Has anyone felt judged for not giving birth at their local hospital?

[Dollywilde]

Maybe I'm imagining this but I don't think I am...

I live in London, relatively close to Hospital A. I'm lucky in the sense I have a lot of hospital options near me, and, on balance, I'd rather give birth at another nearby hospital (Hospital B). My main reasons for that are that a) I used to live very close to Hospital B and b) have had gynecology procedures at Hospital B which are relevant to my pregnancy - I like that it's the same place, I had a good experience during a scary time and I also think there's less chance of things being missed/notes lost etc and c) one of my very best mates is a midwife at that hospital and I find it reassuring to have someone 'on the inside'! My choosing hospital B is no reflection on Hospital A although anecdotally and based on patient surveys Hospital B is a slightly 'better' one.

I self-referred to Hospital B and my appointments have been a mix of hospital midwifery appointments and GP appointments. Every time that I have seen a GP or nurse at my surgery (3 different individuals) they have quizzed me about why I've chosen hospital B over hospital A. I was wondering whether it was something they 'had' to ask but I can't see any reason for it? I'm exercising my choice as a patient, but there's been quite a 'sniffy' air to it - when I explain the background I feel like I'm offering excuses up and having to plead that it's nothing to do with Hospital A not being 'good enough'! It's also been quite quizzing rather than just conversational, if that makes sense.

I've also had a similar response from speaking to people I know who live in our local area. I'm worried that people think it's something to do with being snobby (our area is somewhat more deprived than the area hospital B is in, but it's all NHS and frankly London goes from deprived to affluent in the space of a couple of streets so there's really not much in it).

As a result I was wondering whether it's unusual to pick a hospital to give birth in that isn't your local one, and whether anyone else who has done this has encountered a similar attitude? During rush hour, hospital A is 20 mins drive from us and hospital B is 35 mins so it's not like I'm heading across London with a 2 hour journey in the throes of labour either!

I have picked a hospital which isn’t my closest hospital, I was given the option of 2 and chose the further one as it has excellent maternity care. Not to say the other hospital isn’t just I would want the best care for myself and my baby. I don’t think anyone has the right to judge you over what is a personal choice. That’s the whole point of being given options!

I did the same and am also in London. I found that people in my area gave birth at a wide range of hospitals for all kinds of different reasons. Some went to hospitals which were really quite far away (e.g. we are on the outskirts but I knew people who went to UCLH and St Thomas's). I don't think it's unusual at all and I very much doubt people are judging you! Probably just making conversation.

I chose a different hospital to my "local" one. I live in a large very diverse city and chose one in the next smaller town - they were both 40 minutes in the car but because my local hospital meant driving into the city centre even though it was only a couple miles it would take the same length of time.

A number of factors which some of them may come across as snobby or worse but to be honest I didn't care and chose what felt right for me and what made me the most comfortable

Be aware though that it can have implications for when you register the baby as if you go "out of area" it can be a bit more complicated

I've had a similar experience too. I am equidistant between two hospitals, one in my county and one in the next county. However my GP surgery is closer to the hospital in the neighbouring county.
After reading you can choose your hospital I decided to go with the one in my own county. It's the same town as my husbands work and just emotionally I feel connected to my own county?! Also, I had a traumatic experience at the other hospital's A&E, although I wouldn't say this has put me off the hospital in general.
I've been met with complete bemusement from both hospitals, my GP and Midwife. In fact, at one point both hospitals refused me because they thought I was in the other hospitals catchment. My midwife is refusing to see me in my normal surgery as it's another county so I have to go to a different practice for the entire pregnancy! It's been very stressful considering its my first pregnancy with early complications. I wonder why the drama?!
Hope it's helpful to know you're not the only one!

@sunlightflower I hope it's just my paranoia! I just find it strange that it's come up so often. It's always been phrased as 'why not [Hospital A]?' as well rather than 'why [Hospital B]?' which probably doesn't help! Makes me feel like my GP thinks I'm slighting my local Trust!

I didn't think it was unusual at all but there's been a real sense of 'why wouldn't you just go to the local hospital' when talking to some people in my area. I wondered maybe if it's something to do with the whole health/social capital thing - that people in less well-off areas are less likely to make use of healthcare choices whereas people in more affluent areas are more likely to - but that's a massive assumption that I didn't want to jump to.

@ivfgottostaypositive That's the thing as well - on the one hand I feel like it IS a bit snobby to say 'well Hospital B is a bit better based on patient surveys so I'm going there' (which is a factor, albeit not as significant as the main ones I've listed). But then I think - so what, how is it snobby to want to go to the best hospital in my area - surely that's just me picking the best available option for me and my child? As @Prettylittlelady says, what's the point in having options otherwise? Thank you for the heads up re registration though - I've looked and hopefully it shouldn't be too much of an issue as Hospital B's register office isn't too far from us.

I chose the hospital I wanted to give birth in because I'd had fertility and gynaecology treatment there and also because I was high risk and they were a regional centre. It wasn't my closest hospital and I did get some questions asked - I thought out of curiosity.
I currently have care at a hospital over an hours drive away and have been asked why on many occasions I choose to think its nothing but curiosity.

Oh that sounds like a nightmare @hummingbirdhm! I've been fine bar a few issues (Hospital B's trust talks about 34 week appointment, Hospital A and my GP talk about the 33 week so there's been some confusion when booking things) but having to attend a different GP's sounds really bizzare! I'm sorry you're experiencing that, it can't be helpful with your pregnancy complications, not to mention the pandemic moving things (a lot of mine have gone from face to face to phone appointments and back again).

The silly thing is that we have the option for choosing a preferred hospital, so why isn't the system better equipped for it? If the system said 'you've got to go to your local hospital and that's that' then I probably wouldn't question it, but why give us choices and then appear to be confused when we make use of them? Don't get me wrong, I love the NHS - I used to be a medical secretary in the era of Choose & Book and I'm aware of the principle of empowering patients doesn't always make the logistics easy - but I honestly didn't think that I was doing anything unusual or weird by chosing a hospital 4 miles from me rather than 2 miles from me, even if they were different trusts!

We have two hospitals in our county. One is 16 miles away and one is 30 miles away. I chose the one 30 miles away because I had my first there and was under the care of a birth trauma specialist who was a consultant obstetrician but also offered counselling. He'd offered to deliver my baby and he knew my history so I went with hospital b.

I expect you're just an exception to the rule. Most people opt for the nearest hospital so they're probably just querying your reasons as they're not the norm.

Nobody ever thought it odd but I did get asked. My reasons were sound and I was comfortable with my decision. Perhaps you're reading a reaction that isn't there due to expecting to defend your choice or because you don't want to appear like you're judging other people's choices.

@dollywilde

To be honest I was lucky in that most of my midwives agreed about my local hospital so I didn't get the impression they didn't support my choice and it had nothing to do with local surveys and more to do with the local area..... - yes it had ok reviews and had plenty of consultants on site but it was a typical "inner city" hospital and I just wouldn't have felt comfortable there for a variety of reasons - some feedback I had heard from friends who HAD gone there would probably get my post reported! 🤦‍♀️

I've had the opposite, I feel like my midwife is nudging me towards the hospital that is further as it has a midwife led birthing centre - but that is a 40 minute drive away and my nearest hospital is a 4 minute drive!! To me, with that difference, it's a no brainer and I'll go for the closer one thank you very much, but they do seem keen to change my mind!

As you say, they give you options so you should be able to choose without it being questioned. Hopefully it's just curiosity, maybe ask why they're asking next time?

I didn't go with the usual hospital for our area as I had an awful time the first time and every time I visit I have an anxiety attack.

So for baby DS I went with a different hospital so I couldn't visualise anything and had a much better (in terms of care etc) stay.

Patient perspective: I’m not booked with my nearest hospital. I live roughly 30 mins from three different hospitals and the one I’m booked with is slightly further away than that. I booked at the hospital I work at as it’s most convenient for me to access appointments etc. and I’m lucky that I’ll be looked after by someone I know. I also know the doctors so feel I can be a bit pushier when it comes to decision making.

Midwife perspective: It’s a pain in the arse when someone books at a different hospital and then expects the care to be seamless. No I can’t see your blood results. Yes you’ll have to chase them up yourself, same goes for the consultant appointments that I don’t know why they haven’t made. Basically, the next nearest hospital near us is a bit shit at following up their out of the area patients and it makes everything take ten times as long as it needs to so it’s frustrating when I’m expected to know everything or have to do the legwork.

Bottom line is book where suits you but anticipate that it might not be simple in terms of test results, appointments, paperwork etc.

Don’t get me started on hospitals where all their notes are electronic and we can’t access the notes. Thankfully we only see those ladies postnatally now. Massively unsafe.

Our closest hospital is in a town with some negative connotations. There are a quite lot of women who book in at the next hospital to have a naicer town on the birth certificate!

I'm also thinking of giving birth to a hospital that is 40 minutes drive roughly (vs the local which is literally 10 minutes away), as I had my daughter there, it was a good experience overall and I'd line birth of my children to have the same place in their certificate.

I'm currently 22 wks but this conversation hasn't come up yet with my midwife. When is it best to discuss this? Is it ok to have all the tests, scans, etc at my local one and change at the latest stage, or is this risking virtual info not getting through to the hospital that I will deliver?

And is it the midwife that will be managing the changeover or do I need to self refer?

Apologies for all the questions

Are they in the same trust? If not, there might be financial implications for the trust (not impacting you but may be why they don’t want like it).

i think it's fine. i nearly returner to the hospital where i had my first baby despite moving much closer to another hospital, as i had good care at the first.

fwiw (i don't know if this is your first) i did move as new hospital is 5 min down road, and i had #2 in January, and i remembered #1 drive in and yep, CHRIST I'm glad i did. being a passenger in a car in labour is NOT a pleasant experience.

I live 8 miles from hospital A and 15 miles from hospital B. I had both my DC in hospital B - because I’d worked in both hospitals as a doctor, knew the staff, and knew that B had a better maternity unit. It was also easy to attend antenatal appointments without taking time off - I could just pop out of the operating theatre, nip across to the clinic and be back in time to relieve my colleague.
That was 30 years ago. Hospital B has since lost its maty unit and become just a midwife led birth centre, with no obstetric staff and no emergency cover. Mothers or babies who suffer unexpected life threatening complications face a 20 mile ambulance transfer to hospital A’s fully staffed unit. At least one baby has died in transit. Can’t say I see that as progress.

If you've had pregnancy-relevant gynaecological procedures at Hospital B then giving birth there seems the obvious choice!
If I were a GP dealing with a Mum-to-be that had been through pre-pregnancy gynaecological procedures at a specific hospital, I wouldn't hesitate to query her choice to give birth there.
Besides which, you will already know the actual hospital, where things are, parking, etc - ok, not directly maternity related but being in a familiar place should make your mental state easier as birth approaches.
I'm not a mum however I've had to go to my local hospital a few times for various reasons & all my records have been easily available.
I was referred to A&E recently by my GP & when I gave my name & DOB at the check-in, they were able to check ongoing meds & problems, review my next of kin (!). It's good not having to give all the information AGAIN each time.
Stick to your guns & best of luck!

Yes, when my MIL was alive she gave me a really hard time about it as baby ‘wouldn’t be born in Yorkshire’ 😳🙄

I had no faith or confidence in our local hospital thanks to several close family members having horrendous, life threatening experiences there.

MIL has since died and I had my second baby at the same hospital I had my eldest at, no problems, no issues. So well looked after.
Unfortunately my beloved granny passed away in the local hospital thanks to a fuck up with meds that made her bleed out. She was too old to be resuscitated. This has further cemented my belief.

I have done this for both pregnancies now. In my first my local London hospital wasnt a good one at all and after a horrible experience with a midwife I switched to Kings which was at lesst 30 mins drive away. Didnt regret it at all.

I am in Hampshire now and have had another bad experience so not going local but to one 20 mins away. I would find it so odd if anyone commented on my choice of hospital, it is quite personal I think.

Our local hospital is 10 mins away but a midwife only unit, I opted to go the hospital 40 minutes away (the one the local one would send you to in an emergency). So not the same as your situation exactly, but honestly I got questioned about the decision at every appointment, and they frequently tried to change my mind. I think it’s because the local one is at risk of closing, and I do understand that must be hard, but I just wasn’t comfortable with the idea that if something went wrong, I’d have to be moved to somewhere half an hour up the road, it seemed too long to me. The day I was in labour I phoned the helpline- it’s just one number but midwives from both hospitals man it, and she asked which of the two hospitals I was going to and I said. As she had my notes up and could see I lived closer to the other one, she started saying ‘why on earth are you going there given where you live?!’ Really wasn’t a conversation I wanted to have, for the twentieth time, whilst in a lot of pain!

I'm right on the county lines , so I'm close to two hospitals. A is a 15 minute drive , b is about 30/35 but weve chosen b. We ruled hospital a out as everytime I've been there I've had awful experiences, I've just not liked it as a hospital. While all my experiences with hospital b have been very pleasant. If asked I wouldn't justify my choice. You need to go where you feel most comfortable.