St Thomas's: if you were high-risk, did you get one-to-one care ?

[SuiGeneris]

Running a bit ahead of time, but after not-so-great experience first time round I am looking at hospitals for number 2 (not yet conceived).

For various medical reasons, will need to be followed in hospital more or less from the day after a BFP, so have to look into things now.

So, if you have given birth at St Thomas's recently and were classed as high (or medium) risk, did you get one-to-one care during labour? Did you see a consultant during labour? Did you get an epidural when you asked for it? Were you happy with the experience?

According to NHS choices website they offer one-to-one care, but then I note on their website that the labour ward has 18 delivery rooms and 11 midwives on shift at any one time. Which to me suggests 1:2 care....

I had a baby there last year and had consultant led care
Didn't see a consultant during labour but didn't need to
Didn't have an epidural either but didn't ask for one

It can get very busy so it all depends on your luck/timing
I had to wait a while for a delivery room as they were full when we got there

I did then have a MW with me once we got the room though

I had DD2 there just under 2 years ago, I was high risk due to having had a very premature DD1 for reasons that were likely to recur. Chose St Thomas as neonatal and specialist antenatal care were what we rated highest. The antenatal care was excellent, also the community midwifery as I mostly saw the same midwife who answered my many questions.

In labour I got one to one care from a great midwife, I also think the fact that my friend who acted as doula is an ex-tommy's midwife helped. No consultant but experience has taught me that if a consultant obstetrician positively wants to see you things are not going well. ( darkly humorous )

Reservations? It is a very, very busy hospital and one where the junior docs are used to doing a lot of sections. I had a second EMCS for which there were good clinical reasons but which I still think might have been avoided if I and my birth companions had been left the f* alone The last published VBAC rate is very low, I queried it at the time and never got a satisfactory answer as to why as it seems at odds with the fact that otherwise they are very pro active birth. I realise that this is just my perspective (and also that the published statistic may just be wrong)

I can't answer your question about epidurals, as I didn't have one - may sound weird but my labour belted along too fast to think about it.

OP, one correction. I found some more recent info which suggests that the 2009 VBAC rate was 85%. May not be relevant to you, but just wanted to be accurate.

Also, my overall experience was that the nursing and midwifery staff were very professional and took good care of us....both my labour midwife and community midwife stopped in to see us when I was on the postnatal ward.

I gave birth at the Hospital Birth Centre at St Thomas's in Jan 2009. I was classed as high risk as I had slightly high levels of amniotic fluid and was 40+12 when I went in.

I didn't have one on one care, in fact we were left in the reception area for almost 2 hrs on arrival despite my notes saying I must be assessed as soon as I went into labour.

Then I was strapped to a CTG and left for most of the night. The whole labour ward felt frantic and out of control. It was awful.

There is a certain (quite senior I think) Irish midwife who works at the Birth Centre who is a particularly unpleasant woman. I won't give her full name here, but her first name is Fiona. Avoid avoid avoid!

However, I am assured that I was very unlucky and it's not always like that. I know people who have had wonderful birth experiences on the Birth Centre and have had one on one care when they needed it.

Post natal ward was hectic and impossible to get rest.

I am due to give birth there again any day now and would be low risk if I wasn't 'post dates' again! So I will report back, hopefully with a happier tale this time.

I must say though that my midwife who has done all my antenatal care (part of a caseload team) has been absolutely wonderful. I couldn't wish for better care. And the staff at the Day Assessment Unit and the Fetal Medicine Unit are also universally lovely and brilliant.

Hi I had dd2 at st thomas's 8 weeks ago
I was high risk with an elective section
in comparision with Queen Elizabeth where my dd1 was born the care was exemplorary (sp -sorry)
I saw the consultant every 2-4 weeks on top of midwife appts ( at times I felt there were too many appts- bit of a drag getting to hospital as I live quite far away)
pre op there was always a midwife in the room ( 3 bed bay)
post op on labour ward there was always at least one midwife in the room and when my dd2 had breathing difficulties a paed was there within minutes
post natal ward not as bad as I expected, I planned to transfer to the private ward but care was so good I stayed on the nhs wing ( saving 700 quid a night!)
I got pain relief immediately when I requested it
only downside was getting discharged it took a whole day!
The staff were so lovely in fact the Obs who did my op came in on her day off to see me and the baby and also did the paperwork for my dishcharge as she correctly predicted that it would take a long time the next day ( a saturday)
I would definetely reccommend the hospital excellent experience that restored my faith in the NHS !

HTH

Midwifery care at Tommy's is patchy IMO. I had a high risk pregnancy there and spent 10 days on the antenatal and labour ward before giving birth. The High Dependency Unit is excellent and the MWs who work there are generally very good. When I wasn't in active labour, I was left for days on the labour ward (for pg complications) and I felt very frightened and neglected. The registrars often did not have time to come to see me as it is a very busy place and I saw my consultant infrequently even though there were a lot of problems with my pregnancy.

When I was in active labour, the midwife did not really leave my side and was lovely. But they generally look after 2 people at the same time. It took 3 days to induce me despite my consultant saying it needed to happen immediately. Even though I had a very difficult labour (my baby was born not breathing and with no heartbeat) and they pulled the alarm, all the drs came running but no consultants were present. The neonatal care is world class though.

I did get an epidural within about 45 mins of asking but the philosophy there is quite anti pain relief and CS IMO.

I would have another baby there but it is an incredibly busy place so the care can be hit or miss. The good MWs are amazing though!

Yes I would add that although it's incredibly busy, with a high risk pregnancy I'm not sure I'd want to be anywhere else as you do have access to some of the best consultants and midwives in the world. NICU is marvellous if needed too.

You just need to know when to be assertive to get attention if you are in labour on a busy night and feel you need support/help. But if things start to look complicated during your labour you will find all of a sudden a lot of midwives, registrars and consultants (if you need them) will be watching you closely so don't worry.

Not high risk as such but I gave birth to DS2 there, he had been diagnosed in utero with severe difficulties which meant that we were aware that he would not survive for long after birth and that no attempts would be made to "save" him.

I cannot fault the staff - they made what was a horrendously difficult time for me and DH manageable.

I received one to one care throughout DS's delivery and although I did not have an epidural I did have extensive pain relief and an epidural tube was sited as it was likely that I would need surgery post delivery (although in the event I didn't) the anaethetist was fabulous - all my options were explained and she couldn't have been kinder.

The midwives were wonderful and the dr that saw me immediately after delivery and had to manually remove my placenta was second to none, as was my consultant.

I have given birth in four different environments in three different hospitals and can honestly say St Thomas's would have been hard pushed to do better.