St. Thomas hospital midwifery vs. consultant led private care

[noosch]

Hi, has anybody had an experience with the private Landsdell Suite in St. Thomas hospital. I cannot make up my mind as to if to go for midwifery or consultant led care. Could anybody help, please? Thanks

check out midwifery staffing levels particularly how many midwives actually on for direct patient care in the middle of the night when people actually give birth. Only one midwife to 7 women when I was there in the midwife-led unit. And same in hospital birth centre, or she'd have shipped me over. No experience of Landsell.

When I enquired a few months back they were no longer offering MW led care at the Landsdell as MW was retiring

I was there yesterday and they said midwifery led care is still available. I hope that at least if you are paying for midwifery care they will have enough midwives there, however they said that if I were to go for consultant led care then a midwife would not necessarily come from the Landsdell suite and may be one of the midwives normally working in the birthing center - which makes me wonder how they would do this if in the birthing center they already have shortage of midwives!

Hi Noosch,

When I was looking at private maternity facilities (Nov 05) I visited St T's. Two things that put me off:

1. I was told the consultants were not pro-waterbirth and they reeled off a list of reasons from the 1980s! Incredible. The consultants there were clearly not comfortable with use of pools, which also suggested to me that their approach was going to be highly medicalised. This may not be an issue for you, but it was for me because I wanted as natural a birth as possible...unless I screamed for an epidural of course

1. The labour facilities they use are exactly the same as the NHS facilities. Fantastic for an NHS hospital, but my point is that basically you're paying through the nose for the benefit of the private room afterwards. At about £800/night, if I remember correctly. And they were single beds so difficult for stop-overs for hubby.

You may as well use the NHS facilities and save yourself the cash by booking into an expensive hotel afterwards

Great NICU facilities though, if you're high risk.

Maybe you get guaranteed 1:1 care from your m/w if you go private?? Worth asking.

But really depends what type of birth you're after.

Thanks a lot for your help! I am in a lucky situation where my insurance will cover the costs for private birth. I was deciding between St. John and St. Elizabeth and St. Thomas and thought that for the first baby I would prefer to have the security of a full NHS hospital, although everything which I have heard of St. John and St. Elizabeth sounded highly appealing to me. The consultant I was thinking of, Mr. Mascarenhas, seems to be supporting natural birth, will definitely ask him at my first antenatal appointment about water birth. Also I would hope that private care implicates garanteed one-to-one midwife care (otherwise, I would not understand what you are paying for), but would definitely clarify this as well.

I ended up going to John's & Lizzie's and nearly cried when I had to leave! The whole thing was so fabulous they were going to have to kick me out. A very special experience. And on a practical note, the pools are in the delivery rooms which is a bonus over St T's where they are in 2 separate, very clinical rooms (which may be in use).

Do speak to J&L about their transfer rates to other hospital NICUs. It was an initial concern of mine, but found a chat with the team there put my mind totally at ease.

Noosch - final thought, because re-reading your post it sounds like you've booked into St T's (which I'm sure will be great), do specifically ask him how many women the midwife(s) would be covering.

Thanks a lot for your help! I am going to the ante natal appointment next week, so I will know what to ask

I had DS at St Thomas privately with Mr Mascarenhas. He is lovely and was very supportive of my wish for a "natural" delivery. In the end my waters broke without the contractions starting which meant DS had to come out relatively quickly after that (within 48 hours) due to the risk of infection. The contractions started but weren't very effective and 24 hours later I was effectively being induced. Actually it was the mid wife that "scared" me into an epidural, Mr Mascarenhas didn't mention it as I had asked him not to offer 1 unless I asked. As i was private I got a consultant to do the epidural - worth it just for that!! I got fully dliated eventually (after several worrying hours with the mid wife thinking i should have a em c-section) but was so knackered by then didn't manage to push DS out. Mr Mascarenhas delivered him by forceps (apparently very high) which hurt like hell and the stitches were sore afterwards. BUT i did avoid a c-section which is great now I am expecting no 2. I'm sure I would have been in theatre before I had chance to blink if I was on the nhs as that seems to be the "easy" option for the doctors now.

I had 1-1 care from the midwife too (from the birthing centre) - she never left the room to check on anyone else.

Am having no 2 at St Thomas too although not privately - feel more able to be in control myself second time round and am hoping it will be relatively quick this time and I will be home soon aftwerwards. DH won't be able to stay anyway as we have DS! Also the single bed wasn't an issue - I didn't want to share a bed anyway and DH had a camp bed in the room with me. The 3 of us were together the whole time which was lovely.

HTH and sorry if TMI re birthing story!!

Hi, hotlipsmummy, thanks for your mail! It really makes it easier to decide where to go if somebody has had the experience before As far as I understand you opted for a consultant led care. Was Mr. Macarenhas with you during the whole labour or only in the end? And a very stupid question why do you need a midwife as well?

Mr Mascarenhas only delivered DS and did the 4 hourly checks. He did come and check me though when the mid wife/junior doc was muttering about a c-section and I demanded that they get Mr M before making any decisions as I was a private patient etc etc.

I think that its usual for the mid wife to be present during labour (regular checks and I was being monitored anyway due to epidural and drip) and the consultant to only be there if necessary and at the end. But perhaps that's something to ask!!

Thanks a lot, I will see what he tells me at the appointment