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Childbirth

Share experiences and get support around labour, birth and recovery.

Baby no 2 - deciding between NHS and private

36 replies

RebeccaJM · 17/05/2023 15:31

Hi lovely people,

I (36F) would love some advice from anyone who has given birth recently / is currently a patient at UCLH (NHS or private) or at the Portland Hospital.

I had DD in 2019 at UCLH, delivered naturally in the Birthing Centre without interventions or issue. The midwife at my birth was outstanding. However, it could easily have been a different story. I arrived at the hospital at 10.30am on the day of the birth, having been in labour for 36 hours. After waiting for almost an hour to be seen, at triage I was sent home pretty brusquely. Not long after getting home, my waters broke and my contractions began coming every 30 seconds. We rushed back to hospital - a taxi ride that was by far the worst experience of my labour, with an overwhelming need to push coupled with panic that I was not somewhere safe when baby was clearly coming right now. My hospital notes show that I was admitted at about 1.30pm and my baby was born at 2.15pm.

I don't mean this at all as a "poor me" story, I had a fantastic first pregnancy and an "easy" birth overall with a healthy baby, and I know how lucky I am for that. But reflecting on the experience now that I am (at last!) pregnant again with no 2 (yay!) I find myself wondering what would have happened if there had been any danger or problems with DD given I had no medical care or monitoring right up until I was actually giving birth to her. I would have been better off having a planned home birth.

So, even though all turned out well at UCLH, I'm feeling some misgivings about going back. I feel like the individual medical staff are all excellent and doing their best, but the shortfalls in care I experienced were due to understaffing. And by all reports things have only got worse in the NHS in the past 4 years. My baby is also due just before Christmas, and I'm worried about the further impact that holidays plus seasonal illnesses might have on staffing levels.

I'm currently exploring going private (through a combo of insurance and self-paying, if I can make the numbers work). I'm looking at the midwife led package at the Portland Hospital, as I am within the criteria and would ideally (all being well) have another natural delivery. I also like the idea of being able to have the same 1 or 2 midwives for my entire pregnancy as part of the package.

Has anyone got any experience of the Portland Hospital, particularly the midwife led package? The Portland has a NICU and adult medical services in case of an unexpected emergency, and it is only a few minutes down the road from UCLH in the (I hope!) unlikely event that intensive care is needed.

I'm otherwise considering the Fitzrovia Suite at UCLH. It's attractive to be within the overall hospital as if there is an emergency I know the staff there will deal with it, and at the Fitzrovia I would have a one-to-one midwife during delivery. However, it's significantly more expensive than a midwife led package at the Portland as I would have to pay for a consultant on top, and (again, assuming all goes well!) I am hoping that my pregnancy just won't need that level of monitoring.

Sorry for such a long post. Really appreciate anyone reading this far down, and any comments people might have!

OP posts:
ZuliKyanLarsFoz · 31/05/2023 15:46

Im a midwife and had a midwife friend work at the Portland. She came back to the NHS after about 6 months as she didn't feel that it was a safe environment. Her stories put me off ever going in there.

From what you have written, I would honestly look at the homebirth stats. Look at the Birthplace study (www.npeu.ox.ac.uk/birthplace#:~:text=Delivery%20Research%20Programme.-,The%20Birthplace%20cohort%20study,'low%20risk'%20of%20complications.). If you are keen to be in a hospital, I would see if you can find a private midwife with admitting rights or see if UCLH now has a case load team you can join so you have a named midwife on call for you so you aren't met with an unfamiliar face in triage.

Bells3032 · 31/05/2023 16:07

I planned to go private with my first but things didn't work out that way due to a number of complications. When looking i decided against Portland, despite being born there myself, as whilst they do have a NICU it can't deal with serious complications. it was also a fortune and not covered by NHS so at the time i think i was quoted £1-2k a night for NICU and babies can be there fore several days or weeks.

UCLH was closed at the time for refurbishment at the time for me so it wasn't option so can't give birth.

Lindo and Queen Charlotte are both fabulous and QC do a midwife led package if you're interested in that (QC is near westfield white city). I was under Bryony Jones there and she was great (though her receptionist was a tad useless!). QC also has one of the best NICUs in the country, beaten only by St Thomas in Waterloo which also has a private wing if you're interested in that and is slightly cheaper.

In relation to price, I also had BUPA and they would cover nothing even though i was opting to go private due to pre-existing medical issues.

The prices listed on the website only cover the hospital itself, obstetrician prices ranged from about 8-10k (three years ago) and additional nights and aenethatists on top of that. I was told to budget at least 20k.

Midwife led packages are around 9-10k all inc but if something goes wrong you'll be transferred to an obstetrician which you'll have to budget for. Though i think you can chose to go NHS then but you can't then switch back to private for use of the rooms and aftercare if that happens.

I did a lot of research if you have any questions

RebeccaJM · 05/06/2023 14:01

Thanks so much for the info @Bells3032 - it's really kind of you to take the time to explain your experience. Lindo and Queen Charlotte seem excellent, but I haven't considered the option because it's just too far away from me, especially if I was travelling in a crisis / another strange fast labour. I have a friend who had her baby at St Thomas recently and speaks extremely highly of the care - but I have the same distance problem. It's so useful to know about the potential pricing and the budget you were advised (and lack of BUPA support, which helps me be realistic...).

Hi @codhat ! For now, I've ended up making a decision which I think is safest and best for me, based on a better understanding of what happened with my labour first time round.

Until this pregnancy, I hadn't reflected to any great extent on my daughter's birth (since, after all, it was a low risk natural delivery where everything turned out fine, and afterwards I had a baby to think about). When I began thinking about a second labour, my original thinking had been that the UCLH triage had made a mistake by sending me away, and I had thought that this was a clinical error or to do with a lack of beds.

Having now spoken with a consultant and several midwives, and done some further reading, I now understand that I had a relatively unusual labour in that it was so rapid, and this isn't something triage would have expected, especially for a first pregnancy. The latent labour stage lasted on and off for 36 hours (which is why I hadn't originally understood myself to have had a particularly fast labour), but the "active labour" phase began suddenly and progressed to delivery within about 2 hours. I've also been told that it is likely that my second labour would be similarly fast (if not faster!).

Given that, where I've landed based on my own very specific medical history where I'm at real risk of a BBA, is to take the approach that @teezletangler so helpfully suggested to me, which is to go for a combo of private midwife careand UCLH NHS care. I'm reassured that @ZuliKyanLarsFoz as a midwife also suggests this approach!

I've chosen a really lovely private midwife and she has told me that, based on my history, as soon as my contractions started (ie when I'm only in the latent stage) she would be coming to my house, as it's likely that the whole thing would progress very fast since my body knows what to do and will be more efficient about it. She would also accompany me to UCLH if there is time to get there safely (which is a question mark!), albeit she would then have to be a support person only with a UCLH midwife in charge.

DH is on board with this - his default preference is still hospital, but he's comforted by the idea that the midwife would be with us from the start and she would have the experience (and equipment!) to monitor the baby during labour and advise if transfer to hospital is needed during early labour. And, if I have another rapid labour, it would be far safer to have my midwife with me the whole time and give birth at home under her care rather than on the floor of a taxi somewhere on Euston Road.

This is all on the assumption that my pregnancy stays low risk of course. If anything changes on that front and I'm looking at a complicated delivery / c-section then I'll revisit this plan! But for now I'm satisfied with a plan for UCLH Birthing Centre plus midwife care at home from the start. (Also, having now toured the Fitzrovia suite and the Portland, the UCLH Birthing Centre room I gave birth in last time was much bigger/ nicer than the birthing room I saw in the Fitzrovia, and equivalent to the rooms in the Portland. And it is free, and next to the best available NICU and maternity care.)

I also wanted to say, I've now booked into UCLH and I've been impressed so far by the NHS care. It is of course early days (I've only had the booking appointment and bloods etc) but so far those appointments ran broadly to time and the staff are great. Since my last pregnancy UCLH has also introduced an app which keeps all your appointments, medical notes and tests done in one place, and also provides direct updates with test results and analysis, which I really like.

The other great thing I want to mention about UCLH is that the clinical/community midwife I saw through my first pregnancy was really wonderful - she was lovely, passionate about her work, very research/science led and willing to explain and discuss the basis for medical advice, clinical studies etc. At my booking appointment, I mentioned my 2019 midwife's name and asked if there was any chance I could see her again for my regular midwife appointments for this pregnancy, and UCLH was able to arrange that. Which is excellent continuity of care!

So that is where I've ended up, all going well. Thanks again to everyone for their input and advice.

OP posts:
Bells3032 · 05/06/2023 14:06

@RebeccaJM that is really good to hear you've got a plan and a sensible one at that. Like you i had a very fast labour first time round (first contraction to her being here was less than 4 hours) but she was prem so maybe less next time round. It may even inspire me to get a private midwife too, it's a good idea as I was very nervous about being turned away/left alone so it would really help with that anxiety.

Good luck with the little one!

oliveandwell · 05/06/2023 14:45

That's great news! A private midwife will be such a comfort knowing you're going to have care wherever you are!

Good luck OP!

renthead · 07/06/2023 04:54

@RebeccaJM that sounds like a great plan and very appropriate for you. Glad you're getting good care so far, continuity can make such a difference. Wishing you a healthy pregnancy and birth! (This is teezletangler with a recent name change)

RebeccaJM · 07/06/2023 21:46

Thanks everyone! :)

OP posts:
AllieBeen · 28/11/2023 16:09

as I understand it homebirth is much safer for mother, and as safe for baby as hospital, there are risks where ever you go. This is the lancet study of 50,000 homebirths https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(20)30063-8/fulltext

You have to birth at the end of the day, where ever you feel safest and happiest. though i understand you need your DH on board to support you. As you said you didn't have any monitoring and nearly birthed in the taxi, at least home you have control over your space with a good midwife. you can also get a midwife and doula team for maximum support.

these are the 'private midwives' stats https://privatemidwives.com/outcomes-and-results/

  • much better than many nhs/mlus, though I know these are mostly lowrisk pregnancies, as yours is, and self selecting mothers who feel comfortable birthing at home

Outcomes & Results - Private Midwives

https://privatemidwives.com/outcomes-and-results

Phineyj · 28/11/2023 17:04

I did something similar. DH was also anxious and found it good to have the midwife to advocate for me and explain stuff.

Although I did go into labour on Christmas day and no ambulances were available so DH had to drive us. Maybe don't do that!

On the plus side, everyone who looked after me was very cheerful - my doctor friend said they were likely locums on overtime rates. Certainly no-one was very familiar with the hospital...

Bells3032 · 30/11/2023 14:45

This reply has been withdrawn

This message has been withdrawn at the poster's request

MixedCouple · 01/12/2023 01:37

Unfortunately no matter where you are if the baby can't be helped it wont matter where you are.
My friend had a healthy pregnancy and is a healthy person at 26. She had her baby at 40weeks in a consultant led hospital. All was fine after 5mins baby went into distress. No top Dr or top equipment could save her baby. And she now understands and says it herself. What will be will be. Even in the safest place guarantees nothing. Home or hospital.

It is all down to preference. I was classed as high risk but listened to my body and gut and had my baby at a midwife led centre as that aligned with my goals and we are both fine. As an NHS worker I know the risks pros and cons and as a parent you have to make an informed choice and live with the consequences either way.
P.s I live quiet remotely in the countryside and our consultant led hospital is 1hr and 15mins away.

I have heard awful stories of NHS hospitals in terms of lack of care and especially so postpartum. Yes funding shortage of staff but sometimes the individuals are just horrid. Worked alongside some nurses/midwives/Drs who have 0 bedside manners and nothing to do with funding or stress. I went the extra mile for my patients and I was stressed and I had a 1 hour commute to and from work. Working in south London major hospital on a very low wage. My day started at 4am and didn't get home until 8pm. It is no excuse for foul umannered people. Don't tolerate it. Report any misconduct and behavioural issues you see. I always encourage my patients to do so. You are there vulnerable and in need. They made the choice to work there.
Sorry rant over 😂

Even as an NHS worker I refuse to willingly go to a consultant led hospital. Unless mandatory.

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