NHS vs private maternity care

Dr Chrissie Yu Dr Chrissie Yu MBBS (Lond.) MD (Lond.) FRCOG, Consultant Obstetrician & Specialist in Fetal-Maternal Medicine Published March 18th 2024

Maternity care, otherwise known as antenatal care, describes the healthcare that nurses, doctors, midwives provide to women during pregnancy, childbirth and beyond. Maternity care can be provided as an outpatient service, as an in-patient and at home. The aim of maternity care is to ensure the health and well-being of mother and baby. Maternity care involves a range of specialist services and support to monitor the health and wellbeing of mother and baby and manage the various stages of pregnancy, facilitate a safe and healthy delivery, and provide care and advice during the postnatal period.

Maternity care includes

Antenatal care: This involves regular check-ups and medical care for pregnant women before the baby’s birth. It includes monitoring the health of the mother and the developing foetus, providing wide-ranging maternity advice, and managing any potential complications.

Labour and delivery care: This covers the medical assistance and support provided to a woman during labour and childbirth. It can involve medical interventions, pain management, and, in some cases, surgical procedures such as caesarean sections.

Postnatal care: After a baby’s birth, postnatal maternity care continues to monitor the health and well-being of mother and baby. This may involve monitoring for any postnatal complications, providing guidance on breastfeeding and baby care. Postnatal maternity care also supports the physical and emotional needs of the mother.

Maternity care is provided by obstetricians, midwives, GPs, family doctors, and other healthcare professionals. The specific maternity care a woman receives during pregnancy and childbirth depends on factors such as a woman’s health, the potential complications, and her preferences for the type of birth she requests whether natural, assisted or elective.

In the UK the provision of quality maternity care is crucial for monitoring healthy pregnancies, reducing the risk of complications, and supporting the mental and physical well-being of mothers and the care of newborn babies.

In the UK, the National Health Service (NHS) provides maternity care to pregnant women, and like any healthcare system, it has advantages and disadvantages. It’s worth noting that people’s experiences can vary, and therefore views on the advantages and disadvantages of NHS maternity care may differ.

Advantages of NHS maternity care:

Access for all: One of the key benefits of the NHS is that it provides healthcare to everyone, irrespective of their financial status. This ensures that maternity care is free at the point of care and accessible to all.

Skilled healthcare professionals: The NHS employs well-trained and skilled healthcare professionals, including midwives and obstetricians, who provide care during pregnancy, childbirth, and the postnatal phase.

Comprehensive care: NHS maternity care typically covers a range of services, including antenatal care, labour and delivery, and postnatal care for all mothers-to-be and new mothers.

Free at the point of care: In the NHS, maternity care – like all NHS services – is generally free at the point of use. This has the advantage that pregnant women can receive the necessary care without worrying about the financial implications

Integrated care pathways: NHS care features integrated care pathways, which aim to ensure a coordinated approach to maternity care. This involves collaboration between healthcare departments and professionals to provide coordinated patient care.

Disadvantages of NHS maternity care:

Pressure on resources: The NHS, like many healthcare systems, is facing considerable strains on its resources as well as strike action by junior doctors at the time of writing. This can lead to longer waiting times for appointments and limited availability of specific services.

Staff workload: High patient numbers and conflicting demands on healthcare professionals can impact the time and attention each patient requires.

Variable quality: While the NHS strives to maintain high standards of care, there may be some variation in the quality of maternity services in different regions, locations and healthcare facilities.

Limited Choice: Some people feel that the NHS system limits their ability to access certain healthcare providers or birthing options, because the availability of some services may vary based on where one lives.

Regional variation: Certain NHS facilities and services may differ region to region. This can result in differences in care quality and experience depending on where one lives. It’s worth noting that ongoing efforts are made to address these challenges and improve the quality of maternity care within the NHS.

Private maternity care, provided by private hospitals or private healthcare facilities, offers an alternative to the publicly funded healthcare systems like the National Health Service (NHS). Below are some of features and benefits of private maternity care:

Advantages of Private maternity care:

One to one, consultant-led care: A feature of private maternity care is that it is designed to provide a more personalised and consistent experience. Pregnant mothers can benefit from one to one care from a consultant obstetrician.

Choice of consultant: Expectant mums have complete flexibility to choose their preferred obstetrician or midwife, as well as the hospital where they want to attend their appointments and deliver their baby. This choice can be based on personal preferences and the reputation of a particular hospital and consultant.

Shorter lead times: Private maternity care typically offers shorter lead times and greater flexibility for appointments, tests, and procedures compared to the NHS. This which can be appealing for those who value – and can pay for – prompt and efficient care.

Luxurious facilities: Private maternity hospitals such as the Portland Hospital and the Lindo Wing offer more comfortable and luxurious facilities, with an environment and atmosphere more akin to a hotel for outpatient appointments, antenatal care, labour, delivery, and post natal recovery.

Extended visiting hours: Private maternity hospitals offer longer and more flexible visiting hours, enabling family and friends to spend more time with the new parents and their baby.

Cons of Private Maternity Care:

Cost: One of the significant features of private maternity care is the level of fees; for charged by the consultant and the hospital.

Lack of universal access: Access to private maternity care is limited to those with the financial means – whether self pay or insurance – to fund it.

Insurance coverage issues: Depending on the region and insurance coverage, not all aspects of private maternity care may be covered by an insurer. Some patients may find they have to fund a shortfall when the insurance settlement is less than a consultant’s fees.

Focus on medical interventions: Depending on the hospital and the consultant obstetrician there may be a higher rate of c-sections or other procedures which may not align with a patient’s preference for a natural birth.

Limited availability of specialised services: Private hospitals may not offer the same level of specialisation for handling high-risk pregnancies or neonatal intensive care as the larger NHS hospitals.

Varied quality of care: While many private maternity hospitals provide high-quality care, the quality can still vary among different providers and locations.

Ultimately, the choice between NHS and private maternity care depends on three things:
individual preferences, financial considerations, and regional availability. Some patients may opt for a combination of NHS and private maternity care based on their needs and circumstances.

Antenatal care, or prenatal care, is the healthcare provided to women to monitor and manage their health during pregnancy. The features of antenatal care can vary between the NHS and private hospitals.

The key differences are listed below.

NHS antenatal care:

Access for everyone: NHS antenatal care is available to all residents in the United Kingdom, irrespective of their financial status. As it is part of the UK’s publicly funded healthcare system, antenatal services are free at the point of care.

Standardised care pathways: The NHS follows standard care pathways, with a set schedule of appointments and tests that pregnant women are encouraged to attend. This helps ensure a consistent level of care for all women.

Midwife-led care: In most cases, where there are no complications or high-risk factors, NHS antenatal care is provided by midwives, who specialise in maternity care. Obstetricians may become involved in the event of a high risk pregnancy, if there are antenatal complications or problems during baby’s delivery,

Public hospitals: Most NHS antenatal care takes place in maternity units in NHS hospitals, and the choice of obstetrician, or midwife, and birthing options may be more limited than in a private hospital.

Private antenatal care:

One to one consultant-led care: Patients who opt for private maternity care will be under the direct care of their chosen consultant for the duration of their pregnancy, delivery and postnatal care. Private patients will also have access to a dedicated team of PAs supporting the consultant to organise appointments, tests and hospital bookings.

Personalised and flexible care: Private maternity care offers patients a more personalised and flexible service. Pregnant women may have more choices in terms of consultant obstetrician, appointment scheduling, and birthing options.

Choice of healthcare provider: Individuals may select their obstetrician or midwife, based on recommendation, referral or reputation. This personal choice helps build a closer doctor-patient relationship and can lead to a more personalised approach to maternity care.

Luxurious facilities: Private maternity clinics and hospitals often feature more comfortable and luxurious facilities, creating a more spa-like or hotel-like environment for expectant mothers.

Shorter waiting times: A key feature of private maternity care is the shorter lead times for appointments and tests compared to the potential lead times in the NHS.

Increased focus on patient experience: Patients who opt for private maternity care may experience a higher quality overall patient experience, amenities and a more comfortable environment.

Additional services: Private maternity care providers may offer value added services, such as prenatal classes, yoga, alternative therapies, massage, or boutique services that go beyond the standard antenatal care provided by the NHS.

It’s important to note that these are general observations, and experiences can vary widely within both the NHS and private maternity care providers.

The ability to choose between private or NHS maternity care depends on individual preferences, financial considerations, and specific needs in pregnancy. Some patients choose a combination of NHS and private maternity care during their pregnancy.

The costs of private maternity care can vary widely depending on several factors, including the specific services provided, the healthcare provider, the region or country, and the level of luxury or amenities offered. It’s essential to check with individual healthcare providers to get accurate and up-to-date information. Here are some general aspects to consider regarding private maternity care costs:

Consultation and check-up fees: Private maternity care will involve fees for consultations, ultrasound scans, medical tests at patients’ appointments with their consultant obstetrician or midwife. These fees can vary provider to provider.

Ultrasound scans: Consultant obstetricians offering private maternity care may charge for ultrasound scans, which are a routine part of antenatal care. The number and type of scans varies from patient to patient and can impact the overall cost.

Blood tests and screening: Consultant obstetricians offering private maternity care may charge fees for various blood tests and screening procedures, including genetic testing, which may not be covered by a patient’s insurance policy.

Hospital or facility fees: Private hospitals or private maternity units will charge fees for the use of their facilities. These fees can include the cost of labour and delivery rooms, postnatal rooms, food & beverages and other amenities. Patients will also be charged for prescribed medications and disbursements such as medical dressings.

Birth options: The patient’s choice of birthing options, such as a luxury room, water birth, or specific birthing suites, can also incur additional costs.

Medical interventions: If medical interventions, such as anaesthesia for a caesarean section or assisted delivery, are required, additional fees may also apply.

Postnatal care: In a private healthcare setting, after the baby’s birth, fees may be associated with postnatal care, including hospital stays, follow-up appointments, private midwifery care and care for the newborn baby.

Additional services: Some private maternity care providers offer additional services, including antenatal classes, breastfeeding and babycare support, or postnatal therapies. These may also add additional cost.

Insurance coverage: Private maternity care costs can be fully or partially covered by private health insurance, but coverage varies. It’s crucial that patients check their policy coverage and exclusions with the insurance provider to understand the extent of coverage and any co-liability.

Regional variation: Charges for private maternity care may vary depending on the geographic location. Private healthcare charges may differ in London from other big cities in the UK.

If you’re considering private maternity care it’s worth checking costs with your chosen consultant and hospital, including any potential additional charges that may arise. Additionally, checking with private medical insurers about coverage details and limitations is important to avoid significant unexpected charges.

Diagnostic procedures and laboratory tests include private medical scans and blood tests are diagnostic procedures that people choose through private hospitals, outside the NHS. Private diagnostic services often offer faster access to appointments, tests and results, and provide the added benefit of privacy, and convenience. Here’s an overview of private medical scans and blood tests:

Private medical scans:

Ultrasound scans: Private hospitals offer ultrasound scans for pregnancy monitoring, abdominal imaging, and musculoskeletal assessments. Ultrasound scans through a private hospital may provide quicker appointments, more detailed scans, faster results and follow-ups.

MRI (Magnetic Resonance Imaging) scans: Private MRI scans are available for detailed imaging of soft tissues, organs, and joints. Patients with private medical insurance may opt for MRI scans from a private hospital to avoid NHS lead times which can sometimes be lengthy.

CT (Computed Tomography) scans: Private CT scans are used for detailed cross-sectional imaging of the body. Like private MRI scans, people may opt for private CT scans to avoid lengthy lead times for appointments and follow-ups.X-rays: Private X-ray services offer imaging for various purposes, such as detecting fractures, assessing joint conditions, and evaluating the chest and abdomen. Like private MRI scans, people may opt for private X-rays to avoid lengthy lead times for appointments..

DEXA Scans: Dual-energy X-ray absorptiometry (DEXA) scans are used to measure bone density and assess the risk of osteoporosis. Private DEXA scans may be chosen for faster access to appointments, results and follow ups.

Private blood tests:

General health assessments: Private blood tests can provide comprehensive health assessments that check a range of aspects of an individual’s health, including cholesterol levels, liver function, kidney function, and blood glucose. The range of tests required can often all be specified directly to the provider at the time of the appointment.

Hormone tests: Private providers offer hormone tests to assess levels of hormones such as thyroid hormones, reproductive hormones, and cortisol.

Cancer markers: Some individuals choose private blood tests to assess cancer markers. Certain cancer markers may be elevated in the presence of certain types of cancer.

Genetic testing: Private genetic testing may be available for anyone interested in assessing their genetic predisposition to specific health conditions or for family planning purposes.

Allergy testing: Private blood tests can be conducted to identify allergies by measuring specific antibodies in the blood.

Vitamin and nutrient levels: Individuals may choose private blood tests to assess their levels of vitamins and minerals, such as vitamin D, vitamin B12, and iron.

Reasons for choosing private scans and blood tests:

Quicker access: Private services often provide faster appointment times and quicker access to results compared to the NHS.

Privacy: Given the choice, many people prefer the privacy of private hospitals for consultations, sensitive tests or for certain conditions.

Choice and flexibility: Access to private healthcare enables people with insurance or the means to self-pay, to choose specific tests based on their location, needs and preferences.

Convenience: Private hospitals may offer more convenient locations and flexible appointment options.

It’s important to note that while private medical scans and private blood tests can offer certain advantages, people should discuss their healthcare needs with a qualified healthcare professional who will advise on the most appropriate tests and diagnostic procedures. Additionally, people should always check the credentials and accreditation of private healthcare providers.

In private hospitals, private amenity rooms refer to enhanced and more comfortable rooms or suites for patients who choose to pay for upgraded accommodation during their hospital stay. These rooms are designed to offer additional amenities and a higher level of comfort compared to standard hospital rooms. The specific features of private amenity rooms can vary depending on the healthcare facility, but here are some common aspects:

Privacy: Private rooms offer increased seclusion and confidentiality for patients and their families. These rooms are usually designed to minimise interaction with other patients and provide a more secluded and peaceful environment during treatment and recovery.

Space: Private rooms tend to have more space than standard hospital rooms, with additional room for the patient and their visitors. This can contribute to a more comfortable and relaxing atmosphere.

En-suite facilities: Many private hospital rooms come with private en-suite bathrooms. This allows patients to have their own bathroom facilities and not share with other patients.

Upgraded furnishings: Private hospital rooms usually feature upgraded and higher quality furnishings, including larger beds, better-quality linens, and additional seating for visitors.

Entertainment: Private hospital rooms are often fitted out with high quality entertainment options such as larger flat screen tv access to a wide range of channels, and streaming services.

Room service: Some private rooms offer enhanced food and beverage from a dedicated kitchen, including the option for room service. Patients can choose from a more extensive menu, and meals can be delivered directly to their room often 24 hours a day.

Concierge services: Patients in private rooms may have access to personalised services, such as concierge services to help with non-medical needs.

It’s important to note that all private hospital rooms incur additional costs, and their availability may vary depending on the hospital or healthcare facility. Patients interested in private amenity rooms should always enquire about the specific features, services, and costs associated with these upgraded accommodations.

Postnatal care refers to the healthcare and support provided to a woman and her newborn baby following childbirth. Both the National Health Service (NHS) and private maternity hospitals offer postnatal care, but there can be differences in the range of services and patient experience. Here’s an overview of postnatal care in the NHS compared to private healthcare:

NHS postnatal care:

Universal access: NHS postnatal care is part of the public healthcare system in the United Kingdom, providing universal access to all residents. It is generally free at the point of care.

Midwife-led care: In the NHS, postnatal care is often led by midwives, who provide support and guidance on various aspects of postnatal recovery, breastfeeding, and newborn baby care.

Home visits: NHS midwives may conduct home visits to provide care and support during the early postnatal period. The frequency and duration of a midwife’s home visits can vary based on a patient’s needs and circumstances.

Health visitor services: Health visitors are trained professionals specialising in child and family health, who provide ongoing support and advice. They can assist with infant feeding, postnatal mental health, advice and general well-being.

GP follow-up: Postnatal care may involve follow-up appointments with a general practitioner (GP) to address any health concerns or issues related to the mother’s recovery.

Breastfeeding support: NHS services include breastfeeding support, including advice and help with latching, feeding positions, and common breastfeeding challenges.

Screening and immunisations: The NHS provides screening tests for newborn babies and offers vaccinations according to the NHS immunisation schedule.

Private postnatal care:

Choice of healthcare provider: Private postnatal care allows individuals to choose their obstetrician, midwife, or other specialists. This can result in a more personalised and potentially more individual experience.

Luxurious facilities: Private maternity units offer more comfortable and luxurious facilities for postnatal care, with private rooms, en-suite facilities, and additional comforts.

Extended postnatal stay: Some private providers offer postnatal patients the opportunity for longer stays in the hospital, providing more time for recovery and support before returning home with the baby.

Access to specialist services: Private postnatal care may offer patients access to a range of specialists, such as lactation consultants, physiotherapists, and postnatal fitness experts.

Wellness services: Private postnatal care may include wellness offerings such as postnatal fitness classes, massages, and other therapies designed to support the physical and emotional well-being of the mother and aid recovery.

Concierge Services: Some private maternity hospitals offer concierge services to assist with non-medical needs, making the postnatal experience more comfortable and hassle-free.

The choice between NHS and private postnatal care often depends on an individual’s personal preferences, financial considerations, and specific healthcare needs. Additionally, some people elect to combine NHS and private care depending on their circumstances.

Meeting with a professional is always recommended when concerned.

Book Appointment
Private Pregnancy Care

Ultrasound scans guide

Ultrasound scans are used for multiple purposes from monitoring an unborn baby to diagnosing a condition & more. Read our guide to learn more.