Cornwall only has one hospital trust for maternity care: Royal Cornwall Hospitals NHS Trust, with only one major hospital (Treliske).

But just because we don’t have the options of multiple hospitals, doesn’t mean we don’t have a choice when it comes to giving birth…

Gemma from Born to Birth thinks about the locations to give birth in Cornwall while holding a doula clients baby — **There are lots of places to give birth in Cornwall…**

This is going to sound stupid, but I didn’t realise people researched the hospitals and NHS trusts around them when choosing where to give birth.
Not until I became a doula anyway…

Having lived in Cornwall the vast majority of my life, I’ve always known Treliske (or RCHT as it’s formally known) to be ‘the hospital’ and so when it came to giving birth (and knowing I wanted to do this in a hospital setting) I never even considered going anywhere other than there. Truth be told, it’s the same for virtually all of my friends and 99% of the clients I meet now.

But - as with everything - doula training has revealed a lot about how it’s done elsewhere. As I heard stories of of ‘good’ birth places and saw the statistics shared by the home birth teams, birth centres and obstetric units themselves, it became clear that choosing a place of birth was a bit more complicated than it seemed here in Cornwall.

My first thought? Relief.

Phew, I thought. At least us Cornish lot don’t need to make these tricky choices. But then I realised that was not the case at all.

Working with birth across Cornwall like I do, soon shows you that there’s plenty of choice with regards to where to give birth. But it also highlights how few families take up the other options?

Is it because RCHT Treliske is genuinely the best option?
Is it because we don’t expect to go anywhere else?
Is it because we simply don’t know the options?

I am not here to tell you the best place to birth in Cornwall: that’s your decision to make. What I am going to do though is give you the unbiased information to make that choice.

giving birth in water at home in cornwall — **Where you choose to give birth (in Cornwall or elsewhere) DOES make a difference…**

Of course your priority is being in the safest place. The problem is defining exactly what that version of safety looks like for you …

Throughout history, the vast majority humans gave birth in their homes until the 1970s when the Peel Report said it was safer to give birth in hospitals. So the majority switched and birth was standardised. But then, in the 1990s, people started to acknowledge that this blanket approach to birth wasn’t working either, and that woman centred care was vital to positive experiences. And so, choice started being introduced into maternity care.

While this reintroduction of choice of where to give birth always good thing, it lacked substantial information about the real and relevant benefits and risks of the place of birth you were choosing. That is until the Birth Place Study of 2011.

Examining the risks of adverse perinatal outcomes (bad things) happening when labour took place in different locations, this study - and the follow-on ones that took place after it - dug into the relative definitions of safety for births taking place at home, in birth centres and on obstetric labour wards for all categories of mother.

What it revealed was that the choice of birthplace can really influence the way a labour or birth experience goes. For healthy women with low risk pregnancies and birth situations:

… vaginal delivery with fewer interventions was more likely outside of an obstetric or hospital setting.

… and who are second time (or more) mothers, there is no difference in risk between homebirth and a midwife-led birth centre.

… and who are first-time mothers, there is a 0.9% chance of a poor outcome during birth when planning a homebirth in comparison to 0.5% in an obstetric unit.

And importantly, for ‘high risk’ pregnancies, the label of ‘high risk’ did not necessarily mean that hospital was the safest place to give birth either. While some women did need the obstetric support, others did not; the huge variation of factors that signal a ‘high risk’ pregnancy or birth simply means that it’s not the same for all women with this label.

Gemma from Born to Birth Cornwall talks about the pros and cons of the places you can give birth in cornwall — **So what does all of this actually mean for you as you choose where to give birth in Cornwall?**

Well, it emphasises the importance of three things:

There is no such thing as a universally perfectly safe place to give birth.

Understanding the risks and benefits of your birth place options will help you make an informed decision about what’s safe for you.
Having the confidence to choose the place that feels right for you, despite what others say or recommend, can hugely influence your birth.

Where can I give birth in Cornwall?

Unless you have a desire to give birth out of county (which you totally can do by the way), there are four places you can give birth in Cornwall:

1.Give birth at home in Cornwall

Cornwall is served by a homebirth midwife team which runs county-wide. Independent midwives are also well equipped to support home births across the county but you’d need to find, hire and fund one of these privately.

Pros: home comforts can help people labour better, lower rates of intervention, no need to disrupt labour with a transfer to hospital, support of midwives used to seeing physiological labour.
Cons: limited drug-based pain relief options, potential limited availability of midwives and ambulances for emergency transfer.
Things to consider: home-births in Cornwall are recommended for low-risk pregnancies and births; if you are high-risk at booking, or develop into a high-risk category through your pregnancy or labour, advocating for homebirth support may require negotiation, time and effort. Additionally, staffing can be an issue as two midwives are required to support home birth and they will be coming from anywhere across the county.

2. At a free-standing birth centre in Cornwall: Penrice and Helston both have midwife-led birth centres which, as free-standing facilities, are associated with lower intervention, physiological births despite being a more medicalised setting than home.

Pros: quiet and private as you’ll be the only one labouring here; calmer than a hospital environment. Both facilities have full size birth pools and a whole range of equipment designed to promote physiological birth. They’re associated with lower rates of intervention and caesarean birth; usually staffed by homebirth midwives.
Cons: you still need to transfer from home to the birth centre which could be disruptive. Not all drug-based pain relief is available here and transfer to hospital required if further medical support is required; potential limited availability of midwives and ambulances for emergency transfer.
Things to be aware of: while birth centres should be accessible for all low-risk pregnancies and births, if you are high-risk at booking, or develop into a high-risk category through your pregnancy or labour, advocating for a freestanding birth centre delivery may require negotiation, time and effort. Additionally, staffing can be an issue as two midwives are needed to run the centre.

CQC Report: Cornwall Maternity Services

3. At Truro Birth Centre, a hospital based birth-centre in RCHT Treliske: this midwifery-led birth space lies within the main hospital and is positioned directly opposite the obstetric unit and neo-natal ward. It’s a beautiful space that’s designed to support physiological birth with the reassurance of obstetric support right across the corridor.

Pros: birth pools and other equipment designed to support physiological labour are available in all four of the rooms; a quiet and peaceful environment that doesn’t feel like a hospital space once you’re into the centre. Very close to the obstetric-led delivery suite should you want or need to transfer for additional medical support at any point so no ambulance is needed.
Cons: the transfer rate to delivery suite is relatively high; people who choose to give birth in birth centres within close proximity to an obstetric unit (delivery suite) are associated with higher rates of interventions and caesarean sections and this is often concluded to be because the option to turn to medical support is a quick and easy one. Not all drug based forms of pain relief are available here.
Things to be aware of: Truro birth centre should be accessible for all low-risk pregnancies and births, if you are high-risk at booking, or develop into a high-risk category through your pregnancy or labour, advocating for a freestanding birth centre delivery may require negotiation, time and effort. Additionally, staffing can be an issue as two midwives are needed to run the centre.

4. On Delivery Suite at RCHT Treliske: this traditional labour ward is supports birth with a team consisting of obstetricians and midwives. Once in active labour, you can come onto delivery suite where you will have a private room and 1-2-1 care with a named midwife, and access to medical support and drug-based pain relief if needed.