Rising UK birth rate and increased demand for private care

Couples seeking a more personalised service are choosing private maternity over the National Health Service, as Lilian Anekwe reports

The private maternity industry only accounts for around 1 per cent of births in the UK, but is increasing in popularity among those who want – and can afford – a more bespoke experience than the NHS can offer.

Over recent years, with the birth rate on the rise, the NHS has struggled to recruit and retain obstetricians and midwives, leaving labour wards struggling to keep up with demand.

Dr Karl Murphy, a private obstetrician at the London Maternity Centre and consultant obstetrician at St Mary’s Hospital, also in London, says: “The NHS has good staff, but there aren’t enough of them.

“Some people want more control over their birth. The private sector has been led by consumer demand and has risen to the challenge of providing a good-quality, safe birth experience.”

For couples who opt to go private – for example, British expats living abroad who return to the UK to have a child, foreign expats based in the UK and increasingly working couples who want a more personalised service than the NHS – private maternity offers choice and flexibility, but with the support of the best aspects of the NHS.

A range of private maternity services are available either at private hospitals, in the case of London’s Portland Hospital, or more commonly at private wards or wings of NHS hospitals, such as the Westminster Unit in St Thomas’ Hospital or the Lindo Wing at St Mary’s Hospital, where the Duchess of Cambridge chose to have her birth, led by royal obstetrician Dr Marcus Setchell.

There’s an emotional side of pregnancy and birth that the NHS does not cater for

Such private labour wards and wings are staffed by midwives, obstetricians and consultants who also work in the NHS.

In NHS labour wards, babies are delivered by midwives and it’s the role of consultant obstetricians to oversee the wards. However, in private units, babies are delivered by consultant obstetricians chosen by the couples, and in most units couples are also given a dedicated midwife throughout the labour and the birth.

In the rare event of complications during labour, being located in an NHS hospital means couples have the support of a full team of surgeons and clinical staff, with well-equipped operating theatres.

“When I am working on an NHS ward, my job is to lead a session, oversee the more junior doctors and give feedback to the midwives, as well as complete administrative tasks. I wouldn’t normally deliver babies,” says Dr Murphy.

“But I became an obstetrician to deliver babies and that’s the part of the job I enjoy. In the private sector, I’m responsible for a baby from pregnancy until six weeks after birth and can give much more personal care.”

Lawrence Mascarenhas, clinical director of obstetrics and gynaecology, and consultant obstetrician at Guy’s and St Thomas’ Hospital, says the experience private obstetricians gain by spending years working on busy NHS wards is invaluable in the private sector.

“A senior consultant knows when to leave well alone and when to intervene where necessary,” he says. “In the NHS, if there’s a problem, first it will be referred to a midwife, than a junior doctor, then a middle-level doctor, then a senior doctor and then a consultant, and all these delays may worsen the problem. You can avoid all these steps in private care and go straight to a senior, experienced consultant obstetrician.”

Erika Thompson, a board member of Independent Midwives UK, who also works as an NHS midwife, says private patients are looking for choice and flexibility, which the NHS is unable to offer.

“There’s definitely been an increase in women who need our services,” she says. “The NHS is a one-size-fits-all system and women are turning to us because they’re finding that the NHS is not meeting all their needs. There’s an emotional side of pregnancy and birth that the NHS does not cater for.”

Mr Mascarenhas adds: “The NHS is reliable and generally does a good job. But it can’t offer one-to-one care and that’s how problems can arise. For those who can afford private maternity, the security and peace of mind are well worth it.”

GLOSSARY

OBSTETRICIAN

A medical doctor who specialises in the care of women and babies during pregnancy, labour and birth.

PRENATAL TESTS
Used to predict for abnormalities during pregnancy, for example the Harmony test and the nuchal translucency test.

HARMONY TEST
A blood test to analyse the baby’s DNA for chromosomal abnormalities, such as Down’s, Edward’s or Patau’s syndromes.

NUCHAL TRANSLUCENCY TEST
Predicts the risk of having a baby with Down’s syndrome or other abnormalities. It looks at the baby’s physical features and a blood sample from the mother to identify two pregnancy hormones.

ULTRASOUND SCAN (SONOGRAM)
Uses high frequency sound waves to produce images of the baby in the womb. These can predict due dates, sex the baby and spot abnormalities, such as spina bifida.

3D ULTRASOUND SCAN
Shows a preview of the baby, which can offer a view of the baby’s face or other parts of the body.

4D ULTRASOUND SCAN
Like a 3D scan, but with the added dimension of time – as in a film or video – so the baby can be seen to be moving, for example yawning or stretching.

SONOGRAPHER
A specialist who performs scans using an ultrasound machine.