FAQs

While maternity care is provided through the National Health Service (NHS), many people simply want a more patient-centred service driven by their needs, both clinically and personally. During prenatal care, many patients would rather avoid crowded and older facilities, sometimes associated with the NHS. Patients often also wish to ensure their care is undertaken in new and well-maintained surroundings. In the NHS, patients will mainly see a midwife throughout their pregnancy, and given the shortage of midwives across the country, often a different one on each visit. Access to doctors can be limited, and when one does see a consultant, these can be junior doctors rather than senior consultants. NHS hospitals vary in their ratings, so it is best to check the UK Maternity Statistics page your local hospital's rating. Many people choose to deliver in their local NHS hospital but elect to receive private prenatal care and ultrasound scanning.

This will depend on a number of factors including how comfortable you are delivering in your local NHS hospital, whether you need increased access to a senior consultant due to risk factors, and what you can afford. Many people feel comfortable delivering in the NHS but want more assurance during the pre-natal stage that all is well with them and their baby. This typically means the Peace of Mind Package is the right option.

For those who value extensive access to a senior obstetric doctor, and wish to deliver privately, the Full Consultant Package can be the right choice. This needs to be weighed up against the additional cost involved for the extra pre-natal visits and the private hospital charges.

Other parents-to-be will want to develop a birth plan with an experienced private midwife and to deliver at home or in hospital, with their personal midwife present. In this case, the Midwife Package will be the best choice. This option is especially important for people wishing to take on a more active role in their pregnancy and who value designing their plan to incorporate more "natural" birth elements.

The Birth Clinic will take you through a list of questions that can help you and us determine the best doctor and clinic for your specific pregnancy package. If you already have particular preferences, we will do our best to achieve all of your stated priorities.

What should I do to proceed with private care?

It is up to you whether you let your NHS provider know that your are receiving supplemental private care. Doing so should not prejudice your care, but in any event you must maintain consistency with your lead NHS clinician so that all is coordinated for your eventual delivery. The Birth Clinic is happy to help liaise with your NHS caregiver if you wish us to do so.

Depending on which package you choose, this can range from £1950 for the Peace of Mind Package to £6,600 for the Full Consultant Package (excluding hospital charges). While the Midwife Package costs £8,600, it is important to remember this typically covers all associated fees including the birth of your baby, while the Full Consultant Package will incur an additional hospital fee which can range from approximately £3,000 to £8,000 depending on where you deliver, what services you require there, and how long you stay.

Typically for your first visit before signing up, you will receive an ultrasound and an obstetric consultation with the doctor. This will be charged in advance. This fee will be credited to you should you go on to purchase one of our packages. If you wish to continue with a Birth Clinic Package, we will take a deposit at this time, and you will then periodically settle as you periodically receive care.

Most UK insurance companies do not cover pregnancy care unless there is a strong medical reason for doing so. However, it is worth checking with your provider. On the other hand, international insurance companies often do reimburse for private obstetric care. The Birth Clinic will work with you to determine the level of care covered. In certain cases the insurer will not cover the entire fee. If this is the case, you will be required to settle the remainder. Depending on the insurer, we may request a Letter of Guarantee for your coverage. We are of course happy to help you through this process in any way we can.

A full antenatal blood profile is usually taken between 12 and 16 weeks and again in your second and third trimesters. The following is a list of blood tests given and what each test means:

• Blood Type:The test will indicate your blood type, either A, B, AB or O.
• Rh (Rhesus): It is important to determine whether you are Rhesus negative or Rhesus positive. If you do not have the Rh antigen in your blood, you are Rh negative, if you do have it, then you are Rh positive. This test is crucial because problems may arise if the mother's blood does not have the Rh factor and the baby's blood does.
• Glucose Levels: This is to measure the mother’s ability to metabolise sugar and also to screen for gestational diabetes. If theglucose level is above a certain level, you may undergo a “tolerance test”.
• Iron Levels: This will determine if there is an iron deficiency in the blood. If your blood is low in iron, that does not mean that you are anaemic, but it does make you more susceptible for anaemia. If your levels are low, you may be prescribed iron tablets or injections.
• Haemoglobin Levels: The blood test will identify the level of haemoglobin, which is the oxygen-carrying power of your red blood cells. A treatment for anaemia will be prescribed if your level falls below a certain level.
• Sexually Transmitted Diseases:To determine whether you have syphilis, hepatitis B, or HIV.
• Rubella (German measles):The results of this test will determine if you have antibodies for rubella and whether or not you are immune.
• Toxoplasmosis:Toxoplasmosis is typically not harmful, but may cross the placenta and cause harm to the baby.
• Group B streptococcus: Group B streptococcus (GBS) is a type of bacteria that can cause illness and potentially death in newborns. The bacteria are found in the GI tract (gut) and are sometimes found in the vagina and/or rectum. Sometimes during pregnancy, GBS may get into the rectal area or vagina. If GBS is not treated with antibiotics, it may transfer to the baby and place the baby at risk for serious infection or even death.

Our packages of care will typically include at least 4 ultrasound scans: Viability Scan, Nuchal Scan, Anomaly Scan and Growth/Wellbeing Scan. If you are not seeking a package, we can of course offer individual scans.

First Trimester Scans

7 to 12 Weeks

Early Pregnancy Viability Scan or Dating Scan: A scan to determine how many weeks pregnant you are, and to assess the early pregnancy.

11 to 14 Weeks

Nuchal Translucency Scan: A scan which determines your baby’s risk of Down’s syndrome and other fetal abnormalities.

Second Trimester Scan

21 to 23 Weeks

Anomaly Scan: A scan to monitor for any abnormalities by looking at organs and the anatomy of your baby in general.

Third Trimester Scan

23 to 40 Weeks

Wellbeing or Fetal Growth Scan including Doppler: This scan measures your baby’s head, abdominal region, and arms and legs. The baby’s position can be ascertained, and a fetal weight estimated.

The heartbeat can be seen on abdominal ultrasound from about weeks 7/8.

If you are carrying twins, you will need to have extra scans to allow the doctor to ensure that both babies are progressing equally well. Often, twins or multiple pregnancies require scanning every 2 weeks early in the pregnancy and every week later on. Twins and other multiple pregnancies require special attention.

A three dimensional scan (3D) is a still ultrasound image produced in colour showing the outer layers of the fetus or organ being imaged. The movement of the fetus can be seen in real-time and this is the 4^th dimension (4D) of the ultrasound scan. A 4D scan incorporates time sequences, like a video. The main reason for having these types of scans is to get a "sneak preview" of your baby.

Keep track of what triggers the nausea and/or vomiting. It could be the time of the day – such as morning or early evening. It might also be good to relax or eat a small meal to increase your blood sugar level before these times (like on waking up). Some people find that smells set off nausea, so avoid these if you can. Other things that might help:

• Wearing a travel sickness wristband (rubber bracelet that has a button which presses on a particular spot on your wrist).
• Try not to eat too much, instead eating tinier more frequent meals and snacks. 
• If you are often sick, it is important to cleanse your mouth afterwards to prevent the acid in your vomit from harming your teeth.

If the nausea continues to be a problem to the extent you cannot keep food or drink down, you need to contact your doctor or midwife as soon as possible.

The placenta is an organ unique to mammals that connects the developing fetus to the mother's uterine wall. The placenta supplies the fetus with oxygen and food, and allows fetal waste to be disposed of via the maternal kidneys. Placenta Praevia is a complication in which the placenta is attached to the uterine wall close to or covering the cervix. It can sometimes occur in the later part of the first trimester, but usually during the second or third. It is a leading cause of vaginal bleeding. Usually this doesn’t harm your baby, but if you have vaginal bleeding you must tell the doctor or midwife. A persistent placenta praevia will obstruct the passage of the baby through the birth canal and a Caesarean section may be necessary.

What if I experience bleeding during pregnancy?

Absolutely. Exercise can promote muscle retention, strength and endurance. Being active during pregnancy can help alleviate fatigue, swelling and backache.

Exercise during pregnancy should be carefully undertaken. You should avoid activities that can cause hard falls or contact. Low impact activities are the best activities during pregnancy.

Eating a balanced healthy diet is important during pregnancy. There are, however, some foods that are thought to pose a risk to pregnant women, these include:

• liver and liver products
• soft mould ripened cheeses, such as Camembert, Brie and blue-veined cheese
• pâté (including vegetable pâté)
• uncooked or undercooked ready-prepared meals
• uncooked or cured meat, such as salami or Parma ham
• raw shellfish, such as oysters 
• fish containing relatively high levels of mercury, such as shark, swordfish and marlin, which might affect the nervous system of the fetus
• unpasteurised milk or dairy products made from unpasteurised milk
• raw or undercooked eggs or products containing them such as fresh mayonnaise
• alcohol – it is safest to avoid alcohol altogether
• tuna – no more than two medium size cans or one fresh tuna steak per week 
• caffeine – to 300 milligrams a day. Caffeine is present in coffee, tea, colas, energy drinks and chocolate

Cigarette smoke is made up of more than 3,000 chemicals, including cyanide, lead, and at least 60 cancer-causing compounds. When you smoke during pregnancy, those toxic chemicals gets into your bloodstream, your baby's only source of oxygen and nutrients. It is therefore important that you take steps toward giving up smoking. Please ask your doctor or midwife how to approach cessation as soon as possible.

Some experts now recommend that you give up alcohol altogether, either throughout pregnancy or at least for the first three months. If you do drink alcohol while you are pregnant, this should be limited to one or two units of alcohol, not more than once or twice per week.

In general, it is not advisable to fly after 32 weeks of pregnancy. Women who have complications with their pregnancy or who are considered to be ‘high risk’ should not travel. This includes women placental abnormalities, hypertension, sickle cell disease or those at risk for premature labor.

It is always a good idea to discuss your travel plans with your health care provider before you leave. It is also a good idea to obtain a doctor’s note saying that it is okay for you to travel, especially if you are in your third trimester. Some airlines require a doctor’s note to let you fly so check with the airline before you travel.

If you are flying while pregnant, there is an increased risk of developing a blood clot. Therefore, you should try following these tips:

• Wear a loose fitting, comfortable outfit
• Stay well hydrated by drinking lots of water
• Avoid crossing your legs
• Wear some compression stockings; which will help keep the blood moving from your ankles to your heart and lungs
• Try and walk around the aisles every hour and stretch out regularly. This will help with your circulation.

Yes, if your pregnancy is normaly there is no problem with having sex. However, if you have complications such as a low lying placenta, you should consult your caregiver.

That depends on which medication and other factors. You should discuss this with your doctor or midwife.

Complementary therapy is a range of ancillary services that complement conventional western medicine. Some complementary therapies include; Reflexology, Aromatherapy, Pregnancy Massage, Osteopathy and acupuncture. The Birth Clinic has relationships with top professionals able to offer personalised services at a discount. To learn more, please Click here.

There are many opportunities to take classes on a range of topics such as hypnotherapy and breathing methods. The Birth Clinic can advise you about providers if this is of interst.

Yes. You should consider this as early as possible so that we can provide a choice of doctors and midwives with the appropriate experience and background.

You are likely to be offered an induction if:

• You are beyond 41 weeks and considered overdue. You will usually be offered induction sometime between 41 and 42 weeks to prevent your pregnancy continuing beyond this time.
• Your water has broken but labour hasn't yet started. Most women go into labour within 24 hours of their waters breaking. If this doesn't happen to you, there is a risk that you or your baby could develop an infection.
• You have diabetes - provided your baby is growing normally, it's recommended that you're offered an induction after 38 weeks of pregnancy.
• You have a chronic or acute condition such as kidney disease that threatens your wellbeing or the health of your baby.

Some women ask for their labour to be induced for personal reasons, such as their partner is about to be posted abroad with the armed forces and would otherwise miss the birth.

Other women may request an induction because they are worried about a previous stillbirth or complications in their current pregnancy. These requests are considered on an individual basis.

Some women will know they need a caesarean section before they go into labour. Other times the decision to opt for a caesarean is made immediately prior to or during labour.

Some of the conditions that may necessitate a planned caesarean section include:

• The baby is in a breech (bottom first) or transverse (sideways) position, or has a known fetal illness or abnormality.
  
• There are three or more babies.
• The mother is having a genital herpes outbreak, which can be passed along to a baby delivered vaginally.
• The mother has placenta praevia (when the placenta is implanted so low in the uterus that it blocks the baby's exit), or abruptio placenta, when the placenta is separated from the uterine wall and the fetus is in danger.
• A mother's pre-eclampsia is rapidly worsening, making it dangerous to delay delivery.
• There is a maternal history of invasive uterine surgery or multiple caesarean sections.

Women have an unplanned surgical delivery for several reasons, including:

• The baby's heart rate becomes irregular, which means that he or she may not be able to withstand a vaginal delivery.
• The umbilical cord prolapses, or slips, through the cervix, making it vulnerable to being compressed during delivery and cutting off the baby's oxygen supply.
• The placenta has abrupted (come adrift).
• The baby is not moving down the birth canal either because the cervix has stopped dilating, or for some other reason.

An episiotomy is an incision performed between the vagina and the rectum that is used to increase the size of the opening of the vagina to assist in delivery of a baby

An episiotomy can decrease the amount of pushing the mother must do during delivery. It can also decrease trauma to the vaginal tissues and expedite delivery of the baby when delivery is necessary quickly. Doctors who favour episiotomies argue that a surgical incision is easier to repair than a spontaneous irregular or extensive tear, and is likely to lead to a more favorable outcome with fewer complications.

It depends on whether you have any tearing during your delivery or require an episiotomy. Tears are more common in women having their first vaginal birth and range from small nicks and abrasions to deep lacerations affecting several pelvic floor muscles.

You might elect to receive an "epidural" which refers to the process in which an anesthesia is injected into a part of the spine known as the epidural space. An epidural is often used during childbirth to block the transmission of pain signals to the brain.

For a vaginal birth with no complications for either mother or baby, most people are able to go home within 24 to 48 hours after delivery.  If you had anaesthesia during delivery, it may be longer as it will take time for the anesthetic to work its way out of your system.

For a Caesarean section delivery, you will stay in the hospital at least three days.  A Cesarean section is major surgery, and the recovery process is lengthier and more difficult.

Yes. The NHS has in place a health support system, even if you deliver privately. The NHS midwife from your community will come and check on you and your baby several times in the first 10 days. The Birth Clinic also offers post natal services led by midwives or doulas to help assist you to settle in back home.

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