Choosing a hospital in London - HELP please for first time mum

[kiteflying]

I am a first time nervous mum at 39 - my precious bean is the result of a succesful IVF procedure and no way am I taking any risks with him or her. I have already had one miscarriage scare and am doubly anxious. So we looked at hospitals early - I am only nine weeks now, and were astonished at how grubby and plain awful the three hospitals we were given to choose from were. We live in Islington and were told we have to chose from the Whittington, UCH and Royal Free. UCH was where we had our fertility referral work done and I had an infection after an internal scan in their ante-natal clinic. Scary and definitely not somewhere I would hazard twice! Our GP referred us to St Thomas' because of my concerns about my age, precious IVF pregnancy, and early miscarriage scare, and our MASSIVE (though diplomatically expressed) concerns over safety and hygiene at the three hospitals we were offered. St Thomas' have now written back to refuse me unless I have a medical reason for being referred there. I don't understand - I thought at thirty-nine (I will be forty when the baby is due) I would be automatically classed as high risk and accepted there, especially as I am rather anxious to have access to an EPU after my earlier scare. Is there anything I can do? Does anyone have any words of comfort that might make me more accepting of the North London choices we have been given?

Hi Kiteflying - I'm on my first as well (at 35) so don't have personal experiences to offer. I do know of someone who lives in your area that got St Thomas to take her on board even though she was out of the catchment area. She just hassled them - I dont' think there was anything more scientific in her approach except for that. Keep pressing and hopefully they will cave

She had to have an emergency CS in the end, the baby was 6 weeks prem and doing great now. They were very happy with the care they got so sounds like a good place to aim for.

Good luck

Queen Charlotte

Don't register anywhere you don't want to go. Just refuse.

QC is the best. I highly recommend it.

Don't go near the Royal Free. I'm hoping St Mary's is better because that's where I'm booked

I am at the Royal Free. The ante-natal care has been pretty shocking and I have felt alone and awful because of it. I know two people who have had bad times there and one who has not. Having said that, both my GP and my friend's GP have just chosen to have their babies there - so you would hope they have a bit of inside info. My friend who had the bad time said she thought UCH was even worse.

I can let you know more after my induction tomorrow!!

Sorry, not much comfort there.

Good luck poppynic! Thank you for taking the time to respond - you must be hectically preparing.

My GP was an intern at the Whittington and seemed to take offence at my expressed horror of its general level of UNcleanliness when I confided in her. I do not think she tried very hard to persuade St Thomas' on my behalf for her own reasons. I saw her referral letter and it was about three lines long.

Thanks for the info everyone.

I had DD at Whittingtom nearly 5 years ago, the labour rooms were nice as were the midwives, post natal care was pretty crap though, I stayed 1 night and went home next morning though. Things may have changed a lot since then , I think there are a lot of places that are worse.
If you are very concerned have you thought about a homebirth? Or could you afford private care?

Are you allowed to choose any hospital under the new guidelines and get the GP to refer you, or am I completely wrong. Who pays for you to go is it the GP or the hospital?

With regards to access to an EPAU, if you are 9 weeks now, most units only see women up to 12 weeks anyway.

Baked beans, choose and book is only in regard to seeing consultants regarding tests or procedures and who has the shortest waiting list etc. this doesn't applied to maternity services.

kiteflying, St Thomas is good - and many people know that. They have lots of mums outside their catchment asking to deliver there. I was not in their catchment but delivered dd there because I had a medical reason to be referred there by consultants at Harris Birthright, Kings College Hospital - dd had a suspected heart condition that St T's midwife team/NICU was set up to deal with.

However, St T has a private wing, I believe. So that could be another option, if your finances can stretch.

oh sorry I thought you could choose the consultant and hospital of choice, one of my friends has just had CS and changed her hosp cos she had had a bad birth the last time, but I didn't know all the details as she lives miles away.iyswim

Not fair play, - but you could always 'develop' a medical reason. Just hint that you think you 'might' have something and they'll want to keep a closer check. Suggest something nasty runs in the family perhaps!!!

Or you could tell the hospital you choose that you can be booked anywhere they like, but when you're in labour you'll be coming there! My mum did that with me and they gave in!

The thing is when I spoke to my GP about it, I mentioned that my cousin had been there and had had pre-eclampsia so was high risk, and it was because in the end she was safely delivered of both her twins that I felt inclined towards booking there. I also told her and that both my other cousins have had pre-eclampsia when pregnant, and have had to have CS and one had a wonky thyroid, and that my thyroid was looking like it might follow my mother's into wonkiness even though it has been pretty even right up until I fell pregnant ironically.
I thought the family history of both pre-eclampsia and thyroid problems WOULD have counted as medical reasons but the referring GP did not mention them in her letter. Meanwhile my normal GP is sending me off for thyroid blood tests because of my abnormally high fatigue levels, and racing heart...I don't why everything has to be this much of a battle.

kiteflying, can only comment on UCH. I'm sure they are great when the you-know-what hits the fan, however their staffing and hygiene issues probably create half the problems they have to solve.

We lived nr Islington, and I'm afraid we got the credit card out for #2 and went private at John's & Lizzies for a wonderful and memorable birth. We'll be paying it off until he's 16 (when he'll be presented with the remainder of the bill) but i must say it was worth it for the experience.

If I'd gone NHS, it would have been St T's. I'd second the advice to get bolshy and try and get in there, although I'm sure they have all the same staffing issues every NhS maternity dept in the S/East has.

Unfortunately your cousins pre eclampsia are not close enough relatives to have an imapct on the likelihood of you having problems.

Thanks for letting me know - I thought the GP must have had a good reason for not mentioning it.

i had one baby at st mary's & one at the homerton. fabulous treatment at both antenatally & for the births. post-natal not up to much at either but that's fairly common in london. i would reccommend them both.

I think you'll find plenty of people who have both good and bad things to say about pretty much every hospital in London!

St T's is just massively over-subscribed. A friend of mine, also in Islington, had her first there 16 months ago after much hassling and a very supportive GP. She's pregnant again, but has been declined by St T's despite being a 'repeat' customer and having a high risk pregnancy (toxoplasmosis). Your cousin's pre-eclampsia, as per pp, won't be enough of a factor in terms of your pregnancy risk. I looked at the private wing at St T's and thought it was pretty good, is that an option? Although that also involves paying for all your antenatal care too (about £4), plus delivery, plus a per night stay etc etc.

I had my first child at the Homerton. LIke Hoxtonchick, I had great antenatal care, easy access to EPU during some bleeding on and off around 12 weeks, postnatal care was pretty good too but I was given a private room which is a huge bonus. But I had a very poor delivery which went badly wrong, which is why I got the private room and I supsect why I got fabulous postnatal care too.

I am having my 2nd child privately at the Portland.

I have heard mostly bad things about the Whittington, although have a friend who had a great experience there, not so good things about UCH and OK things about the Royal Free.

It's impossibly hard to pick to be honest. I think you probably just have to go with your gut instinct, pick the one where you have the most faith in the staff you meet when you look round, and accept that nearly all postnatal wards are not the best and that your mission is to get out and home ASAP!

Personally I wouldn't waste your energy trying to get in to thomas', if your GP isn't being overly helpful and you're not having a classic 'high risk' pregnancy and have been referred by another hospital it's very unlikely you'll get in there. Plus, it's a FLIPPING long way from Islignton in the rush hour, in labour....ouch ouch ouc!

x

Thanks spudbaloo and everyone for your advice. I think I am going to try and appeal rather than just lie down and take it. Tempted very much by Bethbe's idea of just showing up on the day! What can they do, put you in an ambulance and send you back across the river like an alien invader?

But as we are renting, it may come down to moving into the catchment area for a year. I have lived in Islington my whole eight years in London so I don't really relish the prospect.

It is a shame because my landlord just offerred me my flat for sale and I had already spent hours redecorating in my head as a way of easing insomnia!

Thanks again everyone and enjoy your pregnancies.

one final thought: check whether the UCH maternity unit is moving to the new building before your due date. That would be a massive improvement and possibly equivalent in standard to St T's.

Dear Kitefly,
I'm 12 1/2 weeks pregnant with twins after an IVF and I live in Islington myself. I have teh same thoughts, questions and concerns (see my thread Choosing a hospital in London?? posted a few days after yours). My GP recommended UCH but I went to visit and I was not impressed. My early pregnancy was monitored at Homerton and it seemed a bit better, also so far I've only heard more or less good things about it (that's not the case with UCH, Royal Free and Whittington). You're not mentioning Homerton as a possible choice - which part of Islington do you live in? I'm in N1 and it is an option for me... You can chech your choices here:
www.nhs.uk/England/Default.aspx
I'm going to see a midwife at the UCH today and I'll ask what BrummieOnTheRun suggeted - when is the maternity unit moving to the new building. I'll let you know about that. Try not to worry to much - it's not good for you and your litlle one. Good luck and take care.

Prasessa, we have done the tour of UCH and were told that the maternity unit is moving to the new premises in early 2008. The double effect of this is of course that very little improvement will be made to the current unit in the interim!

Hi again,
look what i found on St T:

"... St Thomas's in London had one midwife to seven women in the (ho, ho) midwife-led unit. She wanted to transfer me to the hospital delivery ward but same staffing problem there. Bloody dangerous. Community midwives told me later St T's has a reputation for being 'lucky' because they haven't managed to kill anyone yet despite having so few midwives." - posted by edam on 21 Jan

Most people say it's good though.

P.S.: Sorry for all the typos in my first message, ;)

Bloody hell. Maybe the only solution is to take a private midwife with you wherever you go for the birth?

Have you actually booked in anywhere? If not, then don't. I was in the catchment area during my second pregnancy for hospital I oh so did not want to go to. The GP told me I had no choice. I showed him I did by changing GPs. I went to Queen Charlotte and was very happy with the care -- and I say this as someone who rarely compliments the NHS.

You may need to accept his next option. So, in my case I said "Hell no" to St. Peters in Chertsy, but then I pretty much needed to be prepared to accept what I got. As it turned out, QC would have been my first pick out of every hospital in the country, but I was prepared to accept others.