Private birth v NHS birth - so confused! UCLH v St Mary's?

[miamch]

Hello everyone,

I'm expecting my first baby in Feb 2018, I'm v new to Mumsnet so apologies if I say anything wrong..

I would like to go private for a variety of reasons but the main one is that as I am likely to have a low risk pregnancy, I'm worried about the care during and after birth.
The NHS is amazing during a crisis - there is no comparison really, but I do think that for mothers to be who are not critical or who do not have high risk pregnancies, the care can be... lacking.
A few of my close friends who had their babies experienced this and in one particular case it led to their baby being quite severely disabled.

I am registered at UCLH and unfortunately their private wing only caters for c-sections (I would ideally like a natural birth). Otherwise I think I would stay on the NHS and only swap to private for the birth and aftercare.

Has anyone given birth naturally at UCLH and had the option of a private room at birth?
Would anyone recommend swapping to St Mary's as their private wing offers both options?

Any advice would be greatly appreciated.

Thanks all x

The birth centre at st Mary's is amazing if you are low risk and come on time. So I assume the private will also be amazing.

I think there are a lot of hospitals where you can deliver on the NHS and then pay for a private room on the postnatal ward. You could also hire a doula or an independent midwife to attend you during the birth and care for you and baby afterwards, which would probably be cheaper than paying for a fully private birth.

If you are low risk and want a natural birth, tbh I don't think you need private hospital care for the birth - just experienced midwives, whether NHS or NHS + independent. In my NHS natural birth (which was amazing) the midwives basically only checked foetal heart rate occasionally, coached me verbally, and caught the baby. You'd be more likely to have the natural birth you want if you are in a birth centre or at home rather than on the ward, as you probably know. I think I'd probably consider hiring private support for the birth (doula or midwife) and choosing a hospital where you can have a private postnatal room, but otherwise just having NHS care. Your other option with a straightforward vaginal delivery would be to go home more or less straightaway - they'll let you go within a few hours.

Thanks both xx

How about a home birth with a doula?

PotteringAlong I'd like to be in hospital incase anything goes wrong. All of my close gfs have ended up with emergency c-sections for various reasons so the idea of a home birth terrifies me!

The people caring for you, the doctors and midwives will usually also work on the NHS, especially if you look at the private 'wing' of an NHS hospital. Have you looked at somewhere like The Portland? They have midwifery led care as well as consultant led, and support all types of births (mostly low-moderate risk, because the costs can get insane if you're high-very high risk)

Loopsdefruits Yes I have, but would prefer to be somewhere connected to an NHS hospital (like Lindo) as there is not so far to go is sh*t really does hit the fan.

*if

miamch that's reasonable :) could you call up the places that are your options, then maybe take a tour? Also if you search on here for the name of the hospital you'll get lots of reviews. You'd be better off paying for the birth privately, just to save yourself some money on antenatal and postnatal care (at home). Would you consider hiring an Independent Midwife to act as 'trained supporter' during an NHS birth, just to open your hospital options a bit?

It sounds like you would be a good candidate for hypnobirthing... have you considered this? You could incorporate this with a midwifery led (low risk) birth centre... here is a link for the one I am a member of however I think your trust may offer their own version so it's always worth speaking to your midwife www.kghypnobirthing.com/
This course is also RCM accredited and widely recognised

What you are buying with private care is continuity of care which suits you not which is not subject to staffing. You get a guarantee of a midwife with you all the time not shared with other mothers. My midwife also did my 2 private ante-natal appointments so I had discussed my birth with her in some detail. You'll have the guarantee that you've chosen a competent doctor to deliver the baby. There's no comparison to the way that my baby was delivered privately and how the consultant managed actually getting the baby out, not because it was private but because of the level of experience. You'll get an epidural if you want one exactly when you want one and you'll be guarantee that you'll get stitched up by someone who actually knows what they're doing. Afterwards, I had one to one breastfeeding support throughout the night, peace and quiet and an ensuite bathroom and nice food.

I had 2 NHS births, the private one was in a different league, not because they employed any special skills but because there were enough staff and they weren't rushed and I knew that they had the experience to deal with every eventuality without panicking .

I'd probably go for a private birthing centre but unfortunately Leeds don't have any. I saw a documentary a while ago on TV about one in London n looked amazing! Steak dinners, etc..! Nursery so that mums could get some rest. Go for it!

Loopsdefruits I did briefly look into it, but they weren't cheap either all their different packages add up!!
I think Neighbourhood Midwives only had a couple that would cover my area (NW1) and they were probably the younger and less experienced of all on offer.

Middiemummy Thanks for the link.
It's not so much the style of birth or where it is that bothers me on the NHS, as Tralalalaz says, it's continuity of care and whether or not someone will be there to provide the help and assisted when needed and spot warning signs in time if it all goes horribly wrong.
Obviously I am under no illusion that private doctors are better, they all do work for the NHS so to claim otherwise would just be plain wrong.

I've done both an NHS birth and a private one. The NHS one was a complete nightmare complete with unnecessary intervention. I gave birth at the Portland the second time and it was worth every penny. Continuity of care and actually being listened to are priceless. The private staff aren't rushed and are there for you. You'll avoid the ward which for me was awful. Oh and you'll get an epidural much faster should you want one!

Interesting point you make about low risk pregnancies, OP.

In my first pregnancy I was assumed to be low risk because I didn't fit the criteria for anything other than low risk - average age for first pregnancy, well within average weight bracket, very good health etc. As it turned out, I was actually extremely high risk but they found out too late and DS1 was born extremely prematurely. He has complex disabilities as a result. Due to our circumstances I was given a freebie private room on the postnatal ward, which would have been lovely - it was spacious and comfortable - had I not been so utterly distraught.

During my pregnancy with DS2 I received absolutely brilliant care at a high risk specialist pregnancy unit - probably everything you'd get and more as a private patient, but entirely on the NHS.

I generally think very highly of the NHS - without it, I'm pretty sure that neither of my sons would be here - but I totally agree with you about the slightly questionable standard of NHS care for low risk pregnancies (or at least those that are assumed to be low risk).

BlackbirdSingsInTheDeadOfNight Thank you so much for sharing. I can't imagine the roller coaster of emotions you have been through xx

UCLH has given me exceptionally high quality continuity of care with a single named midwife. The first booking in appointment was at the hospital with a different midwife, who then told me who my named midwife would be and where /when I would see her. All scans and blood tests have been very efficient and thorough. I would highly recommend them. What I would say is that private care may offer you greater certainty about who will be with you when you actually give birth. Also maybe a nicer environment? I haven't been through that bit yet (32 weeks at the moment) so can't advise. But up until this point, UCLH have given me exceptional care.

If you want a natural birth and are low risk, and particularly if you want to avoid unnecessary interventions, to be honest my personal preference would be to fork out for am exceptionally good independent / private midwife and go for a home birth. In London one is so close to hospital that it's very easy to transfer in (and the independent midwife accompanies you). If you are more concerned about already being in a hospital, and want more monitoring and a more clinical approach (interventions more likely, epidural available) then I really wouldn't rule out UCLH, they are world class. Definitely worth paying for good postnatal support, though - including looking up good lactation consultants in advance if you plan to breastfeed.

Fwiw I think it's a fallacy that the NHS deals with high risk better. Both my pregnancies were high risk for multiple factors. With the NHS I got a different consultant each time and I had to go through the whole thing. They often didn't agree with the previous consultant and I found it all very stressful. With my private pregnancy I had one consultant who knew me and saw me all the way through and delivered the baby. It made a huge difference in the quality of care. Most of the consultants practice is NHS where he leads a women's health clinic and specialised in high risk.

Independent midwives are no longer allowed to do births. Another option taken away from women.

Miamch thank you x

It's highly unusual to be in my sort of situation so I hope I haven't made you worry! Hope all is great in your pregnancy and you are really happy with the care you choose.

My experience with uclh was anything but continuity of care. The medical care for my child was great , but maternity bookings saw someone different every time who told me something different.

It sounds to me like your main area of concern is monitoring during labour. When I had my home birth, I had two dedicated midwives (NHS) who checked the baby every 15 minutes and were completely concentrated on me, so any tiny change would have been picked up immediately. The horror stories you read about in hospitals are often a lack of monitoring owing to short staffing, and even monitor traces going unread. So to that extent I would say that, given that you are not comfortable with home birth, you would be best off with an independent midwife who came with you to hospital. They are not allowed to deliver the baby but can ensure that you are getting that level of attention during labour.

Unlike other private midwives, Neighbourhood Midwives are ensured to deliver at home. I'm sure though that you could have a conversation with them about an arrangement that might suit you.

Alternatively have you asked whether there are any caseloading midwifery teams available in your area? That would give you a named midwife within a small team, and all your antenatal appointments would be with them, usually at home, apart from scans, and then one of them would come with you to hospital for the birth, ensuring that continuity of care. NHS caseloading provision is patchy but where available it's fantastic.

Insured to deliver, not ensured.

@MOIST, some independent midwives are still able to practice, and are covered under the auspices of the NHS trusts they work within. There are definitely still options in London while the insurance situation is being resolved (for example any of the independent midwives in Chelsea & Westminster, which is close enough for the OP).

But it's true that this is a recent development that risks reducing women's choices. Really awful, and I wish there was more publicity about the need to resolve this. I believe there is a test case coming up however.