NHS or private delivery

[Mjlondon]

Hi mums ,

Sorry for Long post!

I am pregnant and was weighing my options here. This is my second child , I had C-section with first born. But I am currently confused as how it works with NHS and private delivery options . I am currently registered at hospital in London but I don't feel well supported. I am not sure is it because my case is uncomplicated or it's just the way it is here. Every question I have , midwife just share some QR CODE to scan and ask me to read on those sites. What's the point of appointment then?
I Had lot of bad experience with NHS a&e for different issues and I am really nervous.
Additionally if I want to go for C-section would they really consider my wish or would they force me to have normal delivery. Do they wait till I go I to labour or can I insist if having planned C-section? How surgery, post surgery care provided?

How is it in private? If any issues occur during childbirth will I be sent back to NHS? Can I only opt to have childbirth in private and continue with NHS till that time say till 36 weeks? Also how is postnatal/ neonatal care works here?

I am new here so my question may sound naive but any help guidance is highly appreciated.

Lastly, anybody has any reviews about Queens Charlotte hospital London?

Thanks!

Nhs consultants for routine care seem to be quite short in my experience. I dont have any experience of c sections. However discuss your wish to have a c section with your nhs midwife she may be able to advise you. Hopefully someone with more experience can help.

The NHS is a mess. Go private and ignore people who clutch pearls saying that you would be treated brilliantly if there was an emergency!

Went NHS first time. There was an emergency but staff were dealing with another emergency….quite honestly there wasn’t enough staff and the young DR held off calling the consultant because he thought he could handle himself. In the end a very stern Sister overrode what he was doing and called for help herself. Recently had tons of experience with two elderly parents and the NHS and the care was a disgrace.

I had great care with the NHS for my pregnancies but maybe this was because I was such high risk. I'd go private in your case. Some emergencies that occur can only be dealt with via the NHS but a relatively straightforward birth would be a better experience privately I expect.

IME if a C-section is the only reason you’re under consultant care you only have contact with a consultant once or twice. I had one phone call appointment to request an elcs after my first emcs. The CS was booked when I was 34 weeks.
As it happens I went into labour before the CS and changed my mind about the CS then probably 5 different HCPs of increasing seniority came to ask me if I was absolutely sure about not having a cs
Post surgery care is on postnatal ward

You can absolutely have antenatal care on the NHS then switch to private for the birth - that’s what I did.

A private consultant will be happy to spend time answering all your questions, but obviously you would be paying for their time.

Private postnatal care in hospital was excellent in the daytime, but a bit lacking throughout the night if I’m being honest - the night midwife wasn’t great. But we had a private room and my husband was able to stay with me and had his own bed.

Many women have good experiences on the NHS, but at the same time, more than half of maternity units are rated inadequate by the regulator, often due to low staffing levels. With a planned c-section, the birth itself should be relatively well organised on the NHS ( though they might try to change the date at the last minute!) but whether you get good postnatal care on the ward is another matter. You also can’t choose who does the section - might be an excellent experienced consultant, or it might be a junior doctor (albeit supervised by someone more experienced).

You wouldn’t / shouldn’t get any pushback on your ELCS request from the NHS, especially since you have had a previous c-section. I wouldn’t be worried about that aspect.

With regard to complications, I was at the Portland where I think you get 3 days of NICU care for free if needed (assuming you have no insurance and are paying your own costs) then you have the option of transferring to NHS care at UCLH which about 3 mins down the road.

At Queen Charlottes I would presume all neonatal care ( and care for yourself if needed) is automatically done via NHS facilities at no cost to yourself as you’d be having the baby in a private wing of an NHS hospital.

The population of women that Queen Charlotte’s Hospital serves (I assume you mean the Hammersmith Hospital in East Acton) tend to have a lot of comorbidities and so if you are a “well pregnant woman” you might find that you tend to not be prioritised. The maternity triage is always busy even in the early hours of the morning with patients sometimes having to stand outside or sit on the floor because there aren’t enough chairs. They are an excellent maternity hospital and deal with some complex obstetric issues but everything always feels rushed when you’re at your MW appointment but very time consuming when you’re waiting over an hour to be seen in a crowded waiting room without enough chairs because of women and their partners/families all attending appointments. You could try Chelsea and Westminster Hospital if you want to be under NHS care - it’s less busy overall.

Appreciate your response ! Just a follow up so when can I tell them that I want to have private birth ? And what are approx charges if you know, I understand it will differ per hospital but since antenatal care is on NHS and I would be shifting at very later stage to private will the cost be lower?. And is there any formal process that I have to follow ?

Oh...ok so it happens in Clayton ward and any neonatal care is on NHS after private birth. Thanks for your response. I hope hospital is little bit better than others.

It’s expensive. A birth at the Portland would set you back around £20k for an ELCS. You have to pay the hospital, the consultant and the anaesthetist separately. The cost is around the same at UCLH, I don’t know about anywhere else.

You need to work out where you want to give birth privately and select a consultant, and contact them. They (their secretary) will be able to help you with the admin side. You should do this sooner rather than later / make sure the consultant is available and that the hospital has space for you. You’ll need to be booked in with the midwives etc - a similar procedure to the NHS.

The first time around I didn’t tell the NHS I was going private, but I’m not sure that was sensible. This time I told them around 30 weeks, explaining that if I went into labour earlier I’d still be turning up at the NHS hospital for the CS (since the Portland is not near where I live). They were totally fine with it and grateful to be told.

Thank you so much! It clears a lot of things for me.

Hi. I was planning to change to private care at 36 weeks but my daughter came at 34 spontanously. however, did tonnes of research for it and even though i ended up in an nhs hospital my private doctor was so helpful in explaining what was happening when i got zero communication from the nhs (weekend) staff!

I would recommend booking asap though as they get booked up. Like the pp said you're looking at around 20k for an uncomplicated c section delivery but if there are more complications which could end up costly you can be transferred to nhs if you can't afford more. you will be transferred to nhs if you need something like ICU if heaven forbid the worst should happen to you. All but portland i think have nhs hospitals with NICUs attached to them.

If you aren't moving til 36 weeks it may be prudent to pay for a couple of additional appointments earlier on to meet the doctor etc. they will run at about 300 each.

The main ones you are looking at in london are

Queen Charlotte
Lindo
Kings
UCLH
St Thomas
Portland
Chelsea and Westminster

Thank you so much. 20k is expensive but worth it I guess... Yeah I will check with QC.

If I am honest, I had a very good experience at st Mary’s with my three children because after the first one I really knew how to make the stay on the postnatal ward comfortable. I had three c sections. My advice would be to save the 20k and hire a postnatal doula or private midwife to stay with you after the surgery for 121 support. And hubby can go home and have some rest to rejoin you in the morning. It will be a lot cheaper if you do not have 20k lying around. x

Hey thank you for your response!. I didn't know about this. So where can I book private doula/midwife? Also do they stay overnight and come home to visit? For further postnatal care like stitches removal , helping in breastfeeding etc.

I had mine privately at C&W. It cost just under £20k and that was almost 4 years ago now so I imagine it’s gone up since.

You choose your consultant, all antenatal appointments are with them in their office and they will write to your GP that they’re taking over your care so the midwives won’t be wondering why you haven’t turned up or anything. You want to do this early to make sure your chosen OB and the hospital have space because they do book out.

Then on the day you check in to the private wing, early since you’re guaranteed to be top of the ELCS list, then walk over to the NHS theatre which is on the same where they do the section then they wheel you back to your room after. If baby needs the NICU that’s all NHS and also all located on the same floor so there’s no transfer- one of mine went to special care for a few hours and all fine, no charges. They discharge you back to the NHS when you leave which means community midwives then health visitor. 6 week post natal check up for you with the consultant is included in the fees.

Hi OP, you have had some really good advice here.
I just wanted to point one thing out to anyone who is having private care but being discharged to their local NHS trust for postnatal care when you get home.

Please ensure your local NHS trust have received notice of your discharge! I am an NHS midwife and we look after a lady postnatally on average once a month who has delivered at The Portland. We never receive any discharge notification from The Portland and usually the woman herself contacts us about 2-3 days after being home annoyed that we haven’t contacted her yet. I have contacted The Portland numerous times to put a pathway for discharge in place but no joy.

Thank you this helps

Also can you recommend any private midwife services?

There is a company called private midwives that offer care throughout the country.
Independent midwives work differently and are completely self employed so you are best to do your own research to find one locally (IMUK is a good start).
They will offer a variety of different packages tailored to your needs and absolutely will see you postnatally at home to do the things you mentioned.
Doulas are not midwives, and whilst they are very valuable at general support, they wouldn’t be able to provide care such as check/remove stitches.

I would hire a private midwife and have them visit me at home afterwards for support and checks.

Thank you

I have heard it said that if there is an emergency, you may well be passed back to the NHS even if you are under private care.

I feel so sorry for women giving birth these days. It must be angst making, given the NHS crisis.

Hey thanks, yes it's true I myself had worst experience in A&e for other health issues and it is kinda giving me all the stress wether delivery would be smooth or not and if would be safe to go with NHS.

Thank you it's been a great help .