Choosing a hospital - should I go private?

[hippopo]

Hi everyone,

I am almost 16 weeks pregnant with first after two years of trying and thought I had two hospitals to choose from - the Whittington and North Middlesex.
Have had three appointments at NM and have not been very impressed and have heard good things about Whittington so have switched.

My DH and I have a good private health care package from his work and we found out today that if we upgrade at a cost of £1000 spread monthly over a year I could have my remaining antenatal care and give birth at the Portland.

Not sure what to do as £1000 is not peanuts for us but we could afford it. My main concern about Whittington or similar is Midwifes being streched and not giving support I might need or birthing centre being full or getting poor after care again due to NHS being so stretched.

What would you do?

I gave birth at the Whit a while ago.
Yes, the NHS midwives do have to work very hard and it is the usual story about resources being stretched. But it is very different from the NM, I think, and the Whit has a very nice shiny new low-risk birth centre which is really worth a look.
Most women I know who have given birth there have been very happy with their care. The post-natal wards are a bit of a zoo, but you would either avoid it altogether (if you deliver in the MLU), be out of there very quickly (with a normal birth) or, if you have a CS there are quite a lot of side rooms and you might be able to get one when your catheter has been removed.

If you think you might need extra support you might want to consider either getting a doula or an independent MW. An independent MW would take charge of your ante- and post-natal care and could act as your doula at the hospital. It might be a happy medium (and less expensive at £3k-£4k instead of the £12k your insurance will cost).

Thanks so much for your posts very helpful. had a chat to DH and think I may have got it a bit wrong, looks like it could cost us £5k and maybe more if complications I think so will most likely have to rule out.

if you're worried about midwives being stretched why not put your £1000 towards an independent midwife? or a doula?

Just bumping this to ask if you can get a private room at the Whittington?

Skatergrll:

I just went to the Whittington today to book into the birth centre! If you manage to give birth there (and it looks really lovely) then you can stay there for up to 12 hours in your own room with en-suite & double bed. You get discharged straight home, don't go to post natal ward.

She said in birth centre get one to one care in labour - but of course there is a (small, but existant) risk that the birth centre is full when you are in labour - and then you end up on the labour ward but can transfer back to the birth centre when someone leaves.

I have transferred from the RF, and am much happier at the Whittington.

They told me today can have free birth preparation acupuncture from 37 weeks and for induction!!!! Plus if waters break and don't have spontaneous labour (provided its during the week) they will try to induce with acupuncture then as well.

You can also consider Edgware birth centre.

Sorry to bump in but I had also thought about going private but after doing my reasearch found that the best Scotland has to offer in the way of private maternity care is a side room with a continental menu! Apparently there is not enough need for anyone to provide private maternity care. I am amazed to read about MLU, we have no such choice, I have two hospitals to choose from both 40 minutes away and both are severly run down as they are being replaced next year by shiney new centralised hospitals. This is in Central Scotland, not somewhere remote. As a result I am going across to the Isle of Man where my husband works to live for a year and give birth there, the maternity services are first class, I had my DS there a few years ago and was so pleased by the care given - this might not be an option for everyone though!

I've had two private births and they were great, but from what I have heard of most of my friends' NHS births, Private is a nice-to-have, but if you would really miss the amount of money, and could do something else nice or useful with it instead, it is not worth the cost.

We are in London and couldn't stretch to a private unit (and I'm glad we didn't as I needed a cs in the end and would be broke by now!). However, we compromised by using an independent midwife, which helped no end with antenatal care and (most importantly) postnatal care. These made a real difference to me.

You could always enquire into private rooms too.I know that doesn't help with the lackof staff, but it's nice to have some provate family space when recovering.

If you can afford £1,000 I would strongly suggest a doula. She'll prob be less than that and I wish, wish, wish I had hired one for DD's birth. Mine was a long slow one, DH was too knackered to support me as well as he would have liked and we were left alone far more than I realised we would be. They also stuck totally to the medical side (although I did get a particularly shitty locum) and didn't do any of the "have you thought about squatting/ have you thought about having DH rub your back" type stuff I had been led to believe they would.

We couldn't have stretched to a private birth, but we could have afforded a doula and, when we have no. 2, asking the MNers for a good local doula will be top of my agenda.

ps If you think your hospital is overstretched, find one that can kick a bit of arse if necessary. It's the squeaky wheel that gets the grease and all that...

Be very careful as the emphasis in private care is making money, so you are far more likely to end up with a c section or masses of intervention for no particular reason because they cost more. Ask your local hospitals if they provide 'caseload midwifery care' which is where you get looked after by the same (or a team of)midwife/s and they generally have far more time to spend with you and get to know you well. This is the best care you can get, and its FREE!!

haver I don't know about north London, but here in the south that type of care is practically unknown. I had a team of midwives who supposedly provided care, but the team was so large I barely saw the same person twice and none of them was on a hospital day when I went into labour....

What about this? www.privatehealth.co.uk/private-hospitals/nhs/featured-units/knutsford-suite/

If you do go private, please do it attached to a big teaching hospital so that you can avail of all their facilities should you need them. Although I know loads of people have had great Portland experiences, I know I would feel happier with the back up of the SCBU, ICU etc of say St Marys (not far from The Portland if you are thinking of that). The Lindo Wing is the private wing of St Marys and is excellent. Can't comment on the N London hospitals, as I really don't know anything about them.....

I gave birth at the Whittington 2 and a half weeks ago and have no complaints really; if I were in your situation I'd go to the Whit and spend the £1000 on something else. But I'd 2nd the suggestion that you do a tour of the hospitals and then see how you feel.

You can go through NHS and pay separately for a private room at the Whitt if one is available. You just want to tell them when you book in - it's about £100 per night. I got one free (smug) - I also cannot recommend the care there highly enough.

when i had my whittington birth centre booking in appointment she said most women who gave birth in the birth centre stayed there until ready to leave, most within 12 hours of the birth. they have 5 rooms but can only actually cope with 2 labouring women at a time, so the rooms are intended for afterwards too! they have double beds - she said not only was DH welcome to stay but if we wanted DD and DS could come right after the birth and stay until we were ready to leave as well.

I am having my baby via the link Tostaky has posted. You can prebook lovely private rooms next to the postnatal ward, do a completely private package or have a private delivery with NHS antenatal care which is what I am doing. I have the reassurance that I'm being delivered by a midwife that I have met before and got to know and who I have absolute trust in and also by a consultant who I truly believe has my best interests at heart and who most importantly, has listened to me and taken my feelings into account. The fees for a Vaginal delivery and a csection are the same so there's no motivation to push patients into a section. It's much cheaper than any of the central london options and has the security of being in a large and IMO very good NHS hospital.

I gave birth at whitt almost 7weeks ago- it was a horrific traumatic birth but only a small part of that was down to hospital, rest was just way my labour was. baby was on NICU for a week after birth and i was on postnatal ward hell for 8days. The NICU staff were amazing as were 50% of the postnatal midwives, the other 50% gah! I think if you are lucky enough to have a straightforward delivery and can be in and out then whittington is great, i would have loved the birth centre but wouldn't have made it and had to have an epidural (well two in fact as first didn't work!). To be honest if your birth wasn't straightforward at the portland and you need emergency care or nicu etc you would be transferred back to NHS.
The whittington community midwife care once you are released from hospital is phenomenal- especially the woodside team- all of them are fabulous.

If I ever get over the trauma of DD's birth (brain damaged during delivery) and have another- I would still go back to the whittington so I guess that must be praise indeed!

haver, sorry but I don't think you are well-informed about private care. The priority in private care (in my experience) is the mother's choice, so many women who prefer an ELCS choose that and nobody gives them a hard time over it. At no time in either birth did anybody encourage me to have further interventions and my obstetrician's fee was the same whether I had a simple VB (which I did) or a complicated EMCS. An CS would have required a longer stay so the hospital would have made a bit more, but my caregiver (the consultant) had no upside from it.
Caseload midwifery care is great if you tend to have straightforward births, but like it or not, if you require any sort of intervention (whichever stage you are at) it may not always be sufficient.

Thandeka, so sorry to hear about your DD

Gosh Thandeka - amazed that you have anything positive to say about the hospital after your experience there.

Hope your birth debrief wasn't too traumatic.

Well second thoughts I just finished my praise and complaint letter- my praise letter was 2 pages a4 my complaint letter is 4 pages and still got more to write! But really most of the complaint is about our post natal care and we were unlucky enough to have to stay in 8 days afterwards. The only real complaint I have about the labour is the initial being left on my own (early hours of sunday morning and typically I am labouring during shift change!) and the fact my midwife once it all calmed down wouldn't let me be on any other position other than on my back with legs in stirrups (had an epidural) for the pushing stage- she was a 9.5lb baby I was effectively pushing her up a hill- no wonder I couldn't get her out! I wanted to be on all fours- when it was apparent that I and baby were struggling another midwife did try to help me go on all fours but by that point it was too late- I was too far gone and couldn't move.

Oh and the policy of no food for women who have had epidurals is also something I want to rant about- (many hospitals do have this policy incase of emergency c-section- but some hospitals don't- as my community midwife pointed out- you could get knocked over by a bus having just had a big mac and need immediate surgery so "nil by mouth" for general anesthesia isn't the end of the world) anyhow basically as I started labouring at 4.30am (reason I had woken was because I was starving hungry then my waters broke and i forgot about food!) anyhow basically I had nothing to eat at all by time it came to pushing stage at 3pm there is no wonder I had no energy to push! I didn't even get my tea and toast until 6pm so pretty much 24hours without food!

But honestly the issues I had with the hospital are more to do with individuals and some aspects of hospital policy that happened to my case but every case is different and I wouldn't be dissing the whittington because of my case as I genuinely think its an okay place to give birth and like I said the community midwife care is awesome. Also follow-up care is good- have my debrief and lots of counselling for what happened and my DD is having a very close eye kept on her. Way I see it is it was just luck of the draw rather than the hospitals fault (although certain things may have contributed to DD's condition).

Thandeka - slightly alarmed by your comments about being made to push lying on back with legs in stirrups, even though you wanted to be in a different position - that really is unacceptable, no one should be made to push in this position when they don't want to - even with a full epidural you can be propped up with pillows into a sitting position and you should certainly complain about that midwife in your complaint letter. Do you think that being forced into pushing in this position could have affected your DDs outcome?

re: labouring on your own in early labour - although not totally ideal I think this is very common in most NHS hospitals. I am booked into the MLU at the whittington and she said that sometimes they can be full not because the rooms are all full but because they don't have enough midwifes to provide one to one care... so they send you to the labour ward instead (!) where no doubt you'd be labouring on your own . As this is my DC3 and I am pretty confident I wouldn't mind at all (labouring on own with DH) but can see for first baby esp with long first stage that would not be ideal and you'd need the support.

re: no food - other hospitals do have different policies - and certainly mention this too as a complaint, esp as you were so hungry. I read somewhere that actually its lower risk to eat if you HAVE had an epidural as you can have a crash CS without a GA. If you haven't had an epidural and need a crash CS then you wouldn't have time for an epidural and you would need a GA. I have always eaten at home just before going to hospital so its never really been an issue for me (and I have lots of cartons of apple juice in hospital bag). Also each time have taken sandwiches for afterwards so no waiting for food.

re: postnatal - I suspect that 8 days on most NHS post natal wards would be a living hell unless you got a single room. I spent one day on the post natal ward (RFH) after DD was born as it was terrible.