Maybe a controversial question but...

[Confused521]

..has anyone ever not used the NHS for maternity care and done a combination of private screenings / scans and perhaps used a doula?

The reason I ask is because every interaction I have had with then NHS has been awful, from midwives to health visitors, it causes me waaay too much anxiety and, without going into details, I end up feeling like I am fighting for my right to have my baby in the way I want. On top of this, I think all the added corona 'mitigations' will only make it worse.

While I am not under the illusion that medical intervention in these circumstances is often needed and the difference between life and death, I can't help thinking there is a less clinical, invasive and collective risk averse approach available to people.

I would appreciate your thoughts.

How would you plan to deliver? At home, privately, midwife led unit etc? What would happen if things were to go wrong during the birth and you had to end up in an NHS hospital anyway? I can understand your perspective but I think these are the questions I’d need to spend a long time thinking about before making a decision.

@Blueballinthegarden

How would you plan to deliver? At home, privately, midwife led unit etc? What would happen if things were to go wrong during the birth and you had to end up in an NHS hospital anyway? I can understand your perspective but I think these are the questions I’d need to spend a long time thinking about before making a decision.

Yes, ideally at home. What happens usually if you have diffculty with a homebirth? I imagine you'd end up in an NHS hospital but then it would be because it was necessary and not a given.

I'm really torn. With my first, who is now 11, I took all the advice and guidance, although I disagreed strongly with the basis of it (early induction based on policy, not personal medical status) and it was a horrible experience that we were both lucky to survive. With my second, I put my foot down with the care plan and the birth was a lot better (no pain relief at all amazingly) but I still had to fight up until 7 months for midwife-led care.

Which area do you live in? My grandchild was born in Brighton and I cannot imagine the care would have been any better anywhere else . Same midwife throughout pregnancy,same midwife throughout labour...did not leave the room all night and her community midwife came in on her day off to deliver the baby and stayed with us until she went to post natal ward hours later . There was the option for home birth if my daughter had wanted that.

Yes, if a homebirth goes wrong you would likely end up in an NHS hospital unless you’ve made other arrangements. Depending how long this takes and what has gone wrong there could be disastrous consequences. When I had my first things went from being fine to really not fine within moments, I was traumatised by the intervention but grateful that my daughter was born alive and that we were healthy afterwards.

You may not be considered a good candidate for a home birth depending on how your pregnancy progresses, how high risk it is etc, without the benefit of any medical training (which doula’s don’t necessarily have) how would you be able to make this risk assessment?

I’m surprised about your fight for midwife led care, my NHS trust begins with midwife led care which can (depending on how things progress) result in more consultant led care although I can appreciate that things obviously differ between trusts.

How pregnant are you? Do you have much time to make these decisions? I’m hoping someone much more knowledgeable comes along shortly to add to the conversation!

@olidora63

Which area do you live in? My grandchild was born in Brighton and I cannot imagine the care would have been any better anywhere else . Same midwife throughout pregnancy,same midwife throughout labour...did not leave the room all night and her community midwife came in on her day off to deliver the baby and stayed with us until she went to post natal ward hours later . There was the option for home birth if my daughter had wanted that.

Maybe we need to move to Brighton. I'm in London now but that experience was at Stoke Mandeville in Aylesbury.

@Blueballinthegarden

Yes, if a homebirth goes wrong you would likely end up in an NHS hospital unless you’ve made other arrangements. Depending how long this takes and what has gone wrong there could be disastrous consequences. When I had my first things went from being fine to really not fine within moments, I was traumatised by the intervention but grateful that my daughter was born alive and that we were healthy afterwards.

You may not be considered a good candidate for a home birth depending on how your pregnancy progresses, how high risk it is etc, without the benefit of any medical training (which doula’s don’t necessarily have) how would you be able to make this risk assessment?

I’m surprised about your fight for midwife led care, my NHS trust begins with midwife led care which can (depending on how things progress) result in more consultant led care although I can appreciate that things obviously differ between trusts.

How pregnant are you? Do you have much time to make these decisions? I’m hoping someone much more knowledgeable comes along shortly to add to the conversation!

Your advice is super helpful thank you, and echo my own thoughts and considerations. I am around 9 weeks and for some additional background, I had a rather mismanaged MC last year in London and while the midwife was lovely, I never met her and there was no way she could have supported me through this. So, I definitely don't want to 'login' to the system until I have passed that point at, at all if possible, because, at least in the first few months (prior to screenings, which I'll still probably have), there is nothing anyone can do to prevent bad things happening.

What I'll most likely do is see how the next few weeks go and then if all seems well, book a private scan and see how I feel then (and how things are in my local Trusts).

Can you afford private antenatal care and a midwife for your home birth? If not you need to talk to your local midwifery service and ask about home births and continuity of care - most women in the U.K. use them nhs and most have good experiences. One bad one doesn't mean all are bad

I have seen the same 2 midwives throughout this pregnancy. I think a lot of trusts are trying to achieve this for continuity of care. it might be worth talking to your midwife at your booking appointment to see what the care plan is for you. I'm 34 weeks and all my appointments have been face to face as well but that varies massively across the country.

You could hire a private midwife for a homebirth. If needed you would still get transferred by ambulance to the closest hospital with maternity services though but by that point, it's likely all you'll care about is getting the care you and baby need.

I’m sorry to hear about your MC and mismanagement, I can see how that must add to your reservations. Do you have a good support system with friends/family who can also help you think through these decisions? I haven’t ever done the NCT group thing but only because I’ve been lucky enough to be pregnant at a similar time to others within my friendship group so we were all able to bounce ideas around between us.

Things can change so much within trusts, I’d have a very long chat with a midwife at booking in appointment time and let her know your worries and reservations and see how you go from there.

When I had my first in London I booked for a home birth and had all my appointments (apart from scans) at home, as it turned out I didn't give birth at home but the care I had by the community team was excellent

@Blueballinthegarden

I’m sorry to hear about your MC and mismanagement, I can see how that must add to your reservations. Do you have a good support system with friends/family who can also help you think through these decisions? I haven’t ever done the NCT group thing but only because I’ve been lucky enough to be pregnant at a similar time to others within my friendship group so we were all able to bounce ideas around between us.

Things can change so much within trusts, I’d have a very long chat with a midwife at booking in appointment time and let her know your worries and reservations and see how you go from there.

I have an excellent support system, thankfully and hubby's thoughts are in line with my own.

I did NCT with my first and it was fantastic, although I found it impossible to follow the principles in practice - the first time around anyhow! I will never forget them speaking about the "cascade of intevention", starting with choosing to give birth in hospital and that alone leading to a higher chance of medical intervention (induction leads to epidural, epidural to c-section etc) and my experience was text book that!

I will get in touch with a midwife next week and pick her brains! Thanks for all your help.

@MissSmiley

When I had my first in London I booked for a home birth and had all my appointments (apart from scans) at home, as it turned out I didn't give birth at home but the care I had by the community team was excellent

That sounds wonderful. Where abouts in London are you?

You have time to make these decisions and time to look into the options.

A private midwife can support you alongside hospital care or alongside NHS midwives.

A doula can support you through the process, they do not make any medical decisions but instead help you find the information you need to make that decision. (I am a doula).

You can pick and choose what elements of care you want to have from the NHS and what you want to do privately. Equally, local doulas will know the lie of the land.

It might be worth booking a session with someone local to you or maybe a power hour with someone like Kemi Johnson. Prepare a list of questions. I have attended a zoom training with her and I follow her on social media. Maybe take a look to seeing she might be right for you before booking. Relationships are very important in our business. It is important that you find a midwife or doula that you trust and like.

@ChateauMargaux

You have time to make these decisions and time to look into the options.

A private midwife can support you alongside hospital care or alongside NHS midwives.

A doula can support you through the process, they do not make any medical decisions but instead help you find the information you need to make that decision. (I am a doula).

You can pick and choose what elements of care you want to have from the NHS and what you want to do privately. Equally, local doulas will know the lie of the land.

It might be worth booking a session with someone local to you or maybe a power hour with someone like Kemi Johnson. Prepare a list of questions. I have attended a zoom training with her and I follow her on social media. Maybe take a look to seeing she might be right for you before booking. Relationships are very important in our business. It is important that you find a midwife or doula that you trust and like.

Thanks, that's very helpful. I'll look her up. I've also bookmarked a local doula.

Look for a private midwives company.