Best place to have a baby: Kings or Tommy's?

[sillywoman]

Lots of personal experiences of good and bad practice at each Hospital on this thread. As someone with fairly close links to the maternity services at both hospitals I've been following this thread with interest.But I do feel I should declare my colours.

It grieves me if I'm honest to see a "where's best to have your baby?" title. It immediately sets the two units in competition, which they really are not. The unit's are very similar, both essentially massive Obstetric led units with a similar number of women through their doors each year. Tommy's strength is it's small midwife led unit where a small proportion of women can give birth, Kings strength is that they provide an excellent post natal support service and a lower Caesarean rate. Other than that i genuinely believe that there's not two pins to choose between them.

Kings is geographically my nearest and so tends to be the hospital I have the closest links to, so I am quite defensive o their behalf (as you may have guessed if you've read my posts!). I see how the staff (most) work hard to keep everyone safe and well cared for, to not turn away frightened women, and to generally do all they can to give each woman the best birth experience she can have within the constraints they have. I know that those at Tommy's do the same, but it hurts me to see the 'Kings is not as good' tone of a few of these threads. This IS NOT TRUE. KIngs is a world leader in maternity care. We have some of the best midwives and Obstetricians in the world. Tommy's unit is slightly newer, but really that's all. It's just surroundings - and that's only the HFH which hardly anyone ends up in anyway.

Given all the statistics and concrete information available (rather than heresay and 'my midwife says . .') I have to agree firmly and wholeheartedly with many of the sensible posters on here and say; if you live in East Dulwich, the best place to have your baby is the closest hospital to you. And that's Kings. You can choose to go elsewhere if you want (and you are very lucky to have two great hospitals to choose from), but you don't get better anything at Tommy's - only more of the same. And if you were only basing your choice on benefit to your baby you'd chose Kings anyway for their postnatal services - so be clear about who your choice is for and why.

I'm not aiming this at Clare in particular. She has been offered a choice and weighed the pro's and cons to make her decision. Really I'm just saying that the services at both hospitals are very, very similar. And Kings, like Tommy's is a GREAT hospital, unless you have a specific issue with them (and I know one or two do) there's no sound reason to change.

[ClareC]

Just come back from being away for the weekend and quite surprised by some of the negative comments that have been added to what was (when I left) a thread containing helpful friendly advice and opinions.

Bonce,

It's only about the environment to the extent of putting myself in an environment that makes me personally as relaxed as possible and therfore hopefully ensuring as shorter labour as possible. I like the idea of a home birth but realise because I am nervous and its all new to me this is not for me - I would be more comfortable knowing there are emergency facilities down the corridor (don't think my first aid kit is quite up to it ;-) ).

I have never been negative or moany about King's or to Kings or their staff, I don't beleive there was anything in my original post that suggested this. My original post makes it very clear that I think medically Kings are extremely good. My reservations lie with the bedside manner, which in my experience has been rather luck of the draw. It is about how they care for a run of the mill standard, no complication labour.

I am concentrating on myself and my part in it in so far as I recognise I am scared! This is not about negativity, or being moany this is about doing something I have never done before and that I know can be very long, painful and can lead to mortality of mother and / or baby (thankfully this is unlikely given the medical facilities we are fortunate to have in this country).

Seeing a poor woman appearing to be in established labour left waiting ages in a full waiting room did not fill me with confidence - I am sure medically she was fine and there was no risk to either her or her baby, perhaps she was fine with that but I know if I were in that situation I would not be comfortable and would feel quite upset.

If I were to be induced, at Kings I would be admitted to a post natal ward (with 3 strangers and their babies) and depending on whether labour started in visiting times or not, could potentially be alone without my partner in early labour. This may be something that doesn't phase some people but it's really not my preference and I would be out of my personal comfort zone.

Tulip,

your comments are not even slightly helpful. It may come as a shock to you but complications do occur even in the "lap of luxury" western world hospitals. I am sure if you were nervous about something (presumably you are never scared and are confident in all you do) being told to "Get over it" wouldnt help, is offensive and entirley unecessary.

Heidi Hi I agree, thanks for the support :-)

Belle, completely agree

Buggie, as you are no doubt aware no the labour tour does not involve touching either open wounds or newborns. I does however involve going in a "clean" labour room (which presumably is not then cleaned again prior to being used) to look around, and being free to touch things in there including the equipment (inc resuscitiation area) . I am sure you are aware that there is currently a swine flu pandemic and cleaniness of hands is paramount given the bug (and other bugs) can live on surfaces for some hours.

20 people using the spray did not disjoint the tour in the least at St Thomas's - 20 people can't get through the door all at once and it took less than a second for each person to spray their hands - people did it when they were a couple of people from the door and rubbed it in as they were walking through the door. Worked very simply as these things should.

I did not judge the facilities on this alone however opinons are based and decisions are made on all the facts available to a person at the time of making the decision. This was something that did not impress me, especially given the media coverage of swine flu and its ability to transfer from touching surfaces.

Yes Kings did have posters which is positive, so did Tommy's. In comparison to Tommy's Kings didn't go that extra mile and physically tell people to sanitize hands. I am sure on another day it could be the Tommy's midwife that doesn't do this and the Kings one that does but that was not my personal experience.

I realise there are plenty of good and bad story's for both hospitals, both have an excellent medical record and we are really lucky here in ED to be able to choose between two outstanding hospitals.

For me personally, it's been a tough choice (hence asking for advice and which in itself shows I doubt neither hospital medically). Having considered all the facts available to me and my personal experiences I simply feel that Tommy's is somewhere I will feel more relaxed. This is not based on it being a newer unit etc but mainly because they have made me feel more than just a number, that me being comfortable and not scared is important despite not (in theory) having any forseen complications.

I realise that maybe my fears are unfounded, that birth is natural and millions of people do it and go on to do it again and again but for me simple things like knowing my partner can be there with me makes a hell of a difference. If I were to be induced at Tommy's, he wouldn't be sent home. Certainly not life or death but it really is the simple things that can make a world of difference.

[sillywoman]

Oh Clare, he will be sent home if you're induced. I'm afraid either someone has misinformed you, or my info is out of date- I really hope it's the latter!

The set up is the same at both hospitals. If you go in to be induced then you're on a separate ward (not the postnatal ward, but a smaller gynae unit linked to the labour ward), and you are both subject to normal visiting hours until you're in established labour and able to move to the obstetric unit. You won't get the home from home because your labour will have been medically started.

Sorry to be such a cassandra. :(

[Pickle]

Re: inductions... I was induced both times at Kings, and both times I was in the labour ward the whole time. My husband was able to stay as long as he wanted, I had a room to myself - dare I say it was even quite pleasant (apart from the fact that for my first baby it took 2 days for my labour to start, in which time I felt like I'd watched the whole of South London arrive pregnant and leave with a baby :)) ). Second time, due to the fact it had taken so long with my first baby, they even moved me into a different room so that I had a TV (not needed, very quick 2nd time!).

[bonce]

At St Thomas',

women are induced on the hospital birth centre and their partners can stay. If they only require one lot of prostin and or breaking the waters and then go into labour they can also go to the home from home. If women give birth on the home from home they can stay there for about 24 hours and their partners can also stay all night.

if they end up on the postnatal ward their partners can be there most of the day but have to go home at the end of visiting times unless they have a single room which would only be if their baby was ill or they had been readmitted post natally. Partners can also stay if they go to the private post natal ward.

[ClareC]

I specifically asked the question about being induced at Tommy's and was told by a midwife there that although I would be unable to use the HFH unit (induction being a "medical procedure"), I would be given a labour room in the medical section and my partner would be able to stay with me. The rooms are apparantly the same, the only difference being there is medical equipment in the non HFH rooms. To be honest I would be happy with a Kings room in that situation, it was the being stuck on a ward without my partner that I really had an issue with.

I have a friend who has been booked into Tommy's to be induced in a couple of weeks and she had exactly the same concern as me and specifically questioned her consultant at Tommy's on this point - she was told the same.

Another friend's wife had a baby there a few months ago and needed to be induced, she was given a room on the medical section and her husband allowed to stay with her.

Sillywoman, I am hoping this is the norm now and your info is out of date - would be very wrong for them to mislead people if this is not the case.

Pickle, sounds like you were really lucky, other than the two day wait ;-) How long ago did you have your two? I did specifically ask the midwife at Kings about this and she told me I would not get a room on the labour ward until I was in established labour, this is understandable, there are not that many of them, I was rather shocked by where she told me i would be and that I potentially may be unable to have my partner there :-(

[Pickle]

My inductions were January 2007 and June 2008, so not too long ago. They really were as accommodating as they could possibly be, we were really impressed. Both times I had to ring on the morning I was booked for induction, and told what time to come in, it was very straight forward and stress free.

My babies were both being monitored quite closely due to my illness (I had obstetric cholestasis in both pregnancies), but I don't think that played a part in my being kept in the labour ward as they can do the monitoring on the other wards too.

[Dulwich Born And Bred]

Clare, you are right regarding Kings and inductions. I had my son there 13 weeks ago,my baby's father was told he had to leave the labour ward, my mum had to go home but my baby father did stay because I was not happy at all about being left alone as I was in so much pain, I had to argue with the midwives to allow him to stay and they gave in and said he could stay in my cubicle with me. He did have to leave though after I gave birth, hence I was bedridden and unable to tend to my son.

You don't need to explain yourself to anyone, you pay your taxes, you go where YOU feel comfortable.

[sillywoman]

Yes, this is the situation at Kings, you know this Clare because it was all covered in your NCT class - including that partners wouldn't be able to stay overnight ;-) The only difference from Pickle's time is that now they have a separate antenatal section on the labour ward itself (4 or 6 beds) which is kept specifically for women being induced (and a few other situations). This is still subject to normal visiting hours. You don't get put on a ward unless that section is full. Of course it's all relative and there's some flexibility in this - if you're the only one on that unit, or you get an understanding midwife like Heidihi, then you may be allowed to keep your partner with you, but if you don't ask, you won't get.

I've emailed the HOM at St T's for clarification as to whether Tommy's still does the same thing. Will let you know what her reply is because you're right Clare - it's not good if the midwife is giving inaccurate information.

edited to say; of course I shouldn't be giving inaccurate information either, and seeing as what you've been told is current practice by the midwife doesn't tally with my understanding of current practice, it would be good to have clarity on the topic so that one of us can alter the information we give.

[Keef]

My wife was induced at Tommys in April, and I was given a matress and stayed from Sunday evening til Tuesday afternoon when she was moved to the ward.

[veryseriousgirl]

I was induced at Kings last week - I went in at 9am on Saturday and we were in the "induction bay" until around 5am on Sunday waiting for things to progress. My partner was able to stay with me the entire time. Even though it was nightmarishly busy for the midwives (so many women were having babies on Saturday that two women nearly gave birth in the induction bay but labour rooms were freed up / cleaned out in the nick of time), but even so, I felt completely supported by the medical staff the entire time I was there.

We had a few hairy moments during the delivery and the midwives and doctors were great about explaining to me what was happening, potential next steps and making sure I understood and was clear about everying.

I spent three days on the post-natal ward as the baby was jaundiced (requiring phototherapy) and was also incredibly grateful to the night shift midwife who sat with me for nearly an hour out of every three trying to get baby to take her formula top up, which she needed to prevent dehydration whilst in the incubator. Overall, my experience was incredibly positive despite the stress of a difficult delivery and the baby spending quite a lot of time in the incubator and I put that down to the dedication and kindness of the staff at Kings. Sure, there were a few midwives with whom I "clicked" more than others, but even the one who I felt brushed me off during our first contact was amazing and caring when she realised how stressed and traumatised I was.

No experience of Tommy's, but wanted to say how grateful I am to Kings! I know this is a bit rambly, but it's my first break from baby for ages and I'm still a bit loopy! :)

[Keef]

Congrats.

[veryseriousgirl]

Thank you!

[Pickle]

Congratulations on the new arrival Veryseriousgirl, and I'm so pleased to hear another positive induction story from Kings, sounds like your experience was as good as mine. Take care of yourself and the little one x

[The Nappy Lady]

Lovely news veryseriousgirl...well done. :))

xxx

[sillywoman]

Ooh, congratulations veryseriousgirl, and welcome to veryseriousbaby! Actually just remembering the whole new baby glow thing makes me feel all warm and fuzzy. Well done for such a lucid & lovely post - no sign of baby brain at all!

SW.

[ClareC]

Congratulations veryseriousgirl! Thank you for taking the time to post such a positive experience, especially when you must have only just come out of hospital :-)

Did all the partners of people being induced at the same time as you get to stay? Must admit this is the part that terrifies me most (being left to deal with the unknown alone). The midwife that hosted the tour told me this wasn't allowed :-( Maybe this is one of those things that the rules say one thing but the reality is often different.

Mental note to self to bulk buy RLT ;-)

[Dulwich Born And Bred]

ClareC Wrote:

-------------------------------------------------------

> Congratulations veryseriousgirl! Thank you for

> taking the time to post such a positive

> experience, especially when you must have only

> just come out of hospital :-)

>

> Did all the partners of people being induced at

> the same time as you get to stay? Must admit this

> is the part that terrifies me most (being left to

> deal with the unknown alone). The midwife that

> hosted the tour told me this wasn't allowed :-(

> Maybe this is one of those things that the rules

> say one thing but the reality is often different.

>

> Mental note to self to bulk buy RLT ;-)

No, as my mum was told she could not stay. I had to fight to get the father to stay yet opposite me a lady had three adults with her, and everyone else did not have their partners. Depends on the midwife I guess!

[veryseriousgirl]

Thank you for all of the congratulations - our little girl is wonderful and it is so good to be home with her.

I think nearly everyone on the ward had a partner with them - I could definitely hear other men's voices through the night (and I am certain they weren't there to be induced themselves).

[Vangough]

I had my first child at Kings and have just written to PALS (on the recommendations of my midwife - I am pregnant again) as my experience in 2007 was nothing short of horrific.

I read the earlier post about women not being left in a corridor...well sorry to say, I was (albeit at Kings). Staff were completely over-run and I was shunted from seats in the waiting area, to an equipment room to yes, the corridor, where even though I was hanging onto the railing in pain (I was 5 cm) I was told to 'go for a coffee on the ground floor' (we were 3 floors up) I did eventually get a room at 6cm but a very agressive midwife told me 'if you're not at least 5cm - you're out'. On the whole midwives were rude, agressive at times and totally disinterested in what I had to say.

Thankfully once the door closed I got a 'human' midwife who was lovely, and she listened to me. I got great post natal care (I had complications) but no follow up care at home (I am SE19) Kings midwives refused to come and Croydon midwives didn't answer my repeated messages left on their answermachines. I finally rang an emergency number and got a midwife in the evening 6 days later only to find out I had a roaring infection and was instantly re-admitted. The midwife was v abrupt with me - I can only imagine as she realised she should have come out days earlier. I suffered a year of complications due to that infection and subsequently had to have corrective surgery. All because of a huge lack of local resource, communication & care.

It makes me VERY nervous about having a 2nd baby and I have begged Delaines and Albany to let me self-refer to them as my friends who have had midwives go with them to hospital have had great experiences - nothing like the treatment I was subjected to. Does anyone know of any other self-referral midwife facilities locally? or does anyone know of a Kings affiliated private midwife? I would love to have a better experience this time !

One last note - I was in the labour ward at Kings this week (the MAU was closed) and my husband and I were stunned at how QUIET it was ! there was one woman there !! perhaps its not so busy now?

[The Nappy Lady]

Vabgough, so sorry to hear your story.

Check out Verona Hall, a local independant midwife, and also it may be worth looking at the Brierley, though they are primarily a home birth team they will accompany you to hospital if necessary.

I wish you the positive birth experience evey woman deserves this time.

Molly

x

[Mellors]

Re private midwives, I used these people and can't recommend them highly enough:

http://birthcentre.com/

The head of the place (Caroline Flint) was my NCT teacher first time round, and I so wish I had had her then. They will either deliver you at home, in their birth centre (which is next to St Georges in Tooting) or accompany you to any hospital.

I had a bit of a fight with Kings as I was VBAC (emergency c-section in Tommys first time) and 14 days over with No 2, and they wanted me to have another C-section. My lovely ladies argued against it, and I ended up with a marvellous, natural 6 hour birth in water at their Birth Centre.

Having said that, the Lanes (the midwives at DMC who are my doctors) didn't exist then, but I believe they offer a similar service now (for free).

[tulip]

Of course it is anxiety provoking having a baby and of course things can go wrong in the best hospitals. The fact remains that Kings and St Thoms are both excellent hospitals and any difficulties experienced are likely to be due to the volume of women and the staff available at the time (the number of births at present simply is too great a demand for our maternity services in their current state). I can pretty much guarantee that either during your antenatal or postnatal care you are likely to experience some difficulty because of capacity or because of staff are spread to thinly. From personal experience the only think I would say is pick the hospital with the most relaxed visiting hours (if you end up in there you will valie your partner being allowed in at all hours) and the most convenient travel/parking from you as the medical care you get is ultimately likely to be fantastic at either hospital.

When I had my own children I experienced a host of complications, was an in patient on the labour ward for a week and stayed in another week after the birth (babies delivered prematurely by c-section). In that time I saw an awful lot of women come in with birth plans, music, intentions for water birth etc etc. They had chosen their hospital and planned every detail and I and watched it all fly out the window when the labour (and sometimes the complications) came. You can fuss and plan all you want, in the end the baby is coming out one way or another and there will be plenty of help when that time comes from fantastic staff and state of the art equipement. In my blunt way what I mean is you will do fine, wherever it happens.

[maisiemoo]

Vangough, I had a similar experience at King's. It was horrendous and I suffered PTSD as a result which I am sure some would find 'overdramatic'. I do agree though that it is very hard to plan for labour as it can become complicated and I will have different expectations with my second. However, what I do know is next time I will pay to have a midwife by my side who communicates and shows some level of care and empathy. It's all very well to say 'get over it' but actually I didn't get over it for a very long time so I think Clare is right to explore her options. Having said all of this I have a friend who had an excellent birth at King's so luck of the draw (or bad luck of the draw) in my case.

[sillywoman]

I think tulip's point is that personal stories aren't really all that useful in making a choice between St Thoms or Kings to have your baby. Ultimately you stand as much chance of having an excellent, mediocre or awful experience in one hospital as you do in the other. You should consider other criteria in order to make your choice.