Hospital and midwifery-led units

Most hospitals and midwifery-led units (MLU) have a range of facilities available such as a birthing pool, beanbags, birthing balls etc, and these can make life much easier if you have PGP as they support you in keeping active and managing your pain. One of the main aims is to remain mobile and avoid lying on your back with your legs in stirrups, which is when most strain can be put on your pelvis and seems to be the cause of more long-term problems for many women.

MLUs may be freestanding (i.e. not on a main hospital site) or alongside a main hospital unit, although they may be on a different floor from the main labour ward, also known as an obstetric unit (OU). They provide the same care for low-risk women as an OU in that a doctor will not be involved in your care, but the difference is that a doctor is not present in the MLU. The environment tends to be more homely in an MLU, and they have the facilities to deal with an emergency, but do not have access to epidurals, and should you need an emergency delivery with forceps, ventouse or by caesarean section, you would need to be transferred to an OU, usually by ambulance.

For most women at low risk of complications in labour (which is around 45% of women), MLUs offer the best outcomes for you and your baby. It is recommended in the Intrapartum Care NICE guidelines that for women who have their baby outside of hospital, there is less chance of complications which would require intervention and this is therefore a better experience for women with PGP.

Water birth can be particularly helpful for women with PGP as it allows you to move around easily and change position, as well as giving you the normal pain-relieving effects of water.

Communicate your needs

• Make sure that the people caring for you know about your PGP and what you can and cannot do. You can use your birth plan to do this. It is a really good way of giving information to the team looking after you by describing what you can and cannot do. See our Birth plans page for guidance.

• When you arrive at the MLU or labour ward, tell the midwife that you will need extra help on the ward. You should be offered a room with en-suite facilities if one is available. Mention that you need an adjustable bed and cot, and any other equipment you need. Don’t forget your crutches if you have them, as distances on the ward tend to be much greater than at home.

• Let the housekeeping staff know that you cannot collect your food from another room; they will then bring it to your room. Write your order on the menu form each day. If anyone is awkward or unhelpful about this, do not take it personally. Wait for someone else to come along. Taking proper care of yourself now should reduce further damage to your pelvis and should speed up your recovery.

• Ask to have a bedside cot and an adjustable bed for when you return to the ward. The cot is bolted to the bed and makes it easier to get your baby out, especially if you’ve had a caesarean section. There may also be adjustable-height cots available so try asking to be given one of these. Alternatively, ask for a side to be put on your bed (a cot side) so that you can have the baby in bed with you safely.

• Ask to see the physiotherapist while you are in hospital, so that he/she is aware you are there and can raise the awareness of the midwives caring for you (unfortunately, in most hospitals the physiotherapists are not available at weekends). Also, it may be an opportunity to see an occupational therapist (OT) if you have not already done so and ask for some equipment/advice.

• Make sure you are given enough pain relief and that it is administered regularly so that you are comfortable. This is particularly important after you have had your baby. Beware that pain relief masks pain (which sounds obvious) and that you should therefore be wary about rushing about doing more until you have stopped taking pain relief and are confident that you really are pain-free. Otherwise you may irritate your joints and not discover this until you reduce your pain relief.

Going home

• Your community midwife, GP and health visitor should receive a discharge letter communicating your condition and needs.

• The hospital or MLU midwife will discuss your care needs before discharge.

• The community midwife will continue your care at home.

• The doctor and midwife should review your pain relief and arrange adequate medication to take home with you.

• A follow-up appointment for the physiotherapist should be arranged as necessary.

Content reviewed and updated in 2017.