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Childbirth

Private consultants for caesarean

60 replies

martha7731 · 04/03/2008 14:00

This question is not dissimilar to Kitstwins' question about consultants below, but with a slightly different emphasis!

Last October, I had an early miscarriage - it was my first pregnancy. Though I obviously can't know this, I'm convinced that part of the reason I miscarried was that I was in a state of terror about the whole process, particularly the birth part - to the point where I couldn't really eat/sleep/function at all.

I am now considering getting pregnant again - and also seeing a psychotherapist to try and deal with some of my issues beforehand so I don't go quite as mental this time! But what has become apparent is that the only way I could ever have a baby is by elective caesarean - and I don't say this lightly by any means, as I do know all of the many disadvantages and risks involved.

If I did get pregnant again, I would seriously consider going private (I'm based in London), so what I wanted to know was if anyone had any recommendations of private consultants who would be suitable given my various anxieties? I know that if I pay for a caesarean I can get one, but I would like a consultant who took my fears and choices seriously rather than simply writing me off as 'too posh to push'. Ideally within a private wing of an NHS hospital, but am willing to consider all options.

OP posts:
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helibee · 05/03/2008 00:13

hi, i would suggest that you get a private midwife. I used Amelia Parker www.essexindependentmidwives.org.uk/
I needed someone to be there for me exclusively as i have fibromyalgia and chronis fatigue. Amelia is excellent and she will fully support all of your choices and will become a good friend. I truly could not have done it all without her there. She also does reflexology which is very relaxing

As for consultants, i know that Dr Yehudi Gordon is highly sought after-he is at the St Johns and St Elizabeths in London. Hope that helps and i hope you get the pregnancy and birth you want [big hugs and hope for a safe pregnancy]

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Rochwen · 05/03/2008 16:30

Martha,you might find that with your very real fear of childbirth the NHS would offer you an elective c/s too. Have you tried speaking to them. You can also ask your psychotherapist to confirm your phobia in a letter to your GP and then it's in your files and I'm sure you'll get your elective c/s with no problems.

Good luck and don't let your fear keep you from having a baby ! It's magic !

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eleusis · 05/03/2008 16:34

I would steer clear of the midwives and stompmy feet in an NHS consultants office demanding a section. Don't take no for an answer.

Refuse natural childbirth full stop.

Oh, and choose your hospital wisely. Choose one with a high caesarean rate. One with a high doctor-patient ratio. I highly recommend Queen Charlotte for an NHS elective caesarean.

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Smurfs · 05/03/2008 16:40

agree with eleusis - now is the time to start the stomping of the feet. I have had 2 NHS electives on the basis that I never wanted to go through a vaginal birth. No medical reason but my/our personal preference. Happy mummy = happy baby in my book. If you don't get the answer that you want change consultants to find the more flexible one. Good luck with it all

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Rochwen · 05/03/2008 16:40

THat's a good point. Don't speak to a midwife. Go to your GP and get a referral directly to a consultant, armed with the letter from your psychologist. Consultants are usually quite happy to give you an el c/s.

I'm sure you can do it ! Save the money for your dc university days instead.

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margoandjerry · 05/03/2008 16:44

Midwives strongly prefer vbs not just because they are statistically safer (though I didn't and wouldn't have one myself) but also because in an ES situation, they basically hand over the reins to the drs which obviously they don't like.

I would echo the views on here - find yourself a friendly consultant (and insist on seeing one) and you might find you can get one on the NHS. My sister did, for similar reasons, at UCH though I wouldn't recommend there as they tried to discharge her the day after her section

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eleusis · 05/03/2008 16:45

Oh, and it helps if you show up pregnant.

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eleusis · 05/03/2008 16:51

I don't actually believe this line that vaginal births are safer. I think it's a load of scaremongering for the sake of their budget, not for the sake of your welfare. Cetainly not for your baby's. There is a view that uncomplicated vaginal births are safer. There is another (equally credible) view that uncomplicated (i.e. planned) casareans are safer.

There will be several posters here soon ot vehamently disagree with me. But there will be others who will agree.

I wish I has a tissue for every mumsnet birth story I have read about a vaniginal birth that went wrong and ended up in a disabled or dead baby. I've never read such a story on a planned section.

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mears · 05/03/2008 16:52

There is something a bit wrong here in the suggestion that midwives will not support elective C/S and should therefore be avoided at all costs.

Midwives do not resent doctors being the main care giver and I think it demonstrates an ignorance of maternity care provision to suggest that.

There does not require to be any stonping of feet either.

Birth choices are all about making INFORMED decisions. The elective CS route is not a safer option but may well be necessary for the mother in the long run.

I would not jump to private care initially but instead would have a full and frank discussion with both obstetrician and midwife. That can be achieved on the NHS.

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mears · 05/03/2008 16:55

eleusis - not going to enter a debate here but the evidence is available regarding the safety of CS.

I see birth first hand every day and can categorically state that not all elective CS deliveries are by any means straight forward.

I do not think your comments are at all helpful TBH.

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margoandjerry · 05/03/2008 16:58

eleusis, I have a suspicion you are right but I have no evidence for it.

My suspicion is that a lot of the problems caused by badly managed vbs are internalised by women (incontinence, sexual problems, trauma) so never register on the NHS cost radar. Whereas problems with a badly managed ES are surgical so end up costing the NHS money.

I don't really have an axe to grind here and don't want to upset anyone either way but your feelings rung a bell with me.

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Lulumama · 05/03/2008 17:01

i totally agree with mears, i could tell you stuff about c.sections that would give pause for thought.

at the end of the day, you are talking about major abdominal surgery.

there are pros and cons for each mode of delivery, but i am of the opinion that a vaginal birth should remain the norm.

and informed choice is the way to go.

sounds like the OP could have an elective on teh NHS without any foot stamping required

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orangina · 05/03/2008 17:08

martha, i was looked after by a lovely consultant at the lindo wing (attached to st marys paddington) after i felt completely anxious about all sorts of things, including the labour (it was dc #2, had dc#1 at st marys nhs, horridly long labour, etc, couldn't fault midwives, they were great, just felt v anxious about not knowing who was going to help me in labour, and getting pain releif in time etc). don't know whether he is particularly pro or anti cs, but do know he was very patient, kind, non-patronising, and I felt that all my fears and concerns were addressed calmly and intelligently. couldn't have asked for more. Would suggest if you want to go down the private route, that you choose your hospital (can recommend the lindo, though not as swishy as the portland or johns/lizzies), and meet a few consultants. trust your gut instinct.
in the end, birth fine, managed brilliantly by consultant (as far as i was concerned), and i feel positively nostalgic about it all, not a word i could have used at all re: birth of dc#1!
haven't had a cs, but have had abdominal surgery, the after effects were vile.

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orangina · 05/03/2008 17:10

ps: happy to give you details of consultant, can you cat me? should I have signed up to it?

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eleusis · 05/03/2008 17:14

It has been my experience that foot stomping is required any time you want anything on the NHS that costs it money.

Mears, I actually think and I've said this many times before on this website that you are one of the few midwives I have encountered who I feel I could trust.

Now, when I said avoid the midwives and go to the consultant I was perhaps stereotyping and writing off the whole lot. You don't belong in that group and there are probably many others like you.

But there are also a whole lots of midwives in the NHS who frown at women who mention caesarians. They do have power struggles with doctors. They think they know more, and they over rule the doctor's advice when he/she leaves the room. I witnessed this myself at Queen Charlotte.

However, I do think if you want the facts about caesareans you need to talk to a consultant (or doctor) who performs them. Talk to the midwife too. But you won't have to make any special requests to do that, as you will see a midwife when you go to book in.

One of the resons I feel the statistics are flawed is because when a vaginal birth goes wrong and ends up in a section, they put that birth in the section statistics. Seems to me it's a vaginal statistic.

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Rochwen · 05/03/2008 17:16

THe problem with talking to a midwife is that s/he would think your phobia is curable (which it might possibly be) and by making you go through that kind of a circus they would cause you a whole lot more stress. I understand why you would want to avoid that. They would be full of talk of homebirths and hypnobirthing and that wouldn't get you any nearer your elective c/s, which is is what you say you really want, so that's why I think you need to get a referral directly to a consultant.

Going OT here: The problem is that not all vb are straight-forward. I fully believe that a straight forward vb without intervention is the way we should give birth but it very rarely is totally straightforward for a first time mother. None, and really it is none (including myself), of my friends or either of my NHS and NCT class had a 'straight-forward' vb. There were lots of em c/s, ventouses, forceps and inductions. ...and surely an epsiotomy is surgery too, no? So, I can see that some women think that the only way to avoid all of these is choosing an elective c/s. That way they know for sure what they are getting.

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Lulumama · 05/03/2008 17:22

why are you presuming all midwives would dismiss genuine tokophobia? and presuming that consultants will accept it? lots of blanket presumptions

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VictorianSqualor · 05/03/2008 17:24

Personally, I am of the belief that a cs should be because of a physical problem with giving birth naturally and would suggest that you take mroe counselling to come to terms with a possible vaginal birth.

Especially as even if booked in for an el CS you could possibly go into labour beforehand and end up having a vaginal birth, so it is best to be prepared for it iyswim.

However, I don't think that if there is a real mental reason that you cannnot give birth vaginally that you will be forced, just be aware the cons are more likely to try and sort out any issues you have regarding vaginal birth before agreeing to a CS.

As for eleusis' remarks on women that have had bad birth experiences due to vaginal birth, these experiences are more likely to be seen/found on MN because they happened and the ladies who are trying to deal with it find MN out of looking for support, so please don't let that scare you even more.

A CS is not necessarily a scare free- easy way of labour, I know, I've had two and am petrified of ever having another.

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Lulumama · 05/03/2008 17:24

you and your friends might have been unlucky. out of all of my friends, there is only myself and one other who required a c.s.

everyone else had straightforward VB. only one had an episiotomy, one had ventouse, the rest were 'normal'

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Rochwen · 05/03/2008 17:25

Blanket presumptions are not right. I agree.

but seriously, let's ask the midwifes here, if Martha came into your surgery and said 'I am seriously scared of giving birth, I need an elective c/s.' What would be the first thing you would say to her?

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Lulumama · 05/03/2008 17:27

well, i can;t answer as i'm not a MW.but if someone approaches me as a doula or as someone who has experienced birth trauma, i would ask them what they want from the birth , and how best i can help them attain that. whether it be a homebirth in water or an elective c.s

what i would not do is force one way on to them as the right or only way

even an elective c.s can have emotional repercussions

birth is more than one day and it is important to consider all options and make an infomred chice

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Rochwen · 05/03/2008 17:28

cross posted, lulu.

yes, that's a lot of 'unlucky' women. 9 im my NHS class, 6 in NCT class and 5 of my close friends. Not a single 'straigh-forward' birth between them.

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VictorianSqualor · 05/03/2008 17:33

All at the same hospital as well Rochwen? Maybe the hospital has a higher CS rate? Maybe they are more inclined to start intervention earlier which in many cases leas to more and more intervention.

I don't think a control group of someones friends is enough to take into account tbh, there are millions of women giving birth all over the world daily, and the vaginal success rate it a lot higher than the one in your friendship group.

Plus it has to be taken into account why these births were not 'successful'.

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VictorianSqualor · 05/03/2008 17:38

Anyway, this isn't helping the OP, more than likely it is increasing ehr fear, so this argument should be taken somewhere else if it needs to continue.

OP, speak to your MW, see what she says, explain exactly how terrified you are, I had to literally break down in front of my cons for ehr to realise just how emotionally damaging it could potentially be for me to have another CS, your mw needs to know that you are as fearful of natural birth.

At the very least get her to refer you to a consultant, it's your body, your pregnancy and your child, so they will listen to whatever you have to say.

Yes they may push you into counselling, but surely if the outcomes of that are either A) You find yourself able to come to terms with a VB and are willing to have one, or B)You aren't able to come to terms with it and get your EL CS, then either way it's not wasted?

Good Luck.

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Rochwen · 05/03/2008 17:38

some were in the same hospital some were in hospitals all over the world. The reasons were varied, from undiagnosed breech, to failure to progress to baby in distress. The interesting thing is though that the ones with the vb still have a lot more long term problems than the ones with the c/s. And of course the experiences of women who I know and friends are going to influence my opinions more than statistics.

Sorry to have gone OT, Martha, this is your thread.

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