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.

thanks bozzy and pupuce, I think they sound great and my first labour and birth was truely hideous so would like some additional support (err..should I ever get pregnant again!)

I have to say, I was sorely tempted by the Portland - all that lovely food and star spotting and comfy beds, but a dr warned me not to, which was enough for me. It's not that fashionable anymore anywhere, everyone is at St John & St Elizabeth in a waterpool these days.

I'd be scared stiff of things going wrong in a private hospital; although I have to say that the actual stay in Kings was a main factor in putting me off hospital at all.

I had an independent midwife and she enabled me to have a fantastic normal birth. From the beginning, I knew that I wanted my baby to be born at home, I knew I didn't want much in the way of antenatal testing, and I knew that I was likely to go quite overdue. I didn't want to spend my pregnancy having to justify my decisions or fight medical protocol, so we opted for an independent midwife very early on.

As it turns out, it was a very good decision to make. dp was able to make it to almost all of the antenatal appointments, so we all knew each other well by the time I went into labour. I went into labour naturally when I was 13 days overdue, and had a very long slow labour (44 hours). dd was born in the most gentle circumstances. Under NHS care, I would probably have ended up in hospital with a lot of unwanted intervention.

Yes, it was well worth the money. We'll do the same again next time, even if we have to juggle the finances (it would certainly come ahead of a holiday). I've never been very comfortable with the idea of private healthcare or private schooling, but my midwife likened herself to Steiner schools rather than to a public school.

Zebra - Don't know if you'll see this message, but yes, if you go to the Portland and something goes wrong they have no intensive care there, I think. Anyway, you will most likely be transferred to St Mary's. My sister used to be a paediatric nurse at St Mary's and said she saw some shocking thing being transferred from The Portland. Also, another friend who had her baby there becasue he was breech, said the care was very good from the consultant/nurses etc point of view, but she had almost no support post-natally, was told to start topping her baby up with formula on day 3(!) and really struggled when she came home and gave up feeding after a week. So private in that case no better than NHS.

I used an independent m/w for ds, but had to be in hosp due to medical condition. Ended up with c-section anyway, but loved having the m/w all through pregnancy and for the wonderful 6 weeks of support afterwards - worth it's weight in gold having her help me with feeding, weepy moments etc etc. I would have loved to have her again for dd's birth but simply couldn't afford it. Managed a VBAC on the NHS at St Thomas's (lovely hosp) but very medicalised still. If I have another baby, I will do my utmost to be able to afford an independent m/w again.

Thanks Wilbur.

Funny what Aloha said about the Portland not being "fashionable". Should we go around choosing medical care on the basis of what's in style? Some of you MNers move in circles I will never understand.

Thanks Wilbur.

Funny what Aloha said about the Portland not being "fashionable". Should we go around choosing medical care on the basis of what's in style? Some of you MNers move in circles I will never understand.

I hired an independent midwife at 34 weeks pregnant because I'd decided to go for a home birth, having looked around my local hospital. I really didn't like the thought of giving birth in hospital and wanted the best chance of getting a home birth. The independent midwives I've chosen are experienced in home birth and I'm confident that they won't send me to hospital uneccessarily. Having said that, my husband and I had to think very carefully about spending what seems an astronomical amount - two and a half thousand pounds - at a time when I'm going to give up work for a while. We've had to make some big sacrifices in other areas.

I am due in three weeks time so will let you know how it goes. At the moment I enjoy the fact that I'm getting to know the midwives and that the care is so convenient. It's lovely listening to the babies heartbeat in your own home with your husband watching on. I do feel guilty though about entering the world of private health care. My midwives seem really focussed on ensuring I have the best possible birth experience - it would be nice if the same care was afforded to everybody

I had a birth doula in Nov 1998 for my daughter's birth at Newham General Hospital. The doula was awful, a complete waste of space and money, in fact she made things worse. I had initially gone to some antenatal yoga classes and the teacher there agreed to be my doula; then she changed her mind and let me down quite late in the day; she gave me a few contact nos. and this was the one most likely to agree. In fact she was in it for the money and was quite unfeeling and hardened. The day I went into hospital (about 4pm) we waited until 8pm before calling her, but she did not show up until 11pm. Obviously she had decided to put her own kids to bed and watch telly before coming to me. (I had already paid her). By the time she arrived I had already had an epidural and an enema so her presence was completely redundant, however, she did manage to have arguments with all the midwives over minor issues which really did not matter at all (like whether the door was open or closed) and really got their backs up. I had explained that I was not desperate for a natural birth, I just wanted moral support, but when the time came, she did not give me moral support, she just "fought for a natural birth" which was stupid because as I said, she just annoyed the midwives who then took it in out on me. In the end I asked for a ventouse and instead of supporting my "choice" (of course had she turned up on time, I might not have had an epidural and had a quicker labour and not been so exhausted as to feel I could no longer carry on... that was the idea of getting her in!) as I say instead of supporting my "choice" she tried to make me feel bad about not pushing the baby out myself. I am very sad when I think about all this; I had an awful, traumatic birth and every time a friend has a baby the feelings of terror wash over me. I suppose it is just as well I could never face having another baby as I am now 40 with a marriage on the rocks (we live under the same roof for financial reasons only).

vitto, so sorry you have had such an awful experience. Hopefully in time you will not think about it so much. I know I will be devastated if my babys birth is not as i would like it to be. I have an independent midwife but trying to be openminded. Just try and focus on your baby and remember the main thing is you have got a baby. Im sure its hard for you not to dwell on the birth though.

I had an independant midwife for the birth of my daughter (2 weeks ago) and she was fantastic. Worth every penny - and actually probably worth more than that. We got to know one another really well during my pregnancy, and she was like a rock to cling to during a rather tumultous (sp?) transition. But where she really has made all the difference to me is in after birth support - I would have given up breastfeeding very early on, I think, if not for her willingness to drive over to me late at night and help me latch the baby on. She has just been fantastic. Sadly she has now officially discharged me from her care, but is still around to offer b/f help.

I think the thing to remember with independant midwives is that the vast majority of the are independant NOT because they can charge huge fees as "private" providers of care, but because they really care about midwifery and the model of "normal birth" and feel unable to offer the support they feel should be offered within the NHS. It is a huge commitment (most being effectively "on-call" for 11 months of the year) and certainly mine was fabulous.

Vitto - that is not just acceptable - did you have a chance to complain to anyone about her services ????? I know many doulas and have never heard such a bad story - HOWEVER I have heard bad stories from MWs saying how bad the doula was... but that is their perception not necessarily the mother's.
I can assure you that I do not know 1 single birth doula who earns enough (as a birth doula) to make a living. We all have to either have a supportive husband or a seperate activity to rely on.... A birth doula charges £250 to 500 and it is rare that one takes more than 1 birth a month,.... you do the math!

Well I had a doula with my DD2 4 weeks ago (no prizes for knowing who ) and I would have her again in a heartbeat.

I've said in another post somewhere how felt reassured, found I didn't need any gas and air (acutally I was just kinda holding the tube for dear life rather than using it, but I let go of it), had the confidence to use the water. DH, poor love, was so upset at the state I was in, but having a doula there to guide me through when DH couldn't was fantastic.

With my first birth, I had no confidence to even get off the bed and to be honest I don't remember any of it, it was such a disappointment and trauma.

But I would LOVE to do it all over again (except the SPD and hyperemisis), I never thought I would have that belief and confidence in my body. I really should sort out the long term birth control!

If you can have someone there, especially a doula etc, who doesn't have the emotional investment and so can give you support and guidance when others are upset/shocked/concentrating on catching the baby, then I would say go for it.

I had my second baby privately in an NHS hospital - Queen Charlotte's in West London. Had my first baby there too on the NHS. The medical care was fine and I had complete faith in the hospital but what I hated was the fact that no-one was accountable to me first time round - when I gave birth there were 5 docs in the room due to complications and I didn't know their names and felt like a piece of meat being pushed around on a table.

So when I was pregnant again I decided I was going to go private so I'd know my consultant and have the peace of mind of knowing that he'd be there on the day having seen me for each and every one of my antenatal appointments. I also wanted an elective caesarean and he was happy to do this for me (for medical reasons - not just b/c I didn't fancy pushing second time round!!). Anyway, it was a great experience, the midwives on the private ward were great, and I don't have any complaints.

By the way, a friend of mine has just had her second child there privately, with Professor Bennett. She had a 10lb 1oz baby and the doc guided it out so carefully she only had a tiny 1st degree tear. She said he was an absolute living legend!

I also had a post-natal doula. She was fantastic. Came every day for 4hrs, cleaned my house, took the baby so I could sleep, entertained my toddler, changed my sheets and made me endless cups of tea. She was originally a trained nanny and had done maternity nursing so was a fount of good advice. She was also very easy to have around, very supportive, and made life with a new baby much easier and more enjoyable. Would recommend a post-natal doula to anyone having second or subsequent babies.

Hi

I'm seeing an independent midwife next week. I would be very grateful if anyone could please advise me what questions I should ask her.

Also, would you have a doula (at the birth) as well as an independent midwife? Or is that just overkill?

Thanks in advance for your help.

NGPY, I would say having a doula and a independent m/w would be overkill as and ind midwife will be with you throughout, she will have a 2nd m/w there for the final stages of giving birth so you could have rather a lot of people in the room if you had a doula as well. Ind m/w in my experience tend to be very touchy feely and lovely and so you get a lot more emotional support from them, like you do from a doula. I would ask about post-natal care, what their rates of normal birth (no medical procedures, epidurals etc) are, and what they do in an emergency. Hope this fast post helps. Baby yelling, gotta run.

NGPY - It would be overkill in most cases but not all.... it really depends why you are looking for this support (and no one here can judge on your circumstances and needs). I am a doula and I have yet to be asked to work with an Ind. MW but my local IMW has worked with doulas whilst others would refuse (I know one who has) to take on a mum if she has a doula !
One thing a doula does a lot (at least I do) is work WITH the dad... I want to make sure he participates in the birth at a level he is comfortable with... I want him to enjoy it (if he wants to be there). I want to help him feel confident on how he can support his wife/partner. I don't do anything clinical yet my obstetrics knowledge is good so I can really support a mum and allow her to make informed choices and feel in control (an IMW would do that too of course).

Thank you, Wilbur and Pupuce for these replies, these comments are helpful

Sorry if this has been asked already but if you were going to choose between an independent midwife or a doula, which would you go for? Apart from doulas being cheaper?

I am planning a home birth for my 3rd baby and while some of the community midwives are excellent others are less ideal and I'm worried I won't get one of the ones who's supportive.

Fennel - the 2 are quite different.... (besides price though both are on call for a long time around your due date - and that a great demand on an individual)
The Ind. MW is great if you are in a specifically "trickier" situation... breech or VBAC at home or if you know that local MW are not supportive. If you had a first baby in hospital and what you want is a home birth but feel you need support and someone who could be your (educated/informed) birth partner and be your advocate than a doula should be enough.... also it's a personality issue.... you may meet a doula or Ind. MW you click with.

Thanks Pupuce, I think I will check out local doulas. I'm not officially a risky case just don't seem to be very good at getting them out had two very prolonged transition phases.

Do you know where to look for doulas?

Check the Doula UK website. It contains a list of doulas per region. A lot of us will travel up to 1 hour from where you live so if there isn't one in your neck of the woods don't despair!
Also some doulas get booked very early. I was booked in early December for a late June birth ! London in particular is VERY bad.... book very early. Meet as many as you can/want as we are all very different. Ask for references! All the doulas who are on the Doula UK website are monitored, mentored, have a code of practice and are part of a network of doulas. And it cost you nothing to get in touch (i.e. you don't pay a fee or anyhthing to Doula UK).

thanks pupuce for the website link.

there aren't many are there, none in my area (Manchester).