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experiences with BUPA for C-sections at Portland please!

(19 Posts)
Samvet Wed 24-Aug-11 13:48:59

Hello,
After a truely horrifying NHS birth, what I would described as the worst days of my life afterwards in the hell that is St Michael's Bristol and overcoming PTSD I have decided that if I have another baby I will have an ELCS. I am pretty much phobic of the NHS now due to their extreme shitness and have BUPA insurance. They tell me they will cover all bills from the Portland IF a consultant recommends a section for medical reasons. They do not count PTSD as medical reason.
my questions are:
Did BUPA cover everything? Any exclusions?
Has anyone had a section covered by BUPA when an ELCS is your preference but technically you could give birth vaginally (although would likely tear along MASSIVE epi scar)?
Has anyone had an ELCS at the Portland when you live outside London?

thanks very much, not even pregnant yet but will not be so if the NHS or any ripping of my whotzit are involved in the birth.

(PS not debating benefits of VB vs ELCS, understand all that, believe me no one is pulling a massive baby out of me again with forceps that fell on the floor, a ventouse that flew off the babies head and some other thing they found in a cupboard).

QTPie Wed 24-Aug-11 14:53:12

Hi can't help directly with your questions, but....

I live in Bath (so down the road). After the many horrifying tales from the RUH (mainly relating to unavailability of epidurals, being kicked out of hospital quickly - even after a CS - and terribly poor postnatal care) AND a few experiences with a really hurried, stressed community MW (made me very worried that there are not nearly enough MW resources available in our area), I signed up for a private birth in London (Hospital of St John and St Elizabeth, maternity now closed) when I was 14 weeks pregnant.

DS was born back in Jan 2010 (now 19 months). We intended to "self pay" because it was likely to be a normal VB.

We could have had the option to have the prenatal care locally (in Bath, on the NHS) and the delivery and postnatal care in London. However we chose the whole hog. This meant lots of trips up to London (once a month in the beginning, then once each two weeks from about 18 weeks, then once a week at the end). It was made a LOT easier by having family in London: my prenatal appointments were always Monday/Friday - so we would always go up for a long weekend (I wasn't working, husband runs his own software business).

Then, some time before birth, baby was diagnosed as breech - so huge chance of ELCS. He didn't turn, I followed it up through Bupa (I had a fully comprehensive policy) and things were rough. Between Bupa and the Consultant's secretary, they could NOT pre-authorise the operation despite 3 weeks notice! Bupa said "fine, don't worry, we will sort it out afterwards". It took 4 months of chasing Bupa (lots of phonecalls, lots of frustration) until they finally paid about £3800 of the £15k bill! Yes, I wasn't expecting the whole bill to be paid, BUT that was ridiculously low! Not happy and since left Bupa....

HOWEVER I have heard different stories here (and I think that Bupa work better with the Portland than with J&L). You need to get things very "sewn up" well in advance of delivery I think (since trying to sort it out afterwards is a nightmare!). Hopefully someone with experience of ELCS at the Portland and Bupa will post.

Bupa will still only settle certain costs - worth being prepared for paying some of it. I don't believe that they pay ANY prenatal care costs, but you could get past this by having your prenatal care in Bristol (on the NHS - although there is a private OBGYN, who does prenatal care, in Bristol too) and just delivery and inpatient care at the Portland.

My ELCS was booked for 39w+1 and we went to stay in London (down the road from the hospital - where family have a house) at 37w - just in case! I had my hospital bag packed (in case of a mad dash down the M4) from 35 weeks too. I would strongly recommend going to stay in London (with family/friends) a few weeks before. We even looked at "weekly flat rentals" - so that was another option. However, you also need another "Emergency Back-up Plan" if everything starts to happen whilst you are still in Bristol (and if getting to London doesn't seem feasable). Would have been the RUH for me - was so relieved when 37 weeks came and we went to stay in London!

After the birth, we stayed as inpatients for 5 days, then spent a couple of days (staying with family) in London, then came straight home (DS was a week old - he slept the entire 2 hours home).

Postnatal checks (after we left London) were done by Bath community midwives (who called into our home) and then - after a few days - I was handed over to the community Health Visitors.

Re ELCS - It was my only birth (although would love another one) and was fantastic. However, I think that you would find a private VB to be VERY different to a (poor) NHS VB.... (However if you had a VB at the Portland, you would have to self pay - Bupa wouldn't cover that).

If you are looking for a Consultant at the Portland who is sympathetic towards ELCS for previous birth trauma then suggest PMing BagofHolly - she has experience there and MAY (not sure) be able to help.

Whatever you decide, very good luck. I understand exactly where you are coming from (although I didn't have the birth trauma to prompt my decision). I do not regret the time, hassle or money of opting for a private birth in London (with us living in Bath) and - if I am lucky enough to get pregnant again - I would do it all again in a heartbeat...

QT

NoseyNooNoo Wed 24-Aug-11 15:25:26

People I know who have wanted to use BUPA for ELCS have found that the BUPA covers the cost of the medical side but not the hospitality side. Also, the medical fees are so high somewhere like the Portland that they don't cover all of those fees either - e.g. my consultant at NHS hospital works at the Portland and all of her fees are not covered by BUPA.

BagofHolly Wed 24-Aug-11 15:34:44

You need to speak to them and check your individual policy limits. AXAPPP for example only cover the consultant's fee to £350 which is of course ridiculous. Also, the rate the insurance company pays is not what the hospital lists as its charge - they negotiate a special rate.

There's no substitute for calling BUPA to see what's covered on YOUR policy.

Samvet Wed 24-Aug-11 20:04:46

Thanks all. I spoke to BUPA and they said they pay all costs from the Portland BUT they need a consultants letter saying an ELCs is medically necessary. (not including PTSD). (!). Am worried about being left with a bill but it would perhaps be worth it. qTpie - do you know the name of the private obs consultant in Bristol?
Thanks all.

BagofHolly Wed 24-Aug-11 20:27:17

I know I'm repeating myself but you need to get them to WRITE to you with what "all the costs" means. The absolutely definately have a cut off for what they will pay for the actual section. You also need to check when your baby's cover will start and if they need time in SCBU/NICU that those fees are covered.

As for Bristol, you may well find a private obstetrician but there are no private wards or hospitals to deliver in. There's only London or Watford.

Your consultant's clinical decision on whether you need a cs is final, but what isn't clear us whether PTSD would be covered by the terms of the policy. But if you find an experienced consultant they'll know what and how to word things.

BagofHolly Wed 24-Aug-11 20:30:18

Just to clarify, the Portland bills the insurer separately to your consultant, and the Portlandis the cheap bit, ad they negotiate preferable rates with insurers. It's your chosen consultant's fee that might be queried - BUPAs limit used to be about £350, which is about 10% of the ACTUAL going rate of £3500, so you'd be left to pay the balance.

QTPie Wed 24-Aug-11 21:15:24

Hi

I agree with what BagofHolly says - get everything in writing: Bupa are very "slippery".... They seem to be unable to provide a documented policy for CSs and their call centre people (even the managers) are at best inept and at worst obstructive...

There is also a private maternity wing at John Radcliffe, Oxford.... I didn't know that until recently (learnt it on here, but checked it out through Google).

I am pretty sure that the private Obstetrician that I found was Mr Fraser McLeod (http://www.privatehealth.co.uk/privatespecialists/find-a-doctor/gynaecologists-and-obstetricians/fraser-mcleod/ ). But that was two years ago. Suggest you do what I did: do a google search through all the private OBGYNs in Bristol, then systematically phone their secretaries and ask what private obstetric services (if any) they offer. Despite ringing LOADS, the only one who offered anything was Mr McLeod. And all he would offer was "full antenatal care and the possibility of delivering your baby". There was no guarantee that he would deliver your baby (i.e. if I went into labour when he was otherwise engaged or on holiday, then I was on my own - no back-up obstetrician). Deliveries would take place at Southmead (NHS). It wasn't cheap, either (can't remember how much though).

However it MIGHT be worth exploring the options further: IF you wanted an ELCS, then you MIGHT be able to work something out with someone like Mr McLeod (because he could schedule an ELCS for a time when he could actually do it - although if you went into natural labour before your ELCS date, you would end up with whoever would be on duty to do the CS). However that would be at Southmead and you would be in the NHS postnatal ward (not sure if - as a CS patient - you could secure a single room there). It depends what your priorities are and what you are prepared to put up with.

Food for thought....

Wrigglebum Fri 26-Aug-11 00:15:03

Watching with interest- I am Bristol based and had an awful birth with DS. Midwives said my pelvic arch is really narrow and a combination of a strong pelvic floor (not sure that's a problem anymore) and small lady bits led to my 6lb baby needing an episiotomy and then a massive third degree tear. I'm allergic to aspirin so couldn't take anything other than paracetamol for the pain so was walking like John Wayne for some time after. It's only now I'm accepting how awful it was, labour never really got going, needed all sorts of drugs to keep it going and apparently my flexibility and stamina were the only thing keeping me from an EMCS. Even with an epidural i had a lot of pain and could def feel to push. Luckily DS remained calm until the last minute or it could've been another story.
Midwives and the docs that stitched me up said not to attempt another natural birth and now we are thinking of ttc, I read all the stuff about cuts and trying to reduce ELCS. I am getting really fearful they won't book me in and will make me try another VB. We have BUPA cover and could potentially borrow from parents if we had to to go private. Obviously I'd prefer not to as it's a LOT of money.
Have made a doctor's appt to discuss as I am feeling so stressed it will not help ttc!

citymonkey Fri 26-Aug-11 12:19:46

I would also add re the consultant's fees that my consultant (who delivers at the Portland and C&W I believe) charges £7500, not the £3500 indicated above, so £350 towards that is barely a dent.

Samvet Fri 26-Aug-11 12:38:05

Wrigglebum - I think the NHS would give you a section. The GP told me they would - my issue is my problems during and post labour and the fact that it was so so awful aftercare wise. My GP said to go see them before you concieve and ask to be referred to the consultant obs. They can advise on options at that point. I also think that if that consultant wrote to BUPA they would ok the section - the problem seems to be this disparity of what they pay (see Holly's post). They seems to be happy to cover the portland fees - it is the consultant fees that are the trouble - like you I might be willing to beg/steal and borrow to avoid the NHS!
Thanks all for the feedback - insurance companies are sneaky bastards arn't they? Costs enough each month - I think I have more than paid for a section!!

QTPie Fri 26-Aug-11 13:21:43

Citymonkey, think that Consultants fees depend on who you have and what you have: maybe £7500 for prenatal care and delivery, but £3500 just for delivery? I think that it is not uncommon for many women (especially those using UK Insurance - since they do not cover prenatal care) to just have an appointment or two plus delivery with a Consultant (to keep costs down) rather than the full prenatal package.

So having prenatal care on the NHS, but the all important delivery privately is one way to keep costs down.

BagofHolly Fri 26-Aug-11 13:41:24

Yes, what QTPie said. I only saw my private chap a few times, the rest was NHS.

Wrigglebum Fri 26-Aug-11 14:01:17

Thank you Samvet. I've booked to see my GP and my DH is taking the morning off to come with me, time it takes to get an appt might be pregnant by then anyway as we were first month of trying last time (albeit without the stress of this and no toddler around).
I guess once we have more ideas about what the NHS or BUPA will cover we can make an informed choice, ie would we pay to top up consultant's fees if BUPA would cover the rest. I've read about the Portland, JR in Oxford and MUMS in Solihull which all sound good but I might put up with Southmead if I can get a section there as it's really close to us (10 mins drive) so less disruption for my DS. I did find an OB online who does private deliveries at Southmead so it's another thing to consider.

QTPie Fri 26-Aug-11 14:49:46

Wrigglebum - is that Fraser McLeod or someone else? (see my second post on this thread... I think that may work with an ELCS (since that could be "scheduled", but his secretary was quite clear that there was no guarantee that he could do the delivery (for a VB) and that there would be no "stand-in" if he couldn't do it (i.e. straight back with a normal NHS delivery).

I think that you could pretty much bypass that problem with an ELCS. However, you would have to talk things though with him and how any problems were managed (i.e. if you went into labour before your ELCS date, if anything happened to prevent him doing the ELCS etc).

I think that would be a good way for both you and the OP to go (if you could put up with Southmead and NHS postnatal care): get a local private Obstetrician to do your prenatal care and agree - and put into place - an ELCS. I don't think he was cheap though - something like £4k just for prenatal care (2 years ago) I think.... I would possibly expect an additional amount if he did the ELCS, but not exactly sure how they would work it (since it would be an NHS ELCS as such - just him doing the ELCS). Or he may just be able to ensure that you get an ELCS on the NHS at Southmead (and you would be delievered by whoever was on duty).

Regardless, Bupa do not cover prenatal care - so any costs would be self-pay (in the region of £4k for a full pre-natal package). You may be able to see him for considerably less appointments than that - JUST to get a referral for ELCS on the NHS.... I really do not know.

Obviously seeing what you can get (for free) through the NHS first is worthwhile. IF you struggle to secure an ELCS (and/or want more care), then maybe worth escalating through a private Obstetrician or the Portland?

Good luck smile

Wrigglebum Fri 26-Aug-11 19:12:05

No it wasn't Fraser McLeod, saw these people online and says they also do deliveries but no real information on it. I'm not looking in to it too much yet but will look into I will as and when it's needed.
I wouldn't be bothered with private pre-natal care (unless needed to get a referral for an ELCS) as I was perfectly happy with the NHS for that. I wouldn't even mind being in Southmead post-natal as it is so close to home (this time I would take ear plugs, an eye mask and get DH to bring in loads of food and drink, plus I shouldn't be so out of it as last time after 50hrs without sleep then bugger all sleep there).
I suppose the only thing putting me off an ELCS on NHS if allowed is that if they are busy you can get rescheduled to the point where you go into labour anyway and need an EMCS but I guess that can happen anyway on private as births are pretty unpredictable. Plus private is lovely and if BUPA would cover a lot of it, it would be nice. Then again, could use the money for a rather fabulous recovery holiday later on instead!
Thank you so much for your help guys, it's really appreciated. Was having a bit of a freak out yesterday after visiting Southmead for an unrelated appointment and getting scary birth flashbacks, was shaking with fear. DH was away with work last night and I was just feeling a bit rubbish about it all. Now I have made a doctor's appointment and got some great info here I feel so much more positive.
Good luck to OP with getting your ELCS.

QTPie Sat 27-Aug-11 20:27:47

Hi Wrigglebum

Interesting. Have you spoken to them yet? These are the people that I had my first scans with in 2009 (I had an early pregnancy scan - since I had had an early miscarriage a couple of months before conceiving - and an OSCAR scan there). VERY good sonographers (would highly recommend them), but their administration was poor (my OSCAR scan was incorrectly booked and I had a bit of a disagreement with them over that - they, or at least the Consultant doing the scanm sorted it out in the end.... so all ok). However I am PRETTY SURE that they had the same wording on their website then and I enquired about private deliveries with them then, but they couldn't actually provide me with anything concrete (just a list of consultant names for me to phone myself I think! That was how I found out about Fraser McLeod - no-one else on their list seemed to offer private obstetric services...).

HOWEVER that was two years ago, so maybe what was "aspirations" then is actually more organised now? Maybe they can actually deliver on their advertising....

You may need to be in longer than 2 days after an ELCS, but you may be fine to go home. You also may be able to get a "private" (single) ensuite room if you have an ELCS at Southmead. Hospital policies seem to vary somewhat: some hospitals prefer CS patients in single rooms, some prefer them on the wards... Best to check directly with Southmead.

Private CSs do normally pretty much run to schedule: I was scheduled for 7.30am, LO was born 8.31am exactly. Quite early in the day, but "nil by mouth" and nerves don't make that a bad thing! There isn't the same pressure on operating theatres that you have on the NHS.

Good luck and will you come back and tell us how it goes (and what you find out from "Bristol Pregnancy Scans") please?

ELCS are not without risks (you will see threads on infections etc) and downsides, but many of us who have had them do find them an amazingly calm and enjoyable birth experience: it is about weighing up what is right for you and your family. Don't worry, there are definitely ways of getting one if you want.

Take care.

Wrigglebum Wed 31-Aug-11 16:27:23

I haven't spoken to them yet, I don't want to do too much investigation until I'm actually pregnant, seems like bad luck somehow!

I think if an ELCS is approved on the NHS I will probably go ahead with that. It just seems like even with BUPA there is so much to pay and I can think of better uses for the money! I also like the idea of being close to home as if there was a problem and the baby needed to be kept in we wouldn't need to stay elsewhere or commute. If I get a few things in to make me feel a bit better on the ward (some lovely nightwear, an iPad full of films, lovely food brought in) then I think the experience will be considerably better than last time! Southmead does have private rooms and with a CS I should get priority for one.

OP if you can't get BUPA cover what about getting a doula to provide support in the hospital, sorting out decent food, breastfeeding support and fighting your corner when necessary! Southmead seems to be a bit better than St michaels from what I've heard.

Once I am in a position to investigate a bit more I'll let you know anything I can about BUPA/Bristol private births.

Samvet Fri 02-Sep-11 11:40:51

Thanks so much all for your helpful comments and good luck wrigglebum. I think there is no way I can cope with the NHS aftercare as that really compounded the birth trauma, might save up and do extra work to find the 'top up' money. I can't imagine how nice it would have been to actually eat food and be clean after the birth. Do let us know how you get on. NHS pre natal care is fine, have to pay for OSCAR scans anyway, so just have to suffer odd conversation with midwife. thanks all, appreciate the advice and understanding.

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