Birth choices in UK

Maternity services in UK are mainly provided by NHS- National Health Services in hospitals and community units, depending on woman` s choices or presence of pregnancy complications.

1. Consultant units (available only in hospitals)
These units are mostly choosen by women who prefere "hi-tech" birth enviroment or women who have pregnancy complications and need active management of labour and interventions.

"A woman is usually booked under the care of a particular consultant, but may only see them rarely throughout her pregnancy. Most of her care will be given by midwives. If complications arise during pregnancy or labour, the doctors will become more involved. Interventions such as epidurals and Caesarean operations are usually available in the unit. "

         a.  Obstetrics consultants: specialists in birth where there are complications, like cesarian section
                       
         b.  Midwifery consultants: specialists in normal births

"Hospital midwives work within a hospital. They run antenatal clinics, help women giving birth in the hospital, and look after women staying in the antenatal and postnatal wards of the hospital. Their work usually gives them experience of interventions such as induction, continuous monitoring and use of epidurals for pain relief. They often work closely with doctors.

2. Other Maternity Units ( available in hospitals and community centers )

"These types of maternity units provide maternity care for women who have chosen a "low-tech" birth environment. They include midwifery-led units, GP units and birth centres. They provide friendly, personal care from midwives. They can be grouped according to whether they are at a hospital which also has a consultant unit, or if they are situated away from a main obstetric hospital (community units)."

          a. Midwifery-led units located in hospital

"Recently midwifery-led units have been opening up next to some consultant units. They are a "low-tech" option for women who want to give birth with little or no medical intervention although women can easily be transferred to the consultant unit if there are complications."

          b. Community Units ( GP units )
          mainly for prenatal consultations and surgical interventions through labour

          c. Birth centers

"Community midwives tend to give maternity care outside the hospital, although they will usually be attached to a hospital (or a GP surgery). They may give antenatal care in local clinics or visit women in their homes. They can attend women in labour or giving birth at home, or may accompany women to hospital to give birth. They also visit women and their new babies in their homes for up to 28 days following the birth. As they often work away from the hospital environment, many community midwives are experienced in helping women give birth without interventions. "

 d. Independent Midwives ( not belonging to NHS system)

NHS constantly evaluates maternity care provided within their system. They collect statistics about intervention rates and publishes them to be available for mothers who can more easily decide which type of care they want to choose for they pregnancy and labour. NHS provides this statement about Midwifery care:

" Midwives are specialists in providing maternity care where they are no complications and are the only health workers who do only this. As they are specially trained to look after women having babies, women only have to see a doctor if a problem arises. Since most women have problem-free pregnancies and labours, most women can have all their maternity care with midwives. Midwives are not nurses - midwifery is a completely separate profession, although many midwives have also trained as nurses. "

NHS encourages wommen to choose birth center`s care citing study which confirmed lower rates of interventions in low-risk pregnancies.

"A recent report on an NHS-run Birth Centre shows that women booked with the unit have fewer interventions in labour (even if they are transferred to hospital in labour) than low-risk women booked for hospital birth.^{4" (} Saunders, D., Boulton, M., Chapple, J., Ratcliffe, J. and Levita, J. (2000) Evaluation of the Edgware Birth Centre North Thames Perinatal Public Health)

I would like to ask which type of care would you choose for yourself if available in Kuwait:
1.Obstetritian or Midwife ?
2.Hospital or Birth Center?
3.Interventions or Interventions free?

Stayed tuned for Part 2 : Evaluation of Maternity care within NHS system