Can I choose a far away hospital?

[Ineeeedsleeeep]

Apologies if it's been discussed before, I couldn't find anything recent. I live in a corner of the UK where the hospitals don't have a great reputation for maternity care. I work in a big city with better hospitals twice a week, it's about 110km away though.

If I self-refer to a hospital in the big city (NHS, not private), would they accept me for the whole of maternity care? (I'm planning to have an elective c-section in case it matters).

You can give birth at any hospital however 110km really? What are you going to do when it's your day 3, day 5 and day 10 check ups? Baby isn't supposed to be in a car seat for very long at first and you'll be recovering from major surgery. I would not recommend it purely for your postnatal care.

They won't accept your referral for pre natal care as you're too far away. However you can give birth at any hospital you like - you just turn up in Labour!

I expect they would transfer you back to your local team for post natal. I had 2 private births at further away hospitals and both times I was seen by local community midwives once discharged. That said, I’d consider 110km too far. Even if you’re planning an ELCS, you need to be able to do the journey in labour just in case.

No that's that's too far away.

I had a 15 min journey in labour when I had DC2 (was induced for 1 and 3 so didn’t need to do it) and it was, without a shadow of a doubt the worst 15 mins of my labour. Just because you’re planning a C-section doesn’t mean you won’t need to do the journey in labour.

it is far too far. Really, it is.

It’s quite far away.
As an example with Ds I hadn’t felt him move much on day before due date, by 11pm I called hospital and they said come in just in case for a check up. Only 7km away but took 30 mins to get ready, drive and in. Stayed 2hrs for monitoring on machine.
Went home at 3am.
Twinge at 8am, trip back the 7km was agony within minutes. Baby born early afternoon

i wouldn’t have wanted hours travel to and from to get quick check up, and then in labour, and then straight after. It’s not very comfy in car with every bump day after birth, and Ds screamed his head off on the 7km drive and dh had to pull over 3 times!

Thank you, that's what I was hoping would happen for post-natal. Sounds like consensus is it's not a great idea though.

Yeah, it's DC2 for me, I know what you mean about being in the car when in labour. I was thinking that I'd go to the local hospital if labour actually starts. But consensus seems to be that it's a bad idea, thanks for your advice.

Interesting, thank you.

Are you set on a csection? Is it for medical reasons? Only reason I ask is you could have a home birth, you normally get better continously care with the home birth midwives, but obviously only if it is your choice of a csection and not medical need.

Thank you, I'm set on it for non-medical reasons, my first birth ended up being an EMCS.

You can OP. I did. I then got transferred over to my local hospital for my postnatal care.

Ooh, thanks for confirming it's not completely impossible!

You can but just remember that you most likely won’t get your absolute choice of appointment times (units I’ve worked in have had some Saturday clinics, and sometimes ‘you get what you get’ clinic wise if it’s super busy). So it’s just not as flexible as going local.

If you need to go in for monitoring etc as well it’s also a pain if it takes ages.

none of that is insurmountable though.

Thank you @Iwouldlikesomecake! I've decided to give it a go and will see how I get on. Far away hospital has given me a booking appointment, so it seems OK at least from the admin side of things. The plan is to go to close hospital of course if there are any problems whatsoever.

Sounds good :) mainly it’s about managing expectations and if it gets too much you can always transfer locally.

Wowzers what a lot of judgement on here! Sorry to hear your local hospital is below par. I'm not going to my nearest hospital (but admittedly I've chosen my second nearest, so not as far away as OP). All my prenatal care will be at the hospital I've chosen, which is also where I work, and the birth will be there. But then postnatal care will be done locally. I live in London though so there are loads of options!

DD2 was born in a hospital 45mins drive away, the local one was turned into a covid hospital so we had no choice.
It was fine, however I wouldn't choose it.
The drive was awful when in labour, and meant I probably left home earlier than needed in fear of delivering in the car. I ended up with a straight forward birth and could have been discharged straight away but decided to stay the 6 hours for baby checks otherwise I'd have had to drive back there the next day which I didn't fancy sitting on stitches for.
I'm pregnant with DS1 now and hospital is 8 mins away, and I'm feeling alot more comfortable with this 😂

I had scans and my dc1 was born in a hospital an hour's drive from home- in the city where I worked. I worked to my due date so was close by every weekday. It was all fine and I had my post natal care transferred to the local team (although it did get missed at first so needed to chase it up). My plan was to stay in a nearby hotel if labour started but hadn't progressed so I would be nearby to pop in and out. As it happened, my waters broke, I headed to hospital with DH and dc1 was born within a couple of hours (I only had about an hour of contractions so no uncomfortable car journey). Given the speed of the labour I didn't do the same with dc2 and DC3 and they were both born at my very local MLU. All good experiences.

You can give birth wherever you like - just tell your midwife that's where you're having your c section and they will arrange appointments for you. They likely won't be happy about it because NHS systems make it a nightmare from an admin perspective... but there's nothing they can do about it if that's your choice.

However - that's a LONG way. What if your baby ends up in NICU for a week? A month? 6 months? I would seriously consider another option - BUT you can make this choice if you want x

Thank you all, some more encouraging replies!
@October2020 thanks for mentioning NICU, I hadn't even thought about that as my first pregnancy was very smooth apart from the EMCS I had to have. I'd probably prefer my baby to be in one of the top NICUs in the country rather than in a hospital where maternity and neonatal services are currently subject to an investigation. But it's a very good point to consider and probably worth having a plan for, just in case.

We live in the South West and I had DS 1 120 miles away at The Garden Hospital (later Lizzie and Johns). We arrived in very good time for the birth. As I wanted a low or zero level of intervention but was concerned about hospital transfer if I booked a home birth I had little choice.

@Ineeeedsleeeep How did it all go with using a hospital far away? This is my first pregnancy and all the hospitals in my area are not good so I’m considering doing the same thing as you.

I’ve transferred to a hospital 40 km from being 6 km away. I actually did all my appointments at the near hospital and only switched at 36 weeks after my last scan was done (submitted self referral at 33 weeks) which has taken out the hassle of driving as it felt like a lot of appointments over the months.

Also having an elective csection, surgery was booked and met the consultant within 3 days of the booking in appointment, but may of just lucked out with that one given speed as no current medical indications other than first one was also elective csection for breech.

Not as extreme a drive but I am still absolutely dreading it especially the return, likely if anything really scary went on before my planned date I would probably try and use local hospital again for monitoring if I still wasn’t sure, unfortunately this time around I’ve been getting a lot of false Labour pains so I’m still not sure what’s going to happen now I’m 37 weeks! 13 days and counting…

@Happytimes83 Oh good luck to you and bubby!! I hope it all goes well and the drive turns out to be a non-event. I'll look into doing the same. Use a hospital nearby for appointments and then switch for the birth.