NHS Ante-Natal then private C-section

[AMumAtSW12]

I have a question wondering if anyone has had a similar experience?

I am coming up to 33 week and have been with an NHS hospital for all of my ante-natal care. This is my 2nd pregnancy. I had an emergency c-section from my 1st. However the current NHS hospital views that I should try VBAC this time round even though the consultants from the first (another hospital) have recommended a c-section. Insurance won't cover it so I have been looking at affordable private options as in our hearts an elective c-section is what we think we should go for.

Now I have found an affordable private option only for the c-section (6k + costs to cover any complications that may result from the c-section hopefully none!) and the ante-natal care has to remain where I am. So the idea is that I continue with my NHS hospital and when the c-section date comes I would go to the other hospital for the cut. If the baby does come early I would need to go to my NHS hospital for a VBAC. If I switched care to the c-section consultant now the cost goes up a lot (10k)!

I am seeing my NHS hospital in 34th week and I will have to tell them my decision. I have heard of a suggestion that I shall not tell them as under any emergencies before c-section date I will need to go to them still.

What's the experience out there?

No advice on private CS (except to have a healthy bank balance!) but why not ask to see another consultant or move to another hospital? It's unlikely you will not find any obstetrician who will agree to an NHS section after a first EMCS.

You might like to request a meeting with the Supervisor of Midwives to get her on your side and if the idea of having a VBAC is really not something you can contemplate, ask to speak to their link psychiatrist/psychologist who could offer their support (as could your GP).

I really wouldn't give up on having an NHS section just yet. 6k is a lot of money (and that's if you do it on the cheap, which has it's own complications, such as the finanicial implications for you if there are complications after the section) and you really should be given a say in this.

the consultant at the other hospital did try to see if there is space for me at the NHS side but they are all fully booked for may. he agreed that i should be offered elective c-section but it is indeed a hospital choice. I don't really want to go via the psycho test route... tricky one....

yes i would love to keep the 6k if possible!

Hi, I'm really suprised the hospital won't let you have an elective, can you push to see another consultant or appeal the decision? I'm nearly 21 weeks and my hospital has agreed I can have an elective (has an emergency c-section with DD) but they did try v hard to persuade me to go for VBAC but after a long appt during which I stuck to my guns, cried, and mentioned that the psychologist I'd seen for PND felt my birth experience was a significant factor the doctor agreed I could have a c-section.

reallygrumpy - sounds like you have been to the psychologist. I haven't as I have never felt my 1st experience was so bad compared with many other ladies' stories on this website for example... at the moment I have no positive feeling towards a VBAC at all... ... ... perhaps i should really go for a test with the psychologist

Hi there, I am absolutely gobsmacked that you might have to pay for a private CS. Of course given high CS rates, hospitals should have active promotion of VBAC policy but if you have weighed up the options and its definately not for you then you have every right to a elective CS - on the NHS. Call the SOM and/or HOM and get them to sort it out! X

The NHS is mad. I'm having to go privately to try to have a VBA2C. So far I've done 3 different methods of birth, emcs for 1st, WVBAC for 2nd and elcs for 3rd. Personally I found the elcs very deflating and it took me along time to reconcile emotionally that labour hadn't started and I had let myself and the baby get too big. I found my active water birth by far the best birthing experience, (I have a high pain threshhold) that was in a private hospital in London, consultant was there for the birth but she bascically let the midwives get on with it.
Now we have moved from London and my NHS choices are: home birth or consultant ward of local giant hospital, i can't go and look round because MRSA and swine flu are rife, nice! They will not even entertain the idea of me giving birth in the midwife led ward of the local giant hospital (down the corridor from the other one). Neither option is very appealing so am going to fork out again and go to London.

I didn't think they could actually refuse you an elcs if you've had a emcs before because your termed 'high risk' the consultant said she wouldn't recommend anything else to me.

Also want to add that I am very pro birth choice. If a section is what you would like then that is what you should get.

One has to be mentally and physically prepared for birth and labour. That was the problem with my 3rd, I was tired by having two other toddlers, ate too many pastries and sweeties, didn't exercise i thought it would all just be like my 2nd birth and then I got fairly depressed when it didn't happen and I got arm twisted into having an elcs, scared by stuck shoulder and large baby 10lb 3oz. Mentally I was expecting a natural birth but I wasn't prepared physically.

demsels - interesting experience! I think we are not prepared for a VBAC at the moment. I will try my GP on Monday and see if she can suggest another hospital. It is really annoying as it really just depends on the policy of the hospital!

amumatsw12 - I haven't seen a psychologist recently, I ended up having CBT at the priory after DD was born because all that was available on the NHS was anti-depressants.

Do you know what your PCT's policy on elective c-sections is?

You can ask to have a second opinion or go to a different hospital.

I had a traumatic natural birth (lots of stitches and no support from mw etc). DH and I went to see a consultant before we even ttc and he agreed to a c-section. He wasn't keen at first but then I cried (still very emotional about how let down I was by mw) and dh explained our request in a far better way.

Turns out I'm having ID twins so it probably would have been the case anyway.

Good luck xx

I don't know the policy at my nearest hospital as I asked to be referred to St Thomas' which is the better hospital in London (at least on the league table back in early 2008). However i will ask my GP on Monday. At this point I would even consider the psychologist test if needed because at the bottom line we think VBAC is not acceptable to us given our experience before.

Can you change hospitals or is it too late? I don't know if it's too far from you but Queen Charlotte's (W London) won't force you to have a c-section if you feel v strongly that it's not for you, nor (I believe) will Chelsea and Westminster where quite a few of my friends have had babies and all had positive experiences.

reallygrumpy - that's helpful. so do you know if a psychologist assessment would be required in these hospitals?

Found this link over the weekend and may explain why it has been so difficult....

www.thisislondon.co.uk/standard/article-23704043-hospitals-offered-cash-in-big-push-to-reduce-caesarean-births.do

Finally managed to get an elective c-section at St Thomas'. I am leaving something here for those who may search for it in future.

I didn't have a psychologist assessment. I went to my GP who faxed them a letter. Then a consultant asked to see me asap and he finally reviewed my experience during my previous labour more thoroughly and confirmed that I shouldn't have been told a psychologist assessment. He did offer controlled VBAC. as well as an elective c-section, and asked us to consider them. We continued to prefer a c-section and he gave us our 1st "yes" for it. Then I had to get a 2nd "yes" from another consultant in the hospital, which I got today. He was pro-labour-choice so it was agreed fairly quickly.