Where to plan pregnancy?

[nancy27]

Hi mumsnet members,

I have been following threads on this site since last couple of months and today decided to join. Really pleased to see how people help out each other with there problems here. I have been trying to reach some decisions in my life since last couple of months but not able to. Hope you guys can help me.

My DH and I moved to england last year from USA. We are thinking of planning our first baby now. however, I am really skeptical about having baby under NHS due to all complications I am expecting to have in my delivery:

1. I am RH negative and my husband is positive
2. I have severe asthama and sinus issues.

I live in canary wharf.

What options do I have in terms of delivery in this area?
What are the best NHS hospitals I can apply for delivery? Can I apply in C&W?
Can you please suggest and share your experiences?
If i choose to go private, can you please guide what kind of money I am looking at?
Another possibility is to move back to USA and have baby there.. but i quite like england and cannot believe that such an advanced country would not have support for my case. I guess i am going paranoid :) But my medical condition is scaring me.

I am unable to find clear answers to these questions at the moment. hope some of you can help me ...

Don't worry about the Rh neg stuff at all. You will be offered Anti D during and after pregnancy as per NICE guidelines.

I can not advise u where to have your baby but would say with regards to your health issues you would be looked after by an Obstetrician And their team who would assess your health issues and create a plan of action.

Everyone will give you good and bad stories with the NHS (myself included and I'm a Midwife) BUT I do think the NHS overall gives good obstetric/midwifery care and you can always ask for a second opinion.

Private obstetrics I believe is around £6k but that will vary with each hospital, you may want to look at St Johns and St Elizabeth's/Portland Hospital/St Mary's Paddington for private care.

Good luck

Hi nancy. You might want to post this in the chat section or maybe pregnancy to get more answers. A lot of people on the conception board are still trying for their first so won't have first hand experience to share with you.

I wouldn't worry about the rh neg. this is relatively common and you'll be offered anti d injections during pregnancy and after the birth.

I am really skeptical about having baby under NHS^

Please don't believe all the negative stuff about the NHS that has been doing the rounds in the US since the Obama healthcare bill controversy. The NHS is mixed, but mainly good for obstetric care (this site is not necessarily representative of experiences since people are more likely to post for support with problems than describe problem-free experiences).

The NHS did brilliantly for me and my siblings, through 7 births, including IVF, a vanishingly rare and life-threatening pregnancy complication, births as an older mother and one emergency Caesarian.

Bear in mind it is not either/or: you can try a middle way with private midwife support, choose a private ward in an NHS hospital (a better option than fully private, I think, and people I know have very good things to say about private care at St. Mary's Paddington) and go NHS but see a consultant privately. NHS care can be more minimalist than in countries like the US, so adding extra private care may give you more peace of mind.

I'd agree with the rh neg issue. They check you and give you the anti d injections you need.

I was in your position in this respect and didn't even have to ask, in fact I didn't know about it before they told me!

We have had friends who had their first child in the US and second child here in the UK very recently and have nothing but Praise for the way the NHs handled their very complicated and risky situation (more risky than yours I believe).

Obviously hospitals will vary as will peoPle's experiences but don't assume the NHS is the poor relative in terms of care given.

Hello,

I did some research into figures for private for myself. I don't have the figures to hand but as far as I remember
Lansdell Suite in St Thomas's. About £7K - £9K
Private in C&W. About £8K to £10K
The Portland. About £12K upwards

The breakdown of fees for example in The Portland would be like this:
The Portland is £5900 for the first 24 hours incl delivery (vaginal birth, no issues) and your consultant fees would be on top of this. Consultant fees are £5K-6K depending on the consultant.
Each additional night in a standard room is £1100
Here is a list of the Portland prices

If you went for a elective c-section and stayed for four nights in a standard room, you'd be looking at about £18,400

• aN elective c-section

From talking to a friend who gave birth in America the main differences I could see are;
Your consultant isn't as "close" to you as it appears to be in the US, you will not have lots of appointments, they are not your obgyn and you may not see them after the birth.
The rooms are smaller, your partner will not be able to room in with you; visitors are not allowed in the delivery suite.
It's free!!
There is no community midwife/HV as standard in America.

We do have community mw & HV as standard here, and partner is allowed into delivery suite with you unless you are having an EMCS under general anaesthetic. Where I live anyway, maybe it varies from place to place?

ellypoo, I think Wips was saying that her points apply in the US, not in the UK.

Thanks so much to all of you for coming back so quickly on my queries.

I had same dilemma before posting this thread as all my contacts were suggesting against having delivery in UK and I have had nothing but good experiences since I moved here in all aspects. I could not believe that such an advanced country would be lacking in such a sensitive issue.

All my worries are due to my advanced asthma and weak immune system. I have developed additional medical conditions since moving here like chronic hives. All this adding up is just scaring me to have baby under even possibility of neglected medical care. Although, I feel much better and confident now after hearing back from you guys.

The above is reason I want to choose a hospital with all advanced facilities available if required. The private sounds too expensive for me. I might opt for an intermediary option like EldritchCleavage suggested.

There is one more thing I would like to have your opinion on, I am currently living in Canary Wharf(east london) and wish to apply to hospitals on the central/west side of london like Queen Charlotte / C&W / St Mary's Paddington. Do I need to move to these locations to apply?

I know Queen Charlottes take people from out of area (but beware: that is why it is full to bursting and you wait a long time to be seen). I had good care there especially once I got into the delivery suite but the pre-natal care sometimes involved very long waits, at least it did last year.

Meant to say, my sister has also given birth in the US (DC) and felt the NHS compared favourably in terms of medical care (but not accommodation!).

Seriously, the recent American scare-mongering (Sarah Palin going on about 'death panels' for the elderly, for heaven's sake) is utterly spurious and wholly political rather than factual. My American brother-in-law rated the NHS care his family got as one of the very best things about their time in the UK. He was very impressed. it's not problem-free, or the same everywhere, but in London it's good.

I seem to remember reading somewhere that birth outcomes (i.e. worst case scenario mortality rates) are actually better in the UK than US.

You won't get the consultant attention here (but do you need it? - ultimately most women birth their babies themselves, it's what our bodies are designed to do; and of course consultants are available if help is needed) and the surrounding are not always pretty, but it does the job. Its for post-natal care that I think the NHS lets itself down.

Your particular health issues do not sound extreme at all, as you describe them. Much more difficult cases will be seen.

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I know a few people who have had high-risk pregnancies due to ongoing conditions of their own (one cardiac, one post-transplant and one endocrine/mental health).

They all found their NHS care to be excellent with their consultants for their own conditions and their obstetric consultants working together very well. They were also monitored far more closely and had far more appointments than an average NHS pregnancy. All had happy outcomes and two have since had subsequent well-managed and uneventful pregnancies.

This is in Scotland, but I've no reason to think that care in a large centre such as London would be any different.

@ eurochick

HI- I'm American and I've had two babies in the UK (at King's). I won't deny that the experience was different from that which I would have had in the USA but I can't say that it was worse.

I think there are a few things that you need to think about- What kind of birth do you want? A private room, epidural at 3cm, champagne and lobster afterwards? Or a water birth at home with a physiological 3rd stage and a lot of skin to skin? A what is the impact of your asthma on pregnancy and birth? Although that might be one to talk about with you doctor. I would think the Rh issue wouldn't be a problem in any case as this sort of thing is pretty routine. Also, do you have any private medical insurance through your's or you DH's work? You might qualify for additional care through your insurance.

In my experience the most difficult part of giving birth on the NHS was not understanding how to negotiate the system, but you've got Mumsnet so you can always get help with that. On the plus side, being in London you will access to some of the best doctors and facilities in the country so if there are issues you will be in good hands.

But can I ask why you are interested in the Portland, C&W etc/ Is it only the private aspect of it? Or is it because this is were posh people have their babies? Because there might be another hospital that is a better fit for your situation.

Ok, reading that back it doesn't make a whole lot of sense. But if you ever have any questions about what to expect on the NHS and how that differs from what you get in the US, please feel free to PM me.

The hospitals I listed had good feedback in terms of handling if complications occur in the delivery. That is the reason I listed them out.

However, I am fine with equally good hospitals in east london as well, its just that I am not aware of them. I and my DH did not know anybody when we moved here and so mostly rely on the internet information and what we hear from doctors at NHS.

I do have private insurance through my employer but that does not cover pregnancy( or any complications in pregnancy) :( which I found very strange.
I am not scared of pain and labor as I understand thats part of the process. I am just worried about any unnecessary complications. I guess its my nature to prepare things well in advance. but I understand in the end no-one can predict what kind of birth you are going to have.

But one thing is for sure.. its my first thread on mumsnet and I am already enjoying talking to all of you so much. Its soo awesome that I do not feel scared any longer :)

Morning-

Sorry if my questions about the hospitals was rude, I find that sometimes Americans have this weird West London bias and I was just so hot....I wasn't expressing myself very well.

I appreciate you wanting to be prepared about the pregnancy and I think that will serve you well if you decide to have a baby on the NHS. Do you have a good GP? It might be worth making an appointment to discuss pregnancy. I imagine they would want to review your medications before you TTC anyway and you can also use this appointment to get some more information on the local hospitals and whether or not you would be under the care of a consultant. In your area I would think that the GPs would have lots of patients from abroad who have questions about these sort of things. Also, are you seeing a consultant from your asthma and related issues? It might be worth getting in touch with them about a potential pregnancy. There are three things to remember when using the NHS- 1. manage your own medical history, 2. understand your treatments and the alternatives, 3. shout the loudest

Maybe you can also start a thread about asthma in pregnancy to get some idea of what sort of care you would be offered. I found this which might be helpful. I have no experience with asthma in pregnancy, but I have a cousin (in the US) and a SIL (in the UK) who both suffer from Crohn's Disease and their care in pregnancy is absolutely the same.

I'm afraid I can't be much help in terms of hospitals in East London. Homerton has a nice new MLU but that might not be your primary concern here. One thing to keep in mind is that hospitals don't like to take people outside of their area because is requires more paperwork.

And, anyway, when you do get pregnant you're going to have a happy healthy baby with no complications [positive thinking]

I used to live near Canary Wharf. While I was there a good friend and neighbour's wife became pregnant. They looked into all sorts of private options. They also asked around some of their dr friends. They all said to go to a big NHS hospital. They did that in the end - the Royal London, probably one of the nastiest NHS hospitals in terms of bells and whistles (peeling paint, dodgy food etc) but good at "hard cases" (it's where the London air ambulance takes emergencies).

There is Barkantine Birth Center right opposite to my house. But they do not have basics like epidural which I am most probably gonna need.. Is it possible that I get all my pre-natal checkup done at barkantine and go to a big hospital for delivery. I have called them for registration as I had been using the GP sitting at my workplace private clinic until now.. they are ok.. but they don't seem to handle pregnancy. Some big hospitals I found in East London:

1. Royal London
2. BMI - Blackheath Medical center(private)

I am thinking of getting a GP at Barkantine. Will start a new thread under pregnancy to explore more about there birth centre.