advice pls: spend money on private birth or night nurse / nannies

[whampsteadgirl]

Hello, I need to make a decision about where to spend the budget I've set aside for having my first baby, and I'd appreciate some advice.

I'm an American living in London and am 19 weeks pregnant with my first baby (after 3 years of trying to conceive and 3 rounds of IVF.)I have always planned to have a private birth, because it's closer to what I'm familiar with in the States: mainly that I would have a doctor rather than a midwife, I would get continuity of care, and I wouldn't be placed in a ward for recovery with my husband limited to visiting hours. however, as I'm away from home, and I'm sure the first few weeks with a new baby will be stressful to say the least, I would also really value having after-birth support to help teach me about parenthood and help me get the baby onto a schedule.

as my funds aren't unlimited, I can't really afford both options. for those of you who have looked at similar options, what would you recommend? Which is more valuable - peace of mind during the end of pregnancy and childbirth, or support afterwards?

Thanks for your thoughts!

I'd also consider a doula who provides both labour support and postpartum support. You would meet with her ahead of time during your pregnancy and build a relationship. She may even go in with you on some of your visits with your midwife. The doula will also be there throughout your labour....this will help with the continuity.

She may spend early labour with you at home or meet you at hospital. Afterwards she may either make some home visits or possibly even stay at your home for a period of time to help with the transition. What the practice is like will be determined by the individual doula and the family's needs/desires.

I wouldn't have any. I had really good NHS births and wouldn't want anyone else looking after my baby. Spend the money on a cleaner and someone to do the ironing etc.

Firstly congrats on your pregnancy!
I would go with the after care help if I were you. I have had two DC's on the NHS at Chelsea Westminster. To be totally honest the after care is pretty rubbish but the birth stage is fantastic & at the end of the day that's the most important part. Neither of my two DS's births were totally straight forward, both had intervention & one of them ended up on the neo-natal ward for a few days (totally fine now thankfully) I felt the care when it mattered was excellent - both for me & them. But only for the birth stage, the post ward there is pretty dire compared to the private ward. You can try to get a private room but it's something like £750 a night and it's not on the private ward, it's still on the NHS ward, just your own room rather than the six to a room ward. Chelsea Westminster NHS is app one of the top maternity hospitals in the UK too. If we have another DC I would again have it at Chelsea, on the NHS.
If it was me I would rather spend the money on care once you're home with the baby, especially if it means you can get some sleep - I think that sleep dep. is one of the hardest things about having a newborn!
The doula suggestion sounds a good one too.
Good luck with it all!

just to clarify the £750 ammenity rooms ARE on the private wing NOT the nhs postnatal side you can't reserve a room on nhs postnatal they are kept for women whose babies are in nicu.

I had a private midwife for all my antenatal care and the birth, and she came out for a month afterwards to help with breastfeeding and getting to grips with parenthood.

That type of care should cost anything between £3500 and £5000, in London.

Personally as a low risk mum I'd rather be delivered by a midwife than an obstetrician as they are more likely to get a good outcome (ie, less likelyhood of c-section or severe birth injury).

Good luck!

If I had had money to spare I would have spent it on letting dh take unpaid leave so he could do the caring after birth: would have hated having a stranger around the house when neither it nor I were looking our best. And I felt very strongly that dh and I needed to muddle along and make our own mistakes rather than have the expert baby carer looking on.

I can't imagine anything worse than an expert baby carer looking on-it would have undermined the little bit of confidence that I had!

Hi,
Apologies me23, I had been told (by the hospital) when I had my first DC that the room you got if you paid for it by the night were one of the ones on the NHS ward, not the private ward. I looked into it after the birth of DS1 as he was in NICU & I also had complications so we were there for 7 nights.

Agree Piscesmoon - but not all 'experts' tell you what to do. My private midwife who visited on and off for a month after the birth just supported me with breastfeeding, gave me lots of praise, listened to me when I was feeling panicky and encouraged my DH to let me rest. Would have hated for anyone to stand over me telling me how to handle my babies and how to respond to them!

Thanks again for all of your thoughts and opinions. I've got another couple of questions - what does a private midwife do if you're on NHS care? Is she just like a second, fully dedicated midwife, or does she literally take the place of the midwife the hospital would have provided? And, does being under midwife care make it harder to get pain medication, such as an epidural?

Independent midwives can take charge of all of your ante-natal care (referring you to the hospital/ a consultant (private or NHS as you choose) if needed), deliver the baby at home and then look after you postnatally.

Alternatively if you want a hospital birth an independent midwife can look after you ante-natally (alongside any NHS care you might also be receiving), accompany you to the hospital for the birth, where she will act as doula and then provide extra post-natal care as well. It used to be the case that independent midwives could deliver their clients' babies in hospital but due to insurance issues these days they can't. What they can do is act as an advocate for you and help you make decisions about what you want to happen. I think it adds a level of continuity of care that otherwise can be lacking. Certainly in London it is fairly unusual to be looked after by someone who you've met before when you give birth, so having an independent midwife can improve that situation.

If you use an independent midwife you are still entitled to NHS scans, blood tests etc and you can still book at an NHS hospital.

Generally speaking (on the NHS anyway - I am not sure about private midwife-led care) I think you can't get an epidural if you are under midwife-led care. If you were in a hospital's MLU and you wanted an epidural the norm is to transfer to the consultant-led side and get your epidural there (which is not a difficulty, per se, more just a change of bed!). The reason is that epidurals have their own complications and further monitoring etc is needed as compared to an epidural-free delivery. Of course, if you had a private midwife she would come with you to the consultant-led side, still acting as doula, to help you as needed. On a consultant-led unit you would still be monitored etc by midwives, but a doctor would be closer at hand and the approach is often more medicalised.

hi just saw your post. lots of good comments. my experience is this. i recently had my 2nd boy at portland, had a cs and had night nurse until baby slept through the night. i did the same with my first child. if i had to choose, i would choose to spend money on night nurse. if you are going to have your baby on NHS, it would be better to assume that you would get the minimum care so that you are not disappointed. i am sure that the well being of you and your baby would be looked after, but it would be minimum cos they are so busy. and esp as this is going to be your first, i would definitely hire a night nurse. for both times, the nurse would start work at around 8pm and leave 12 hours later. 8-9pm is a good time because dinner would be over, you are ready to hand over baby so you can get 8-10 hours sleep. this would help you recover from birth, make milk and be ready to enjoy your little one during the day!
my 2nd LO has just turned 5 months and looking back, having night nurse was invaluable. also if your budget allows, do not forget to get a cleaner.

Heron - how does having a night nurse work with breastfeeding?

I don't think many fully breastfed babies could/should go through the night in the first few weeks and months?

Thanks Mrs Happy and Heron.

Heron - I like the idea of the night nurse. can you recommend an agency that's good?

hello, veryfragile my LO did not sleep through till he was about 10 weeks old. i am still breastfeeding now. the night nurse would come get me when the baby is ready for a feed. she would do the burping, changing all that.

i went an agency called nightnannies. they have a website called nightnannies. the website is very informative. and the service i got was very good. one thing to note: remember that you are the mum and the night nanny is working for you. if there is something you would like done differently, then your decision should be the one done. in my case, she wanted my LO to drop the 10.30pm feed. i wanted him to continue with the 10.30pm feed and then sleep through till 7am. that is what we did with DS1. she has other ideas.

any other questions i will try answer as best as i can! areyou going to find out if sex ofyour baby?

I'd go for the private care for the advantages of having staff who know you & that you get the treatment & help you need. Afterwards should be fine just you & the baby - have a list of people to call for help - often the hospital offers that you can call them after the birth & talk to a m/w if you need to.

Heron, does the agency you used make sure that their staff have appropriate breastfeeding training before sending them out to advise new mums? It's just that there are so many maternity nurses and nannies out there who have had very limited education and training in this area. It can wreak havoc on someone's ability to breastfeed in the medium to longer term if they are being advised to limit the length or frequency of feeds in the early days, especially if they want to exclusively breastfeed for a few months.

veryfragile i understand and share your concern about breastfeeding. that is why i engaged Claire Byam-Cook. She visited me at hospital on day 3 and taught me the right way to latch baby on etc. she asked me to show her how i would do it, then she showed me the right way to do it, and i practiced and practiced with her watching until i got it right. thanks to her i never got bleeding or sore nipples. it was really worth the money.

Can recommend marslady doula you will find her in multiple threads

www.blossomsdoula.com i was recommended to them as they can provide post natal help with hours to suit you. Try them.

Thanks everyone for your advice. My hubby and I decided to transfer to the NHS in the end. I think it will be absolutely fine, and I just need to be realistic about expectations (e.g. I should bring shower shoes and ear-plugs.)To be honest, I'm just glad to have made the decision - it was something I was fretting about for a long time, and now it's one less thing to worry about.

We had a very non-eventful 20-week scan last week and confirmed what we learned at 12 weeks - we're having a little boy. I'm very excited and looking forward to the 2nd half of the pregnancy.

Glad you've felt able to make a decision.

If you want post-birth help and you're relatively confident at bossing someone around but you need an extra pair of hands then a trainee maternity nurse or someone looking to get into night nannying might be a good bet. They're usually qualified and fairly experienced as nannies and will be cheaper/less pushy than a 'baby expert'.

Use an agency, though, so if anything goes wrong and you don't want to deal with the maternity/night nanny face to face then you can ring the agency and they'll have a quiet word.

Haribo's mummy

There is private ante natal and delivery through Watford General. Antenatal care is provided at Bushey Bupa with delivery at watford general and post natal care on the private Knutsford suite

WHampstead Girl. Am I correct in assuming that you are in West Hampstead? If so then I would seriously consider using private care through the superb obstetricians at Bushey Bupa who deliver privately at Watford General. It is only 15 minutes from W Hampstead and a complete private antenatal and delivery package will come in at about £7k and probably less than £5k if you have delivery only.

I would go for private delivery and call in for a night nurse ad hoc if you need one in the post natal period, there are loads of them about so you don't have to worry about pre booking anyone.

That's great that you are transferring to the NHS - are you going to consider a Doula? Would be great for you during the birth and postnatally....some even do night work too.

let me know if you want details...x