Rising UK birth rate and increased demand for private care

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.