Third Pregnancy/Third C-Section - NHS vs private Post Reply

[LittleMissSunshine]

Hi,

I am at the beginning of my third pregnancy and already had two c-sections due to medical reasons. My first child was delivered privately, the second one abroad (privately) and now I am considering NHS and private due to a different insurance provider than previously.

Does anybody know how NHS care works if you know from the start that you will have a c-section? Will a consultant be assigned to you, can you choose one or will just anyone perform the c-section who is on duty on the set day? Is all other care done by midwives as usual?

I would greatly appreciate if anybody could share their wisdom if they had medically indicated c-sections on the NHS.

Furthermore, can anyone recommend a consultant at Chelsea & Westminster?

And lastly - I have heard that it is possible to only book a private single room at C&W for after delivery but have the care on NHS. Is that correct and does anyone know how much that costs? I could only find package prices on C&W's website.

Many thanks!

[Midwifejulie]

Hi
congratulations on your pregnancy and I hope I can help a little with understanding the system here

NHS care is the same for your pregnancy regardless of how the birth is going to be - ie most of your care will be done by midwives in the community, rather than in hospital. Many NHS Trusts would recommend you have another C/S this time round, and you would probably see a consultant once or, sometimes, twice during your pregnancy to discuss this, as well as your normal midwife appointments. Of course, if you actually decided you wanted a vaginal birth, you may also be supported in this (depending on your circumstances).

On the NHS you don't choose a consultant, you are assigned one, and the one you see antenatally won't necessarily be at your c/s. Uncomplicated caseareasns are often carried out without a consultant present.

Sorry I can't recommend a consultant at Chelsea & Westminster as I don't know any of them

Another option to consider is having private midwifery care, where you see private midwives for all your pregnancy and postnatal care (which is much more nurturing and time-intensive than most NHS care), and they come with you to the C/Section too, so you've always got someone you know and trust with you. you also get very intensive postnatal care to help with feeding and recovery. Most women in the UK have no idea they can choose their own midwife, but nearly all that do look back at it as incredibly helpful and worthwhile

all the best with everything, and feel free to PM me with any questions
Julie (private midwife), http://www.neighbourhoodmidwives.org.uk/

[LittleMissSunshine]

Hi Julie,

Thank you for taking the time to reply so extensivly.

Can I ask you who is carrying out the uncomplicated c-sections if not the consultant him/herself? That sounds very worrying to me that there might not be a doctor present while having some major surgery.

Many thanks

[AbbevilleMummy]

When I had my planned c section on the NHS I saw the consultant about 5 times in the run up to my delivery date and the same consultant performed my c section.

I wasn't a particularly high-risk case or anything like that, but I explained to my consultant that continuity of care was really important to me and therefore I only wanted to see him. We scheduled all our appointments for the days that he covered my hospital and scheduled the c section date for a day that he knew he would be on duty.

When the day came, we were told by a midwife that as the consultant had worked all night on emergencies, a registrar was going to do my c-section. I freaked out a little at which point hubby stepped out of the room to have a quiet word and lo and behold original consultant performed the c section.

[Midwifejulie]

Hi
caeareans are indeed always performed by doctors who specialise in obstetrics, but often they will be performed by the doctors beneath consultant level - so called 'junior' doctors, however many of these will have been doing their specialism for many years and so are very experienced in themselves.
that's a lovely story about asking for continuity of carer - i definitely agree that if you ask for what you want you are much more likely to get it.
however, having said that, i do think a lot of the senior registrars are fantastic too
Julie

[LittleMissSunshine]

Thank you AbbevilleMummy - that sounds promising. May I ask you which hospital you had the c-section at?
And thank you Julie for clarifying who is performing the c-sections.
If anyone else here has any experience, I would greatly appreciate to hear them

[AbbevilleMummy]

I had my c-section at St Thomas' and midwifery care was with the clapham team.

My consultant was Dr Haytham Khalil but I've just googled him and he appears to have gone into private practice with his wife.

That said, I found St Thomas' amazing. Everything I asked for I got. My concerns were thoroughly respected and my overall welfare was all that seemed to matter. I can't recommend them enough.

[Midwifejulie]

i've heard similarly good things about St Thomas's

[LittleMissSunshine]

Many thanks AbevilleMummy for sharing this info!

[CitySlicker]

I had a C Section on the NHS at C&W. You're assigned a consultant and have all the usual midwife appointments plus one appointment a month or so with your consultant. It's a named consultant but they don't necessarily carry out the procedure on the day. My consultant was terrific and I'm happy to recommend her, Mina Savvidou. I was under the impression that she would perform the procedure herself as she checked her diary to see which date suited her, however in the end, an obstetrician named Natasha Singh carried out the operation and she was also fantastic. She also had someone helping her, I didn't get the impression that she was junior. Don't worry, it will always be a doctor, just not necessarily your named consultant. I had no complications whatsoever, I can't see how anything would have been different had Ms Savvidou carried out the operation.

On the day I had about 10 people in the room including the 2 obstretricians, 2 anesthatists, several midwives etc. I felt in incredibly good hands and don't feel like I'd have had better medical care privately. (In fact it's exactly the same theatre etc). Yes you're getting better food and more 1 to one help postnatally but from a medical perspective, there is no difference in my opinion. If you're planning on BFing, they have all the time in the world in the NHS to help you with it.
A private room is on a FCFS basis on the NHS ward, I had one and it was £300/night. It's nothing special, internal window and boiling hot, was my overall impression.
Hope that helps.

[AMumAtSW12]

I had 2 C-sections, one was unplanned at the Portland as I was fully covered by insurance while the second one was planned at St Thomas's as I had no insurance cover then.

I would definitely recommend the NHS, even if there was insurance cover, with the sole reason that a public hospital, such as St Thomas's and C&W, should be able to handle any complications during the labour / c-section better than a private, as they see so many people with all sorts of problems day in day out.

My care at the Portland was fab but the c-section scar was horrible. The scar from St Thomas c-section has almost all disappeared now with great skills from the OBGYN at St Thomas's. However I did have to wait till early evening for my c-section because that there were many emergency surgeries on the day, which will need to be performed first before the planned ones. Also I could not get a private room as they were fully booked (the private patients get priority) so I ended up in a big room with 5 other ladies and their babies, and I could not say as highly the care in the ward afterwards as the OBGYN. I had these compensated by having a lot of help from my husband and my maternity nurse who came to look after the baby during the day when I was still in hospital. But even with the minuses I would go for St Thomas's again if I were to have a 3rd c-section.

Good luck.

[shaneleone]

I agree with previous posters. I've had two c-sections on the NHS and would highly recommend going that route. For my second pregnancy, a c-section was decided fairly early in the pregnancy, and I had maybe 2-3 separate appointments for that. I had both my babies at St Georges, and it was just the consultant who was there on the day. Each time, it was quite a large, capable team and I also felt in very good hands. The second time, I managed to pay for a private room (£100/night or £150/night with ensuite). I only ended up staying one night, but it was money very well spent. The wards are fine, but a private room is just a much nicer place to recover. Everything else was on the NHS. I'm not sure how it works at other hospitals, but at St Georges, the private rooms are only available on a first come-first serve basis and cannot be booked in advance. So my husband was told to ask about a private room immediately when we got to the hospital, and we also got there a little earlier than we'd been told to arrive in the hopes of getting a private room.
Hope that helps and good luck!

[LP73]

I can recommend Dr Keith Duncan at C&W he does NHS and private.
I am under him private and he doesn't all scans and will be delivering my baby through CS early next year.

[LP73]

Sorry new to this - he DOES all of the scans himself.
Good luck

[MarieCath]

I just want to thank everyone for their advice and feedback. I had my 1st baby in Chicago via cesarean and I'm now 14w pregnant and am hoping to have an NHS cesarean at St. Thomas in August 2018. I saw my 1st midwife at Waldron Health Centre in Lewisham and really liked her. I hope I'm scheduled to see her again (I think I am) at my 16w appointment. I saw a consultant at St. Thomas for my hypothyroidism and extensively verbalized that I want another cesarean. I'm getting the impression that as long as I stand firm with no interest in a VBAC, I will be booked for a cesarean at 36w for the procedure to take place at 39w. If there's any additional information anyone can provide, I'd greatly appreciate it.
Oh, I'd like to book a private recovery room at St. Thomas after my NHS cesarean. Does anyone have any experience with with private recovery rooms at St. Thomas after an NHS cesarean. How do get that scheduled? Thank you all in advance.