Flexible private consultant at Chelsea & Westminster

[EPfds]

Hello,
I’m pregnant with my third and am trying to find a private consultant at Chelsea and Westminster hospital.
I’m considering attempting a VBAC but have some red lines that I would need the delivering consultant to respect in labour - which are:

• no IV/cannula unless it’s an emergency, I don’t want to labour with a painful cannula in my hand and never needed them before but was previously forced to have them.
• I’d probably still want an epidural, again, without cannula unless it’s absolutely necessary
• Absolutely no instrumental delivery or episiotomy, if things don’t work out on their own I want a c section.

I have PTSD from previous births because I was never listened to and already lost a child to an extremely premature birth at 24 weeks, as my entire pregnancy and delivery was horribly mismanaged. Subsequent elective c section was better but I again hated having no agency and feeling coerced into multiple unnecessary things, constant takings of blood for unnecessary tests and so on.

If anyone can recommend a consultant who believes in maternal agency during birth and would respect the above, I’d be very grateful.

They are still a thing but will not normally be allowed to practice in a hospital. So home births only. Obviously that’s an option for the OP as nobody can stop her having a home birth even though as a vbac it would be against advice . And to be honest if she wants to avoid an instrumental it could be a good place to be. Plenty of people have home birth vbac against advice and could use a pool at home but there would be no continuous FH monitoring so she’d need to look into that and the stats regarding it.

OP, there are definitely CTG machines which can be used in pools. Not every hospital has them though. But I was working at a hospital 16 years ago which had them so they’re not a new thing. It might be worth investigating other hospitals locally if this one doesn’t provide them.

I think you get a one to one midwife if you book a private delivery. You’ll only meet them on the day though, so no continuity of care or much chance to build up trust sadly. I’d definitely love to be assisted by an open minded but veteran midwife who has a good few tricks from the olden days up her sleeve - minus a mad unsafe fixation with “normal” birth at all costs.

>> I wonder whether the best approach for you would be to find a doctor with whom you build a relationship over a period of time so that you can develop trust in them; you can ask them to do their best to avoid interventions, but at the end of the day, you can't plan for every situation. <<

I did exactly this OP and it worked out very well. My circumstances were different from yours but I also had PTSD from a previous stillbirth and I wanted to be in the private sector to have that continuity of care and to be able to build up a relationship of trust well in advance. I interviewed six doctors and the one I chose was Claire Mellon. Have a look at her reviews. They are absolutely stellar. She’s at Portland rather than C&W but we’ll worth the trek if you can possibly manage it. I am not local and stayed in a hotel round the corner once I reached term (as many of their clients do).

I’m glad to hear you had a positive experience after such a traumatic previous birth, I’m so sorry.
And thank you for the recommendation, I’ll look into her! Does the Portland still have the problem of lacking facilities in neonatal emergencies or do they have NICU facilities now do you know?

I have often fantasised about a home birth, not least because a considerable part of my birth trauma relates to the circumstance that medical staff immediately took my children away from me and I was not allowed any touch, at my first birth for over 48 hours as we were separated on different wards. That I needed to ask permission from strangers to touch and pick up my own babies has really damaged something in me permanently.
At the same time, I’ve ruled home birth out because my biggest fear is that I may lose another child or that the baby is badly injured during the birth. So I’m really safety obsessed now and have very little trust in both my own body and ‘the system’. But yes, instinctively I know that I’d likely have the highest chance of having a smooth delivery if I could labour as if at home. Then again who wouldn’t.

Thanks so much for highlighting the pool friendly CTG, I will ask the midwives and consultants about this.

Portland has NICU facilities and also critical care facilities for mothers. If you need them, the first three days are covered by their self-pay package. They say it is unusual for them to transfer anyone out as an emergency. Definitely talk to them about this if it’s one of your concerns though. They’re obviously not as well-equipped as a large teaching hospital like UCLH down the road which has a Level 3 NICU and can take babies as early as 23 weeks, but then relatively few places are.

I also looked into home birth but am glad I didn’t go that route. If you need to transfer you would be in the NHS and would lose a lot of control. That possibility just wasn’t worth it for me.

Also yes, Portland has CTG which can be used underwater.

For Chelsea and Westminster, I can vouch for the NICU, which is excellent. It’s level 3, which doesn’t just mean that they can take babies from 22 weeks, but also that they can carry out procedures like ventilation if required.
Our third child, who was born in March, spent two days there with Transient Tachypnea of the Newborn , which is not uncommon for babies born at 38 weeks, as he was. He improved very quickly and we were both home within 48 hours, but initially he came very close to being ventilated after a couple of bad sets of blood gases. We felt in very safe hands, staff were very visibly excellent and very kind and caring, and the unit top notch. I couldn’t rate it more highly.

A friend of mine also really rated Claire Mellon at Portland. I would also suggest chatting to Con Kelleher at St Thomas who did his MD Thesis on urinary incontinence and quality of life for women and was certainly very supportive of my c section request when labour wasn’t progressing for me (I had similar views to you OP on wanting to tap out of labour early doors if there were any red flags re baby position etc).