The below information will tell you all you need to know about maternity service changes if you’re living in the RGH hospital area and due to give birth this year or are thinking about planning a family.

If you have further questions your Midwife or Consultant Obstetrician will be able to explain the changes and how they may affect you.

What’s changing in the Royal Glamorgan Hospital and why?

Several years ago there was a big public consultation, known as the South Wales Programme, about the future of maternity services across South Wales. Due to difficulties with medical staffing it was decided that some services led by specialist doctors couldn’t be provided at every single hospital in the area.

The outcome of this consultation means that from 9th March 2019 services for women who are likely to need doctor-led care when in labour or for babies needing specialist neonatal care will no longer be provided at the Royal Glamorgan Hospital in Llantrisant. Instead, these services will be provided at Prince Charles Hospital in Merthyr Tydfil.

This does not mean that we are taking maternity services away from the Royal Glamorgan Hospital.

Maternity services will still be provided 24 hours a day but they will be provided by midwives in the new Freestanding Midwifery-led Unit and not by doctors.

All antenatal services, clinic appointments, scans and tests during pregnancy will still be available there exactly as they are now. The only difference is the services that will be available to you when you go into labour.

You can choose to have your baby in either Royal Glamorgan Hospital or Prince Charles Hospital, but if you have a complicated pregnancy or need doctor-led care when you are giving birth you will need to deliver at Prince Charles Hospital. Your choice on where to give birth can be discussed with your Midwife and Obstetrician. If you need doctor-led care, we would advise going to Prince Charles Hospital, but if possible we might be able to support you to go to Princess of Wales Hospital in Bridgend.

To prepare for the changes, we have invested £6m into a new state-of-the-art unit at Prince Charles Hospital. This will increase the size of the special care baby unit, develop two new maternity theatres, and create new ensuite birthing rooms to include one birthing pool for women receiving doctor-led care. There will also be an Alongside Midwifery Led Unit, known as Tair Afon Birth Centre. This will include a number of birthing suites, two of which will have birthing pools.

So what are my options for birth after 9th March 2019?

This is an exciting time for Cwm Taf as it will be the first time that the service can offer all four options for women to give birth. These are:

*At Home- where you will be supported by our expert team of community midwives.

*In the new Free-Standing Midwifery-led Unit (FMU) in the Royal Glamorgan Hospital. Here you will be able to labour and give birth in a homely environment and experience a water birth with midwives as the lead professionals. There will be no doctors present at the FMU, so in the unlikely event of any complications you would need to be transferred by ambulance to a doctor-led unit.

*The new Alongside Midwifery-Led Unit (AMU), known as Tair Afon Birth Centre, in Prince Charles Hospital. This also offers a homely environment with access to two birthing pools. Midwives will be the lead professionals for this service. There will be no doctors in this unit but it is located alongside the doctor-led unit so if you have any complications you can be easily transferred across if necessary.

*Consultant-Led Obstetric Unit (OU) in Prince Charles Hospital. Care will be provided by midwives as well as doctors in our new state-of-the-art delivery unit which has newly furbished rooms and a birthing pool. The neonatal unit has also been expanded in Prince Charles Hospital should your baby need special care following birth.

Is it safe for me to have my baby in one of the Midwife-Led Units?

For women who are at low risk of complications, giving birth is generally very safe for both the woman and her baby. National evidence through NICE (2014) and the largest research study to date called the ‘Birth Place Study’ reported that for uncomplicated births midwifery-led units are safe and have benefits for both mothers and babies. You will have been given a leaflet about this at your booking appointment.

During your pregnancy you will have plenty of opportunity to talk through your birth options with your midwife and this will start from the early stages of your pregnancy, providing you with ample time to explore any questions you may have.

Research has shown that ‘adverse outcomes’ for babies are rare regardless of where women plan to give birth, occurring overall in just 4 or 5 births in every 1,000. Following the publication of the Birth Place Study findings, NICE (2014) now advise healthy women experiencing a ‘low risk’ pregnancy to give birth at home or in a midwifery-led unit.

If you haven’t received a copy of this leaflet please ask your midwife for a copy as they will be happy to send you one. Further information regarding the Birth Place Study findings can also be found at www.npeu.ox.ac.uk/birthplace

How will I know if I am a ‘low risk’ pregnancy?

There are very clear guidelines about what ‘low risk’ means and constant assessment helps to identify who is suitable to give birth in a midwifery-led setting. Your midwife will be able to discuss this in detail with you during your pregnancy. All care plans are under constant review and if you are on a midwifery-led care plan and anything should change this will be referred to a consultant obstetrician for review.  If you are ‘low risk’ you can still choose to have your baby in the consultant-led unit in Prince Charles Hospital should you decide this as your preferred option.

What if I decide to give birth in the Midwife-led Unit at the Royal Glamorgan Hospital and I need to be transferred?

There are some occasions when women will need to be transferred to a doctor-led unit during labour. We know that the number of women being transferred out of similar units in labour is 12 to 15 in every 100 with about half of these being first time mothers.

Where these transfers ‘in labour’ take place, the vast majority (well over 95%) are not for life-threatening events. The most common reason for women to be transferred is because labour hasn’t progressed as quickly as we would like.

In the unlikely event this should happen, you will be transferred by ambulance to Prince Charles Hospital. We would advise going to Prince Charles Hospital for doctor-led care, but if possible we might be able to support you to go to Princess of Wales in Bridgend. We will talk to you about this before labour.

We are working closely with our colleagues in the Welsh Ambulance Service and arrangements will be in place to ensure that the transfer process is as smooth as possible. A midwife will always accompany you in the ambulance if you need to be transferred in labour.

What happens if my baby is born in the Midwife-led Unit in the Royal Glamorgan Hospital but needs special care?

Our highly skilled midwives are trained to give all babies appropriate care at birth. Less than 1% of babies will need neonatal care. Often this can be predicted during pregnancy or early labour in which case you will be cared for or transferred to a consultant-led unit. In the very rare event that a baby is delivered in a midwifery-led unit who then requires neonatal care, our midwives are trained to stabilise the baby and together with our ambulance colleagues will transfer you and your baby to the appropriate neonatal unit. Most babies will be transferred to the neonatal unit in Prince Charles Hospital. However, on the extremely rare occasion when a baby might need very specialist care, he or she will be transferred to the neonatal unit in the University Hospital of Wales Cardiff.

What do I need to do now?

You don’t need to do anything now. We will keep you updated throughout your pregnancy and we will give you all the information and guidance that you need to help you make the right decision for you and your baby.

You don’t have to decide where you are going to have your baby before 36 to 37 weeks of your pregnancy, so for now, just relax, enjoy your pregnancy and let us look after you until then.

If you have any concerns at all in the meantime your midwife will be happy to talk them through with you.

Where can I find out more information? 

To find out more about the Freestanding Midwifery Unit at the Royal Glamorgan Hospital please talk to your midwife. You can also read further information about the FMU and choosing where to give birth on our ‘service changes’ page on our website at cwmtaf.wales

If you have further questions you can email  [email protected] or [email protected]