How do I organise a private c-section?

[NoSleepSinceSpring]

Apologies if you have read a similar thread before. I posted in childbirth yesterday and got one reply.

I just found out I'm pregnant but its very early days. I think I have a medical need for a ELCS after a very traumatic/ mis-managed second trimester loss and a subsequent EMCS with DS.

An ELCS would be covered by my private work insurance if it's medically necessary.

Do I have to find a sympathetic NHS consultant who will help me make the case for a medically necessary ELCS? Although I'm convinced it's the right thing, I can also see that some consultants might want me to try for a VBAC. I really dont want this.

I know that some NHS hospitals don't even entertain the VBAC v ELCS talk until 36 weeks.

Surely that's too late to then book in to a private clinic? I really want to go private for the aftercare, which was diabolical after DS. I'm thinking of St Thomas (Westminster Suite) or Portland.

Does anyone have any advice? I would be happy to pay to see a private obstetrician if that would speed things up

Ask your insurance company whicheck obstetricians they cover and make an appt with one of them
It'll be all or nothing - antenatal care and delivery not just turn up for the section

If you've had a previous c secuion it's usually your choice even with NHS care.

Wait and discuss with your midwife at booking and see what she says. If you meet resistance look at the NICE guidelines.

Thanks guys. I had hoped to receive anti-natel care through the NHS as normal. I spoke to the insurers but I left the conversation a bit confused! I will try again with them in a couple of weeks. Just didn't want to leave things too late to get on a consultant's list.

*antenatal not anti-natel! (English isn't my first language!)

You can always choose a c-section on the NHS. They might be grumpy and resistant, but ultimately, they have a duty of care and they can't deny you. Have at look at some of the resources at Birthrights as they've recently been doing a campaign on elective c-section rights.

Thanks for the resource mindutopia.

I think I want to go private to get the aftercare. I struggled after DS and part of that was because of the horrible time I had in the post birth ward. I was left with a full catheter for too long which resulted in infection. The ward was so busy I don't even remember seeing a midwife for the 3 days I was there. But if the NHS would support my choice, I could have the private CS and the aftercare. I will definitely check out the resources.

Obstetricians have to pay around £1500 indemnity for every delivery that they do, so they will largely want to do all your antenatal care as well otherwise it just isn't financially viable for them. Plus they aren't just technicians, they do need to know about your pregnancy care.

Hi there, if you’ve had a c-section already, the NHS cannot refuse you and elective. When meeting with the Consultant Midwife, politely refuse to attend the vbac clinic. Just keep calmly telling them that you’ve made your informed choice. You will definitely get one.

I had an emcs for my first birth. I was referred to a birth options clinic at 16 weeks who didn't try and persuade me either way so it seemed easy to get on the NHS.

Thanks hiyasminitsme. So is it impossible to do as I propose; to have antenatal care with the NHS, a couple of private consultant appointments with the surgeon/obstetrician (one paid for by insurance, one self-funded), and then the private CS?

Thanks all. It's good to hear you have had positive experiences with getting your CS.

I would be surprised if any obstetrician agreed to that, but you can always ask. I can't see you getting it refused on the NHS FWIW.

Thanks hiyasminitsme, this is really helpful. But what other appointments would the consultant want me to have? I was under consultant care for DS and I only had two consultations.

normal antenatal care - two scans at least and the usual set of appointments

I had my c-section at Portland, fantastic care. I would recommend Dr Seni Subair - amazing aftercare, so reassuring and always on call. He went out of his way to make me feel confident afterwards.

Maybe call your insurance and ask what's required. Don't ask them if they will cover a c-section, just call and assume that they will. You've had one before which is usually medical grounds enough.

It may be worth going through NHS process to see if it changes your mind but no big deal if you don't want to.

Insurance will definitely cover CS, but I've been warned there may be a shortfall depending on the consultant I pick etc. The insurers have said they may pick up the shortfall, but I'm confused as to why they would do this. I have a good few months to sort this out, which is good as I think it's going to be a long process!

I haven't read all the posts above but just in case nobody has mentioned it as you've already had a c-section in most areas I know of you will be given the choice of VBAC or ECS and even though a consultant may try to steer you towards VBAC they'll not fight with you over your choice. Plus I'd say in your case if you say you want a ECS they won't even argue the points of VBAC with you. Good luck with the rest of your pregnancy!

Thanks MsStinkey