My due date was fast approaching when I had a moment of clarity. Or it might have been madness, I’ll let you decide.
I’d been receiving maternity care at a local hospital – the same hospital where my eldest daughter had been born almost three years earlier – and decided I really didn’t want to go back there to give birth.
So, at 34 weeks pregnant, I went online and did what I knew best: researched.
With my laptop perched on my ballooning belly, I looked at other hospitals and saw there were some decent options. But, palms all sweaty, I quickly realised it was the thought of another trip to the labour ward that was filling me with so much dread.
I briefly considered a home birth but realised I wouldn’t be able to relax properly if I knew our neighbours could hear me mooing away (and believe me they would be able to hear it – our walls are paper thin).
Then I saw something intriguing on Instagram of all places: a freestanding NHS birth centre and it was just 10 minutes further than the hospital where I’d been receiving antenatal care. How had I never heard about it?
Why I switched up my care
I’m not a particularly anxious person but the very thought of going back to that first hospital to give birth filled me with dread. Just thinking about it would make my heart race.
The thing is, I had always thought I didn’t have a particularly bad experience at that hospital – compared to the horror stories I’ve heard, it was a “walk in the park”. I was one of the lucky ones. My birth was relatively straightforward: it was a vaginal delivery, no interventions, and my baby was OK.
I experienced some tearing but didn’t really think much of it at the time because it was all quite numb down there. My partner got kicked out a couple of hours after giving birth, which I found to be the most distressing part of all because I had no idea how to look after a baby and was absolutely exhausted.
I remember spending the following 12 hours sat in a bloody hospital gown waiting for my partner to be allowed back into the hospital for visiting hours (cheers, Covid) so I could finally have a shower and hand our newborn over to him.
I was exhausted because I’d barely slept all night – my daughter had been born late the night before, so I’d been up all night checking she was still breathing and listening to the coughs of other mums on the shared ward, hoping they didn’t have Covid. It also happened to be the hottest day of the year which only added to my anxiety.
In the days and weeks after the birth, I experienced some issues with an infection and my stitches coming undone. I also saw a GP at my eight-week follow up appointment who checked my perineal area and suggested my tear had been worse than first thought.
“I was one of the lucky ones. My birth was relatively straightforward: it was a vaginal delivery, no interventions, and my baby was OK."”
Compared to a lot of other women who experience traumatic births – it’s estimated 30,000 women are impacted each year – my experience was, I believed at the time, OK.
Only now am I realising that actually… it wasn’t.
I felt I couldn’t really complain about the fact the midwife “popped my vein” – she failed to put a cannula into my arm before I was about to give birth, so we had to wait for a doctor to come and do it. My blood platelets had been on the low side so they thought they’d put a cannula in ahead of time in case I needed a blood transfusion or something – a thought which made me feel really relaxed!
Or the fact that I had to be on a labour ward because of those cursed platelets and all I could hear in the rooms along the corridor were screams.
Or the fact I had two midwives – an experienced staff member and a student – rummaging around in my vagina, one after the other, before delivery. It prompted a panic attack and, I’d argue, was more painful than birth at points. Now, I know midwives are short on time and we all have to learn, but I was not prepared for how painful that examination was going to be. And I wasn’t allowed an epidural because of the platelet issue, so I felt it all.
These things were all unpleasant, but nothing compared to what I’ve heard from other mums. I was a lucky one, right? My baby survived.
Some aren’t so lucky.
I’ve heard horror stories of babies being left with brain damage as a result of mistakes made during birth. I’ve spoken to women who have experienced physical injuries that have left them with bladder and bowel incontinence for years – potentially, for the rest of their lives. Black women in the UK are almost three times more likely to die during pregnancy or up to six weeks after birth.
I realise now – after years of mentally dismissing what had happened – that perhaps there was a reason why my body was going into fight or flight when I sat down to consider the thought of another hospital birth.
My body was saying no, and thank goodness I listened.
So, at 34 weeks pregnant, I switched up my maternity care. It’s fairly easy to do – I self-referred to the birth centre and then called the hospital and explained I was moving my care across.
I had to do another booking appointment (this is the first appointment you usually do when receiving antenatal care in England, where they check your weight, height, take urine and blood samples, etc.,), but on the whole it was an easy process.
And I cannot stress to you how refreshing it was to speak to the midwives at Edgware Birth Centre.
They were so relaxed and didn’t overly-medicalise things. I asked about my platelets again and they didn’t seem worried – my midwife was so reassuring and, unlike at the hospital where I’d seen a different person each time, this person was someone I spoke to continuously for the following six weeks.
It’s hard to express what a game-changer it was having the same midwife for my antenatal appointments. When we chatted on multiple occasions in the run up to the birth, I felt like I was a human, not just a number who was there to pop out a baby.
On the day I gave birth, I went to the birth centre at around 11am when my contractions were ramping up and called my midwife en route, who amazingly was on shift. They got a room ready for me and started filling the birth pool, as I’d asked if I could try that for pain relief purposes and also to help reduce the risk of tearing again.
When we got there, we went straight to the room and I nearly cried. They’d turned some fairy lights on and there was a diffuser pumping out a calming fragrance in the corner. The birth pool was trickling away. There was nobody screaming in the distance. The atmosphere was so... tranquil.
“Do you want a drink?” my midwife calmly asked me, and then my partner. We looked at each other in disbelief.
The next few hours were a bit of a blur but consisted of a lot of reassurance from my midwife and her colleague who kept telling me that I knew what I was doing, to listen to my body, and to let them know if I felt an urge to push.
I believe their kindness and reassurance, as well as the feeling of safety from being in this little sanctuary they’d created on my behalf, helped everything speed up a bit and by 2.30pm, our baby was in my arms.
I didn’t need stitches (thank you, birth pool) and by 7pm we were home.
It was a good birth – and I feel bad for saying that, because so many women do not get to have a good birth. I firmly believe that if I hadn’t switched up my care at the eleventh hour, it might not have been a good birth.
And of course, we can never know, but studies have found having a baby at a birth centre is as safe as giving birth in hospital, yet results in fewer interventions.
However, the story doesn’t end there. A few months after I gave birth, I received an email inviting me to join a consultation about the proposed closure of the birth centre. The NHS North Central London Integrated Care System said that, on average, only around 50 women give birth there a year.
Under proposed new plans, the birth suites could be closed however the birth centre would still provide antenatal and postnatal services. I couldn’t believe what I was reading.
Deflated by the proposed closure, I attended the online consultation and sat listening to other mothers who had received positive experiences there.
The stories I heard hammered home exactly what can happen if a maternity service isn’t overwhelmed with demand and midwives can truly focus on the people giving birth: they are treated like human beings. The midwives have more to give because they are not physically, mentally and emotionally exhausted.
The decision on the fate of the birth centre is due to be announced this spring.
Dr Jo Sauvage, chief medical officer at North Central London Integrated Care System, told me: “Your positive feedback is a great reflection of the midwifery team at Edgware Birth Centre. We want, above all else, for everyone who gives birth in North Central London to have a similarly high quality of experience, and this means making some difficult decisions.
“The proposed option that we put forward for consultation would see us retain and expand the antenatal and postnatal services at Edgware Birth Centre. For those who choose a midwifery-led birth, we are proposing to maintain the option of home birth, and co-located midwifery-led units which provide a home from home environment.”
It’s abundantly clear we need to keep banging the drum for improved maternity care in the UK and that means calling on the government to do more: to urgently prioritise and begin to fix the midwife staffing crisis and to funnel more money into maternity healthcare.
I appreciate money doesn’t grow on trees, but when the Care Quality Commission (CQC) warns that cases of women receiving poor care and being harmed in childbirth are in danger of becoming “normalised”, and 65% of units are not safe for women to give birth in, you know something is fundamentally wrong.
Action group Delivering Better is currently calling on the Secretary of State for Health and Social Care, Wes Streeting – who has openly said the maternity crisis keeps him awake at night – to improve maternity care with two key changes: the chance to see the same midwife throughout pregnancy and proactive health checks after the baby is born at three and six months. You can add your voice to the open letter here.
There’s a lot of work to be done when it comes to overhauling the UK’s maternity and postnatal care system – and one birth centre cannot change that. But if it helps 50+ women each year have a good birth, a safe birth, then I’d argue it’s worth its weight in gold.