indepenent midwives, doulas and private hospitals - are they worth the money?

[Carriel]

Really sorry to bother you guys again, but we?re in the final stages of writing our second book; mums on pregnancy, and are a bit short on some information. We wanted to hear from anyone who has either used an independent midwife or doula, during labour or had their baby at a private hospital. Please tell us about your experience. Did you think it was worth the money and would you do it again? Thanks so much for your help.

[motherinferior]

I know a former independent midwife if that's any use.

PPH has just had one, but may be slightly busy at the mo...

[expatkat]

I used a private hospital both times when I gave birth. Is it worth the money? Depends. For me, yes.

1. Americans (like me) tend to be brought up with a sense of pregnancy as a medical condition. We know it's a false way to think about pregnancy, but it's just the way we are raised. So having a doctor around even during a perfectly normal labour and delivery feels, for us, sort of standard and necessary. I have learned that midwives are amazing and can do the job as well or better than doctors most of the time, but a lot of us just view the presence of a doctor as a reassuring safety net. (Apologies to any Americans who don't feel this way; I can't speak for everyone, just for myself and the Americans I know here.)
   
2. I have heart condition, and knew I could be immediately and quickly linked up to a cardiologist if necessary just by making a phone call to my obstetric consultant. I feared the process would take longer in the NHS--but that may have been my imagination.
   
3. If you have good insurance through your work or your partner's, the insurance will pay for most or all of your medical bills plus hospital stay. In my case, insurance paid for ALL of the expenses incurred by both my pregnancies and births.
   
4. I was not interested in the luxury afforded by private hospitalsand, in fact, chose a scruffy place for my second birthbut there are people out there who do care a lot about a nice room, a private bathroom, decent food, and lots of postnatal attention. I guess for those people, that's an additional reason why it might be worth it to go private.
   
   So basically it depends on the type of person you are: how you view childbirth, what your medical history is, how good your insurance is, and how important luxurious surroundings are for you. For some people it won't be worth it at all; for others it will be.

[pupuce]

Hi Carriel
Of course I am biased
I do know several mums who I am sure would be happy to share their recent views,.... they are not on mumsnet (at least I am not aware they are).
You can contact me off line if you want... I do know that because it's the book you will probably prefer to have testimonies from contributors to the site !

[aloha]

I had my son privately (!) at Kings because it was covered by my medical insurance as I had placenta praevia. Most health insurance doesn't cover pregnancy in my experience. My c-s was with a private consultant (maggie Blott) who I chose because of her experience with problematic c-s. I had a room in the private wing and it had pros and cons. The pros - nicer room, better food, privacy, one on one midwife care and - undoubtedly the best thing - unlimited visiting so dh could visit and take ds and I could sleep. HOWEVER, the downsides were, felt cut off from the ward and other mothers (didn't think I'd feel like that but I did), I couldn't sleep anyway as the private night shift midwife had to stay in the room with me for first two nights and I can't sleep like that. After that ds cried a lot and I didn't know what to do. I felt cut off from the stuff I might get better access to in the main maternity dept - eg breastfeeding counsellor and even the baby photographer. I could have gone to the Portland but decided against it as I wanted a hospital with full facilities in case anything went wrong and most private hospitals can't offer that. There were unexpected expenses that insurance didn't cover and a bit of paperwork and I am glad I didn't pay for it. I would choose NHS in future even though it is grim as I'd rather spend the money in other ways. My consultant was brilliant but she also works for the NHS. I seriously thought about a maternity nurse when ds just WOULDN'T sleep through for month after month after month, but dh didn't want a stranger living in our house, bossing us about.

[twiglett]

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[louli]

I had my son privately last year. My choices of NHS hopitals had really bad reviews in the Good Birth Guide and I felt worried about going to them. From the start the midwives and my consultant were great and I didn't ever feel rushed with my appointments as you often do with a GP. You have so many questions first time around and it can all be quite frightening so it was nice feeling that you had people there for you. The way things turned out I don't regret having gone private after a 36 hour labour, emergency c-section and my baby having to go to the SBCU with strep B. The midwives, my consultant and the nurses were all very supportive and helped us through a very difficult time. Luckily everything worked out well and due to the way the birth went my insurance company picked up most of the costs. I think even if we had to pay all the costs it would have been worth it and would hope to be able to go private next time.

[Lamin]

I used an Independent midwifery practice and think it was the best money I ever spent. I decided to go private after a bungled nuchal fold scan at St Thomas's - told me I had a 1-100 chance of downs baby, I had further tests at the Fetal Medicine Centre and was told my risk was actually 1-6500. Nevertheless this caused a whole lot of anxiety during my pregnancy and I wasn't really convinced until I saw him. As a result I decided I had lost confidence in the NHS and chose private midwives. They were fantastic, I previously had been rather partial to the idea of an elective caesarean. My midwives patiently explained over and over again that my body had the power to give birth naturally and to go with it. I decided to go for a water birth and it was the most amazing experience of my life. I am absolutely convinced that without my midwives I would have ended up with a c-section. My waters broke on the Sunday but my contractions didn't start properly until the Friday, if I was at Chelsea and Westminster I would have been induced within 48 hours. My ds was also in a posterior position but my midwife managed to turn him internally which eased my pain ten fold. I could go on and on - I feel really strongly that everyone should be able to give birth the way I did but sadly this isn't the case. Worth every penny and definitely do it again.

[sleeplessinseattle]

hi carrie et al - I had my first baby in UK on NHS - 'failure to progress' caesarean which I suspect was unnecessary and I was pretty upset about later. I had my second baby in the US - terrified that I'd end up wtih another unnecessary caesarean. I hired a doula. It was without doubt the best thing I could ever have done for myself and my son. She helped me find the right hospital (lower caesarean rate) and switch to team of midwives instead of an OBGYN (who'd be likely to put more restrictions and rules on my labour). She also took me through a huge process of emotional preparation - coming to terms with my fears etc, planning how I'd handle my 'worst case scenarios' etc. By the time I was ready to give birth I'd regained confidence in my body, I'd come to terms with what happened before and wasn't scared. I knew that whatever happened I would be able to cope with it (even another caesarean) and that she'd be by my side. And I had a whole armory of practical techniques for pain etc. In the event, I hardly needed her. I just got on with it in my own way and had an amazing drug free 5 hour birth supported by switched on, flexible (but super qualified) midwives. American doulas are trained by a central organization (doulas of north america) and it's important to find the right one for you. But the studies all show amazing results with doulas, and my personal experience bore this out. do email if you want more on this. my doula was so fab that I'm now writing a book with her!

[CAM]

I asked my consultant about "going private" when I went for my first antenatal checkup with him at 8 weeks pg. He told me that I would be wasting my money (£2000 for a normal delivery) as I would still be under him without paying, would get the same care and treatments without paying and the only thing gained would be a private room at the end of the postnatal ward. Also you could buy a private room at £40 per night if you chose once you'd given birth (presuming one was free, private patients would get priority). I stayed NHS and as it happens, left hospital 8 hours after the birth without ever going near the postnatal ward, so would have absolutely been a complete waste of money for me.

[SamboM]

I would never go to a private hospital for any operation. They do not have crash facilities and the only doctor that they are obliged to have on site at night is an RMO (responsible medical office) who is often not qualified enough in my book (for eg a friend of mine who was a doctor 15 years ago and changed career has just gone back to it and was allowed to do RMO work immediately. A lot of them are from abroad where the standard of care and training is not as good as here.)

If something goes wrong you are better off in a big NHS hospital where surgeons of every description are on call. I know the aftercare is better etc in private hosps, doesn't do you much good if you are dead though.

If I had gone to a private hosp I v much doubt I would still be here.

[SamboM]

RMO - Responible Medical Officer not office!

[expatkat]

With regards to SamboM's post. . .just want to qualify that there are NHS teaching hospitals with private wings--and those obviously would have crash facilities. St Mary's in London is one example; a lot of people choose it because unlike, say, the Portland, it is part of a huge NHS teaching hospital and there is back up if something serious goes wrong.

[expatkat]

Also should add that I opted for St Mary's, & would only go privately again if it could be in that sort of hospital--a decent NHS teaching hospital, as opposed to a truly private hospital.

[SamboM]

expatkat, sorry should have been clearer. Obv private wing of NHS is fine, though you try getting a bed at Chelsea, they are always booked solid!

[pupuce]

To Sleepless post I would add that whether in the US or in the UK, if you look into hiring a doula you need to make sure you are happy with her competencies, experience and that you LIKE her (of course) - as you need to be confident that she will be able to support you and your partner in a manner which is adequate to your specific needs. Not all couples have the same needs.
Doulas who belong to Doula UK (the UK association for doulas) adhere to a code of practice, have trained, are mentored and monitored.

[pupuce]

To Sleepless' post I would add that whether in the US or in the UK, if you look into hiring a doula you need to make sure you are happy with her competencies, experience and that you LIKE her (of course) - as you need to be confident that she will be able to support you and your partner in a manner which is adequate to your specific needs. Not all couples have the same needs.
Doulas who belong to Doula UK (the UK association for doulas) adhere to a code of practice, have trained, are mentored and monitored.

[wobblymum]

Just out of interest, apart from phoning the hospital, is there anywhere you can find out how much a private room in an NHS hopsital would be? Just that I had a really bad time with my 1st pg and had to stay in for 2 weeks. The 1st was horrible because I couldn't get any privacy on the ward. For the first couple of days I didn't mind but after that it really got to me. But the 2nd week a mw, who saw I wasn't having a great time, got me a private room that was available, and I didn't have to pay. So if I have another one, I'd definitely want a room to myself again.

[SamboM]

wobblymum, depends on the hospital. Eg at Chelsea they are £650 per night !!!!!!

AND you can't get one for love nor money. My insurance co offered to pay for one but none were available. They give them to the proper private patients (ie those who have gone private throughout their preganancies) and if you are NHS and just wanting to upgrade for some comfort you don't really get a look in (though dd got one while I was in intensive care for free!)

[issywoo]

i was treated really badly with my first labour on the NHS - i was overdue and was booked in for an induction. i went in at 7pm and was sent home at 11pm because they were too busy, this happened all day the next day (13 days overdue)and they said it could happen again and again because there were people more urgent than me. my husband threatened to sue them if anything went wrong as a result of me being sent home and they eventually relented and after a 38 hour induction when i was mostly left on my own with an oxytocin drip and strapped to a monitor they finally decided to give me an emergency c-section at 15 days overdue. i also repeatedly drew their attention to my excessive swelling and rash since week 38 which they ingnored. during the labour the rash turned to blistering all over my body and intense itching and i repeatedly begged to be seen by a dermatologist - this went on for 2 days after the delivery until my husband told them he'd bring in a private dermatologist into the hospital and they made arrangements sharpish to send someone up. it turned out i had a rare auto immune pregnancy disease and had to go on steroids for 3 months. the induction and lack of care made my condition very much worse than it needed to be so now with no2 i'm going back to the same hospital but privately this time. the difference in care is astonishing and i think for me its money well spent.
my sister in law was induced the other friday and was finally given a c-section on tuesday evening. she was then discharged on the friday without having had a bowel movement and consequently spent last night in hospital with chronic constipation. i think she may go privately next time too

[bozzy]

Hi there,
I used a doula a month ago who came to my home to help me with the birth of my first child and it was fantastic and well worth the money! I first heard about doulas whilst in the US and when we came to the UK I decided I wanted a homebirth having done a bit of research and visited the London hospitals! When I first started my contractions, I called my doula who said she would come and stay the night "just in case" - it was 9pm. She called the midwife at 3am when I was fully dilated and I gave birth at 6am with no painkillers or stitches! My labour was 6 hours 50 mins in total and my husband and I had every confidence in our doula so I had no anxiety or stress which led to an almost pain free labour. I had a birthing pool on standby (which I didn't use in the end) and a TENS machine but all I ended up using was a cold flannel and cold water (it was the hottest day of the year). I lent over the edge of my bed for a few hours and gave birth to a boy at 6am! Two hours later, my husband, son and I were sitting up in bed eating cocoa pops! I would never have had the confidence to have a home birth without a doula and I would highly recommend it to anyone - it meant that my husband could be there for me without having to worry about whether to take me to hospital or not, whether to call the midwife etc. I know that I would have ended up in hospital if I didn't have a doula as it happened so fast and I don't think the hospital would have sent a midwife..as it was, the midwife who came took an hour to get here and I had never met her before...! Good luck to anyone who would consider a doula - well worth it for peace of mind if nothing else!

[katierocket]

bozzy, out of interest, how did you find your doula and how much did she charge?

[zebra]

Someone told me that the thing about private hospitals is that their back up is always the NHS. So if anything goes wrong, in theory you could be whizzed away suddenly in the middle of procedure (?or maybe even an operation?) from private hospital to NHS. True?

[bozzy]

Katierocket, the doulas are on www.doula.org and mine charged 350pounds. There was a reflexologist who I considered until she told me that she was going to charge 650 pounds and she has not had any children. Most doulas should have had children - I think this is important but it doesn't mean that she would not have been good - just think it is important that they have gone through a birth themselves! My doula was Liliana Lammers - I was recommended her but initially she was not available so I called other doulas on this website.

[pupuce]

www.doula.org.uk.... not www.doula.org

[wobblymum]

Thanks SamboM, I'm in Cornwall though, so the only problem would be the availability, as they always seem to be stretched for beds. I don't think anyone down here would dare ask to go private or even ask for a private room in case anyone thought they were too posh!