I am very scared to deliver a baby under the NHS after hearing so many horror stories.

[Nature-Thrive]

For starters, I am a mother to an 8 year old. I am originally from the USA and that is where I delivered my son. I had amazing care and my OBGYN was called when I went into labour. She saw my care from start to finish, including postpartum. I struggled a lot and needed a ton of support and I had great insurance so it was available to me.

Before I start, please understand that I am in no way trying to bash the NHS. All I am doing is trying to figure out how to get good care again.
I haven't had the best experience under the NHS and after talking to some local moms, I am very scared to have a baby here.

We are based In Birmingham and I had a horrible experience at the Queen Elizabeth Hospital to the point where even driving by the hospital causes me anxiety. It was so bad that it's been escalated to hospital heads and we will be having a sit down.

Can anyone provide any insight or advice on what I should do? Do I move to a different area to access another trust? If so, where would you recommend?
Thank you so much.

PS - I do not want an NHS debate by any means and please don't tell me to "go back to my country". I got plenty of that over on Reddit.

The NHS is not set up to provide the kind of care you feel you need as a result of your mental health issues. There just aren't the facilities or capacity to offer the services you're talking about - effectively 24/7 attentive physical and mental health care during labour, birth and recovery, and intensive perinatal and postnatal mental health care that doesn't involve medication. That's not a failing of the NHS, it's just not what it does. No amount of advocating will get you that because it just doesn't exist on the NHS, unless potentially you're having a mental health crisis but it sounds like you are not prepared to let things get to crisis stage.

What you need is private mental health care, starting now, private maternity care, a private birth and then private postnatal care, including a nanny and a night nanny from discharge.

Just to point out - the only private options are in London so you’d need to travel from Birmingham
which might not be practical in labour.

I actually don’t agree with the above posters about the mental health. I was at risk of a very quick and severe mental health episode after birth.

In my CCG If you have an existing mental health condition or risk of a severe one then you are transferred to the complex team. Instead of random 10 min appointments with all and sundry you had a specific named team and hour long midwife appointments who do care for you from start to finish.

I found the care exceptional. I had a named psychiatrist, a perinatal mental health nurse who visited me regularly, named midwife, named consultant etc. They create a whole care package for you which for me included arranging private rooms to enable you to get sleep post partum to smaller things like in an emergency do I want to be talked through what’s happening or prefer them not to tell me the details but reassure me. The level of detail was incredible and it was fully thought through wrap around care.

My nurse did arrive quickly after birth to see how I was doing. Had the same nurse visit at home on top of the midwives and HV. 7 weeks in now and she still keeps tabs on me now and for the next 6 months. I really enjoy my chats with her and am in no doubt that if I did become ill everything would already be in place for me and my son - just one phone call away.

As an aside I get normal MH services are not like that; but with perinatal mental health they really don’t mess about.

Ah... This thread is actually about NHS mental health services not childbirth.

Are MH or social service involved now in your life, OP? How? It sounds like you've had at least 2 severe MH crises since your first child's birth. Both times you were a danger to yourself. Were there other MH crises in your life in last 10 years?

@LemonSwan it's great you got such great care, but I have multiple pre-existing, long-standing mental health problems, all worse in pregnancy, plus a history of PND, and I haven't been referred to the perinatal mental health team despite numerous requests because I don't reach their threshold, which basically seems to be 'actively medicated for bipolar or similar'. I know if I ask for a private room postnatally I will be laughed out of the building, so I am dreading how deleterious it will be to my mental health to be on a ward. I am trying to stay positive.

My friend, on the other hand, whose only issue is fear of birth, saw a perinatal mental health midwife throughout. It's a postcode lottery.

So sorry to hear that. It is a postcode lottery.

I have a lot of gripes with our CCG (cutting our local ambulances) - but I cannot fault their pregnancy and postnatal care. It’s the first CCG in the country to be trialling the complex team to ensure integrated care and I have to say it worked. The care I had was a million times better than my fellows on NCT (not just mental health but general pregnancy care itself) and it’s only because I was with this team.

I am not sure what the bar here is, I am not currently medicated but was previously sectioned for psychosis. So it might be quite high.

With OPs history I would hope she was eligible and the CCG is quite near to her.

It seems perinatal mental health are like a shadowy force. No one really knows what they can do and it’s because they seem to be able to do and access pretty much anything for you. I found it excellent and hope your CCG can catch up and widen eligibility for you or ladies in your area. ❤️

@lljkk I am under care but it is an absolute joke. As far as child services or anything like that, they don't really seem to care. I am now going private for my mental health support. And it is about pregnancy because my crises are during pregnancy only. The last time I was in crisis I was 2 months pregnant. The way I see it is other women can have children when they deal with other health conditions, sometimes every cancer, therefore mental health should be no different. Mentally ill parents can be successful if the right care is in place.

Hi OP have sent you a pm

I wanted to mention that I had a NHS birth. I was fairly enormous at the end and had an epidural injection to numb from the waist down. I was alone quite a lot but did not feel any pain., while in labour

@poppyredred in the US I was alone as well except when the nurses came to check on the baby's heart rate. Was there with family though.

Given your history you would be considered high risk and in your NHS trust there is excellent support for women who experience perinatal mental health problems. There is a specialist team based at the Barberry National Centre for mental health. They have a mother and baby unit for mums who are severely mentally unwell after birth where you can bring your baby. The team also provide preconception support do you could ask to be referred to them.

There is a program on BBC I player called life and birth which is filmed at Birmingham Women’s and the Hartlands hospital. It feature a mum who had severe PND after her previous births so has a planned c section for her third. She seemed to get a lot of support.

I think it is best to focus on what your specific needs are. There is a NHS hospital in Birmingham which also offers private care so you can have a mixture.

Forgot to mention. I didn't take the easy way out with an epidural. My baby was 11 pounds.

I’m trying to follow what OP said.
Is this right...

OP had a son in the USA. (where she had a great experience) but still developed severe postanatal OCD and became suicidal. For this she had “targeted therapies” and was alone around delivery experience, except when nurses came in but also had family there. In England she reckons all she would get is pills from her GP. It is not clear if OP was on Medicaid for this birth or postnatal experience.

OP had a hospitalisation at Brum QEH. She still has anxiety about this awful experience now. This may be when she had a termination, at 2 months pg, 3 years ago because she became a danger to herself, went off the rails, child protective services were called (is it called CPS in England?). Related to this experience is when nurse suggested OP could google what medications to take.

OP is not pg now but would like TTC. OP is still paying taxes in AZ so reckons would get Medicaid there.

Google says OP has to be a resident in AZ but OP said she’s a resident in Brum.
If OP’s husband is not green card holder he will struggle to immigrate to AZ.
I'm concerned OP would struggle to get MediCaid in AZ.

Doulas are not medically qualified, that's not the point - they provide emotional and practical support.

@NameChange30 that must be sooo frustrating for doctors when advising a birthing woman say she needs a caesarean because of the risks, and there's a doula with no medical qualifications saying: no but the woman doesn't want it and I'm here to 'advocate' against it. 🤦‍♀️

Why are they there to advocate for how the birth should go when they have no medical qualification?

Can you simply imagine doing your daily job and every day there's a lady standing there telling you you should do your job differently? and you've studied for 6+ years to do your job, and she had studied none?

😩

With respect, you've misunderstood the point of a (good) doula. They are not there to argue with the healthcare professionals and tell the woman to ignore medical advice. A good doula will support the woman to make an informed decision, will help her ask any questions she might have, and if there is time (for example not a crash c section) might support the woman to request anything in particular that she does or doesn't want when she has her c section.

I used a doula myself and I also encountered other doulas (for example some doulas attended my antenatal course with a single mum they were supporting, and also there are local doulas who run free groups to talk about birth options etc). I don't know any who would do what you describe. Perhaps there are bad ones who might. I guess that's why personal recommendations and meeting/interviewing them first is important.

i do find there is a lot of negativity about doulas on mumsnet from people who have never met a single one and know nothing whatsoever about them!

Not read the whole thread as I hate all this NHS bashing , sorry if this has already been mentioned

You cannot give birth at The Queen Elizabeth

You may be talking about Birmingham Women's which is just across the road

Totally different trusts .. BWH also has Good Hope and Heartlands for you to visit and see how you feel

Personally i'd not worry yet if you not even pregnant yet 🧐

I think you will find massive improvements across the whole country since the Ockenden report was published and trusts take action to address the points raised

I'm a nurse and would never ever choose private health care for a medical matter .. maybe for something cosmetic or very straight forward

I've had one amazing delivery and one horrific, both by the NHS. Unfortunately it's pot luck as to how many staff they have on as they're struggling so much. Good luck in whatever you decide to do

@lljkk - you pretty much got the gist of it. I delivered privately in the US. As far as moving back to Arizona goes, the state will not deny me care under Medicaid no matter what the websites say. If I go in and need prenatal care and the last US state I lived in is Arizona, I will get the care because there's a duty of care involved. There are charities that would help and a there's a lot of grey areas. At the end of the day I can walk into any hospital and deliver a baby and they won't let me leave until I've established where I live and how I will care for myself and the child. Regardless, that's like a worst case scenario anyway. Everything would have to fall apart here for me to take that route.