Hospital Births

I was watching a video tour of a maternity ward in a hospital in England and so many things struck me as so different there. I mean I know things WILL be different and I also know so many things that I never even consider will also be different, but some of these things surprised me and made me wonder just what else is different.

First shocker was they will send you home as soon as 6 hours after birth. I did see another hospital said 'next day' discharge, and that is pretty similar to the US, but I also know they've been pushing in the US to delay discharge until day 2 (or 48 hours after birth). It's been a long time since I have given birth so I am not up to date on the current rules but I thought hospitals all over were done with shooing new moms out just hours after birth. When I had my second child almost 16 years ago now I had her in the evening and went home in the morning- even back then that was super quick, but it was by choice that I did that. I guess I am wondering about all those new moms who would like a bit of time to adjust to being a mom before being sent off on her own. So what do people know about this? Are women really being sent home within a day of birth? Is there any choice in this?

Shocker number two was women having to go to a dining room for their meals. Maybe I am just spoiled but I really enjoyed having meals brought to me in my comfy bed. If I had had to go to a dining room and sit on a chair with my first I would have just not eaten at all because even just laying down was pretty painful. Sitting up- forget it. Is this generally the case, where you have to go to a dining room for meals or go get your own meals from the trolley in the hallway?

Do most women opt for a natural or natural+gas birth? How common is an epidural?

What about episiotomy? Is that routine? Or as routine as it has been in the US? After my first I learned to never again have another episiotomy but with each subsequent birth I have had to fight with the doctor to not get one. The last time she actually tried arguing with me telling me how much better I would feel if I would just let her cut, but I was persistent and am glad I was.

And last- I saw that post delivery rooms are not private, there are up to 4-5 beds in each room. That means you have several other mothers, their babies and potentially family in there at the same time. Again, maybe I am just spoiled but I really can't imagine trying to recover and bond and get breastfeeding down not to mention rest all while having to share a room with so many other people. Is it always the case- where you will share a room? They did mention the option of a private room, if it is available, but there is a fee for it, does anyone know what that fee is?

What hospital/ area were you looking in?  I think some things are standard- like the rooms/ ward but some things are different depending on the hospital so you might get a better idea if we know where you are looking.

I had my first here in the UK and second in the US (both hospitals) and in my experience here I had some of what you mentioned and some was different.  For example the room I was moved to after birth would have had 4 people in it but I was moved to one at the end of the hall so there was just 2 of us.  The curtain was pulled and I never even talked to the other lady.  We didn't have to go to a dining room- food was served at the bedside.  Breakfast was just cereal and toast and lunch I think was a sandwich, I can't remember dinner but it wasn't a phone call/ room service thing like in the US.  Also there were set visiting hours for extended family- DH could come whenever he wanted but anyone else had something like a 2 hour window to be there so it wasn't like you had people coming in and out all day.

I can't say much on the other stuff as far as pain relief I got a morphine type shot because I asked for it and then just gas and air but DD came really fast so there wasn't any time for anything else.  Also I tore so can't say if they wouldn't have suggested the alternative or not because she was so fast.  As far as discharge she was born around 4am and we stayed till the next afternoon and didn't feel rushed to leave but I know a couple moms now where we live who aren't first time moms and they did leave a lot sooner but we live in a different area now.

One last thing- as far as help goes don't forget that the midwives and health visitors will visit you in your home after you are discharged for a week or 2 depending on how things are going.

None of these thing are standard and probably vary from hospital to hospital, they do try to get you Back home ASAP, it freest up beds and many women want to get home the same day! I was in hospital for a few days with both of moine (a natural birth and a section) but I would have preferred to be recovering in the comfort of my own home with my own stuff around me. I have been in a private room and a ward, I personally don't mind the ward, I chatted to one of the ladies and I am still friends with her!  I had an epidural,  you have many man birth choices and you have to be your own advocate and speak up for what you want your birth experience to be like. I had meals at my bedside, but they do encourage you to get up and walk around. They don't do episiomoties as standard at all, only if needed.  My best friend is training as a midwife and we are all so fascinated as to how it all works!

Part of the reason for wanting to get people out more quickly is that the longer you are in hospital, the higher your chance of getting a hospital-based infection like MRSA. For cases that go smoothly without complications or other concerns, they'll send you home when you're ready, and the health visitors keep an eye on you instead. They won't rush you out if you're not ready healthwise.

First shocker was they will send you home as soon as 6 hours after birth. I did see another hospital said 'next day' discharge, and that is pretty similar to the US, but I also know they've been pushing in the US to delay discharge until day 2 (or 48 hours after birth).

My daughter was born at 11pm, we were moved from the delivery room to the ward around 7am, and we left the hospital by 2pm. I could have stayed overnight had I wished but I specifically requested to go home as soon as they could organize my discharge--I didn't fancy the idea of staying overnight without my husband to help with the baby on the first night and was much more comfortable at home. I'm pregnant again right now and haven't decided what I will do this time around. I am sure I will be itching to be at home in my own bed but I also think there are some great resources I could have taken more advantage of (help with breastfeeding, etc) had I stayed longer...though the ward I was on was particularly busy (they had to turn women away to go to the hospital an hour or two away because they had no more delivery rooms left) and help was so scarce I never could track anyone down to even ask where lunch was being served! In the end, I had to send my husband out for food...anyways, so it really depends on how busy the ward you will be on is as to whether you are better off staying in and getting help or going home where you will have the help of your family.

Shocker number two was women having to go to a dining room for their meals. Maybe I am just spoiled but I really enjoyed having meals brought to me in my comfy bed.

I wasn't a huge fan of this, especially because I could never find a staff member around to direct me to where the food was being served! But even though I missed out on lunch being served, there was a kitchen where toast, cereal, tea, etc. was available 24/7 and that was really nice to have on hand. My husband brought me whatever food I needed, so it wasn't a huge deal in the end. I am not sure I will even bother with the hospital food next time around!

Do most women opt for a natural or natural+gas birth? How common is an epidural?

I think it's entirely up to you. I had an epidural when I was on hour 35 of my massive 43 hour labor and I would say if you want one, just make sure they are aware of it well before the point where you need it because there can be a bit of a wait sometimes if there are patients going into surgery, etc. I needed to wait until I reached 4cm before I could have mine and the midwives knew I was desperate for it and told me to go walk around for an hour to try to speed things up and they had everything set up and waiting for me when I got back, so I had it right away as soon I returned.

What about episiotomy? Is that routine? Or as routine as it has been in the US? After my first I learned to never again have another episiotomy but with each subsequent birth I have had to fight with the doctor to not get one. The last time she actually tried arguing with me telling me how much better I would feel if I would just let her cut, but I was persistent and am glad I was.

I didn't have one and the midwife delivering me knew I wanted to avoid one if at all possible, along with the use of forceps of a vacuum. She was really great at working with me to deliver without any of that and in the end she helped me avoid needing stitches. I wouldn't say they are routine but I would say the use of forceps or vacuum is probably a bit more common here than in the US, as they are much better here at avoiding c-sections than the US is. I am actually convinced I would have had a c-section in the US, as my labor was a LONG 43 hours and my contractions slowed WAY down during the pushing phase. I was really pleased that the doctor they called in along with the midwives were all happy for me to push without contractions and helped me to have a beautiful delivery that was SO much easier on my body than a c-section would have been. I am having my second baby here in the UK before we move back to the US because I am that much more confident in the birth system here.

And last- I saw that post delivery rooms are not private, there are up to 4-5 beds in each room. That means you have several other mothers, their babies and potentially family in there at the same time. Again, maybe I am just spoiled but I really can't imagine trying to recover and bond and get breastfeeding down not to mention rest all while having to share a room with so many other people. Is it always the case- where you will share a room?

I didn't have a choice at the hospital where I delivered, and there were at least 20 women in the room I was in, if not more. Everyone had privacy curtains, though it was so ridiculously hot that we weren't allowed to shut our curtains because they were worried about our babies overheating. It was a pretty miserable experience, to be honest, but my hospital just had a particularly bad system and it can be much better at other hospitals. Still, I am *so* pleased with the medical care I received there (I had some major complications in my third trimester and was in the hospital 3 or 4 times a week for several months having my liver monitored) that I can easily overlook/forget about the 7 hours I spent on the ward afterwards! No copays, no bills, no dealing with insurance companies, and specialists that were experts in their field readily available to answer my questions, plus a wonderful, hands-off birth without a slew of intervention--I can't complain!

I gave birth in  North London Hospital 3.5 years ago.  

I was very insistent upon an epidural from the moment I waddled through the doors.  I had heard they try to push gas and air and a more natural birth at this hospital, and I was having none of it.  So I just started asking early and it wasn't a problem at all.  

I gave birth in the early afternoon and I was in a double room.  I didn't get a roommate until the next morning when I was getting ready to leave.  That said, there were rooms of 4-6 beds next door, they were also only about half full.  Must have been a slow day.  

Meals were brought to my room.

Bathroom was down the hall.  I didn't love this part, but hey ho.

I was discharged 24 hours after giving birth.  I was definitely insistent on getting out of there. I just wanted to be home.  

I gave birth in a private room but then moved up to a ward for 6 when they booted us out. I was the only one in there when I arrived but as I had to stay in a few days, it kind of filled up and emptied around me. There were usually 4 beds full. I ended up needing a blood transfusion and although they are a 6 hour discharge hospital, they were in no means rushing me out. I was forever asking to go home though because it was impossible to sleep in there.

Two of our meals were delivered to our beds, but breakfast we had to go and fetch for ourselves. The thing that I had the biggest problem with though was that the bathroom was down the hall. It's a long way to waddle when you think your baby is crying!

I had an episiotomy although I wanted to avoid it, but their attempt at vacuuming the baby out failed and they needed to use the salad tongs so they cut space. My birth was just gas and air, and I only got that because a midwife suggested it. I think you can have what you want, but you have to know to ask for it.

Ugh, walking anymore than a few steps to the bathroom would have just about killed me with my first. And yeah, not to mention worrying about the baby while leaving the room to use the bathroom... hmm.

So the hospital(s) I saw the videos on was in Eastbourne- http://www.esh.nhs.uk/maternity/ (video tours on the left column) you can watch videos for all 3 of the hospitals associated although most information in the videos is the same. But like in one you get served your meals at your bedside but at another you have to get your own tray from the hall and in the third hospital you go to a dining area to eat. So I was wondering which was more common.

And bathrooms- again I am sure it varies from hospital to hospital- although I sure do feel bad for women who have to leave the room for bathroom use.

lilybelle, I think you're right about the whole intervention vs natural birth thing, I really like the idea so much more of how things work in the UK over the US. My last birth was long and hard and drawn out and I'm sure they would have put me in for a c-section if I had not already delivered naturally 3 times before (one being a 9lb 10 oz baby), they even told me that we may need to start considering a section- so I feel lucky in that case. They are just way too quick here to jump right to c-section when things don't go just like they think they should. Some women can even have elective caesareans! I read this in the wiki about caesareans "Caesareans are in some cases performed because they are profitable for the hospital, because a quick Caesarean is more convenient for an obstetrician than a lengthy vaginal birth, or because it is easier to perform surgery at a scheduled time than to respond to nature's schedule and deliver a baby at an hour that is not predetermined"... that's really sad.

Anyway, I'm really just curious about the differences.

As already said in the other replies, it all varies very much according to the hospital!  The one we went to has all private en-suite rooms and although you could venture to the dining "room" (on the same floor) they would deliver your meal if you wanted. 

Epidurals are nowhere near as common as in the US which I think is a good thing (i.e. they don't push them on you as soon as you walk in the door!) but they are certainly available if you want one.  The more natural approach imo was really amazing throughout my pregnancy and labor compared to my sister's experiences in the US. 

The nurses were happy to watch your baby for a few minutes while you went to get dinner or for a walk or whatever although my daughter was in high dependency so we didn't really utilize this.  I was desperate to get out of the hospital but most people with healthy babies who feel fine and have feeding established can go home later that day or the next but it all really depends on circumstances. 

Do you know where in the UK you'll be living?  It would help to research specific hospitals in that area.  I was nervous about the differences but my experience with having a baby on the NHS was overwhelmingly positive!  I think there are quite a few threads already on this as well.  Best of luck!

Don't forget that it also depends entirely on what kind of birth plan you have.  If you chose one that is non-medical in nature (no epidural, c-section, etc) than you can deliver in midwife-led units of hospitals.  These, on the whole, are far nicer places than the consultant led-units. 

I experienced some of both.  I was induced with DD1, so started in consultant-led.  I started in a larger ward for women who weren't in active labour yet.  There were probably around 8 of us in that room--not all in labour, many were there trying to stop early contractions and such.  I thought I would hate the ward, but it ended up being very nice as I just had time to kill and it was good to have other women to talk to and reassure me. After delivery the consultant led wards were in different rooms where no more than four mums were, and you could separate them all by curtains and such.

When I was in active labour, I delivered in a private room.  Since I hadn't had an epidural and could walk and such, they decided to put me in the Midwife Led Unit of the same hospital for recovery.  There had been an influx of women while I was there, so the wards were pretty full.  The MLU was so much nicer.  I had a private room, with a double bed where my husband could stay with me if he wanted to.  It was quieter and very nice.

DD2 was born at a small local hospital that is just up the road.  It was the most amazing experience, and was a wonderful birth.  We chose a water delivery in a large birthing pool, just because I wanted to try it. I had a private room at all times.  The midwives were lovely and helpful.  There were only two deliveries the whole time I was there, so I had any help I needed. I remember the midwife who delivered my baby sat while I was pushing and poured hot water over my back during every contraction to help.  It was a personal touch I'll never forget.

Both hospitals fed us in bed, although I think there was a meal that I had to go to the door to choose stuff from a cart in the consultant-led unit. When we arrived at the smaller hospital for DD2, they brought both my husband and I tea and toast because they knew it was approaching breakfast and DH would need his strength too and likely hadn't had a bite.

I was told with both that it was entirely up to me when I went home--that most women seemed to want to get home sooner than later, but I could stay as long as I needed to.  I stayed overnight with both.

I had an episiotomy with DD1, but only because the midwife saw signs of serious tearing coming.  I didn't have one with DD2, tore a little, but didn't need stitches, and the recovery was SOOO much easier than the episiotomy reocovery had been.  On the whole, they highly discourage them here, which is good. DD2 turned out to be a 10 pounder, so I'm amazed I made it without worse.

On the whole, I felt more rushed with the consultant led birth.  It wasn't as personal, but it wasn't bad.  I was so thrilled to have my little one with me.  The midwife led birth was a beautiful experience that just went at my own pace and was much more natural.  The American in me still bristles a little that if I choose an epidural, I have the choice of that lovely midwife-led unit taken away and am forced into the less-personal consultant led, but it isn't too bad.

Next time, I won't have a choice.  Since my baby was so big.  I will be forced to go consultant led this time.

Hi I had my baby at Eastbourne hospital in 2010 they offered
Me a couple of pain killers but I chose epidural
I ended up having an emergency c section after
I was fully dilated and she wouldn't come out.  I found most of the staff
Helpful but did find the ward experience a bit weird after being used to
Private American hospitals.  I think it was an ok experience good luck

An American friend of mine had her daughter at Conquest Hospital in Eastborne, I can ask her what she thought of it.

I've had both mine here at two different NHS hospitals, with different experiences.

When I had my daughter I went into labor at +8 days the morning they had planned to induce me but wasn't far enough along to warrant a room on the labor ward. They offered me the option of going home for a bit or staying. Because my Dad was at my house I didn't think that was a good idea so I stayed.  Unfortunately that meant I got stuck in a room in the antenatal ward with 3 other women and my husband couldn't be with me.  I should say I have since been told by a midwife at that hospital that is not the norm and should not have happened.  Eventually I progressed enough that me and hubby and Mom went to a labor room, which had it's own toilet and bath.  They decided baby wasn't coming down on her own quick enough and took me to theatre where they did a ventouse and got Jean out.  Because I had the ventouse I had an episiotomy, wouldn't have had one otherwise. I  used gas & air.  Then we went back to the labor room for a couple hours where I had a bath and cleaned up while Jean got lots of cuddles from her Daddy and Grandma.  Then we went to a room on the postnatal ward, with 4 beds and a shower & toilet.  This was a HUGE fairly new teaching hospital about a year old at the time. We ate in our rooms but had to collect the food from the hallway. There were drinks and biscuits available all the time though. I went home 2 days later after very little sleep. 

With my son I changed hospitals because of my personal feelings about my daughter's birth and my early pregnancy treatment.  This was to an older, smaller non-teaching hospital circa about the 1980s.  Again I went into labor at +8 days and after one too early trip to labor ward I ended up right into a lovely large room.  The midwife drew me a bath with Frankinsense and Sage or something or other like that in it and made both of us cups of tea  The bath and toilet were in a room across the hall from the labor room I was in.  I spent the next few hours on a birthing ball, debating whether to try the funky thing in the corner (have since found out it's called a combitrac - see this link http://www.thisisnottingham.co.uk/New-safer-births-city-hospitals/story-12252979-detail/story.html#|).  Never did get over there but happily gave birth in that labor room with gas & air and no episiotomy. Had to go to theatre after to be stitched up but the midwife who delivered Thomas stayed with me the whole time and after.  Back to the labor room for maybe an hour, had the best toast EVER made by my midwife and more tea then upstairs to ward.  Again 4 beds but this time shower and toilet down the hall so just pushed Thomas down in his "fish tank"  .  Was offered to go home that evening (had him at 9:30 am) but as pediatrician wasn't available would have had to bring him back next morning so just went ahead and stayed.  They recommended we eat in the day room down the hall where you helped yourself to breakfast and ordered what you wanted for the other 2 meals.  Again drinks and biscuits available all the time. Went home just after lunch the following day after photographer came and took lovely pics of my sleeping boy 

So really it can vary so much hospital to hospital.

As long as you and baby are healthy they will tend to send you home as soon as possible after giving birth.  This is due to their belief that you'll recoup better in the comfort of your own home rather than in a hospital.  Also, for the first 10-days after baby is born (whether a home birth or a hospital birth) you're still under the care of your community midwife, who will come to your home to check to see how you're doing and coping.  After you've been discharged by the community midwife, you'll get a home visit from your community health visitor, who is a nurse that you can turn to for general help and support from birth to 5yrs.  So, just because you've left hospital, doesn't mean you don't have a medical support network. 

Birth-wise, here in the UK you're in charge of your notes and your birth plan.  Obviously, depending on your past medical history and how your past births went that can affect the way your birth is monitored and guided here, but generally, as long as you're not putting yourself or your baby at risk, you have the ultimate say (not your partner etc.) in the delivery room as to how you want your birth to go.

As mentioned by others, I think the natural methods of pain relief are pushed before drugs, but ultimately the decision is yours (unless timing or for monitoring reasons the drugs would not be beneficial).

As for what pain relief is available, you'll need to familiarise yourself with the individual hospital you're looking to give birth at and what their policies are on epidurals etc. if that's part of your birth plan.  My hospital, where I had both of my children at, had a policy with epidurals that they would only be electively offered during "normal business hours" (Mon-Fri 9am-5pm), but out of hours or weekends they were for emergencies only, though they were looking to possibly change that.  But, that was something my Midwives and OBGYN let me know about in advance.  Personally, I had Entinox, TENs and Diamorphine for my first birth and TENs and Entinox only for my second.  Both of my children had to be induced as they were overdue.  My first birth was 13 hours from start to finish and my second was just under 4 hours.

Again, for Maternity and birthing wards, that varies from hospital to hospital.  I had each of my children in private birthing rooms, which was standard for every Mum at my hospital, but within hours of giving birth I was moved onto the post-delivery Maternity ward.  With each of my children I was kept overnight for observation because of slight complications during birth (an unexplained excessive bleed with my first and my son pooed during birth with my second), but always felt that I had support of the midwives on duty.  Generally, here in the UK babies are kept at their mother's bedside.  This way you can feed your baby and bond with them if you do end up staying in hospital.  You'll find your baby will be tagged on their feet and wrists, and that all staff coming to check baby should check all tags and yours to make sure that there's no mix ups.

If you want your own private room post-birth you'll have to check with the hospital you're looking to give birth at, as to their policies.  And, be prepared for the eventuality that you possibly may end up on ward anyway, as they usually only have a limited amount of private rooms, which will be paid for on a first-come, first-serve basis.

When you are discharged from the hospital, you'll usually already have a visit lined up and be made aware of who your community midwife is and how to contact them if you need to speak to someone about any concerns you may have.  Comminity Midwife visits happen 7-days a week, so their care is usually quite thorough in trying to look after both Mum and baby.

If you have any more questions just ask.

PS - have you seen the show One Born Every Minute http://www.youtube.com/user/4oDDocumentaries?