Lindo Wing...costing queries?

[Laurengrapes]

Hi all, this is my first post here! My hubby and I want to start TTC but I have a severe fear of childbirth and my local hospitals don't allow 'requested' elective c-sections for non-medical reasons, so I've been looking into private hospitals.

I got a price list from BUPA who deal with the Lindo Wing and they quoted £13,500 as a 'complete' package. However I've just looked at the Imperial website for Lindo and for the first 24hrs of care (inc. procedure) plus two extra nights staying there it comes to just under £9000.

I understand the BUPA package starts from 32 weeks whereas the Imperial is procedure only, but is it worth going direct or through BUPA? Is the extra 6 weeks worth it? Or is NHS care fine for before the big day?

Thanks in advance! :)

Dear God, there is some shit on this thread.

lepid0ptera Sun 01-Jun-14 15:33:20
I don't see how anyone could think being cut clean open in the midsection is preferable.

Plus the risk of complications- for both mum AND baby- are higher for C-section. Why would you want that? The NHS is completely right to deny you that, I think it's malpractice not to give a trial of labour in a healthy pregnancy.

I am due to have an ELCS in September. This is my choice. I sought out help and advice before getting pregnant and found a hospital with a progressive attitude to child birth anxiety and got my GP to refer me there. It was initially a little difficult to do as letters went missing and my GP was rather clueless though supportive but I got there in the end after a number of months of trying. The main problem I found is there is currently no care pathway for women who have fear / anxiety over childbirth but have never had a child previously. What little support and understanding there is in place seems to only be relevant to women who have had a traumatic previous birth experience.

I had a very positive response from the consultant midwife I saw. He has a special interest in the area, and as a result of his leadership they have dealt with a number of similar cases. Unfortunately I am in the NW rather than London.

He agreed in principle that I should be allowed an ELCS before I got pregnant. He took a great deal of time reassuring me that how I felt, though unusual was not extraordinary. As he was giving literature to me about the subject, he noted himself that it referenced they only carried out ELCS for medical reasons; he said he should read it more often as was badly phrased and knew it would worry me. He went to great pains to stress that he considered my request for an ELCS to be a valid one and considered it to be medically necessarily on mental health grounds because my case is so severe.

Far from being malpractice, NICE agree with his position. In their guidelines they state that no woman should be denied an ELCS as they believed to do so, could potentially cause psychological damage. Which in its self would obviously constitute malpractice...

As for the shit about how risky CS's are. I wish people read a bit more before spouting that crap. Yes there are risks, but there are also risks associated with a VB (including psychological damage if you force someone to have one against their wishes). Its about balancing risk with the needs of the mother and baby. NICE did state that they found very little difference in physical risk for first time mothers having a planned VB and having a planned ELCS (though they didn't comment on subsequent pregnancies, which is a flaw in their assessment and is something that anyone in this position should be aware of).

I do know that some London hospitals (cough C & W) are refusing to acknowledge mental health reasons as a medical needs. But NOT all. You do, in theory, have a medical reason for an ELCS if it is affecting you to the point where you are delaying having children and actively seeking private routes on the basis of your anxiety.

My advice in your situation, would be to try and see if you can get any success like I have. If you can get diagnosed as having a problem it makes it very difficult for them to refuse you under the NHS. Finding a hospital/consultant who is sympathetic can be a challenge, as can getting a GP who is supportive, but it CAN be done. As you are not TTC yet, you have the luxury of time to try and go down this route, so use it.

I was at one point, considering the same option as you, but with the added complication of living 200 miles away. We decided to try the route we have taken as we figured we had nothing to loose by trying, and fortunately it worked out.

Interestingly, my consultant was slightly scathing about some private facilities because of the ethics involved - remembering he has no problem with requests for ELCS and on principle never refuses one. I know his position is that women who ask for an ELCS generally do so for a reason - its been found to be a red flag for extra support in research done abroad. Its not JUST about the birth. Its about understanding your position and having emotional support if you need it. Certainly performing an ELCS at 36weeks without medical reason is a dubious practice, as this definitely does increase risks to the baby - and I would have serious concerns about anywhere that was willing to do this, based on this evidence and current recommendations that are based on it. Are they really acting in your best interests, or just because you have the cash? If you are putting your life in their hands its important to know.

Remember you have a problem which IS considered a medical issue. Don't let someone phobe you off because they are backwards thinking and 'don't believe its a real issue'. Consider it like other mental health problems, that have taken many years to be accepted by some medical professionals who in the past had shocking attitudes towards people genuinely in need.

RedToothBrush What an amazingly clear and important post. I personally am a huge support of homebirths but at the same I think what is most important is that women are enabled to give birth the best way for them. Birth is not simply a physical process it is also a hugely emotional one and protecting women's right to birth in the way they understand to be best for them is so important.

redtoothbrush thats great that you were able to find the help you needed to get a birth that was right for you.
I have my own preference for childbirth as does everyone else and I think everything possible should be done to ensure that women can give birth in a way that feels right for them as at the end of the day mother and babies health is most important and someones mental state can have a huge influence on that so if all it takes is a planned c section then i think women should be able to have one (even though for me a csection is rather more scary)

I can't believe there are posters on this thread who think they have the right to an opinion on how another woman gives birth.

I am a feminist because I believe women should have the right to control what goes into and comes out of their vaginas

With risk of derailing the thread. It is precisely because I am a feminist that I care how babies come out of women. I believe we really need to change the systems around birth and the images to enable women to birth in empowered ways and take back control of birthing room so they female centered and controlled spaces. At the same time we need to recognize that women may want to birth in very different ways and we need to work so the system can support women to have autonomous control of their body before during and after birthing.

OP we're going private at another London hospital. Reasons:

1. I want an elcs. No fear, I just don't fancy labouring or blowing out my pelvic floor.
2. I want my dh to be able to stay every night in a bed in our room and I abhor the idea of a shared ward or bathroom. You can't guarantee a private room will be available otherwise.
3. The midwife ratio is 1:1 for the first day and 1:2 thereafter
4. Lactation specialists on call
5. Better food
6. Most importantly, excellent pre-natal care. Consultant on speed dial to call at any time with any query, however small. More frequent antenatal checks and scans.
7. Knowledge that all of the staff treating me are at the top of their field. Nobody below consultant. And I don't have to deal with midwives.

Each to their own, and the £15k we're going to pay (assuming three nights in) is quite a bit of money. But to have a calm and assured pregnancy and then a relaxed and private birth and recovery makes it worth it for us.

As for risks, there's less risk in an elcs than a vb for brain damage (1:10,000 vs 1:1000) to the baby, less risk of maternal fatalities (0.31 per 10,000 vs 1.74 per 10,000) and every doctor I know has chosen one, if nothing else than to avoid the 5% chance of incontinence that comes with a vb. As a PP says, there's a reason NICE days you can have one if you want it. They're not risky. bottom line, if you want an elcs and private room, go for it. I think it's some of the best money we'll ever spend. Ignore the tripe about pain for six week too. Everyone my consultant operates on is up and walking the same day.

"As for risks, there's less risk in an elcs than a vb for brain damage (1:10,000 vs 1:1000) to the baby, less risk of maternal fatalities (0.31 per 10,000 vs 1.74 per 10,000) and every doctor I know has chosen one,"

It might be helpful to have a look at the NICE tables comparing outcomes for planned c/s and planned v/b.

here

They don't seem to support the figures above.

My personal view is that planned c/s is very safe, but you are working on a system of diminishing returns, whereas with vaginal birth you are going in the opposite direction - so if you want more than one child you need to look beyond the first pregnancy and birth to get a clearer picture of the risks and benefits of each option.

Would also add that slightly more than a third of the money you're spending on 3 days in the Lindo wing would buy you one to one care throughout your entire pregnancy, your labour, and a month of postnatal visits from a consultant midwife.

Point being - comparing outcomes of planned c/s with those of v/b where many of the women have laboured in the NHS in settings with high intervention rates, sometimes high rates of substandard care, and low rates of one to one care, well, you're not comparing apples and apples are you? Most of the problems associated with planned v/b are attached to emergency c/s, the national rate of which is 14%. Healthy first time mums giving birth in midwife led settings have a rate of unplanned c/s of nearer half that.

Hi OP - just to address the very specific costing differential point between BUPA and Lindo, it might be that the Lindo only quotes the fees payable to the hospital itself (the operating room, the bed, midwifery care, etc). The consultant who will be leading your care, and the consultant anaesthetist who will do your spinal, both bill separately. I was at another London hospital similar to Lindo and £13K sounds about right all in.

nicole the stats I have are from the BTA study analysing quantitative outcomes for more than two million births over a period of two and a half years in England. Elcs came out as less risky for both mother and fetus than both vb and emcs.

As for the care of a midwife, my whole aim was to avoid using them. And I suspect a lot of people who go private do so for the same reasons, namely that they want a fetal medicine specialist. Too many studies showing problems where midwives have tried to avoid intervention or delayed calling doctors during vaginal birth for comfort.

In addition to which, the risks incurred by having up to and including four c-sections are minimal. Risk to the mother of uterine problems only comes with the fifth section and even then, it's a tiny marginal risk. So sure if you want 5+ children you need to look at that tiny hike in risk but realistically how many people want a family that large?

It is also statistically incorrect to say that emergency c/s problems make up "most" of the problems that come with vb. incontinence after a vb sits at 5% across the board and has nothing to do with c/s for example.

Also agree with "Eliot". We're paying about £7000 to the hospital, but then the consultant and anaesthetist will be about another £8000 together on top of that.

"Elcs came out as less risky for both mother and fetus than both vb and emcs."

Sorry - I don't understand. A woman who has a vaginal birth which doesn't end in surgery (ie an emergency c/s) is still more likely to die or suffer serious trauma than a woman who is having major abdominal surgery?

Die from what?

"It is also statistically incorrect to say that emergency c/s problems make up "most" of the problems that come with vb. incontinence after a vb sits at 5% across the board and has nothing to do with c/s for example"

Yes, you are right about that. It's about double what it is for c/s.

"Risk to the mother of uterine problems only comes with the fifth section and even then, it's a tiny marginal risk."

Not sure the RCOG would agree with you.

Their latest report on placental problems says this: "Maternal and fetal morbidity and mortality from placenta praevia and placenta praevia accreta are considerable and are associated with high demands on health resources"

My understanding is that placenta accreta complicated about 1 in 200 of pregnancies following 2 c/s and 1 in 50 for those following 3 c/s. Having had a friend and her baby nearly die from this condition I think that's quite a major worry - it would be for me. I suppose my perspective is skewed by my experience of this.

Hi there,
I was really nervous about chdbirth too - so took a hypnobirthing course and did the meditations and breathing exercises (only takes about 10 mins) nightly for the last 5 months. I was so calm and zen that I did 16 hours if DRUG free labour! Unfortunately, her head tiled and pressed on my uterus causing it to swell so at hour 16 I had an emergency C section - but again I was just so calm from the hypnobirthing techniques it was no issue. I did find the recovery painful and frustrating because you can't really get up to help the baby for the first few days, and it was painful for the first month - so try hypnobirthing for a bit and see if you can lose the anxiety - I'm pregnant with my second and thankfully able to delivery naturally and would not want to repeat the c section recovery.

For those of you who believe a vaginal delivery is quicker/ easier to recover from I can assure you it was freakin walk in the park for me and I'm particularly loving the stress in continence now.
Unless I'm mistaken your body is your own and you have the right to do what you want with it and for some that means choosing a section. Leave her alone all she was asking about was costings

slightlyinsane - the thread is a year old. OP is long gone.

My friend has a fear of childbirth (she works in a children's hospital which may have something to do with that!) and she got an ELCS.

Hi @Laurengrapes,
I’m in this exact position now! Just wondered how much it cost/your experience? I’ve never used this before so would have sent a message directly- just didn’t know how!