RPA Birthing Centre & Labour Ward

**CroMama** · 06-11-2007 15:05

I just wanted to know if anyone had their babies at the Royal Prince Alfred Hospital in Camperdown and whether it was in the Labour Ward or the Birthing Centre? What is the difference between the two & what was your experience like, good or bad?
I went to RPA this morning to book in to have my 2nd baby (1st was at Westmead but its booked out?) & the lady asked if I wanted Labour Ward or Birthing Centre. I wasn't sure so just said Labour Ward as with my 1st baby I was induced due to Pre-eclampsia.
Anyone have any experiences with RPA? Thanks for reading...

**doulacara** · 06-11-2007 17:24

I had #2 in the Birth Centre - totally recommend it. If you are looking for a more natural birth without intervention, this is definitely the place to go over the labour ward. If intervention is warranted, or you change your mind about drugs, you can transfer - easy peasy. I was there almost 4 and a half years ago, but I found that even ante natal appointments were so much more relaxed than the regular cattle yard of the labour ward. Change to the birth centre - go on!

C

**~Kimba~** · 06-11-2007 19:35

I had my DS at RPA in Oct 06. Was booked into Birth Centre but ended up in Labour Ward due to complications during induction and labour and despite the birth experience being quite distressing/ traumatic at the time, I was glad of the care they provided. If we're still living in this area I'll definitely have #2 at RPA and hopefully get to deliver in the Birth Centre next time!

I booked into the Birth Centre when I was 6 weeks and while I wanted all-midwife care I had to do Shared Care with a GP for my antenatal appointments, because I was told the BC were so busy I wouldn't have been able to get an initial midwife appt till I was almost 20 weeks along. So I did Shared Care and only got to have my final few antenatal appts with the midwives, so I never really got to build up a relationship with most of them which was a shame.

If you can do it I'd recommend having all your antenatal appts with the midwives, and it's much nicer to go to the Birth Centre for antenatal appts than to the regular RPA Antenatal clinic where I had to wait many hours to be seen, even with an appt, on the couple of occasions I had to see one of the ob registrars.

I ended up almost 2 weeks overdue so I had to be induced, normally this would mean Labour Ward but when labour commenced after the gel insertion they still let me go to the Birth Centre, so I was really happy about that.

However when I arrived at the BC the middie broke my waters (apparently she felt it necessary to 'speed things up') and there was fresh meconium in the waters, so I was immediately transferred to Labour Ward, stuck on the synto drip and 9 hours later ended up with an emerg c-section as my bub was posterior and deflexed and basically stuck.

In general (with a couple of exceptions) the midwives in RPA Labour Ward were great and many seemed nicer/ more caring than some I'd dealt with in the Birth Centre. I had a middie with me for my whole labour as bub was being monitored continually. It took ages to get a much-needed epidural though! (about 2 hours from when the middie ordered it)

RPA is a great hospital however they are extremely busy and will often tell you they're short-staffed, so be warned, even if you book into the Birth Centre you aren't guaranteed that's where you'll deliver: if they're full, or closed due to no staff (which happens on occasion) then you'll end up in Labour Ward, or even get sent to Canterbury hospital if Labour Ward is full.

I thought the RPA postnatal care was very good and there were some wonderful midwives and lactation consultants in the maternity ward, although again being so busy sometimes it took a while for someone to respond to a call.

A couple of things about RPA...

1) Especially for antenatal care, they are really busy, you feel a bit like you're a statistic/ part of a herd! and sometimes it felt like actions/ decisions were based on 'rushing you through' rather than individual needs - I'm sure most public hospitals are the same though? Also it felt like you had to really push and ask repeatedly to get information or action on things (both antenatal and postnatal in the maternity ward)

2) Even in the 'natural' Birth Centre they still found it necessary to 'intervene' by breaking my waters, even though at that time there was no indicator that this needed to be done. This is apparently RPA's induction policy, but I know of other hospitals/ centres that don't do it - so it felt like it was done purely to speed things up to free up the birthing room. As it turned out though this was a blessing in disguise as it was the first indication we had that my DS was going into distress.

3) After my emerg c-section even though my DS and I were both fine they refused to let me keep him with me him in recovery for skin on skin time and a first feed, despite me specifically asking for it, which I found pretty hypocritical for a 'breastfeeding friendly' hospital...

If you have the choice then I'd suggest booking into the Birth Centre because the BC antenatal care is much easier going than the regular Antenatal clinic, and it keeps your options open. After all you can always transfer to Labour Ward if there are any complications, or if you decide that you need stronger pain relief during your labour (the BC only offers gas and pethidine). But if a natural/ drug-free birth isn't your thing or you can't get into the Birth Centre then I can highly recommend the Labour Ward too.

Hope this has helped!

**CroMama** · 08-11-2007 14:44

Wow, thanks for taking the time to reply ladies, especially Kimba! Sounds like you had an experience to remember, but glad everything turned out fine with you and bub!
Well I called the RPA Birthing Centre today & luckily there is room for when I'm due (late May 08). So I booked in with them & asked for all midwife care, hopefully will get it.
I just wasnt sure as when I went there on Wednesday the receptionist said I couldnt switch from Birth Centre to Labour Ward during the labour so it scared me a little. But its reassuring to know that you actually can switch if something goes wrong or need stronger drugs.
Also it will be easier tagging my toddler along to the appointments at the Birth Centre with less waiting time. When I was at RPA on Wednesday the Ante-natal clinic waiting room was full of women & I thought 'oh here we go again'. Public hospitals I guess!
Thanks again ladies, you convinced me to switch!

**lilpearl** · 09-11-2007 10:45

Great to hear you got into the birthing centre. I had my second baby in the RPA birth centre in October, '05, and it was a good birth. I had a water VBAC, and I was almost treated as just another mother birthing. I agreed to a canula, which is their "just in case" policy, deciding it wouldn't bother me and it'd get them off my back. Their other policy for VBAC was managed 3rd stage. If I had my time again, I'd really try and get a physiological 3rd stage (which I had with my homebirth with my third baby), but at the time, I was happy to have 3rd stage over with anyway, as I tore and that was hurting, so I just wanted more relief. It was a great experience, but I do think the midiwives were a lot more hands-on than, say, an independent midwife, and during my waterbirth, the midwife coached me, which I really don't believe in ("push, push!"), as it's much better to breathe a baby out, that way you both get more oxygen, and there is far less chance of tearing. Anyway, The pre-natal appointments were lovely, as you really don't feel like you're in a hospital in the birth centre, so it's less daunting (beautiful hospital that's for sure!). I dicided to have a couple of days in the maternity ward after the birth, but you can go home staight away (which, if I had my time again, I would have done). I didn't like my stay in the maternity ward, I wasn't happy with many of the staff members, (a lot of them seemed to like the sound of their own voice) and it wasn't restful at all.....+, the food was so disgusting, I couldn't get out of there fast enough, just so I could actually eat something!

That sounded a bit negative....I applaude the RPA for having a "no continual monitoring" philosophy...they go with the evidence there, and I really enjoyed my labour, and remember the place very foundly (and that says a lot, coming from someone who is now super-keen on only having homebirths from now on (if I have more children....my homebirth was my best birth

).

**~Kimba~** · 09-11-2007 20:20

Originally Posted by Liana

I applaude the RPA for having a "no continual monitoring" philosophy...they go with the evidence there

Hmm interesting, do you mean only in the Birth Centre - in which case I thought all BCs were the same - or in RPA in general? Because with me, as soon as they saw the meconium in my waters I was whisked to Labour Ward and strapped to the bed on my back for synto drip and continual monitoring (CTG and scalp clip for my son, which I wasn't asked if I consented to) - and even though I specifically asked NOT to have the monitoring because I wanted to keep moving and use the shower/ bath for pain relief, I was told I had no choice.

Anyway OP I'm glad you got into the Birth Centre and yes it will definitely be much better taking your toddler there for your antenatal appts, they are usually pretty much on time too which is great. It's perplexing to hear that you were told you couldn't transfer from the BC to Labour Ward in labour, as we were told repeatedly that if we decided we really needed an epi or if there were any problems at all during labour (as I sure found out!) then we would be transferred to Labour Ward. You might want to discuss that with the middies in more detail?

Hope that all goes well with your pregnancy and birth, wherever you have it

**lilpearl** · 10-11-2007 15:39

Originally Posted by ~Kimba~

Hmm interesting, do you mean only in the Birth Centre - in which case I thought all BCs were the same - or in RPA in general?

I mean in regards to my VBAC, as there is no other birth centre in Sydney (or Melbourne) that allows VBAC. The RPA, however, treat VBAC women like human beings though, and when I initially saw an ob in the birth centre to screen for my eligibility, she simply said "we don't (meaning the RPA) do continual CTG monitoring, as there is no evidence to suggest it leads to better outcomes", which is so true, (if used as simply policy and not for a true, specific reason). Scalp monitoring, with CTG monitoring HAS been shown to have better outcomes for babies who are thought to be in distress, though - so they probably did the right thing by you

**doulacara** · 10-11-2007 18:02

I agreed to a canula as well - which they wanted due to a previous significant PPH, but was encouraged to have a physiological 3rd stage by the midwives on the day. I am ashamed to admit now, that at the time I had not done any research into 3rd stage and didn't even realise it was an option - so despite my previous blood loss, it was the midwife who really decided I would have a physiological 3rd stage and then offered me homeopathics when I bled later to try and avoid putting up IV synto. It worked and I went home that evening. Yay RPA I say, for starting me on my journey to birth junkie-dom.

Cara