Private insurance and VBAC????

Hi All,
I am due to move to the UK (London) this summer from Switzerland. I have one child who was born here via (what I think was) an unnecessary c-section. We would like to have another child soon. Now that I am about to move to the UK, I am very worried about a couple of things.

1) Everyone I've spoken to about pregnancy/childbirth in the UK tells me that I need to do whatever it takes to avoid the NHS; get private insurance, go home to the US, etc. I can't afford to cover a private in the UK birth out of pocket and the idea of hanging out in the US or say, France for a month until I deliver doesn't really suit me either. I would really like to get a private health care supplement that would cover private pre-natal care and childbirth.  In my first pregnancy, though it was low risk, I got an u/s every visit and I would really like that to have that again (puts your mind at ease). I can't find a private plan in the UK that covers pregnancy except for one that would want me to have coverage for a year with them before they would cover pregnancy and childcare costs.
My question is: are there any private health insurance supplements that would cover pregnancy and childbirth costs in the UK even if I am covered by them for a period of less than a year? A year is longer than we wanted to wait for a number of reasons.

2) I would like a VBAC. Like many women I had a c-section under the advice of medical professions whose advice I now can't justify. How is the general attitude of the UK medical profession vis-a-vis VBACs? Does anyone know of an MD who specializes or explicitly supports VBACs in the UK? Most importantly, does the NHS approve of VBACs or would I have to go private to get one (in the very possible scenario where I have to deliver a baby with the NHS)?


Thanks in advance for your help and advice!
L.

A friend of mine just had her baby at the Portland (the posh hospital in London that is renowned for it's celebrity clientele that is "too posh to push").  She was planning to pay for the entire thing outright, but because she ended up needing an "emergency" C-section, all the delivery fees and after-care were covered by her insurance.  As far as I know, my insurance (BUPA) that I get through work, would also cover a private delivery, should emergency medical intervention become necessary.  But if there was no need for a c-section, or ventouse or forceps, then I would have to pay.  So it doesn't sound like what you want, if you are aiming for a VBAC. 

They still had to pay for the private pre-natal care, which was I am sure several thousand and had she had a vaginal birth, they would have had to pay for the whole thing....about £10K.

I don't think many private insurance plans will cover pregnancy because once you have a condition most private plans just send you to the NHS.

(So, you get to jump the queue because you found a lump, the tests are done quicker, but it is back to the NHS to treat.)

I know people on here have had V-BACs and they are more common than in the US, but because your doctor is based on where you live I don't think it would help much to know there is a good doctor in Wales if you live in London.  Train journeys aside :-).

I think the standard here for ultrasound is two per pregnancy unless there is an issue.

http://www.privatehealth.co.uk/private-healthcare-services/private-maternity-services/private-maternity-costs/

My husband says you can get whatever you want, as long as you pay for it obviously, but it would be an out of pocket thing.  So you want a bunch of scans, somewhere in London someone will do it, but you would pay a la carte.  

D'OH!  EDIT: WILL NOT COVER PREGNANCY I MEANT. 

Thanks for your replies.  It is especially good to know the UK is more VBAC positive than elsewhere!

Now that I think about it, I wouldn't mind (and could probably afford) paying out of pocket for a couple of extra ultra sound scans during pregnancy.The regular scans I received here were very welcome, I would definitely want that again but that's really the only difference I see between what's provided in the UK versus here when it comes to antenatal care. As for the actual childbirth, I got  to stay 8 days in the maternity ward and that was very welcome; I couldn't walk the first 4 and I couldn't have breastfed my baby without all the help I got that first week. (I would have 5 days if I hadn't had a c-section). What is the standard hospital stay in the UK?

But, I am still confused about the NHS thing. They just assign you a doctor (or midwife)? based on where you live? What if you get one you don't like? Do you have to pay out of pocket to see a different doctor or mid-wife?

I hope you understand, I have heard such awful stories about the NHS, and not just from....American Republicans    but from a disturbingly wide range of different people 
So I'm a little freaked out.

There is usually a team in your area, so you can see different people on your team.

Hi-
I thought it might be useful to post my experiences as I have had private care in another EU country, and NHS care here for births.

My private care was much like you describe with ultrasounds and pelvic exams at every appointment with an obstretician.  If your first birth/ pregnancy was fairly normal, the NHS will direct you to a team of community midwives in your area. Unless you choose a homebirth, you will not have any of these midwives at the birth.  The hospital midwives work shifts and generally do not do community midwifery.  They will probably not do a single pelvic exam the entire pregnancy until you go to the labor ward or start contractions.  The midwife appointments consist of checking your urine, listening to the heartbeat and "feeling the bump' (and blood tests when necessary).  You will get two ultrasounds on the NHS.  One, a dating scan, at 12 weeks and another fetal anomaly scan at 20 weeks.  If the baby is breech around the time of the birth, they will do more scans to determine what the best course of action is.  You are listened to on the NHS and if you desire a VBAC, they will be more than happy to support you in that decision.  

To me, the drawback is the lack of continuity of care.  I loved having professionals I knew and who knew me (medical history, personality, etc) at the birth.  I have not had a C-section, but do know of several cases where people struggled to get care after the birth. They had to have family members come and helpd them lift the baby for feeds, etc.

I hope you understand, I have heard such awful stories about the NHS, and not just from....American Republicans    but from a disturbingly wide range of different people 
So I'm a little freaked out.

I am an American Republican and just had a baby on the NHS and I was very pleased with the care. 

If you are moving to London, there are plenty of places that will do extra scans for about £100-150 a pop.  I almost had one done to determine the sex, as she was not behaving during the bog-standard 20-week NHS scan.  But I was called back for another scan by the NHS anyway a few weeks later, so I found out then. 

I was not high risk and just saw a team of midwives at my local dr's surgery.  They were all nice, but there was one I didn't like as much.  They community midwives you see pre-nataly will not generally be the ones helping you deliver the baby at the hospital.  At least that is how it tends to work in London at the big hospitals.  So for me there was no risk of getting the woman I didn't like during delivery.  I could handle her for a 15 minute appointment every so often.  I suppose if you got to the hospital and really didn't like the midwife assigned to you, you could request to have another, but it would be down to availability. 

I was pregnant at the same time as my sister in the US and it was really hard for my mother to come to grips with the difference in care.  My sister had way more tests and scans and everything seemed to be a bit more medical that what I was experiencing.  My mother seemed to thing my care was lacking, but for me it was a god-send.  I hate being fussed over and made to worry endlessly.  In the end, we both had healthy babies and were happy with our care.

I've only been pregnant in the UK so in terms of differences, I can only go by what friends and family in the US have told me about their experiences -- so, anecdotally:

The fewer scans thing is true but like Karin said, you can get private scans for not too much money. You may want to wait until later in the pregnancy in case you get sent for scans for other reasons -- I was thinking about having a private scan but now I'm having growth scans on the NHS every two weeks anyway (started 31 weeks).

I was surprised to find out I couldn't get amnio on the NHS unless they saw something disturbing at the 20 week scan, even though I'm 38, but maybe this is not an issue for you.

It did seem difficult for me to get any kind of prenatal care until my 12 week scan -- almost like no one wants to do anything for you until 12 weeks, even if you have lots of questions or some problems. But that was probably just my experience and if you have been pregnant before then you may not be bothered about this.

Once you know where you will be living, type your postcode into the NHS GP Finder and it will tell you your options for a GP (they don't assign one to you, you have some choice). Some areas will have lots of choice, others not so much. I think your choice for midwives is more limited but if you are really unhappy I think you can get them to switch you. In my case, my community midwives also work at the hospital, so I may have some continuity of care there.

In London you will probably have a choice of hospitals to give birth in, it helps to do some research. I'm going to St Thomas even though King's is a bit closer, for various reasons. St Thomas is very positive about VBAC from what I can tell, so that might be one to consider.

I do totally understand what you are saying because there are times when I'm really nervous about having a baby here. Like, they seem really fond of forceps here, which terrifies me... and my consultant OB isn't even a Doctor, just a Mister, which seems weird... and I've heard so many horror stories about the postnatal wards...

But you could totally have a bad experience in the States as well -- it's really just luck -- so I'm just trying not to worry about it. I think if you do some research and aren't afraid to be assertive when necessary, you can definitely have a good experience on the NHS.

The custom in the UK is for many doctors to be addressed as 'Mr., Mrs., Miss, or Ms.'

Also, while it is true that prenatal care before 12 weeks is not really anything other than getting a letter sent to your hospital to get your booking in appointment, if you have any questions or problems in your first 12 weeks you can usually go to he hospital and they should have an early pregnancy unit you can visit.

The custom in the UK is for many doctors to be addressed as 'Mr., Mrs., Miss, or Ms.'

Indeed!

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1293721/pdf/jrsocmed00105-0010.pdf

And from wikipedia

In the United Kingdom, Republic of Ireland, South Africa, and Australia, medical practitioners who have been admitted to any of the Royal Surgical Colleges discontinue use of the "Doctor" title and revert to using "Mr", "Miss" or "Mrs". This system (which applies only to surgeons, not physicians) has its origins in the 16th century, when surgeons were barber-surgeons and did not have a degree (or indeed any formal qualification), unlike physicians, who held a university medical degree. Veterinary surgeons in the United Kingdom and the Republic of Ireland adopt the titles "Mr", "Mrs" or "Miss".

Oh that's interesting!

I guess I was confused because looking at the list of consultants on the website, most of them were called Dr and had a number of degree abbreviations after their name, and then my guy was just listed as Mr X.

Thanks for setting me straight!

Well, thank you all for your replies, it really puts my mind at ease. Having had a child already, I should know better than to try to plan these things too much but the stories I heard from folks about having a baby in London scurred me!
L.

Oh that's interesting!

I guess I was confused because looking at the list of consultants on the website, most of them were called Dr and had a number of degree abbreviations after their name, and then my guy was just listed as Mr X.

Thanks for setting me straight!

Then, if I'm not mistaken, he is the most senior of them all... (haven't looked at phat's links but I think that's how it works!

Then, if I'm not mistaken, he is the most senior of them all... (haven't looked at phat's links but I think that's how it works!

That's right!