Giving birth in London [from Dublin]

Vica

Hey folks,

I'm considering where to give birth to my second child. My first birth was through cesarean section, and this one I would like to have a normal birth (VBAC) if possible. Do you know if National Maternity Hospital is pro-VBAC, perhaps you know any specific consultant - I heard a lot of stories where some consultants are strongly against VBACs just not to take extra risk on themselves and will do cesarean anyway even if unneeded.


After hearing some bad stories about some medical care here and VBACs specifically, I'm seriously considering a private maternity hospital in London, i.e. Portland Hospital which is considered one of the best in the world.

Do you know the situation with VBACs in Ireland & NMH / experienced any issues with this? And, would you recommend going abroad to UK Portland hospital for quality (money can't buy health, but is this the right option to consider though)? Perhaps some of you had births in UK?

Nevyn

VBAC = Vaginal Birth After Section.

Yes you can have a natural or vaginal birth after a section here, I know of a couple of people who have in the last 3 years in both the Coombe and the Rotunda.

If you are living in this country I think going abroad to have the baby is frankly daft,
heaven forbid something goes wrong and you or the baby need several weeks of hospital care and become stuck there.

LashingLady

As far as I can see the NMH is a pro-VBAC hospital. However, I think you have to be realistic about the chances, and with all birth experiences, things can come up which mean the natural birth just isn't an option.

I had a section for my first in the NMH and am attending again due my second in Sept. The reason I had a section the last time was because my baby was in the posterior position and labour just wasn't advancing (had pains for 4 days and was on oxytocin for 6 hours and only got to 4cm).

My consultant this time is happy for us to aim for a VBAC once everything is normal and baby's position is good but she has caveated that by saying they will not try very hard to push labour (i.e. no induction and only a tiny bit of oxytocin if it stalls). If there are 2-3 hours of not progressing at a reasonable rate it will be a section again. To be honest I don't mind this. I am happy to give the VBAC a shot but the last thing I want is to go through a difficult labour only to end up with a section anyway! She said that she sees the chances of achiving VBAC as being 60%. The current CS rate is 20-25% in there so I think she is giving me good odds.

Like Thaedydal says I wouldn't consider choosing to have baby abroad there is just too much uncertainty involved. Besides, I think we have very good maternity hospitals here.

Vica

Much appreciate your responses. LashingLady, do you mind sharing your pro-VBAC consultant's name in NMH as we're also planning to go there?
My concern was that a hospital might choose to do cesarean even if there are no indications (the hospital raises a lot more money from the insurance for doing cesarean than just normal birth, and surgeons get their bonuses) - this worries me a lot that they will tell you one thing whereby in reality it is another...

Also, I presume for VBAC it is best to go privately and get a consultant that will be present at birth?

LashingLady

I am going semi-private. Private is far too expensive for me! I currently am seeing Dr Kroon at the SP clinic, but unfortunately she is actually leaving the clinic in August. This doesn't really bother me as going public or SP you are treated on the day of labour by the Consultant on duty on the day rather than your own consultant....

To be honest, I'm not sure that they do make all that much more from the C-sections, do you remember how many of them were in the room when you had yours? There were about 10 when i had mine, compared with two mid-wives and a doc for a natural birth!

I'm not sure who the most VBAC friendly docs are but maybe posting on the birth/labour board on Rollercoaster.ie you might get an idea - I know there's a lot of mums aiming for VBAc on there....

I'm not convinced that going private would increase your chances of a VBAC to be honest! My ideal labour scenario would be to spend the majority of time with one of the fantastic midwives with a doc only coming in at the end when baby is being delivered.....

I think if you are firm in communicating your wishes to have a VBAC and discuss this with your consultant from the beginning to ensure they are on-board, and you go into labour yourself then you have a high chance. The chances start going down if you are very overdue as they really won't induce as this increases the chances of uterine rupture.

And be firm with your consultant if you feel they are trying to unnecessarily rail you into a section. My main reason for wanting a VBAC is that i know I would find it hard to cope with teh CS recovery and mind a 2 year old and breastfeed a new baby at the same time.

SanFran07

NMH is one of the best places for VBAC - their rate is around 60 - 70%....other Irish maternity units have rates ranging from 4.5% to 26% for VBAC......so your odds are very good as a public or private patient.

Keep in mind that even if you are a private patient the consultant may not be there for the birth.

One thing to consider for your birth preferences is that NMH likes to do internal monitoring for VBAC mums (so they'll want to break your waters and put an electrode on your baby's head...which comes with it's own set of risks).

Good luck!

Nevyn

NMH = National Maternity Hospital = Holles Street!

Can we keep the acronyms to a minimum please, they confuse those who have not seen them before and are looking for information.