The landscape of maternity in the UK has changed beyond recognition over the last decade. Recent pictures of Halle Berry, at 46, showing off her latest baby bump no longer shock. Yet only ten years ago it would have been unusual to see a pregnant woman over 40.
The recent State of Maternity Services report by the Royal College of Midwives suggested that the baby boom in older mums shows no sign of abating. Indeed, the number of babies born each year to women aged 40 or older rose by more than 80 per cent between 2001 and 2011.
Recent statistics from the Office for National Statistics (ONS) confirm that the number of women over the age of 45 starting a family has almost trebled during the last decade. The ONS believes this shift reflects a greater emphasis among women on building a career before having children and the impact of fertility treatment which has allowed women to be more in control of when they have their family.
There are also clear changes in how women perceive maternity care with many now choosing private care over NHS. Many women, who choose private maternity care, may be those who have delayed having children for career and financial reasons. They may rightly have concerns that as older mothers they are more likely to have complications during their pregnancy and delivery.
Thirty-four-year-old Londoner Nicole Graham decided to go private because it most resembled the care she and her husband were used to in the United States. “We thought the NHS seemed really crowded, and everyone seemed to be rushing around and were really overworked,” she says.
“We didn’t think we would get the best level of care. We liked the fact you have a familiar face each time you visit the hospital and people have time for you.”
Certainly, a quick run through the chat forums on MumsNet highlights backs up Nicole’s view. “I want to be able to choose my consultant and discuss options for the birth, including an elective caesarean,” says one post.
“I want to know an epidural will be available when I request it and topped up when necessary. I want a private and clean room and bathroom, and for my baby to be looked after while I sleep. I’m not confident any of those things will happen in a busy London NHS hospital,” says another.
A report by the National Federation of Women’s Institutes and National Childbirth Trust found that 60 per cent of women wanted more postnatal support from the NHS and 80 per cent of health trusts failed to meet recommended maternity unit staffing levels in 2011.
Midwife Amanda Adams, who works at the private Portland Hospital in London, where more than 2,000 babies are delivered privately every year. She has worked in both the NHS and the private sector, and believes most pregnant women go private because they want the sort of one-to-one care which they feel is not available in the NHS.
“This is why I chose to work in the private sector over the NHS because midwives have more time to spend with their patients. In a busy NHS labour ward, mums don’t have the luxury of a named midwife,” says Ms Adams.
“Staff shortages may also mean there’s no time to ensure a patient can have an epidural, for instance. The mother then ends up having a traumatic labour and a poor experience of childbirth.”
The increase in mothers going private is borne out by the number of online searches for private maternity care. According to Caelen King, chief executive of private healthcare search engine WhatClinic.com, it has increased by more than 40 per cent in the past 12 months.
Many women, who choose private maternity care, may be those who have delayed having children for career and financial reasons
“Women are able to choose their own specialist, their own treatment plan, and structure it all around their existing home and professional lives. With pressures on the NHS growing, many women are sourcing their own private healthcare for this important, and often daunting, time in their lives,” he explains.
Nowadays, private clinics are providing women with all the services they need right from the first scan all the way through to the birthing procedure itself, as well as ongoing postnatal care and non-invasive prenatal testing.
“This process allows the mother’s blood to be tested for the baby’s DNA to look for Down’s syndrome and other chromosomal disorders, without any invasive surgery,” says Donald Gibb, founder of The Birth Company, a private clinic based in Harley Street.
After the age of 35, it is well known that the viability of women’s eggs declines
Rapidly, and there is little doubt that IVF has also played a huge part in making it possible for mothers to decide when and where they give birth.
“Up until now we would see a professional woman of 38, who would want to have her eggs frozen, but it was not possible. Now there is a technique known as vitrification with a formidable success rate,” says IVF specialist Dr Paul Serhal. “Now there is no limit to when a woman can have her eggs frozen and women can truly take charge of their lives.”
Although private maternity care is pricey, typically around £12,000, women consider they are buying better access to senior medical opinion. “The flexibility that comes with going private is a huge incentive, especially for those continuing to work throughout their pregnancies,” adds Dr Gibb.
“Women are looking to private care because they want a higher level of convenience with longer opening hours and Saturday appointments to fit busy schedules. With private care, you are a person not a number, and unfortunately the NHS is overrun with numbers.”