Help & advice regarding the portland hospital please

[mommyof41986]

hi my step daughter is pregnant & she would like to go private at the portland.
we live quite a way from london (Gloucestershire). are there any rules about how far away u live? if it comes to it we would relocate to london for a few weeks closer to the birth.
she would like to give birth vaginally
any advice on choosing a consultant (if needed)
anything we should know? she is 17
thank you

Private is always thought of as amazing but less than 10% of private hospitals even have a crash team. FFS. That's not cool at all.

I learnt this as I'm training to become a medicolrgal advisor but i can't remember the source. The back up plan is always the NHS for these hospitals.

Having worked in some prestigious addresses, I'd agree with a pp ref staffing levels.

I think you're bonkers tbh. A consultant I know charges £25k to supervise a pregnancy and birth. That's just his fees, no midwife or drugs or hospital.

You're driving away from some high quality womens hospitals in your quest for this.

I understand your desire to have more personal attention from a consultant and this is what you pay for going privately. But the flip side of this is you do not necessarily get better care as private hospitals are good at dealing with routine problems and not emergencies/unexpected complications because they do not have the wealth of experience within the whole team that you will find in a good nhs unit. I would seriously suggest you look into a private unit based within an nhs hospital closer to home. That way, if your daughter and grandchild need specialist care they can easily transfer to the nhs unit with no delay. The Portland transfer their very premature babies to local nhs services but you then have to factor in a transfer of a sick baby which increases the stress levels.

Choosing a consultant is the first step but why not speak to your local private consultants and see where they would recommend? They will know if the Portland so will be able to give you a view about it but may also be able to suggest local options that your daughter hasn't considered. I used to know a surgeon (different speciality) and he wouldn't carry out certain procedure in a totally private setting because of the lack of the whole specialist team (anaesthetists, surgical nurses, post-op care, therapists) so would do them in a nhs based private unit. He would happily operate in a totally private hospital for more routine procedures.
For what it's worth, I do agree with those who've commented on the costs and logistics of coming to
London from where you are. A short term let within walking distance of the Portland will cost around £1000 per week for a two bed flat. You've then got to consider the cost of all the other antenatal appointments, tests, scans and medication plus travel and potentially overnight stays in the months before the birth (trying to get into central London on an evening especially a Friday from where you are will be an absolute nightmare and potentially add at least an hour to your journey which you need to consider you might be doing when she is heavily pregnant).

My one final thought is something a midwife said to me when I was asking about being referred to her unit (out of area to my address but had good reviews): what will you do in an emergency? It may be well and good choosing to go somewhere further afield but in an emergency you will be taken to the nearest unit available and you need to consider this. In your situation, I would try the local private consultant and also speak to your local nhs trusts PALS department to see if you can get some reassurance about your local service. If your daughter ends up being rushed there in an emergency, it won't help her to be stressing about being there based in yours and her previous experience.

Wow if I had a 17 yr old daughter I would want her to save her pennies for education or a house rather than a private birth.
Understand she feels let down by the system so far but there will be other nhs options. I have had mixed experiences with the nhs overall but my experience during a complicated birth was first class.

I think you have the right to choose private if you want but I agree that there might be a better solution. I have been to the Portland and while my consultant was and is amazing (if you go that route I recommend her - Claire Mellon) the hospital didn't make me feel that safe. More like a hotel and less like a hospital.

Are there options for private consultant or midwife care in your area? I know a number of women who have gone that route, as well as hiring a doula rtc. Delivery is then either in the nhs hospital or a local private hospital depending on care etc. I have had quite a few medical things handled privately but at nhs hospitals - where the consultant has a different team or timing for private but all the facilities available on nhs. I am not sure if that's possible for maternity.

I also had quite a complicated pregnancy and even though I was happy with the nhs I went to see my private consultant a couple
Of times at the beginning. She did basic scans, reviewed my case, made recommendations and helped to prepare me for what might happen on nhs. While that is probably not enough for your dsd, I think it shows that you can have something in between if necessary. A friend of mine who had had 5 miscarriages did the same - kept private consultant care alongside nhs until she was about 20 weeks. She found it massively reassuring until she was ready to go back to nhs.

The problem here is NOT the fact its private or the type of birth she wants.

The problem is she sounds like she is high risk (I think being 17 in itself increases some risks so its not just her BMI).

Who will be giving her antenatal care? Will she do this locally? Or will it be combined between London and Gloucestershire? If its a mix it increases the risk of something being missed or crucial information being passed on. If there is something not quite right what would she do? Would she wait and see because she didn't want to go locally, go to London to get checked or get checked locally? This is a very important question.

I did consider going private in London for various reasons despite being 180miles away. I didn't.

The reason was it was irresponsible and to do so would have effected my decisions had there been complications during the pregnancy which would not have been in the best interests of the baby.

You could rent somewhere in London for a short while, but realistically you'd only do it for a short period and certainly not from mid way through her pregnancy. It might not be necessary but you just don't know that.

And in a premature emergency situation, being forced to go locally when she is unprepared and unfamiliar and doesn't want to go there, could make a traumatic event even more so, which is not good for either your daughter or grandchild.

I honestly think the best course of action is to flag concerns she has with midwives locally and to get them to build a relationship with her. As she is 17 they probably will be willing to spend more time with her. If she makes a point of saying that she has been treated badly previously on the basis of her age and weight, and she isn't prepared to tolerate it then the way she is treated may differ as a result (sad but unfortunately true). Being assertive and having an advocate makes a difference. It doesn't mean that it will eliminate being treated badly or having a bad experience, but it can help especially if you highlight the fact it is causing a significant amount of anxiety.

thankyou for ur responses.
money is not the issue
she has more than enough funds to buy a house outright and go to uni and enough to not work for a very long while if she chooses not to.
I will speak to her when she comes home & suggest a hospital closer to home - thanku for the recs
we were planning all being well to go to london at end of july

Then double your predicted rental spend as you'll be competing with tourists for short rentals. I genuinely don't think the issue here though is money. As a pp has also said, you need to consider the reality of a high risk pregnancy and/or an unplanned emergency admission to your local nhs facility. Please don't underestimate the increased anxiety these two things will cause your stepdaughter particularly if you let your own anxiety based on your previous experience be visible to her-in an emergency she needs you to be calm and reassuring even if people aren't jumping as quickly as you'd like.

Clearly money doesn't sound like a problem, however I still think this is not a good course of action. Is she really going to want to travel 2+ hours every single time she has an antenatal appt? What about school? That just seems massively irresponsible imo. And as others have pointed out, there is a lot of room for error when care is shared between different / totally separate teams. I'm really sorry your daughter had had bad experiences, but Gloucestershire, like most areas of the country, will have a specialist teenage pregnancy midwife, whom your DSD can likely be referred to. They are generally able to spend much more time with clients than average, which may put her at ease. Another good option already mentioned is an independent midwife for antenatal and postnatal care, alongside NHS care, who could then accompany your daughter to the birth (would not be able to deliver the baby in hospital but would still be there as a support and advocate).

Does the Portland had a good neonatal facility? I just wonder because I have often seen neonatal ambulances tearing down the Marylebone road and have wondered if they are coming from the Portland.

I know two people who delivered there and neither was happy with the care provided. Obviously that is a survey of a grand total of two people and is anecdotal only, but I would always go with the NHS for anything high risk.

Why not pay for an early scan to reassure herself then? Clearly that's affordable. I did, for reassurance with my IVF pregnancy. She's 9 weeks you say, and you also say booking in happens at 6-8 weeks in your area. So she should be getting NHS ante natal care already, no?
Is this a planned pregnancy then? I guess if money's no object, age isn't either?

Didn't the Portland get in trouble a few years back for having a lot of mother and baby deaths!

I am shocked at how judgemental people are being over:

1. How someone chooses to spend their money.
2. How someone chooses to give birth.

It is nobodies business other than the pregnant woman.

And having given birth on the nhs 3 times, with varied levels of care, if she has heard half the horror stories, I don't blame her for wanting consistency of care, a well monitored delivery, good facilities with experienced staff and a pleasant recovery (all things I NEVER received in the nhs).
I speak as a mum who will be travelling 100 miles to London to have a private delivery very soon for all the above reasons.

However, as has been said, I would not choose the Portland given there is no nhs facility (in case of emergency). Her best bet, imo is:

The Lindo wing, St Mary's paddington
The landsdell suite, St Thomas's
The Kensington Wing, chelsea & Westminister

Antenatal appointments are not that frequent (a few more towards the end) but she could look into shared care with an independent midwife who can do lots of the antenatal care (and really importantly support her for 6 weeks after including daily visits for the first fortnight or so). I found mine invaluable and all appointments are at home, so should be able to work around school.

At a hormonally emotional time, she sounds very lucky to have such a supportive step mother.

I don't think I was being judgmental, just passing an opinion :) and you are right, it is no one else's business but if you put it out there on a public forum, people will respond. The fact she has all that money to be set up for life then I can see why she want's to pay for private care. I have not had private care so can't compare. I know that my local NHS hospital is known around the world and people travel to go there. So I am happy to be treated there. As it is very close to the OP, then that's why I have responded :)

I have no anxiety that I am passing on. she witnessed the treatment I recieved first hand & the was treated god awful herself.
I very rarely speak about my experiences because I just got on with life & was happy that my children were born relatively healthy.
as for the deaths I have had a look & these were over 10 years ago & was deemed that these women could of died anyway. it was also the portland that were taking on cs from another hospital in london that were having major issues at 1 time.
I have checked reviews that are not from the portlands website & have found 1 so far that was a negative which was to do with the pediatric department & a newborn circumcision that went wrong.
I looked at john Radcliffe & it is not a private hospital the just offer private rooms.
the portland have an ahdu, picu, nciu and a scbu & are equipped to take babies from 30 weeks.
if there is an emergency then of course we will take her to the nearest hospital (be stupid not to).
as for schooling she is a very bright young lady & will be completing her exams this year. after that she wants to take a break & then go to uni at a later date.
she wants to have a family & then a career.
she has not booked in to see a midwife yet but is seeing our gp at the moment. she has made all the relavent changes to her lifestyle already.
she is going to phone the hospital this afteenoon to book a visit & then decide.
shes going to look at consultant after her pre assessment when its decided wether she is having midwife or consultant led care.
I do not feel that my dsd is too young to habe a baby. she is not some silly teenager thats got up the duff with no thought to the future or how she will support her & a child. she has had a life plan since she was 12 years old. she knows what she wants & she grabs it with both hands.
she came to me & said she wanted to try for a baby & would I sit down with her & go through what thinga needed to be thought about. she had a list of things she thought important and was spot on.

thankyou chocolatebiscuitcake.
I do not mind being judged I have been most of my life & life is too short to care what others think.
her gp did mention something about an independent midwife but I did not realise that they visited at home. will look into it & bring the subject up with her again.
st marys is an option but again in london.
she wants : 1) not to be judged
2) choices in her care
3) to have consistancy
4) to have the option of pain relief without having to scream the place down to get it.
5) she would like to be able to give birth how she feels comfortable if its safe to do so.

Mommyof4 - great to hear she has so much support from you. And as I near 40 years old, you can tell her from me that I feel like an OAP in my third trimester of a 4th pregnancy!!! Oh to be doing this 20 years earlier!!!

Most of the three private wings I mrntioned have consultants that practise on the NHS and quite a few work at the Portland. No private consultant should be judging (neither should they be judgemental on the NHS if they are half decent!!) so really she should visit the hospitals to see where she likes. All your reasons 1-5, sound perfectly valid and whilst plenty of people get those options on the NHS, there is no guarantee on the day. Even less chance if you labour at the weekend... I have friends who work in labour wards and they are always horrified by what greets them on a Monday morning!

I no longer live in London (where first 3dc were born) and as far as my research has shown, there are no private maternity hospitals out of London (other than Kingston), certainly where I live (South uk). So only option is to go to London.

17 year old planned pregnancy?

heels99 yes a planned pregnancy after a very traumatic miscarriage last year.

chocolatebiscuitcake. congrats on ur pg. my 4th at 28 was definitely tougher than my first at 20.
ue right from research ive done Im struggling to find hospitals that offer something more than a private room.
I do support her as best I can as I know how unsupportive ppl can be & after loosing her mum at 5 she deserves it.

I have a distant friend who has had 3 kids at the Portland. She mentioned in passing that the bill for # 2 was 60k in total as baby premature and you can't move a premature baby to an NHS hospital. Their private insurance picked up the bill. Otherwise I think she was happy and had #3 there as well. Just saying that you may want to have quite a bit of contingency on that 12k as you never know.

Having read this thread I am very glad to have got all those things at my local hospital, I find this thread other worldly honestly. If she's got the money then dsd should pay for whatever care will put her mind at rest but I do believe you can get just as good treatment on the NHS without all the money spent and the relocating. If you have these opinions about nhs care though it doesn't sound like you're going to be persuaded by mumsnet so dsd should just research everywhere feasible and make sure all bases are covered. I wish her luck.

Yes, you do need to think about what happens if the baby is poorly.

Ok, so you move down to London a month before she is due (and budget for that). But if the baby is unwell and in hospital then the costs will rocket. And it could be quite some time before a poorly baby can be moved.

I personally would see what care she is being offered on the NHS and think about a doula.

Does her partner have a job or study to be dealing with - can he potentially relocate to London for two months or more, or is that likely to be an issue? He could reasonably easily miss the birth if he has to dash down from Gloucestershire.

Why would they need to relocate for two months?? She is unlikely to labour in less than two hours, so at the point where she is getting contractions, she gets in the car and drives to the hospital. By 38/39 weeks, if they baby still has not come, she can stay in London as planned...at least there is lots to do and see while you wait it out.

I know VERY few first time mums who have laboured in less than 24 hours!! I know no one who has laboured in less than two hours.

Once the baby comes, she can drive home again. I am planning three nights in a private London wing of an NHS hospital and then driving 1.5 hours home.

It is not a big deal.

As for the partner - his ability to attend the birth is no different than any working/studying dad-to-be!!

And other than the Portland hospital, in an emergency, both mother and baby would be transferred free of charge to the NHS for post natal care/NICU etc, as entitled as UK citizens!

"Why would they need to relocate for two months?? She is unlikely to labour in less than two hours, so at the point where she is getting contractions, she gets in the car and drives to the hospital."

I know an awful lot of people who would have found it pretty impossible to be in a car for two hours in labour (and it could easily be closer to three depending on time of day and where in Gloucestershire). I also know a fair number (including ftm's) who have gone from 'could this be it' to birth in only a little over two hours. If the mother's priority is pain relief and choice, bursting through the door after 3 hours in the car at 9cm dilated seems a pretty poor use of 12k (or whatever it costs).

As for the Dad, if he is 2-3 hours away it stands to reason he is more likely to miss the birth than if he is 30-60 minutes away.