Private at C&W - Are you guaranteed your consultant at delivery

[kitstwins]

This is a bit of an odd one and a bit of a ramble and there are a few questions in here, so hopefully people can wade through and offer advice.

I'm not pregant and there is no guarantee that I could ever get pregnant again, but it's a distant fantasy and something that my husband and I would like. We have wonderful twins but we would dearly love another baby. The main issue is that I had such a dreadful time last time (difficult pregnancy and very traumatic emergency c-section) that I have pretty much decided not to have another child rather than risk another c-section. It would be my worse nightmare. I know I was just unlucky and I was just "one of the unlucky ones" but there are no guarantees in childbirth/delivery and so there's equally no guarantee that it wouldn't happen again. In short, I had placenta praevia, a pregnancy filled with whopping bleeds, bed rest in hospital from 30 weeks, a failed epidural so section under GA and a post-op haematoma behind my womb, scarring issues, adhesions, PTSD/PND. You name it, basically.....

I'd do all that I could to avoid a csection but I'm realistic that I could get placenta praevia again (more likely if you've had it before) and because I've had a c section and issues with healing and scarring and adhesions I suspect I'd be heavily monitored which would lead to a cascade of intervention and an emergency c-section in all likelihood. And my big fear is ending up in a hospital in the middle of the night with some knackered registrar at the tail-end of his shift cutting me from hip to hip (this happened to a friend of mine and she's so traumatised by it she won't let her husband see her naked tummy). Equally, if I refuse an epidural given that this is more likely to make my VBAC efforts unsuccessful, if I did need an emergency section they'd have to knock me out again under GA as there wouldn't be an epidural in place. So again, I'd miss my babies being born which from previous experience I found hugely traumatic. I would be devastated if that happened again. So I have an epidural put in place 'just in case' only to pretty much guarantee that it slows things down and everyone gets edgy because of my previous section and scar issues. So I can't win.

The only way round it that I can see is to throw money at it and go private and guarantee consultant care; someone who is fully briefed of my wishes (basically to avoid a c section if I can, but if not to NOT have one under a GA because an anaethetist sticks the needle in too far again!) and who, if I did have a section, would do a good job with all the previous scar tissue and not leave me with a bodged stomach. It's probably vanity, but having gone through the mill last time the ONLY decent thing I can say about my section scar is that it's tiny and very neat. Inside is a mess of scar tissue, but externally it looks okay. Which helps. Not much, but it helps.

So, my question is that if you DO go privately are you guaranteed your consultant? Does he come out in the middle of the night to see you if you've laboured at home for as long as you can. And would he come and do your c section if everything went wrong at 4am?

It would help to know as this might be the answer we need. If I could at least guarantee that I'd be in good, expert and familiar hands it might be worth taking the plunge. And if I had to have a c section again, at least I could be sure that it was the best c section possible and I'd get a good level of care.

Thanks for reading this far. It's an epic but I appreciate it.
K

[SlinkieM]

Poor you kitstwins - sounds like you had a rough ride.
I think each doctor may have their own policy - my understanding is that, yes, they will always come out at 4am to deliver (and operate if need be) - but they do have holidays or nights off occasionally when their partner consultant (whom you would generally have the chance to meet before) would cover. But they would never just send a registrar because they didn't fancy getting out of bed.
I think it's something you might want to discuss with individual doctors given your rough time last time and make clear your preferences. But this is how it works with mine.
Hope this helps.

[SlinkieM]

Also - maybe not what you are after but I have a friend who had a post-emcs haematoma although her advice from her consultant at the time was that any second baby would have to be delivered by caesarian at a major teaching hospital. After researching carefully she opted for Mr Miskry at the Lindo Wing (although she wanted Mary's rather than C&W), I think he gets a good press on here too. It doesn't sound like you are after a similar approach or have been similarly advised but wanted to mention just in case.
I wonder if as a high-risk patient your consultant may make an extra effort to do your delivery although as twinkle says, if they are operating on someone else they can't always ensure 100% to be there.
Good luck and really hope your bad time doesn't prevent you having more babies, which would be such a shame.