Caesarean - private or NHS Lewisham?

[Harveyrabbit76]

Hi
I am nearly 30 weeks pregnant and have been advised in the past and by my NHS consultant to have a caesarean at 38 weeks. I have a high shirodkar stitch which needs to stay in, so something that may cause extra fiddling! I am now slightly concerned about having my caesarian in Lewisham University hospital from some of the things I have read online, especially the postnatal care. I haven't even seen the same midwife twice, is this normal? Can any of you share birth stories, positive or negative?

My alternative is to go private at the Portland (where I had my stitch inserted), which costs a huge amount but inconsequential in the scheme of things.
We would normally think about taking a risk (if there is one!) but I am 40, was previously told very small chance of getting pregnant and we lost a baby at 20 weeks last year due to CI.
Please no judging on thinking about going private, losing a baby is a terrible thing and we just want to avoid any risks.
Thanks for reading!

Do you know the consultant that would do the elcs at Lewisham? It would put me off if there wasn't a named consultant, rather just plot luck.
Can you ask the doctor who inserted the stitch for advice?
Thirdly, can you afford to go private?

I was told I couldn't meet my consultant at Lewisham. It would be pot luck. This really concerned me. I hate hospitals and had been planning a home birth until my pregnancy became complicated. I ended up having a private CS at St Thomas. I wanted to be somewhere with a top level Nicu. I was very happy with my choice and would recommend it. In fact I did and one of my friends is having her CS there with the same consultant today.

Are you able to self-refer (as an NHS patient) to a hospital that you have more confidence in? Not sure why the alternative has to be the Portland?

Hi

Many thanks for the replies!

WhatKatyDidnt - I don't really know anything about other hospitals, but I am keen to find out! I am finding everything really confusing. I have heard QE in Woolwich is pretty dire (my friend also lost a baby there). We have only discussed the Portland as I had my stitch with Dr Gibb at the Birth Company and he arranges private births there, we are meeting with him next week. I trust him I suppose. I also know the treatment I received after the stitch was really reassuring so purely just based on a small experience, although always happy to have new options! I don't need to go private, I just want the best care.

Seashellhoarder - as eurochick says, I am not able to definitely have my consultant do the op, so would find out when the rotas have been sorted. That really puts me off as I am not really straight forward. We can can afford to go private (just) but if someone can give me positive stories of Lewisham then happy to try there! Especially post natal.

eurochick - could I please be nosy and ask how much it all roughly cost and who you saw? I looked at St Thomas' website yesterday out of interest weirdly enough.

Lewisham would be more practical but I lost my baby there last year pretty traumatically so that is another reason that slightly puts me off. I have heard the midwives are understandably stressed and so post natal care can be a bit inconsistent. I am pretty scared about the whole experience and just really keen to avoid experiencing a rerun of last year.

Thanks for all taking the time to read!

I had my ELCS at St Thomas' - the postnatal ward is not great but the actual clinical care (including NICU) is excellent and the senior consultant who did my section was fantastic and got me out of a sticky situation with PP hemorrhage. Kings is also supposed to be great.

I had my baby in the birthing centre in Lewisham and it was a very positive experience, sorry, not much help as you need a CS, hope it all works out well for you after what you've been through.

I'm your circumstances I would be trying to go private. If you go private at another (NHS) hospital you may find it slightly cheaper. Ask Dr Gibb for a recommendation of doctor, you could choose your hospital around that.

I can vouch for kings, as a pre-eclampsia patient (no CS though). I have heard good things from friends who have had CSes there, and also at st Thomas. I've heard mixed things about lewisham- a friend who had her first there is moving to st Thomas' for her second.
I think a practitioner you can get to know and trust makes a huge difference- I know my team at kings, which is so so reassuring. If I was turning up and getting pot luck I'd be in a very different headspace!

Maybe focus on the central London teaching hospitals? UCH, for example, provides top quality care. (As an aside, many of its consultants also do some work at the Portland.) It's a hospital that inspires confidence so I expect you'd feel safe there, whether you went as an NHS or private patient.

Can you self refer to another hospital where you could do the combination of NHS ELCS and private post natal care. For instance, Queen Charlotte's does this and I did it and was very happy indeed.

One of my godchildren was born at Lewisham, mum second c section, 37 weeks, fine.
One was born at Kings, c Section, mum at severe risk. Outstanding, I was there.

Diff midwives each time. As I had. No sweat.

Oh, Kings, also pre term.

You do whatever you feel comfortable with. I changed hospitals because care felt really scatty at Chester (supposed to be great) luckily my new hospital Leighton has been fantastic. I would defo have gone private if Leighton hadnt been so good. (I've had a lot of previous mc. I'm now nearly 41 years old 34weeks and booked for c-section at 39 weeks.
Don't put yourself under any unnecessary stress. Good luck

QE recently won the RCM midwifery service of the year from a brief Google. I suspect it depends on the midwives you get on shift, I've not heard anything awful about QE to be fair (apart from the food).

I live closer to Lewisham but went to St Thomas for everything because it was close to work and that made it easier to make it to midwife appointments. All I did was tell my GP I preferred St Thomas to Lewisham.

I had an EMCS rather than elective but one with a pesky complication and everything went very well. I would definitely have a look at going there for free before booking in with the Portland, unless money is no concern and/or you'd really appreciate all the extras there. Postnatal at St Thomas was no frills but the staff were attentive to any concerns.

Harvey - I had a CS in March last year at Lewisham after a failed induction at 39 weeks (had gestational diabetes). Am now 36 weeks with no 2 and have been booked in for ELCS on 6 July, also at Lewisham. I will be 40 yo in August. Whilst I couldn't possibly know the impact and sadness of your previous experience at Lewisham, I can totally understand why you'd consider going private and the desire to have a continuity and personalised level of reassurance and care. (I haven't had the same midwife twice in either Pregnancy).

Though the CS was during one of their busiest times and in retrospect not ideal, the actual surgical/medical/post natal care was excellent. My son scored 10 in the Apgar and all post natal tests done professionally and kindly. So we're going back for more!

My advice would be to log your anxiety at your next MW appt and ask to speak to the consultant obstetrician who may just be able to confirm the ELCS schedule far enough in advance for you to speak to 'your' surgeon. I was able to speak to the anaesthetist in similar circs this time around based on my concerns last year.

I will try and nab a private room (£75 per night) afterwards tho!

Good luck and feel free to pm me if you want any more detail.

Some consultants will allow you to do a birth only package so you get nhs ante natal and switch at the last minute to private if you need a section. I did this at st Thomas s ehen it became clear I would
Need a section and I wanted my consultant to do it. As it happens my insurance covered most of it but it would have been about £10k otherwise including a three night stay on the private ward. Can't recommend them highly enough. St Thomas is great on the nhs too the staff and the delivery rooms are the same you are just guaranteeing a consultant and a private room which is worth it. I was on the ears first
Time
Round and it was pretty
Awful

Ward sorry! Anyway a private ward of a large nhs teaching hospital will be a lot cheaper than the Portland and arguably safer

I had medical issues and went private to try and feel more in control having the same consultant listen to my concerns from the beginning. In the end because of this close attention it transpired my placenta was failing early at 38wks and I had a planned Caesarian the following morning. All straight forward and generally stress free. I chose the Lindo wing at St Mary's under Mr Teoh's care as they have a NICU unit in case there were problems with the baby. If you have medical concerns and the funds I would go private. It was very expensive but I don't regret the decision and would do so again.

Unless you have private medical insurance or vast riches, don't touch the Portland. The reason is that the NICU and SCBU are also private and are around £4K a night, so if for any reason your baby needs extra support, you could be looking at a giant bill. My uncomplicated delivery was £28k after my child had some minor but significant breathing issues and went off for monitoring to SCBU. We got most of that back on insurance.

In your shoes I'd look at the private wings of St Thomas and Paddington. Phone Mr. Gibb's secretary and find out where else he delivers at, as is be very surprised if he was only using the Portland these days.

In your circ I would definitely go private without question - probably Thomas's - try Kelleher perhaps (although he is v popular). Gibb has mixed feedback here but is obviously a hugely personal decision. Very best of luck. Portland is safe but I have always personally preferred the reassurance of the full NHS back up behind the private wing if something were to go v wrong, but with decent care, it's less likely to.

I'm so very sorry for your loss, it's desperately sad. I am so glad your new baby is almost with you now.

Kings is an international centre of excellence - the (private) Fetal Medicine Centre is a private branch of their pre-natal medicine. If I had the choice, and if they cover childbirth in their private wing (no idea), in your situation I'd want to be there.

I've heard that the Portland isn't really geared up for high-risk pregnancies, though it offers great service in comfort terms. I do understand the fear, but if you think private care is an option, might it be an idea to look at NHS private wings, which offer the same level of service with all the bells and whistles being attached to a major teaching hospital can afford, too?

My cousin had private sections at Chelsea & Westminster's Kensington wing and was very happy with them. There's also the Lindo Wing at St Mary's in Paddington. St Thomas' is also supposed to be good. I should also say that I don't know anyone who has had an NHS planned section who hasn't been really happy with the care (emergency, and the opposite applies, though).

Personally, I would want to be in a teaching hospital, not the Portland. Their focus seems to be comfort and security rather than high-risk care. But that could be a misapprehension on my part, of course.

Op I had both of my children (one of which was stillborn) by private c-section in London and can't recommend it highly enough. You see your named consultant really regularly, you get regular scans and (most importantly) you can choose a consultant with a niche specialism. If you can afford it, I'd say go for it. The peace of mind it brought us was worth every penny.

I do not recommend the Portland Hospital. They discharged me twice to my husband when I had been severely injured by a physician’s mistake during my labour and I was left in a wheelchair in severe pain and very badly injured but they told us and in writing that I was making a steady recovery. I had actually lost the use of my hip joint and my husband has been reading more recently to find out that actually I was dying from a septic condition that was setting in after the physician’s mistake.

They have never provided any support but left me in a wheelchair dying, I am left requiring major repetitive surgery for life, the impacts of the situation have cost us our home and worse, and the Portland Hospital management will not even accept that the incident happened. It’s not even in the copy hospital notes I have so no independent inspector would ever know.

As long as everything goes perfectly then you will be fine but the reality is that often things do not go perfectly. The Portland Hospital is not equipped to deal. And if something goes wrong they do not want anyone to know about it so they won’t call A&E. If it wasn’t for my husband figuring out that something was badly wrong then I would probably be dead. I have recurrent major surgery for life which the management do nothing about nor any of the other terrible problems that have happened thereafter.

I have all the details now so if anyone thinks this is a fake post then you can be sure that it is not. This is a genuine situation and I have my second major recurrent surgery in only a few years time now while they are there enjoying a plentiful income and nice holidays.

QE is awful. My SIL had her Dd there and couldn't wait to leave. Dirty, horrible midwives and security staff like little Hitler's!