Royal London Hospital

[VanillaIce]

Hello,

The Royal London is my local hospital and I am supposed to have my baby there or at the Barkantine Centre in Canary Wharf. The thing is, I have heard some bad things about the Royal and am wondering about maybe getting a referral elsewhere. My GP tried St Thomas's for me but they're not accepting from outside the catchment area anymore so my only other option would be UCH which is apparently easier to get referred to. This would mean having all my appointments there whereas if I stick with the Royal I get to do everything at my GP surgery (apart from the scans of course).

I went on a tour of the Royal last week and it was ok-ish. Not particularly attractive hospital, very old, bit rough round the edges. The main downsides I thought were the birthing rooms, they were tiny and no ensuite bathrooms. And, in all snootiness, I have to say the post-natal ward looked a bit grim.

The Barkatine is supposed to be a lovely alternative facility and I know we're quite lucky to have such a thing on the NHS but obviously there's no epidural to be had - with this being my first, I have no idea if I'll want one.

What do ladies think then of the Royal London option? Be as honest as you like - I can take it!

Thanks

why not have a home birth.

We live in a flat and I'd be worried about disturbing (mentally, that is) the neighbours!

Hi
I too am in Tower Hamlets and due to give birth at the Barkentine (first baby). Because i'm hoping to have it there, I haven't been round the maternity ward at the royal london (even though I will be transferred there if there is a problem). Is it really that bad? I was under the impression the hospital was one of the best in London but please tell me if that's not the case!

Um, it came in the bottom 10 of all UK maternity hospitals. Barkantine is supposed to wonderful though from what I have heard so stick with that and you'll be fine. I went on a tour of the Royal and it wasn't as bad as I feared. Are you ok with having first baby without epidural? I would love not to have one either and if I was certain about it I would plump for the Barkantine and forget about the Royal. But I wonder if I am being naive and if I will get into the throes of labour and wish I had gone for the drugs when I had the chance!

Oldboiler can I ask has anything in particular given you the confidence to go epidural-free?

Sorry if I've worried you about the Royal - medically I haven't heard anything bad, just the post-natal care really and the general tattiness of the place.

Um, I probably shouldn't say this but I know the Royal London extremely well (from the inside, if you get me). In many ways it is a good hospital, and if you do end up going there it wouldn't be the end of the world, but if it was my choice I would go for the Barkentine or UCH. You may want to read the Healthcare Commission report on maternity services, published a year or so back - I think the Royal London (Barts and the London) came out in the bottom five in the country. Don't panic: the clinical care is not bad, there's no reason to think you'd be at risk there, but it fell down badly on staffing, cleanliness, customer care.

Of course, it has also worked hard to improve things since the Healthcare Commission report came out. But do check it out.

Of course, it has also worked hard to improve things since the Healthcare Commission report came out. But do check it out carefully.

Thanks for this as it just goes to show unprepared I haven't even looked at maternity ward statistics - i was just told by my midwife it was one of the best and accepted it (blush)

Also had no idea I wouldn't be able to have an epidural at the Barkentine either - just assumed I would be as wasn't told otherwise by either my midwife or by the Barkentine when I went for the tour. Something i'll have to raise when I go back to see my M/W next week I think!

Thank you for the advice!

Interesting post from an ambulance driver re the barkentine. Have to admit that the whole 'wait 20 mins, then 20 mins transport' thing would make me nervous if something were to go wrong...

randomreality.blogware.com/blog/_archives/2008/11/7/3966516.html

Hi Vanilla Ice
Just to let you know i've spoken to my midwife today who has said that you can have an epidural at the Barkentine (a relief!). Can I ask where you heard you couldn't? (am just worried as my midwife has got a few things wrong before so want to know she is right on this one). I've also looked on the Barkentines website and it does mention epidurals on there as a pain relief option so am hoping it will be ok (as being my first too I am pretty sure i'll want one).

I too am at the mercy of TowerHamlets Hellcare Healthcare services, and am pg with my third.
WARNING - [SOME]GRIM DETAILS TO FOLLOW.
Had first dd (now almost 4)at home. MWs completely stuffed up gas and air pain relief, in that they brought one leaky cylinder which ran out after about 20mins use, and another cylinder of OXYGEN. All in all ended up with about 1.5hrs worth of pain relief in 16hr labour. Then had tearing and meconium in waters so ended up being transferred to the RLH anyway. Subsequently discovered MWs who attended me at home were not qualified to do so.
At the RLH staff REPRIMANDED ME for having my first baby at home, esp since she weighed 4kg. Tutted at the tearing saying MWs should've dealt with it at home. Ended up in huge amounts of pain and discomfort in very hot dirty postnatal ward for two days with staff showing no concern whatsoever for me. My BF got off to terrible start; none of the MWs were able to advise me on getting my baby latched on properly. one told me there's really nothing there yet anyway.

2nd time round (dd now 2)we 'opted' for hospital birth, not trusting that the borough actually has the whole homebirth thing under control. THANKFULLY labour was short - 2.5hrs start to finish - . We went in to hospital asking for a 6hour discharge if all went well and kept beating that drum. I had pethidine followed by gas and air and it all went really really well. The labour room was small and grim; the MW was great, and made all the difference. She listened to me and did not intervene much AT ALL. DD born at 1:50am so stayed overnight but home by 10am.

Unfortunately I think much of your labour experience will be determined by those carers who are around you at the time. Incompetent MW's turned what should've been a straighforward birth into a nightmare start to motherhood for me. Competent MW in terrible hospital gave me a huge boost.

I'm not really considering the Barkantine bec about 20min drive from us on good traffic day; also really don't like the idea of being transferred if something goes wrong.

Also am inclined to be sceptical about the epidural at the Barkantine -surely quite medical? Sure my MW said you can't have it there; can have gas and air, pethidine and then water birth stuff.

Hi there! I had my first two babies at the Royal London when I lived in Canary Wharf. I had placenta praevia with my first son (now aged 5) and was admitted as an emergency to the Royal London. I have to say that despite my reservations - for exactly the reasons you state - the care I received was fantastic. Due to this I opted to have my second son (now aged 3) at the Royal London and had another great experience. I do think that so much of it is down to the midwives available at the time (luck of the draw!) and your individual experience. I now live in Surrey (due today with my third... a girl this time!) where the hospitals are apparently much better but then you also hear the same horror stories so I think you have to go with your gut feel. Do bear in mind that if there are any complications then the Royal London is geared up to emergencies and they have recently received funding for their maternity wards. Good luck whatever your choice is!

Your midwife is wrong, you can NOT get an epidural at the Barkantine. However, you could transfer to the RLH if you wanted that pain relief - at least then you could say you had given it your best shot and you stand the best chance of getting the good postnatal care and facilities that are on offer at Birth Centre. Apparently only 27% of first time mothers transfer to the RLH, and that would include medical complications as well as a need for further pain relief. That means 73% of women there have a birth without any interventions, anaesthetic or complications , which is a good statistic imo. Also, you would have the guarantee of the pool, which is a form of pain relief, whereas there is only one pool at the RLH (not sure how well used it is tho').

I heard recently that at the RLH they no longer have clip on cots to the side of the beds, which I thought a very retrograde step, and with probably only 1/2 midwives to a ward of 39 beds (many of whom will have had c/s or other health complications) you are not going to get good help with breastfeeding, baby care, personal hygiene or other things that would be lower down the list of priorities for overstretched midwives but you might really appreciate as a first time mum.

On the other hand, I did hear just this week that in the labour ward they are really trying to improve things...and in a recent audit there were 75% of women who had 1-2-1 care with a midwife rather than a midwife having to be running between 4 labouring women, which is a big improvement as that figure was 35% last time I heard.

When I transferred to the RLH last time there was no toast available after the birth and despite the fact that I had baby poo, blood and my own poo all over me, I didn't get a shower until the next day when I got home because I was anaemic and needed help to the shower and noone thought to clean me up or help me clean up. If I had the chance of going to the Barkantine this time (I'm not low risk though) I would definitely go, because all I have heard is how excellent it is.

Aim high, have faith in your abilities and go to the Barkantine is my advice.

When I say I had various types of poo and blood all over me, I don't mean all over me..just in the obvious places really, not on my head or anything.

I had my first child at RLH - and yes, the labour rooms are grim. I got a corner room which I thought was just the room to wait in till I got allocated a proper labour room - boy, was I mistaken! It was May, so very hot - and the windows were open to let some stuffy air in, except that meant I could hear all the construction going on outside.
It's luck of the draw with the midwives. Out of 4 I had (I was in the labour room almost 20h), 1 was superb and caring, whilst 1 was aggressive, rude and detached.
The postnatal wards were even worse, with blood stains on the floor, and the toilets smelly at times from the bins not being emptied regularly. It's 5 beds to a room, so can get crowded. There are cots you can wheel next to your bed, not clip-on cots.
I found food to be in short supply. If you missed the meal round, you were stuffed for food unless you found a midwife kind enough to get some toast for you.
Midwives were in definite short supply on the postnatal ward - and woe be onto you if you dared to supplement breastfeeding with a bottle. My daughter was in the incubator for jaundice and needed fluids every 2h - I had to go to the front desk and justify why I needed a bottle of formula every time!

Pros of RLH:
Emergency care very good. I had a lot of bleeding post-birth, and was taken into theatre and stitched up very, very well by the obstetrician on call. No pain at all afterwards. Also got checked in by the obstetrician quite a lot after that in the recovery ward.
Saying that, I had to wait nearly an hour for the obstetrician during delivery for her to use forceps, as she was stuck next door helping a woman deliver twins.
I'm pretty sure you don't have to share midwives whilst on the labour ward - I had my own dedicated one (even if she was always scooting off to the tea room) throughout.
The anaesthetist also came up pretty quickly when I decided I wanted an epidural.

Conclusion:
For my next baby in October, I'm probably going back to RLH. This time though, I hope to be in and out of there with minimal stay in the postnatal ward. (First time round i was there for 5 nights, with excess blood loss, blood transfusion and then my daughter's janudice).

I've just been round the post-natal and labour wards at RLH - they're the only ones I've ever seen, so have nothing to compare with. But, initial impressions were:

• very clean and inviting
• calm and quiet! (I was expecting something much more ER-like and noisy, maybe it was just timing =)
• super-friendly midwife who took us round (they've all been, in my experience around the E3 area)
• super-hot (DP won't like it), but with air con in the rooms
• nine OK-sized rooms (one room with a pool, only one room with en-suite)
• average of 15 babies born there each day
• two theatres - felt a reassuring ratio for the nine rooms
• epidurals - 2 anaesthetists in daylight hours, 1 during the night
• apparently the average labouring woman will see 1-4 midwives, depending on length of labour, which seems fairly logical given they do 8 hour shifts

So, I'm feeling pretty OK about my choice to deliver there (DC1).

Anyone have any recent (say, 2009/10) experiences?

Thanks so much in advance - happy to hear both good and bad of course!

Hi, I had my little there a few months ago.

I had to be induced at the Talbot ward, which was absolutely horrendous. Midwives are uncommunicative, rude and agressive, and the midwives on the night shift sleep during their shift and are not intrested in helping you.

The labour ward is slightly better as their are doctors around who are fantastic. Again midwives let it down, they do not listen to what the doctors suggest and force their opinions on you. Midwives seemed inexperienced at the concept of active births and would rather you were strapped up to the bed so they can get a 'good' ctg scan.

The postnatal ward is surrounded by midwives who do not care about the patients it seems they are there more to crack the whip rather then offer support. The postnatal rooms is cramped, small, very noisy and the lights are turned of very late and switched on very early in the morning, with hustle and bustle of cleaners and breakfast being served. Food served is unedible so make sure you have some breakfast bars handy for the morning. The expereience at the Royal London is not at all how the midwives and Physiotherapists discribe it at the antinatal classes and recently they have alsoannounced for 2011 until they move to the new buidling they will not be providing ready made formula milk, their is no place or you to sterilise your bottles so all this should be taken care of by yourself.

Interesting to hear a mixed bag of RLH experiences.

I was due to have a HB with an independent midwife, but ended up at RLH as there were complications in very early labour.

The staff on the labour ward were fantastic through what was a very frightening experience. I had my own midwide and a RLH midwife and an obsetric registrar with me for the whole three hours I was in there. I then had an immediate EMCS. The obsetrician was clearly nervous as it had all gone a bit panicky, but she did a fantastic job and DD came out with an APGAR of 9 (although only 5lbs!). The anaesthetist was amazing.

On the minus side, it's filthy and you'd die of malnutrition if you were there longer than a couple of days. The staff were hit and miss. There were a couple of lovely, caring and highly knowledgable midwifes and others who didn't have a clue. Of the four ladies on the postnatal ward I was on, all apart from me had given their babies formula (at the MW's suggestion) by the end of the second day. And then they got told off by aother midwife for doing that on the Monday!

So, I suppose my experience is of highly competent staff when it really mattered, working in pretty busy and grubby conditions.

Just an aside, but I've heard some good reports about Homerton. Is that worth also considering. And another aside- of the twenty or so people I know who planned to have their first baby at the Barkentine, I know of only one who actually did. They are very cautious, and first time mums are very likely to be transferrd to RLH.

Hello both - thanks so much. Yes 'mixed bag' does seem to be a good phrase.

@Kelly - did you have antenatal appts with the RL midwives? Or was this a completely new group of people? Could you give an example of what sort of things the midwives didn't listen to?

And @helza - I'm high risk (39, first DC and ongoing kidney problems), so I'm deffo up for hospital rather than eg Barkantine. Another reason I want to stick with RL is because all my other treatment has been there. The food is poor, hard to believe anyone can get better eating it!

So in summary...seems PN is the place to escape asap =), bit worrying about the formula / bf conflict of advice too.

Thanks again, really helps me to prepare a little more.