Who performs planned c sections on the NHS?

(27 Posts)
SquashNutButter Wed 21-Nov-12 21:22:13

Is it always a consultant? or could it be someone more junior?

SquashNutButter Wed 21-Nov-12 21:22:50

Interested because trying to decide whether to try and go private

Fourandstillcounting Wed 21-Nov-12 21:48:41

Could quite easily be registrar but there would be a consultant on duty in any event. ELCS is very straightforward though, and a senior reg would be more than capable.

merme Fri 23-Nov-12 12:41:48

In the same boat here- worried about a planned c on NHS. Not only on who does the op but also the aftercare. It seems to be so random as to whether you get a good experience, and maybe at least with going private there is more control ...but yes it is a hard decision!

RarelyUnreasonable Fri 23-Nov-12 21:45:33

I had one today, performed by registrar. All v straightforward, but j believe they use consultants if they don't think it's s straightforward job.

WidowWadman Fri 23-Nov-12 21:53:33

I think mine were both done by registrars. I didn't ask them for their certificates.

My spinal for the ELCS was done by the consultant anaesthesist though, because apparently "she likes doing them on a regular basis so she doesn't lose the skill".

As for aftercare - I was out after two days, and any aftercare had been done by the midwife anyway.

SquashNutButter Mon 26-Nov-12 05:51:58

Thanks folk. V helpful. It probably doesn't make a lot of difference but I think I'd feel better if I knew I was getting the top man for the job. Ouch to the purse though - going private!

QTPie Mon 26-Nov-12 08:12:18

Going private does give some peace of mind. There are times when - even going private - the OBs cannot do you operation (bad illness etc): but they will have good cover who you should be able to meet beforehand.

Good luck.

LadyIsabellaWrotham Mon 26-Nov-12 08:21:18

Bear in mind that a private hospital may not have the full emergency resources in unlikely event that it goes wrong. There may be many reasons to go private, but a better quality of surgeon isn't one IMO.

drcrab Mon 26-Nov-12 08:23:33

Mine was done by the head consultant (complicated) but the spinal by the registrar supervised by the consultant who was sat beside him.

QTPie Mon 26-Nov-12 09:13:50

90% of private maternity is a wing of a major NHS hospital - so you have all of the advantages of the NHS too.

Having a great surgeon is a very good reason to go private. Yes you may get the same surgeon on the NHS, but it is a lottery.

QTPie Mon 26-Nov-12 09:34:30

(I have a very neat external scar and have had two ObGyns comment on the "neatness" of my internal scar too (ie the quality with which the uterus was seen back together). So having one of the best ObGyns in the UK has pain off in many respects (both self image and the very good repair of my uterus) in addition to the most important things (safe delivery of baby and my safety). Yes that sane OBs works on the NHS, but firstly I am we'll outside of the area for her NHS hospital and secondly there would be a very good chance that I wouldn't have had her on the NHS anyway).

YouOldSlag Mon 26-Nov-12 09:43:17

I don't know the status of the surgeons who performed my 2 NHS sections, but I can tell you they both did a fantastic job and you'd be very hard pressed to see even tell I'd had one, so neat was the stitching. Scar is almost invisible. I had about a dozen people in the room for both my EMCS and my ELCS and very closely monitored after care.

I have no complaints, and mine were both done in different NHS hospitals with different staff.

SquashNutButter Mon 26-Nov-12 14:58:25

I'd be in the private wing of the NHS hospital where I had my first. It's actually the postnatal ward there that got me thinking about private care in the place. It was pretty awful though I was luckily not there for long.

Now facing a C section - my first surgery - and reflecting more on the options. I'm pretty terrified of the procedure and think I need to know a consultant will be performing it, ideally one I have met before.

Hope I get a neat scar too!

phlebas Mon 26-Nov-12 15:34:01

in my hospital it is always a consultant (I've had three electives & emergency - the emergency was not done by a consultant) & always a consultant anaesthetist as well. They have a separate list & theatre for electives too so you are not bumped for emergencies.

I knew all the consultants at the hospital & asked by GP to refer me to the one who was most interested in cases like mine & I saw her only for three pregnancies. You can get utterly fabulous treatment from the NHS - amongst other things my consultant gave her mobile number in case I had a panic & had open access to clinic & scans.

YouOldSlag Mon 26-Nov-12 15:45:25

As scary as elective sections are to the woman about to have one, they are regarded as routine.

I don't blame you for being cautious but I honestly had good experiences and no idea if it was my surgeon's first or 900th. There were so many people on stand by in the room that I felt very well cared for even if I didn't know their history and status.

The scariest bit was being wheeled into a room full of scalpels glinting on tables. As soon as the staff started talking me through everything and doing the prep, it became a really good experience- and very fast- baby was out in three minutes!

tanteclaire Mon 26-Nov-12 15:45:56

surely junior surgeons assist at significant points? otherwise how do they learn the skills required to become a consultant? when my brother's gf was training as an OB (at SHO level) she was certainly involved in resewing ladies' cs back together, albeit under the supervision of someone more senior.

bonzo77 Mon 26-Nov-12 15:54:29

I had my nhs emcs done by a registrar and a house officer (I think that means they've been out of medical school up to 2 years, though not sure about that), someone very junior. My scar is a bit longer than average, about 6 inches, but has healed perfectly according to drs and sonographers. I would be surprised to have a consultant operating unless it was quite complex.

janinlondon Mon 26-Nov-12 15:54:30

Of the six c sections done in my antenatal class the five done by registrars on shift in the ward (they are doing these all day, every day, they are GOOD at it) were fab. The one done by a senior consultant (who apparently only did one or two a month) was a disaster zone. I'd go for the guys who look like they're 14 years old but can do it in their sleep. Honestly.

maresedotes Mon 26-Nov-12 16:02:47

I was asked whether I minded someone junior doing my emergency caesarean. I didn't care at that point who did it. She was slow and meticulous stitching me up afterwards, really neat. It was commented on when having my next one 6 years later. I made a comment at the time "so long as she's qualified" which I thought at the time was hilarious (I blame the drugs).

VivaLeBeaver Mon 26-Nov-12 16:15:45

Its rarely a consultant. Normally a registrar, sometimes an SHO (well supervised).

QTPie Mon 26-Nov-12 20:20:14

A private birth is a lovely experience IF it doesn't break the bank...

I was expcting to have a natural NHS birth (first DC), but got rather scared at both the stories of lack of availability of pain relief (ie epidural - wanted it available IF I decided that I wanted it) and the complete rushed/stressed nature of the midwives that I saw at my prenatal appointments.

At 14 weeks pregnant, I flipped and we changed to private maternity care. I ended up with an ELCS (for breech).

Everything was so much less rushed and stressed and I felt cared for and looked after: I didn't have the anxiety that I had with the thought of NHS care. I had a stress free pregnancy, I had a brilliant ELCS and very good aftercare . I think that this really helped us get on our feet in a very good way. No PND, no trauma - everything great.

This doesn't mean that you can't get this on the NHS: there are some great NHS maternity services out there. Also, if you weren't having a section, then there are homebirths or some great (smaller) birthing units around. However, if you have to have a CS, there is a bit of a lottery around.

You could keep costs down by having NHS prenatal care and then have the delivery and postnatal care privately?

SquashNutButter Mon 26-Nov-12 21:45:27

That's a good idea, to mix it up.

I have international insurance which in theory covers a lot/everything but I don't quite trust it. Maybe the thing to do is go NHS to 35 weeks and then switch. My last birth was NHS and was fine - in a birth centre. But I feel I was one of the lucky ones (on the day at least, not necessarily with the recovery) and that, as people have said, public health care is more of a lottery. I didn't think the c-section ladies on the postnatal ward were getting that good care, though that is aftercare and not the same thing as their surgery, which was probably fine

QTPie Mon 26-Nov-12 22:21:19

I think that care on the post-natal ward can be very important after a C Section...

Because of my private maternity care (but it may vary from hospital to hospital), DH could "room in" with us (he didn't leave the entire 5 days that we were there): he was always there to help (pick up and pass DS to me for feeds, change nappies etc) and so were midwives and midwife assistants. All I did those 5 days were recover, feed my baby, bond with my baby and eat (pretty nice and nutritious hospital food). I never felt alone and I never had to sress or strain myself physically trying to look after my baby.

If you have International Insurance that cover all of it, then I would investigate it and try to go private from the start - build a good relationship with your chosen consultant.

QT

ladymarian Sat 01-Dec-12 12:03:36

I had an ELCS 3 weeks ago on the NHS and it was a great experience. My case was straightforward as it was done on psychological grounds. The op was performed by an experienced consultant assisted by a registrar. My wound is very neat and I have had no problems so far. The care I received overall was first class - I couldn't fault it at all. The staff on the post natal ward were very helpful with bringing my DD to me for feeds before I was mobile and helped me with breastfeeding.

Hope this reassures you a bit, OP

xmasevebundle Mon 03-Dec-12 17:13:17

I am having a ELEC in 2 weeks on NHS.

I am seeing the head consultant on thursday, who will be performing it.

YouOldSlag Mon 03-Dec-12 18:01:03

The staff on the post natal ward were very helpful with bringing my DD to me for feeds before I was mobile and helped me with breastfeeding.

That's a big improvement on my experience. I had my baby with me all the time and was reprimanded for calling a midwife to pass me my baby for BFing when it was too painful to move after my 2nd CS. "You should be doing more for yourself by now".

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