Private maternity in London - how much does it cost???

[Elizad]

Hi
Can someone let me know costs all in for Elective CS at LINDO, PORTLAND and CHELSEA? I know it wont be exact but to get a rough idea would be so fab...each website itemises most things but there is so much I have no clue about ( bloods, scans, consultant fees)

Thanks

[larrygrylls]

I think this idea that obs are "better" than midwives for normal births is misplaced. It is also a bit of a waste of the obstetrician's time. Have they really studied 7+ years then done additional study to assist (if necessary) in a normal birth? Sure you can get anything you pay for, if you have enough money. On the other hand, how many of you would demand a top consultant as your GP? I am sure if you were prepared to pay £500 per appointment, you could do it. A good midwife is like a good GP. She/he will know a lot in their own right and will also know when to get a more medically qualified professional. Both my wife's births ended to at least some extent medically (emergency C section, forceps delivery due to bradycardia) and the midwife called the appropriate obstetrician as soon as the traces gave cause for concern.

I think that the Portland is a bit like flying club class and staying in a 5 star hotel for a few days. It is fine if the money is basically loose change but if you are substantially compromising in other areas of your life for it, I think it is a bit of a waste of money and you may come to regret it later. I also think (although I could be wrong here) that, if a baby needs complex support, they will still be transferred to UCH.

[QTPie]

Midwivesdeliver, I feel the need to start a fan club for you or something - you sound really fab :)

I am sure that the vast majority of midwives are like Midwivesdeliver - or at leats start that way... It really is the money/resources of the NHS that often stops them being able to provide the service that they want to be able to. Midwivesdeliver's view of his job is exactly what I would hope a MW's role would be.

I live outside of London in a small city, but with a big hospital that serves as the high risk maternity centre for a very large area. So it probably isn't that different from a maternity unit in London. Those women I know that have birthed there have just about all had rotten experiences: lack of availability of epidurals, lack of midwife support during labour (i.e. midwife being busy with more than one woman), very little constructive support with breastfeeding, even a CS patient being turfed out after only 24 hours.

I haven't had a VB (ELCS for footling breech), but I am sure that GOOD MW support has a very positive impact on good birth outcomes. Being well supported, having trust and confidence can only relax someone more and that can only help.

One group that definitely has a very "rose tinted glasses" approach to natural VB is the NCT. I think that the delivery of the course depends very much on the teacher, but it is very "pro-natural birth, not a big fan of various types of pain relief (except gas and air), against induction and provides very little information about CS". You need to "read between the lines" and do your own research in some areas...

However there is a very fine balance on knowledge: between knowing what will be useful and frightening yourself witless... (and that balance is very different for different people). The medical profession in general (not just childbirth) is very much based on dealing with problems as they arise and not worrying too much about "what may arise". I was having a conversation about this with my husband's uncle (a well respected Pathologist) relating to cancer screening. I guess that much of the medical profession is a balance between resources/money and "benefit". This is always very difficult to take when it is one of us (personally) who is involved.

To be perfectly honest I see little in the analogy between "private maternity care" and "flying business class". Private maternity is not just "a nicer room and nicer food": it is about having access to the resources (in particular the time of medical professionals - mainly MWs and aneasthetists) that you wouldn't have in a very busy NHS hospital. It is about "one to one" care and very quick access to epidural (as quick as possible). Those can make an awful lot of difference in the birth experience. It is just sad that those resources are not available at all NHS hospitals (I think that they would be much more likely to be available at smaller NHS birth units).

QT

[thefurryone]

PeaceandHope you seem to think yourself and incredibly reasonable person but you were not just stating a personal preference you're just denigrating an entire profession because they can't help you to control every single moment of childbirth.

If I recall correctly you have been through quite a traumatic birth so I imagine your viewpoint is a little skewed, but despite your experience and the impression given reading childbirth forums the majority of women will have relatively uncomplicated vaginal deliveries assisted only by midwives.

I will be ecstatic if I don't see an obsetrician during this pregnancy as it will mean that I will have remained low risk and that I will have been able to have what will hopefully be a reasonably uneventful birth.

Also I wouldn't pay to go private but then I'm very fortunate in that I see the same community midwife at all non-hospital appointments (unless she's on holiday of course), and she was the same midwife who came to visit me after DS was born. I have a well staffed modern maternity unit just up the road, that has both an MLU and CLU. There is also a very high chance that you get to have your own room post-natally without charge. The midwives on the ward were amazing, they gave me endless help with breastfeeding, encouraged me to co-sleep and checked on me in the middle of the night when DS wouldn't stop screaming. I honestly don't know what I could have paid for to make my care better. It makes me really sad that this level of care isn't available to all women, but instead we end up with the luck of the draw postcode lottery or if we have enough money to throw at the problem.

Oh and apart from her teabreak I had the same midwife with me throughout labour. Although giving birth 7 minutes before her shift ended no doubt helped that a bit!

[larrygrylls]

QT,

I assure you that flying business class can make a huge difference in the "travel experience" too! I agree with you re epidurals but I don't think you get much better access to other medical professionals. I think there is also an issue of the quality of midwives who work at places like the Portland. How on earth do they get any practice at delivering babies when the consultant comes in at the last minute to do it? I know our private midwife told me that people she knew who worked at the Portland as midwives did not especially enjoy the experience (although it was well paid and relatively stress free).

I am also curious as to how (and whether) you really can get an immediate epidural at a private hospital? I mean, how many anaesthetists are there on standby the time? If a couple of women suddenly have to go to theatre, surely you will have to wait until the anaesthetists are finished there first? I read that the Portland delivers 2,000 babies a year, which is roughly 7 per day. Do they have 2-3 anaesthetists on standby 24/7?! I am not sniping, just genuinely curious.

I am not against private healthcare at all and we use it as a family selectively, but I do think that people should make the equation of the cost versus the quality of the birth experience (as you said) rather than feeling it will be safer or give a better outcome, as I don't feel that is the case.

[ghislaine]

Hi Larry, if you click on this link and look at some of the clips it may well answer some of your questions about the Portland. Yes, they do have anaesthetists there 24/7 and I think about 1/2 the women there have a vaginal midwife-led delivery. So I assume that is how the midwives there keep up their practice, they aren't inferior handmaidens to the god-drs.

The Portland also has a SCBU and a NICU for babies born after 30 weeks, so it is only in rare cases that there would be a transfer to the NHS - although this is also a risk you run in the NHS. There are always stories about mothers in one hospital and the baby in another, or twins split up, etc.

[larrygrylls]

Nappy and Ghislaine,

Thanks for coming back. Take your points.

I do think though that some private Drs create a culture of dependency on basically well patients. We saw a private ob for a while (v good one in terms of medical skill) when we had some concerns about risks of miscarriage (luckily false ones, was me being slightly neurotic). He insisted on doing scans every 2 weeks. This gave us some peace of mind, but for over £1.5k, and also there was nothing the scans really told us that made any difference to the outcome. As we had a cat, he also tested my wife (at a cost of £100) for toxoplasmosis antibodies. The only real advantage of that is that I KNEW that I had to change the cat litter, rather than doing it anyway as a precautionary measure. Luckily, we are reasonably comfortably off so that kind of money will have no effect on the rest of our lives. I think my reason for posting here is to alert people to the above. If they are comfortably off and it means a lot to them, I think that a private birth will probably offer them what they want.

Re the Portland in particular, I have only heard good stories about the birth experiences. OTOH, my own experience in seeing a private paed there and what friends have told me kind of makes me wonder where their priorities lie. They were the medical establishment in my whole life who insisted on in advance credit card payment (rather than billing in arrears), and the paed took a very aggressive and paternalistic line rather than actually interacting with our baby or listening carefully to our concerns. And, as to my friends who they had their baby at the Portland, they are IMO slightly overconcerned parents and the paediatrician there was very happy to check their (healthy) children every 6 months and personally administer all the usual vaccinations, for a very large fee, of course. Contrast that to another private paediatrician (also with a great reputation) we saw locally who billed in arrears, listened to us, played with our baby and then, when he was confident the problem was resolved, insisted on discharging us saying he did not want to see a "healthy baby".

[ghislaine]

Not to argue the toss with you, but isn't there a body of research that says that frequent scanning and TLC can help prevent miscarriage? Something to do with reducing stress hormones? So perhaps the dr was following a recognised line of treatment?

Re your friends, if they were happy to pay for something they could have had 'free' on the NHS, well, it's up to them how they spend their money. But when it comes to having a baby in London, money does make a difference, sadly.

ps I don't work for the Portland!!

[larrygrylls]

Ghislaine,

Really, never heard of that but I will check it out. Interesting idea.

Are you sure re working for the Portland? :).

Of course, people should be free to spend their money how they like. But, I would like to think that very well qualified professionals would feel morally obliged to give good honest guidance, such as telling them that a nurse can draw a syringe and inject it just as well as a paediatrician and that healthy children don't need regular "check ups". And, I think that most do, which is why that story rather shocked me.

[skandi1]

OP

The Portland is first class and I highly recommend it.

Choose your consultant carefully and by that I mean someone who suits your personality/outlook on life. Some are very hand holdy cuddly types and other come across more clinical. Depends how you like to be treated by a medical professional really.

I chose Donald Gibb. He is great. He is of the old school clinical type but great sense of humour under neath.

Total cost for consultant and CS was £13k but add to that £4.6k for the day I had a massive bleed and went into premature labour at 35 weeks and had a 3 day stay at the Portland.

The treatment during my emergency at 35 was excellent. Consultant was on the ball from the minute I called wailing and panicking to calming me down when we got to the Portland. We were all fine and DS stayed put for another four weeks after.

Actual birth was an amazing calm and lovely experience. And midwife care afterwards was fantastic. All in all they were very good to me and whilst expensive I certainly got my monies worth.

It all depends what's important to you.

Most consultants offer an initial chat so you can see them face to face to see whether you like them enough to deliver your baby.

Hth.

Ps ignore all the why are you going private just for a better room posts. There is far
more to it than that.

[QTPie]

larry, whilst one would expect a better seat/bed and (very marginally) better food, plus a few other "frills" (lounge access, priority check-in and boarding and luggage etc) in Business Class, you wouldn't really expect huge "health" benefits over economy class. MAYBE less chance of DVT ("economy clss syndrome"), but I have even seen cases of DVT reported in Business Class passengers....

I honestly think that a private birth (either MW-led or Consultant-led) brings more than just "comfort" benefits (i.e. "flying Business Class"). Obviously there are a LOT of different aspects to any birth, but the "state of mind" of the mother MUST effect the ease of birth (and the chances of intevention etc). If a mother feels more confident and relaxed, then things have to be easier. For me, that would be having one MW supporting me all of the way (subject to shift changes) and knowing that I can have pain relief when required (since extreme pain is a little worrying...).

As others have said, private hospitals (including Portland and J&L when it was operating) offer "private MW-led births" (where the MWs are responsible for the birth unless intevention is reuired).

The Portland, specifically, has a high proportion of ELCS and this is useful in "scheduling" anaesthetist resources. Nowhere can guarantee an "immediate" epidural, but when you are paying £10k+ for a birth you can bet that you are not going to be easily fobbed off....

I have no doubt of the great quality of the MWs/anaesthetists/OBs working for the NHS at all, but I have huge worries that they are so stretched that they often can't give their patients the attention/time that they would like to do their jobs to the best of their abilities.... They end up "fire fighting".

The NHS is a great institution in a fairly poor state (in many areas): they are still managing to save lives, but there is often not the money/resource to "care".

QT

[scarlettsmummy2]

Small observation- I have given birth twice on midwife led units, on the NHS, and both times the care I received from the midwives who delivered my babies was absolutely fantastic. I also happen to have gone to school with the obstetrician for one of the hospitals and although a lovely guy, the thought of him with forceps was frankly a terrifying experience and I would prefer a midwife any day!

I also think some of the posters are being unrealistic about what labour is actually like. For a start why they would want a midwife sitting with them constantly while they laboured is beyond me as it is totally unnecessary. Also I do not get the obsession with access to an epidural, especially as it can actually cause further complications. I had my last baby in a birthing pool with just gas an air and it was a lovely experience and I was up and walking around straight away. I had a gorgeous private room for three nights and husband got to stay with me, and had his own bed, all on the NHS. Why anyone would spend 20k to have this I don't know.

[QTPie]

Scarlettsmummy, I think that you were incredibly lucky... If you were at my local hospital you would have a VERY different story to tell. If all NHS hospitals were like that, then there probably wouldn't be much of a demand for private hospitals.

Pain is very subjective and people react to it VERY differently... The same with having a MW there: what is "unnecessary" to one person is "vital" to another. It is better to have access to something and not need it, than to feel that you desperately want something and not to be able to have it.

[MsF1t]

skandi - Are you referring to me with your PS? (I don't think anyone else mentioned the private room?)

I asked a genuine question- I was not taking a pop at all. I grateful for the helpful replies, and have continued to read the thread with interest, as I wasn't aware of the issues people were facing in London. I am in Scotland, and it seems we have better care and facilities.

As it happens, a close friend of mine had to fight to get an elective caesarian (she is in England) as her reasons for wanting one were not taken seriously. I do know how stressful these things can be, and I wouldn't ever want to be critical of people who feel this is something they want and can afford to choose, or who would like the extra midwife support during/after the birth.

Thanks everyone who has contributed so far, as this is not a subject I know much about (private healthcare etc). Very interesting, but sad that things appear to be so poorly run and funded in the NHS down there.

[ghislaine]

MsF1t, it's more likely that skandi was referring to Portland bingo which always comes up on these threads. You can guarantee that in any Portland thread, there will be mention of at least two of the following:

You/your baby will need to be transferred out to the NHS
alternatively: The Portland has no NICU/SCBU
(Two) women have died in childbirth at the Portland
You're just doing it for the fancy room
alternatively (I give extra credit for this as it shows insider knowledge): I wouldn't go there just for the Molton Brown toiletries
The Portland only does ELCS
You don't get better care by going private

[Tregony]

I had my dc privately at J&L (now not doing births). I decided to go private after a friend had a terrible experience at the Royal Free labouring in the corridor and hardly a midwife in sight. 1to1 care is what I paid for (and yes, my care was midwife led).

I had thought that I would have a perfectly normal/no drugs delivery - it didn't turn out that way and - yes I did have to wait for an epidural because the consultant anaesthetist was in theatre. I was happy just to get through with an emergency caesarian as both me and my dc were fine. The care from both the consultant and (all) the midwives was second to none. The aftercare was also excellent.

On to the comments re normal vaginal delivery - I have had several people, uninvited who have asked if I feel "cheated" by having an emergency CS or who have made points about how "X" has "done well" by having a vaginal birth with no or marginal drugs. It is not a competition.... I had obstructed labour and was in a very serious way when taken to theatre - a bit of flexibility in thought on this and sensitivity would go a long way.

[skandi1]

Ghislaine. Exactly. I was referring to the Portland bingo. Not any posts in particular.

Fwiw I had my first DC at UCL where their negligence almost killed both of us. I had procedures carried out without consent and a number of humiliating experiences on the ward.

The irony is that my GP refused to recommend a consultant for my first DC privately and told me that mothers (2) had died at the Portland, that they were very CS happy and I wouldn't have a normal
Birth and I would not be looked after well as they were only interested in money. And he highly recommended UCL as it was "just brilliant". What a joke and it was on me as I followed that advice rather than trust my instinct and go to the Portland.

So second time at the Portland was everything it should have been. And the midwife who cared for me was absolutely fantastic.

It may have cost £20k all in but I would have happily paid £100k to avoid treatment like the first time.

[PeaceAndHope]

thefurryone:


Actually, I haven't described any of my personal birth experiences in detail so far. I think you have assumed something just so that you can patronise me by saying I am "biased due to my trauma". It's a fairly typical tactic, one that people commonly use to dismiss the opinions of women they disagree with.

An uncomplicated childbirth experience is NOT experienced by the vast majority. If by uncomplicated you mean avoiding a crash CS or an assisted birth, then perhaps. (Although given that roughly 16% of the women have a crash CS and 14% have operative VBs, we already have a high percentage of complications if you put the two statistics together.) Even if a delivery occurs without interventions there can still be complications such as pelvic organ prolapse(which affects roughly 50% of women to some extent), incontinence, PPH, severe tearing etc. I know of a textbook birth that resulted in a baby with erb's palsy. So contrary to your assumption, we cannot prove that majority of the women and babies have no complications at all. Even a second degree tear that takes ages to heal or gets infected may be looked at as a complication by some people.

Lastly, your midwife is hardly representative of all midwives. You may have had a good experience but plenty of people are not as lucky. It doesn't prove much either way. You have good care by virtue of your postcode, but many others don't.

And for the last time- it's fab that you are low risk, but there is no piece of research that actually proves that uncomplicated pregnancy=uncomplicated delivery. Sure, your chances of ending up with interventions may be lower than someone who is high risk, but you can hardly ever have a guarantee for an uncomplicated, smooth birth.The most miserable of pregnancies end with easy deliveries and the most easy pregnancies can end with difficult and traumatic deliveries.

It personally gave me no comfort with regards to the delivery to be called low risk during my pregnancy. I don't think one has all that much to do with the other.

And yes, I dislike midwives. That is my opinion and I think I am entitled to it even if it offends you.

[PeaceAndHope]

ghislaine:

Yes, these things are always mentioned by someone or another.

Two women died at Portland. So? There isn't a hospital in the world where at least someone wouldn't have died is there?
Shall we list the several women and babies who have dies due to NHS negligence? I can post the articles right now if anyone would like to have a read.

Oh and this statement is quite funny- "The Portland only does ELCS"
Really?I must have imagined the friend who had a water birth at the Portland then.

The Portland DOES have an NICU and an SCBU. They also have an HDU for mothers who may require it. Don't take my word for it though. Here's a link-

www.theportlandhospital.com/Emergency-Obstetric-Facilities.asp

[PeaceAndHope]

midwivesdeliver:

You seem to be making assumptions about the journalist and the statistician. Perhaps because they don't match your views?

Anyway, approximately 30% women have CS in UK. It isn thought that about half of these women have crash CS while the rest are planned (repeat CS, breech presentation, pre eclampsia etc.) Secondly, about 14% of women have operative vaginal deliveries. Vaginal tearing is experienced by approximately 90% of women to some extent, second degree tears being the most common. About 9% experience third or fourth degree tears. (Source RCOG).
Approximately 50% of women end up with some degree POP, while a significant percentage experience some form of incontinence. The side effects of a VB also count when we separate complicated from uncomplicated.

This could go on forever, because different studies will show up different findings and each of us can come up with some logic to support our views.

I don't believe majority of births are completely uncomplicated, just as I don't trust midwives. If this opinion disturbs you, so be it.

[PeaceAndHope]

scarlett'smummy2:

People pay £20,000 to have what you did because not everyone can get that on the NHS. As my daughter would say, "Duh".

[heliumballoon]

According to the FAQs on their website, the Portland does not have birthing pools; if you want one they hire it in. (I would be pleased to be corrected if the website is out of date). When they boast about pain relief using water in labour, they mean, you can have a bath in your private bath room. Unfortunately by the time i was 9 months I could not physically get in and out of a bath...
I agree with what posters say about the Portland's attitude to payment. When I went for an early scan in pg due to bleeding, they first made me stand up to fill out a long form and pay. I was faint, bledimg and crying and was not offered a seat but barked at through a glass screen. Once I got inside it was all fluffy carpets and long lovely appointments though.