Questions from a confused husband

[confusedhubby]

Apologies but this is not a 'to be mum' but a husband who is looking for answers. I just want the best for my wife and it's apparent that she is pregnant and a bit panicky. So if you can help that would be great.

Context: She is 12 weeks pregnant and expecting in Nov. She had two cycles of IVF but only 1 imputation as the 1st cycle was unsuccessful. She is expecting a single child. She is 30 years in age and of average weight.

The problem: She is scared. Big time regrading her delivery.
We live in Croydon and aren't impressed with the NHS facilities in miles. She already had a botched day surgery prior to us shifting our IVF treatment to far away central london.

Questions for the forum:

1. She wants a C-Section delivery rather than natural. Is it best to go private and is this our only option?

1. My problem is that someone like Portland are at least 30-40 minutes away in a ambulance from CR7. Won't she have a issue if I book a delivery mid-wife or consultant and she goes into labor with all the travel time.

1. I ideally want her to get some antenatal private care also as she frets that she isn't be checked for so many additional things that can be..for e.g. iron deficiency if any to mitigate which she could take some vitamins

1. Let's say if Portland say that £10k is the delivery charge for a C-Section but a complication happens. Can they give me a amazingly high £30k inflated bill to handle it or will that complication get treated on NHS. I don't have a £30k budget:-(

My ground work: I have got a list of obsterician's from Portland and I made a few calls who said that they would charge £280 for consultation, £1000-1100 for delivery + Portland charges of around £8-10k for doctor led delivery. Any advises on this also plus the above 4 points will be greatly appreciated from a confused husband.

Apologies for storming into this forum

Just weighing in briefly.

I tend to agree with DrCharlieGirl. A reputable NHS hospital is the safest option. I met mums in the neonatal care unit where my baby ended up after premature birth and emergency C-Section who had been at the Portland but had to be transferred as they simply don't have the facilities. I don't mean to scaremonger. It's just that if both of you are concerned about contingencies, having the right back up care on site is very reassuring.

Good hospitals already mentioned. I was at Queen Charlotte's. Not in my area but I asked to go there. It was excellent.

As to C-section...defo worth a chat with an experienced Ob. Not without problems, but not as bad as people say either.

One more thing: if she can try to relax it will help. Hard, I know. It all feels a bit out of control. Might be worth a look at the Dr Gowrie Motha book (the Gentle Birth Method) and relaxation tape/CD. Some places do special pregnancy massages and there's a private midwife called Toni Tucker who specialises in fertility and acupuncture. She will do acupuncture sessions to help pregnant women relax. Sorry I've gone a bit off-message but an ability to avoid worrying too much will make for a smoother pregnancy and birth.

Congrats and good luck.

Good luck. I second some of the advice above

1. Antenatal classes - NCT classes can be really good and also give you an inbuilt support network for late pregnancy/first year of babyhood. Many people make lifelong friends through these.

1. Doula. Yes, yes, yes. They are wonderful, and relatively inexpensive. Look on Doula UK. Best thing is to look up a number of doulas who work in your area and chat to them all. You'll know the right one - she will be the one whom both your wife and you instinctively feel comfortable with, and who is respectful of and supportive of your wishes re: caesarian etc. Pick someone who offers both delivery and postnatal support - the postnatal support will be really helpful. You may be able to find one with experience of helping mothers breastfeed after caesarians (if that's what your wife wants to do) for example, which would be invaluable. Doulas will also have experience of local hospitals and can be helpful for talking through which one you want to choose. They are invaluable for helping you fight your corner about your choices, and for helping to making sure you get the care you want at the time (when the mother may be in no state to insist, and the father may be too stressed)

1. You can have extra scans/blood tests etc. at private clinics, for very reasonable costs. The Fetal Medicine Clinic is one. I chose to have an extra scan (not in London) at 36 weeks just to be sure my baby had turned into the right position (she had, and was born a couple of days later...)

Lots of good advice on this thread. My feeling is that you might be better off going NHS, but pulling in a range of private support as listed above - this will give you a full package with better support than blowing all your limited cash on the Portland. And that £15-£20k you save will come in very very useful in your baby's first few years of life!

Good luck :)

Difficult one and a very personal decision - there is no right or wrong as this is so subjective; also a question of finances:

I had very poor care after a late MC at an NHS hospital (I still feel traumatized by it) and then was very lucky to fall pregnant again two years late despite very low chances. I wanted a safe environment for my baby to be born and minimize risks; I did not care about my pain or recovery as I wanted this baby so very much. I also have a friend who lost baby in week 39 due to NHS mistake. My husband's older brother died during birth again because of a NHS mistake (but that was back in the 1970s so does not reflect on NHS today). However, I know about anxiety and understand it very well.

I am sure that there are excellent NHS hospitals and that anxiety counselling for your wife is a good option but if your local hospital is not so great then I can definitely and unreservedly recommend The Portland. It is expensive though and you are looking at about £10000 - £20000 overall depending on how long your wife will stay after birth, whether it is consultant or midwife led birth, ELCS or emergency CS or natural birth, you have consultant led pregnancy care, etc. Price info should be on the Portland website. Lots of money!

I had booking appointment at NHS hospital and it was rubbish again so that I went for a private 12 week scan at The Portland. BUPA did not pay - obviously - but I loved The Portland as I was treated with dignity.

After hearing too many horror stories about my local hospital (confirmed again by my NCT class mates), I did research into going private. I had consultant care during pregancy (about £6000; a friend of mine currently pays £7000 with different consultant) and a ELCS at the Portland. I live in Kent and just took the train to London and had the baby (during the Olympics). The other mother in my NCT class that decided on private care was a GP (NHS) who had experienced too many scary things during her training. My Portland consultant was pro natural birth and only because baby was big and I was older did she agree on the ELCS. Recovery was quite tough initially but felt completely normal within weeks. Felt relaxed during ELCS, all calm, organised, clean and The Portland is absolutely excellent.. I know several other people (I spoke to them before I took decision) that had their second baby at The Portland after bad NHS births. Should I have a second baby, I would rather not go on hols for 5 years and save up so I could have it at the Portland again.

My consultant also said that I should always have enough time to come to The Portland even if baby came early and I had contractions - again I live in Kent. Don't be put off by living a bit further away. If you have an ELCS, then no problem anyway.

Does the Portland provide detailed information about maternal and neonatal outcomes like NHS hospitals have to do?

They have this report on the information they submit to external bodies here but not being a clinician myself I don't know how this compares with the NHs in terms of specificity. It does say they report on stillbirths and maternal specific outcomes.

I want to point out that even if the NICE guidelines state that CS should be by maternal request this does not mean hospitals have to agree to this. The guidelines are just that, guidelines, not the law or a set if rules. There are lots of things set out in the intrapartum care NICE guidelines that don't happen often in real life.

That said, it's all about informed decision making and you and most importantly your wife need to really educate yourself on the pros and cons of caesarean before making any decisions.

Yes, Portland tells you everything you want to know and you definitely need to educate yourself before deciding! Information is everything

I had an elective c section at St Marys private Lindo Wing in London and travelled from the north of England for it, staying in a hotel the few days before.
It was the best thing I ever did...care was fantastic , was also cheaper than the Portland. 7,500 for elcs then 900 for each extra night after the first. consultant fee was 4,000. I was in on the thursday morning and left on the sunday midday feeling fine.
I kept on the books of the local NHS in case of early labour and saw a local midwife but also saw my consultant in London. had a relaxed pain free birth and great aftercare. I had been so nervous and worried about local NHS care too after friends bad experiences