to our emergency call and their arrival at the Birthing Centre. Therefore the transfer time is the ambulance response time, and on average a 30 minute journey to North Tees.

Maternity Unit at the University Hospital of North Tees The Maternity Unit at the University Hospital of North Tees provides Midwife-led care as well as Consultant-led care.

Where is the Maternity Unit? The Maternity Unit at the University Hospital of North Tees is on the 1st floor of the hospital. The Unit is locked for the safety of you and your baby; access is controlled by staff. The Unit is managed by experienced midwives who promote the normal birth process and help women have a good experience during and after delivery.

For those women who need extra support, the Unit has a multi-disciplinary team including, obstetricians (doctors who specialise in pregnancy and birth), anaesthetists (doctors who specialise in anaesthetics), theatre staff neonatologists (doctors who look after newborn babies). A Neonatal Unit, including Neonatal Intensive Care, where premature, newborn and sick babies can be cared for, is available at the University Hospital of North Tees.

Can all women have their babies delivered at the Maternity Unit? Any woman can book to deliver at the Maternity Unit at the University Hospital of North Tees. If this and previous pregnancies have been straight forward, and you have no medical conditions, you can book under the care of the midwives. Women who have had previous complicated pregnancies or deliveries will be under the care of a consultant obstetrician and will be advised to deliver at the University Hospital of North Tees Maternity Unit. Your midwife will discuss your birth place choices at your booking appointment and will have a further discussion with you at around 36 weeks pregnant.

What facilities are available?

There are 14 delivery rooms. 1 has a birthing pool. All rooms offer a birthing experience which can include the use of active birthing equipment. The rooms offer rocking chairs, birthing balls, bean bags, delivery mats and stools, and encourage mobility throughout labour. All rooms are en-suite.

Pain relief available includes: • birthing pool • TENS machine (provided by yourself) • entonox • Pethidine or Diamorphine injection • epidural.

What are the advantages of a Maternity Unit delivery? The advantages of the Maternity Unit are: • a calm and relaxed environment. • one-to-one care in labour (where possible). • a birthing pool available for either labour and water birth • en-suite delivery rooms. • your birthing partner can stay while you are in labour. • obstetricians available 24 hours a day where support is

needed in labour or delivery. • neonatologists, anaesthetists and theatre staff are on site if

needed.

• additional care and support is available for women who have premature labour or babies.

The Maternity Unit offers a family friendly environment where you and your birthing partner can enjoy the birth of your baby. The aim of the Maternity Unit is to support normal birth by providing Midwife-led care in an environment in which you feel comfortable and respected.

What are the disadvantages of a Maternity Unit delivery? The disadvantages of the Maternity Unit are: • no home from home environment. • there are times when the unit is very busy. • your partner may not be able to stay after you have had your

baby.

Who will deliver my baby? Most babies are delivered by midwives. Midwives are trained to identify and deal with emergency situations; calling for medical assistance when needed. If you need further help with your labour or delivery the multi-disciplinary obstetric team is available 24 hours a day to give extra care, and deliver your baby if needed. North Tees and Hartlepool NHS Foundation Trust is a teaching organisation. We could not train future doctors, nurses or other health professionals without the co-operation of patients. You may meet students in various stages of their training and they may sometimes be present during your appointment or involved in your care. Students are supervised by fully qualified staff. If you do not want students to be involved in your care please tell us; this will not affect the care you receive.

What happens after the birth of my baby? After the birth of your baby you may:

choose to go home from the Delivery Suite if both you and the baby are well.

stay on the Postnatal Ward for support with feeding your baby.

stay on the Postnatal Ward if you or your baby are unwell and need medical support.

Contact numbers University Hospital of North Tees Community Midwives Stockton North Monday - Friday, 8.30am - 9.30am Ragworth Children's Centre St Johns Way Stockton telephone: 01642 528061 Stockton South Sunrise Children's Centre Yarm Road Stockton telephone: 01642 527218 High Fliers Children's Centre Tedder Avenue Thornaby telephone: 01642 527809 Non-urgent messages can be left on the answering machine and will be picked up throughout day. If your call is urgent you should contact the hospital where you are due to have your baby. Antenatal Day Unit telephone: 01642 624239 7 days a week, 9.00am - 5.00pm Outside these hours calls are transferred to the Delivery Suite. Delivery Suite telephone: 01642 382718 24 hours a day, 7 days a week

Antenatal/Postnatal Ward telephone: 01642 382722 24 hours a day, 7 days a week

University Hospital of Hartlepool Antenatal Day Unit telephone: 01429 522879 7 days a week, 9.00am - 5.00pm Community Midwives telephone: 01429 522279 7 days a week, 9.00am - 10.00am Non-urgent messages can be left on the answering machine. East Durham Based at Peterlee Community Hospital telephone: 01429 522270 Monday - Friday, 9.00am - 10.00am

Reference 1. The Birthplace Cohort Study www.npeu.ox.ac.uk/birthplace

accessed October 2017 2. National Institute for Health and Care Excellence (NICE)

Clinical Guideline No. 190 – Intrapartum Care for Healthy Women and Babies (December 2014)

This leaflet has been produced in partnership with patients and carers. All patient leaflets are regularly reviewed, and any suggestions you have as to how it may be improved are extremely valuable. Please write to the Quality Assurance Team, University Hospital of North Tees or email: patientinformation@nth.nhs.uk

Comments, Concerns, Compliments or Complaints

We are continually trying to improve the services we provide.

We want to know what we’re doing well or if there’s anything which we can improve, that’s why the Patient Experience Team is here to help.

Our Patient Experience Team is here to try to resolve your concerns as quickly as possible. If you would like to contact or request a copy of our PET leaflet, please contact:

telephone: 01642 624719 Monday – Friday, 9.00am – 4.00pm

Messages can be left on the answering machine and will be picked up throughout the day.

freephone: 0800 092 0084

Email: patientexperience@nth.nhs.uk

Out of hours if you wish to speak to a senior member of Trust staff, please contact the hospital switchboard who will bleep the appropriate person.

telephone: 01642 617617 24 hours a day, 7 days a week

The Patient Experience Team is available to discuss your concerns in person Monday – Friday, 1.30pm – 4.30pm. The office is based on the ground floor at the University Hospital of North Tees.

Data Protection and use of patient information

The Trust has developed a Data Protection Policy in accordance with the Data Protection Act 1988 and the Freedom of Information Act 2000. All of our staff respect this policy and confidentiality is adhered to at all times. If you require further information please contact the Information Governance Team.

telephone: 01642 833551 or email: information.governance@nth.nhs.uk

University Hospital of North Tees, Hardwick, Stockton-on-Tees. TS19 8PE

University Hospital of Hartlepool, Holdforth Road, Hartlepool. TS24 9AH

Telephone: 01642 617617 Fax: 01642 624089

PIL1027 April 2018