Private Maternity Healthcare in the UK

[LaraCameron]

Hi ladies!
Im am very curious to know how does one go about getting private care for childbirth in the UK outside London? I know there are plenty of hospitals in London but what about outside London?
Does anyone have any experience with this in any city( not London)?
The trouble is that I have very severe tokophobia and when I give birth it will have to be by c section.
I have recieved mixed answers about whether or not this is possible on the NHS. I would be very willing to go private, only Im not sure where in Uk hubby will be transfered. Can I possibly land up in a place where private healthcare is not available? Or is it available everywhere?

Also, don't be too nervous about the NHS. I had my daughter in a mid wife led unit in Northern Ireland and it was brilliant. I had my own large, modern room with ensuite with bath and baby bath, and my husband was able to stay in with me all four nights I was kept in. This was all free of charge. There is also another excellent hospital in Belfast where you can pay to have your own room- i think it is only £100 a night.

You can also be treated privately at the Royal Victoria in Belfast and book in for an elective section, my friend did this as she had had a difficult and traumatic first birth. The consultant arranged to do it before his skiing holiday! she paid about £2000 plus the use of the private rooms.

I have just re read my last post, it is a bit unclear, my friend arranged her own private treatment- the hospital didn't do it for her. But this is very common in Northern Ireland, I have several friends who have done this as did my mum, however I chose not too as I had a straight forward pregnancy and was quite happy with the midwife I saw from 8 weeks pregnant. Had I started to have complications I would have arranged to see a consultant privately.

Thank you soooooo much everyone. You've all been so supportive! For once I didnt get to see long posts about how stupid it is to want a c section, how dangerous it is, real women labor, blah, blah!

Btw ladies I've discovered more private maternity hospitals outside London.
There is a center called "Mums" in the West Midlands around Birmingham. The consultants deliver in nearby NHS hospitals, where you are treated as a private patient.
There is "Reassur3d" in Sheffield run by former NHS consultants.
There is the John radcliffe hospital in Headington, Oxford. Its an NHS hospital with a separate area for women who want private births.
Addenbrooke's NHS hospital in Cambridge accepts private patients.
In Surrey, the Royal Surrey County hospital allows private consultant led births.
Many other hospitals in London allow the same and to get private c sections in various NHS London hospitals one just has to go through The Birth Clinic.
So, it doesnt have to be Portland- can be the NHS hospital close to your place.

Of course if you aren't anywhere near the above mentioned areas, you are entirely at NHS's mercy.
Btw, I called their helpline yesterday, and they werent sympathetic about tokophobia at all and sent me a long email about how maternal choice alone is never an indication for a c section. Funny I always thought that hey its my body, so logically I'll get to decide what I want to do with it.

The thing is that maternal choice is never an indicator, they are quite right. However, there are plenty of cases where it is not simply maternal choice - and tokophobia is one of them. If you go to any surgeon, and ask for a section simply because you want one, most would counsel you not to. If you go and state that you want one for these reasons you're more likely to end up with one.

Stay away from that final thought - we all know it's your body, but ask for a section for the 'right' reasons!

Laracameron, you've posted about Addenbrookes - they go indeed accept private patients - but these are people who don't qualify for NHS care and then have to pay themselves. They have private rooms but you can't book them in advance and they're also used for isolation and stillbirth mums. Just because it says "private" doesn't actually mean it's any different to the NHS and for a fully private service and facilities, there isn't anywhere outside of London and Watford, with the possible exception of Belfast.
If I were going to pay for private delivery, I'd want private post natal care too and again there's only London and Watford.

buttonmoon78- I agree- got a little carried away there.
Id be suspicious if some surgeon just simply agreed to do a section no questions asked! Id be glad to discuss the pros and cons-thats what any good doctor would do. I just dont appreciate doctors who dont respect a patients decision even after the discussion is over and the patient is aware of the risks. Maybe India and America spoilt me too much- Im used to too much freedom:) Doctors there are all about informed consent- if i choose a c section and sign a paper saying that Im aware of the risks they simply cannot refuse. If they do they are compelled to find another doctor who will perform the procedure. Just the advantages of private healthcare i guess!
And people rarely go to midwives there. In India its considered irresponsible to go only to midwives- in fact there are hardly any midwives there. Everyone goes to obstetricians and c sections are considered a very safe choice.
In the USA, the midwife trend is catching on but everyone I know there goes to obtetricians. The American College of Obstetricians and Gynecologists has been supporting maternal choice cesareans for 5 years now. In Brazil, China, Thailand, and several europeon countries like Italy c sections are the norm. This is probably why it caught me by surprise that in UK, it is quite difficult to get one outside of London. Thought it would be the same here.

BagofHolly- I understand what you are saying, but it said on the Addenbrooke's website that patients who would rather have the benefits of private care can do so. Sure, it is still a NHS hospital not a private one but you can get consultant led care and delivery if you pay for it yourself.
The same with the Royal surrey Hospital- except that they offer private rooms as well. (obviously if NHS patients need those rooms it is different but mostly they can gaurentee one).
"Mums" and "Reassur3d" support mothers choice and provide consultant led care but the delivery is done in NHS hospitals nearby.
For women who cant travel all the way to London, this can be a good option, especially if they are hell bent on consultant led care and a c section like me! Id be OK not having the private room(though mostly they can arrange for one-so they claim) if I was having my wishes as a patient and mother-to-be respected!
Sorry if I was a bit vague in the post you are referring to, I didnt mean it was fully private.

Are you sure that applies to maternity too? I was an inpatient on the antenatal ward for 10 days in December and there was not a private room to be had, and no staff to deliver NHS patients let alone private ones. There was absolutely no "private" post natal service at all, and that's the best bit! I transferred to deliver at The Portland, and although the staff at Addenbrookes were fantastic, the difference in service is sadly night and day.

BagofHolly- Hmm, I think it applies to all services, but the thing is that if you have private consultant or midwife led care, they will personally be there( and arrange for the staff Im assuming)- so they say. That is part of the package I suppose. I might be mistaken about the private rooms.
It is very sad to hear these things about NHS.
Even though India is a developing country the medical facilities are beyond fantastic. I would LOVE to deliver there. Everyone gets private rooms, you always get the final say as a patient and there is always someone to attend to you- the hospital can be taken to task if there isnt someone to attend to a patient. Of course it is not free, but worth every penny and certainly not as expensive as Portland.
And most residents have some sort of insurance, so for them it is even better.
The doctors there are rather qualified. Great place to give birth or fall sick;)
And you always get to choose your doctor- there is no GP assigned to you. You can pick any doctor you are comfortable with at any hospital you like. No restrictions whatsoever.

I have looked into private pre and post natal care and cant find any. (Im in west yorkshire)

None of the local private hospitals deal with pregnancy at all (not even just for a saline drip when i was dehydrated with HG)

Ill HAVE to be NHS, or a IM for homebirth.... as im happy with my midwife and homebirth has lots of NHS support im opting for a NHS birth and fingers crossed i'll continue to be low risk, and hopefully have baby at home, under NHS

Have you actually spoken to an NHS midwife about this? I think you're making massive assumptions about how midwives will respond to tokophobia without having talked to your midwife about it. I can't imagine any of them being unsympathetic if you request a referral to a consultant to discuss c-section.

Also, before you get to hung up on the dangers of midwife led care and the horrors of the NHS, perhaps this will make you feel safer in the UK:

Neonatal mortality rates:

UK: 3/1000
USA: 4/1000
India: 39/1000
Netherlands (most midwife-led place I can think of): 3/1000

MainlyMaynie- Hi! I spoke to my gp and she wasnt sympathetic. Will speak to the midwife in the area we are transfered to. I have heard that some of them are sympathetic while others aren't as they mainly support natural births. I'll wait and see which one I get. Although if Im in an area where private care is available, I'll definitely opt for that.
And the neonatal mortality rate of India is actually misleading as it probably includes the very rural areas where the govt hasnt yet been able to provide
proper medical facilities. The rate in cities like New Delhi and Mumbai is actually around 4/1000( source is the AIMS website). I have lived in Delhi with hubby for 4 years and the medical facilities are simply brilliant.

And I would feel safe delivering in any country as long as I had a sympathetic doctor I could trust!
No matter how hard I try I cannot get myself to accept the concept of midwives. Im terribly sorry if Im offending anyone. But they cant do forceps or ventouse deliveries or c sections- so basically they aren't qualified for emmergencies. They must be great for straightforward births, but given my family history, I doubt I'll have one of those. My own medical history is quite horrific. Ive battled with variuous gynecological problems including endometriosis all my life. For my peace of mind I'd have a consultant- I wouldnt feel safe with just a midwife. Blame it on the fact that Ive grown up in countries where OB/Gyns are the norm.

OK
tokophobia is a widely recognised indication for a CS.
if I'm right in thinking that you've had 2 CSs all ready you're pretty much getting out of VBAC territory anyway aren't you? sorry if I'm wrong

The NHS helpline (I didn't even know there was such a thing is not in a place to advise you about this -as indicated by them sending you a print out that was completely irrelevant)
you really need to concentrate on getting in contact with the right services locally (are you pregnant now? whereabouts are you? at what stage of pregnancy will you be moving? is there really a possibility you would be anywhere or will it just be major cities? could you stay where you are to deliver? etcetc) you don't need to answer all that just some points to think about.
once you've found mat services locally I'm sure (and hope) you'll be OK you're going on inapprop info from some 'helpline' and 1 GP who sounds a bit wrong to me anyway

I'm sure you'll be fine

(I do have to disagree that more private healthcare in the UK would automatically be a bad thing and with your lumping all medical facilities in India in the same bracket-you presumably had pretty unlimited hard cash to use for your maternity care the situation is quite different without that)

not1not2- Hi! This is actually my first:) Had I already had a c section, it would be unethical to force me to have a natural delivery the second or third time around- second c section is always a woman's choice from whati understand. I dont know how Ive given the impression Ive had two c sections already!
And actually I think private healthcare anywhere is a good thing(particularly in the UK)- it means a lot more freedom and better treatment in some cases. Not to say that public healthcare is not good, but in some situations and for some people its not always the best choice. There is public healthcare in every country actually,but most countrie also have widespread private hospitals to give people more choice.Secondly, in India even the best of private care is very affordable compared to the private healthcare in UK. Most people have insurance anyway so one doesnt really need 'hard cash':) Even without insurance, when i was treated for dysmenorrhea and later an injury it was very affordable.It is my opinion that there is a better system there- but thats just me and my experience. The experence is better probably because you can choose your own doctor, and there are no referrals required. Most hospitals are unnaturally huge and there are literally dozens of them in the bigger cities so you dont really have to worry abut whether they can accommodate you. And while I didnt give birth in India or the USA, I have been admitted in the hospitals there for various other problems(never been the healthiest person) and it was wonderful. Im sure it is good here as well. My collegues who did give birth in India loved it. One of them has taken an early maternity leave and is actually flying all the way there for her second delivery! Sorry if Im offending anyone, but Im not criticising any system just comparing dfferent systems and stating a personal preference.

"One of them has taken an early maternity leave and is actually flying all the way there for her second delivery!"

I am possibly flying out to Singapore to see my ob/gyn for my second birth if I develop any problems and don't feel 'looked after' here.

This is partly a reaction to my treatment after I had a D&C for a miscarriage and felt passed from pillar to post and no one could tell me why I didn't have periods but had period pain. I had to self-diagnose and the whole palarver took 2-1/2 years. I moved to Asia, went to my ob/gyn, who agreed with my diagnosis and operated (successfully) within 4 days. I trust him with my daughters' lives.

By the way, in the UK it isn't a given in all healthcare trusts that they will give you a repeat section. Some hospitals will push you towards a vbac.

Luckily mine doesn't seem to be one that does this and I don't want a vbac. Besides, consultant said with previous Ashermans' rupture risk is high and when it happens, it's baaaaaaaaaad.

I have had the best private medical care you can get in Asia in Singapore and private care in Russia (urgh, actually) and Egypt (ok) and I have to say my NHS care here has been very good so ar (6 months) and I feel reassured. I had preeclampsia with my first so saw consultants (only 2 in 5 visits so far) from very early on and they were sympathetic, explained everything well and seemed to know their stuff.

Midwives were more mixed. Nice women and very caring but their advice was a bit off. One told me to stop breastfeeding my 2-1/2 year old but couldn't give a convincing reason why.

I'm also glad to have a section as I don't want to be in the position of having a vbac, going into labour at a busy time in a hugely stressed ward in inner London (Kings)

If you are likely to have pregnancy complications then you will probably see a consultant anyway.

I wish you all the best, get what you think you want in place (even if you have to travel to London) but don't write off the NHS either, is my advice.

Before I got pregnant with my first I was very exercised by this and was adamant I'd never go NHS, but so far so good.

Unfortunately, I think you have made too many assumptions about the NHS and midwife led care. I think you will find that in the UK midwives are far more qualified and able to deal with most pregnancy care situations than you think. You need to get away from the idea that a midwife is simply a nurse who assists a doctor.

Also, most doctors in the private healthcare sector also work for the NHS. They often do a shift in an NHS hospital before doing another shift in a private one. As a result they are often tired. Most operations in private hospitals are done in the evenings and at weekends for this reason. Obviously this isn't true of all private hospitals but it certainly is of the ones round here.

I only have experince of NHS healthcare when I had DD, and it was a very positive one. I would suggest that you be a little more open minded. Yes, in private hospitals you get your own room and better food, but in general the quality of healthcare is no better than you would get in an NHS hospital.

"Most operations in private hospitals are done in the evenings and at weekends for this reason. Obviously this isn't true of all private hospitals but it certainly is of the ones round here."

Sections are done in the morning, at least at our hospital in London and the Portland et al.

Otchanyaniye-
Wow. I certainly have a lot to adjust to!
I had no idea a doctor could insist that a woman get
a VBAC. Thats the kind of stuff we sue doctors for back home.
Yikes! No doctor Ive ever known would insist on something like that-
there is too much of a legal risk.
There is certainly an obsession with natural birth here.
Im so sorry to hear about your miscarriage- I hope things work out for you
and you dont have to go to Asia.
I would have considered that myself but hubby might miss out on the
birth that way.
Im not writing anything off yet- if my gp agrees then great. If not, I'll be left with no option but to go to London.

Bunbaker-
Hello!
Im actually not making assumptions- Im just concerned because
the people Ive spoken to here have told me very mixed stories.
And Im not really concerned about the quality of healthcare-Im sure its great! Im just not used to justifying my decisions to doctors- Ive always had choices as a patient and my decisions have always been respected.
Im very unused to a system where doctors can refuse c sections and insist on vbac! Its going to take a loooooong time to adjust to that kind of thinking.
So you see its not the quality of healthcare that would make me go private, but simply a desire to have more control over the decision making process.
And obviously a desire to have my request respected.
If that happens with NHS, I will have no reason to go private.
Id like to avoid the inconvenience of travelling to London( and spending all that money).

"There is certainly an obsession with natural birth here."

I think it is because generally natural childbirth is considered safer. I found this website that gives a balanced view of the different methods of childbirth. Read this as well.

Have you considered asking for professional medical help to deal with your fears?

I also think that in the US they medicalise pregnancy and childbirth far more than we do. It isn't an illness, but a natural path that your life takes.

Bunbaker- I agree that an uncomplicated vaginal delivery is the safest
( im not including forceps and ventouse here). However, given the right surgeon a cesarean can be perfectly safe. I suggest all ladies should visit the website- www.electivecesarean.com.
It has interviews with several doctors and moms who have great things to say about cesareans.
Im not supporting or rejecting any way of giving birth- I just believe in
informed decisions. I just believe that we all have the right to choose and
doctors simply cannot force decisions on us.
There are women who prefer natural and those who feel more secure
with medicalised birth. It is a matter of choice and the process of enforcing that choice should not be so hard.
I realise it is a natural process, but to people with tokophobia it doesnt feel like that. Besides years ago,when birthing was not so mesicalised, the infant and mortality rates were much higher.

But now the infant mortality rates can be higher in countries where birth is medicalised (e.g. the US) compared to places where natural birth is encouraged (UK, Netherlands). Your baby is a third more likely to die in the first 28 days of life in the US than in the UK or the Netherlands. Your tokophobia is an individual concern, which may well make it better for you to have a caesarean. It does not make other medical systems superior. We're lucky enough to have a free at the point of access service which prioritises medical care for everyone over additional choice for those who can afford it. Irritating for those who would prefer to buy a full range of superior side benefits, but better for society as a whole I think.

Incidentally, if you're not a UK/EU citizen and haven't been here long are you definitely covered for free NHS maternity care?

Mainly maynie-
Im covered for NHS care- so is hubby.
I think its fabulous that you have a free medical service and its great that you are happy with it. Im simply saying that choice is ANY patients right.
And ultimately I do understand that NHS resources are for people who genuinely require them, which is why Im willing to pay. But apparently
thats not an option in most areas either!

I just dont come from a space where doctors get to tell women what to do- sorry but I will never think it is all right to tell women how to give birth.
If they cannot provide a c section for free thats fine- there should be an oprtion for paying for elective procedures. That way resources for women who require the surgery for reasons considered valid by the NHS, will not be compromised.
I find it shocking that a woman can be forced into a vbac and denied a c section even when she is fully aware of the risks.
As I said, I probably used to too much freedom. Back home I could sue a doctor who didnt respect what we call "patient's autonomy" and "informed choice".
Other countries have public healthcare too- which is fab for people who cant afford pvt care. But there should at least be a better developed pvt healthcare system for people who like to make their own decisions and not have them forced on them by someone else.
Besides considering the high tax rate, I wouldnt call the NHS a completely free service.

Hi LaraC, have you decided what you want to do yet? If you do want to go down the Portland route you dont want to be too long booking your obstetrician as the best ones get snapped up very quickly. I dont want to scare you either but if you do go down the NHS route for a CS be prepared for terrible post natal care and to be chucked out within 48 hours (disgusting I know). If you dont have family nearby to help afterwards if you go NHS then I would seriously consider getting a maternity nurse or postnatal doula to help you.