Where am I more likely to get an elective c-section in London?

[Ginger84]

Hi,

I am a foreigner living in London and feel quite overwhelmed with the NHS system around childbirth. On the one hand, they tell you you have choice, but on the other hand they are very resistant to the idea of an elective c-section. I have a family history of emergency c-sections as far as back as my great grandmother due to having an android pelvis. Now the NHS consider me crazy for requesting to avoid all the agony of an unsuccessful childbirth which I believe will anyway end up in a c-section. I also feel VERY strongly about the use of forceps and ventouse (instrumental assistance in delivery) and would rather die than see my baby's head damaged by those awful and dreadful instruments. I have a good friend of mine who is permanently disabled because of those awful instruments. Not to mention the damage it will do to me...I come from a country where FGM is extremely high and I feel terrified of the idea of having instruments down there and cutting me up down below, as I was one of the lucky few who didn't get to have FGM performed on them. So all this combined makes me very much risk averse and willing to do anything to avoid the risks associated with a natural birth. St. Thomas where I have been referred is blindly resistant to my wishes and prefers to charge you thousands to grant your wishes and not kill your child over giving you a "real" choice on an assurance that I have foolishly paid into for years now.
That said, realistically speaking where can I ask for an elective c-section in London without being turned down? In other words, where are the NICE guidelines being respected in London hospitals?

Alternatively, anyone to have recently had a private c-section delivery that cost in total less than £9k? I am currently able to afford up to £9k but above would cripple me financially. On hospital websites there are always those "packages" specified that EXCLUDE other costs. So it will be helpful to know how much it cost others who have done them in total. Many thanks and sorry for the long post.

I haven't any recent NHS experience but I do know that you can engage a consultant for c-section delivery only at any of the private maternity hospitals/wings across London. Hospital fees would be on top of that and I would budget for at least a 3 night stay.

C-section only package: www.thebirthcompany.co.uk/antenatal-and-birth-fees.php

Hospital fees at the Lindo for a c-section: 2ic5hf2u26uo1u64w43h7rt0-wpengine.netdna-ssl.com/wp-content/uploads/2018/01/The-Lindo-Wing-maternity-prices-2018-1.pdf

This does add up to more than £9k but it might be possible to get it more cheaply if you look around.

I had a private CS in London. Your 9k figure is way off unfortunately; those Lindo wing fees are only for the hospital. All the private hospitals charge around that sort of price but you would also need to pay £7000-8000 to the consultant and possibly another £1500 for the anaesthetist. Then you need to pay out of pocket for every ultrasound, blood test, urine test and if anything unexpected happens, you also have to pay. I didn’t go to the Lindo wing but it was another London hospital and my ‘all in’ bill, baring in mind I had no complications was about £18,000.

No advice on where you might be able to get an ELCS by maternal request on the NHS in London unfortunately, a friend did have one at Kingston but that was in part due to a previous VB from hell.

Good luck!

Hi there, you say you are from abroad, do you have health insurance as international health insurance usually cover a private delivery?

A friend recently persisted with her midwife and Doctor team as she also had personal issues to not give birth and wanted an elective C section. She had multiple meetings and was assessed psychologically and at the 36th week they agreed she could have an elective caesarian so I do know the NHS can do this for mental health reasons. Have you asked for second opinions within your hospital? Maybe a referral note from your own GP that covers how seriously this is impacting your mental health?

You can get a CS on the NHS if you are determined and persist. Follow up every appointment in writing and additional written reasons. Explain your anxiety in detail. Agree to go to counselling and to talk through your reasons/anxieties.

I personally favour VBs even for those with your condition, and believe any poor outcomes come from poor practice rather than a woman's ability to birth, but I also believe in women having autonomy over their body and birth process, particularly where the evidence shows that stress and anxiety during the birth process are likely to lead to emergency c/s anyway which costs more and is way more risky than a planned c/s.

Contact Birthrights. They campaign very effectively on the rights of women in childbirth and pregnancy, and one of their recent campaigns has been around elective c-sections and women's right to have one if they feel it is necessary.

www.birthrights.org.uk/2017/05/do-i-have-a-right-to-choose-a-caesarean-section/

Do contact them -- they have letter templates and may be able to help with advice and support.

Thank you all for your very helpful replies. Ghislaine, thanks for the links you shared. Thebirthcompany is interesting and I may explore this option further.
Troubledlichen, you are quite right! I realised this today when I made a phone tour exploring the prices I found online. The only exception has been King's who have a full package with the consultants fees waived, but they told me they are revising this policy this week and might increase the costs of their packages. I also found that the Royal Surrey County Hospital has a relatively affordable package, albeit out of London. The hospital does have good reviews though.

I think looking at the options out there, I am better off fighting my battle with the NHS. I am going to continue nagging, taking notes and yes do email follow-ups and stressing on how much I believe this is the sound medical choice for me. I also contacted my OB/GYN back home this weekend and he confirmed that given my family history he advises for an elective.
Thanks, MsMotherofDragon (love your name by the way :)), I will contact Birthright and find their campaign to be very inspiring. Thanks for sharing.
As for international insurance, unfortunately with me living in the UK for the past couple of years I didn't opt for an international insurance thinking that it won't be necessary when I am ensured here... probably naive of me, but definitely worth exploring for any future pregnancies though.
Thanks all so much and please if anyone has more thoughts please do share them.
Also one final curiosity, can you by any chance stay on the NHS but pay the consultant separately to perform your surgery? So let's say I fight for the elective and they tell me to check with a consultant, can I hire this consultant separately to perform the operation on NHS? I know you can get all on NHS and then go private, but can you mix and match the NHS?

I have had one approved at Kings College if you are near (possible of you are with st Thomas now).

I have had a fantastic experience getting it approved everyone has been empathic and kind and I have not had to “fight for it” at all. Just going through the process of community midwifes, consultant midwife, obstetric consultant etc to get it all signed off but every single person has been professional and simply wonderful.

Forgot to say that my first delivery was a forceps one and it was horrible in every way. Damage to both me and baby and it took me six years of therapy to consider having another child. I said that basically I would not follow through with the pregnancy if I wasn’t allowed a c section, so strong were my fears. All professionals at Kings have been understanding and supportive of my choice. They also agreed that due to my horrid birth injuries a c section is advisable.

I wish I had never had a forceps delivery, it was barbaric in every way.

Hi Lndnmummy, thank you so much for sharing your experience. I have been contemplating about Kings College as well as I am within their catchment. I am not sure if they will accept me though for referring over to them and asking immediately for an elcs. I am really anxious right now and reached a point of not being able to sleep at night! Still St Thomas doesn't bother...and the community midwives seem to belong to a cult somehow. The cult of natural is good and trying to convince me of something that is giving me even more anxiety. The more they push, the more I am getting anxious and desperate.
I was also exploring the private option at Kings and they had a pretty affordable package. When I called them though they said they are revising it and might increase the costs (luck is not my side!). I am hoping that it remains reasonable and if so I can do a referral and then try to ask for an elcs and it refused go private there? Did you have a particularly positive experience with any of the consultants?

Honestly I don’t think you need to worry, get yourself self referred to the midwife team at Kings and take it from there. I am sure they will be good and sympathetic. I have had to transfer my care from the community midwives to the medical team due to gestational diabetes but both team have been equally great! I can highly highly recommend. 3 and abit more weeks for the actual c section but I can’t fault the care so far.

Kingston Hospital.

I requested a consultant appointment at 16 weeks to get my request in from the start. I saw Dr Andrew Pooley who is an absolute gem of a man. He approved it instantly and I had the most serene elcs at 39 weeks.

Just to say I had a semi elective CS ( I pushed for vaginal originally). They used a ventouse on baby during CS as he was very high up & he did have some mild bruising so instruments are still used.

Another voice chiming in about this.
I had a CS at 38 weeks due to baby being breech. However, prior to the breech discovery (later on in pregnancy) I had an elective CS signed off due to mental health issues. I had had quite a traumatic VB with DD previously and I knew that I would struggle immensely with the physical (same kind of issues as you) and psychological aspects.
If you can't sign up with the wonderful sounding doc at Kingston then I would just be a broken record. Definitely keep asking for it, Birthrights can help you here.
Good luck with getting your choice and I wish you well.
Sorry I can't be of more help.