NHS and Private Maternity Care: Understanding Your Options
Choosing between NHS and private maternity care is a personal decision, and understanding how each works makes it a far easier one
One of the questions I am frequently asked in clinic, by email, and by friends of former patients, is whether private maternity care is worth considering, and how it actually differs from the care the NHS provides. It is an excellent question, and it deserves a straightforward, balanced answer. The United Kingdom is fortunate to have one of the safest maternity systems in the world, and both NHS and private care operate within it, to the same clinical standards and often within the very same hospitals. The choice between them is not a choice between safe and safer. It is a choice about how your care is organised around you: who you see, how much time you have with them, how easily you can reach them, and the environment in which your baby arrives.
This guide sets out how each pathway works, what private care adds, how the two can work together, and the questions worth asking yourself as you decide. My aim is not to persuade you in either direction, but to leave you genuinely informed, because the right choice is the one that fits your pregnancy, your circumstances, and your priorities.
What NHS maternity care provides
NHS maternity care is comprehensive, evidence-based, and free at the point of use. Once you register your pregnancy, you are allocated a schedule of antenatal appointments, scans, and blood tests that follows national guidance, with additional monitoring arranged wherever your pregnancy needs it. For most women with straightforward pregnancies, care is midwife-led: you are looked after by a team of midwives, with Obstetricians involved if a scan, a test result, or your medical history indicates that Consultant input would be valuable.
The strengths of this system are real and worth stating plainly. Care follows rigorously maintained national guidelines. Screening programmes are world-class. And when the unexpected happens, the NHS response is outstanding: fully staffed labour wards, obstetric and anaesthetic teams on site around the clock, and neonatal units equipped for every eventuality. I have spent my Consultant career within the NHS, I continue to hold an NHS post at Chelsea and Westminster Hospital NHS Foundation Trust, and I have enormous respect for what the system delivers every single day.
The trade-off, and it is a structural one rather than a criticism, is continuity and time. NHS care is delivered by teams. You may see a different midwife or doctor at each visit, appointments are necessarily brief because clinics are busy, and the professionals present at your birth will be the team on duty that day rather than someone you have come to know across your pregnancy. For many women this works perfectly well. For others, particularly those with a complicated history, an anxious road to pregnancy, or simply a strong wish for one familiar face throughout, it is the very thing they hope to change.
How private maternity care works
Private maternity care comes in two forms. The best known is Consultant-led care: you choose a named Consultant Obstetrician, and that Consultant personally provides your care from your first appointment to your delivery and beyond. Many private maternity units, including The Kensington Wing, also offer midwife-led private care, where your antenatal care and delivery are provided by a dedicated team of private midwives, with a named link Consultant who reviews you during your pregnancy and is available should Consultant input be needed. Midwife-led private care suits women with straightforward pregnancies who would like the comfort, continuity and environment of a private unit at a lower cost than a Consultant-led package.
In Consultant-led care, you pay a fee for the Consultant's care, usually structured as a package covering your antenatal consultations, your delivery, and postnatal follow-up, together with separate facility fees payable to the private maternity unit where you give birth.
In practical terms, Consultant-led private care changes four things about the experience of pregnancy:
- Continuity. You see the same Consultant at every appointment, and the Consultant who has followed your pregnancy is the one who attends your delivery. Nothing about your history needs re-explaining, and decisions are made by someone who knows the whole story.
- Time. Private consultations are unhurried. There is time to examine, to scan where appropriate, to talk through plans, and to answer every question properly, without the pressure of a full waiting room.
- Access. Appointments can be arranged at times that suit working lives, including evenings and weekends, and you have a direct line to your Consultant's office, and often to your Consultant, between appointments. Concerns are dealt with when they arise rather than waiting for the next scheduled visit.
- Environment. Private maternity units offer private rooms, accommodation for your partner, and a calmer, more personal setting for your delivery and recovery, with one-to-one midwifery care in labour.
The last of these, the environment, applies equally to midwife-led private care: the private rooms, partner accommodation and one-to-one midwifery in labour are features of the unit rather than of any one model of care.
For planned deliveries, whether an elective caesarean section or an induction, Consultant-led private care also means the date is agreed in advance with your own Consultant, who will be the one performing or attending it. For women whose circumstances make a planned delivery important, that certainty is often the single most valued aspect of going private.
An important point about safety: private maternity care in the UK is not clinically superior to NHS care, and any provider who implies otherwise should be treated with caution. Both operate to the same professional standards, under the same regulator, and frequently with the same Consultants. What differs is the structure of the care around you, not the medicine.
Private care within an NHS hospital: the best of both
Something many families do not realise is that much of London's private maternity care takes place inside NHS hospitals. My own private practice is based at The Kensington Wing, the private maternity unit of Chelsea and Westminster Hospital. The Wing offers the comfort and continuity of private care, but it sits within a major NHS teaching hospital, with the full weight of that hospital's expertise on the other side of the door.
This matters for one simple reason: Obstetrics is a specialty where the unexpected, though uncommon, is always possible. If a mother or baby needs additional support, an emergency theatre, a blood transfusion, intensive care, or the neonatal unit, everything is on site, staffed around the clock, and seconds rather than an ambulance ride away. Choosing private care within an NHS hospital means never having to trade comfort against contingency. In my view, it is the strongest possible argument for this model of care, and it is an argument that rests on the excellence of the NHS rather than on any shortcoming in it.
Combining NHS and private care
The two systems are not sealed off from one another, and many of my patients sensibly use both across their pregnancy. There are a few common patterns:
- Private care alongside NHS screening. Some women continue with their routine NHS scans and blood tests while seeing a private Consultant for their antenatal consultations, keeping costs proportionate while gaining continuity and time with one Obstetrician.
- Transferring later in pregnancy. Others remain in NHS care for the first two trimesters and transfer to private care in the third, once the routine screening pathway is complete. A transfer after the 28-week or 36-week appointment is straightforward to arrange, secures a named Consultant for the delivery itself, and keeps the overall cost of private care lower than a full-pregnancy package.
- Returning to the NHS. It is also worth knowing that choosing private care never affects your NHS entitlement. You can return to NHS care at any point, for any reason, and you will be looked after exactly as you would have been. The only principle to be aware of is that private and NHS care are kept as separate episodes: each part of your care is provided fully by one system or the other, rather than mixed within a single appointment or procedure.
Understanding the costs
Private maternity care involves two separate sets of fees, and understanding the distinction avoids surprises. The first is your Consultant's fee, which covers your antenatal consultations, your delivery, and your postnatal care, and is usually offered as a package. The second is the hospital or facility fee, payable directly to the private maternity unit, which covers your room, midwifery care in labour, and your stay. Where an anaesthetist is involved, for an epidural or a caesarean section, their fee is separate again.
It is also worth knowing that most UK health insurance policies do not cover routine maternity care, so the majority of private maternity patients are self-funding. Reputable practices and units are transparent about their fees, and I would encourage any family considering private care to ask for a full written breakdown before committing, covering the Consultant package, the facility fees, and the common additional charges, so that the complete picture is clear from the outset. My own fees and packages are provided in full, in writing, at the point of enquiry, and I am always happy for families to take their time over the decision. To request them, please visit our services page or contact us directly.
How to choose: questions worth asking yourself
There is no universally right answer, but there are questions that reliably point families toward the answer that is right for them:
- How much does continuity matter to you? If the thought of one known, trusted Consultant through pregnancy and at your birth brings you significant peace of mind, that is the core of what private care provides.
- How was your last birth? Women whose first birth was difficult or frightening often choose private care for a subsequent pregnancy precisely for the planning, continuity, and unhurried conversations it allows.
- Is your pregnancy higher risk? Complex pregnancies benefit particularly from Consultant-led continuity, though it is worth saying that the NHS also provides excellent Consultant-led care for higher-risk pregnancies.
- Do you want a planned delivery date with a chosen Obstetrician? If a planned caesarean or induction on an agreed date with your own Consultant is important to you, private care is the pathway that guarantees it.
- What does your budget comfortably allow? Private maternity care is a significant expense. A later transfer, a consultations-only arrangement, or midwife-led private care where your pregnancy is straightforward can each bring the benefits within reach at a lower cost than a full Consultant-led package.
And if you are undecided, meet the Consultant. Most private Obstetricians, myself included, offer a complimentary introductory appointment with no obligation whatsoever. Half an hour of honest conversation about your history, your hopes, and the practicalities will tell you more than any article can, this one included.
Frequently asked questions
No. Both NHS and private maternity care in the UK operate to the same clinical standards, under the same regulation, and are frequently delivered by the same Consultant. What private care changes is the structure around you: a named Consultant throughout, longer appointments, direct access between visits, and a private setting for your delivery. The medicine itself is equally safe in both systems.
Yes, and it is very common. Many women remain in NHS care for their routine scans and screening and transfer to a private Consultant in the third trimester, often after the 28-week or 36-week appointment. The transfer is straightforward: your Consultant's office arranges your registration with the private maternity unit and your records follow you, so your care continues without interruption.
Not at all. Your right to NHS care is unaffected by having received private care, and you may return to the NHS at any stage of your pregnancy, for any reason. The only principle to be aware of is that NHS and private care are kept as separate episodes rather than mixed within a single appointment or procedure.
In most cases, no. The majority of UK health insurance policies exclude routine maternity care, although some cover complications of pregnancy, and a small number of international or corporate policies include maternity benefits. Most private maternity patients in the UK are self-funding. If you believe your policy may provide cover, it is worth confirming the details with your insurer in writing before booking.
Where private care is based within an NHS hospital, as it is at The Kensington Wing at Chelsea and Westminster Hospital, the full resources of the hospital are immediately available: emergency theatres, blood transfusion, intensive care, and a neonatal unit, all on site and staffed around the clock. This is one of the strongest reasons to choose a private unit located within a major NHS hospital.
Costs vary with the Consultant, the unit, and how much of your pregnancy is cared for privately. There are two main components: the Consultant's package covering consultations, delivery, and postnatal care, and the private unit's facility fees for your delivery and stay, with anaesthetist fees separate where applicable. Reputable providers are transparent about their fees and provide a full written breakdown before any commitment. My own fees and packages are provided in full, in writing, at the point of enquiry, via our services page or by contacting us directly.
Some families choose private antenatal consultations for continuity and reassurance while planning an NHS delivery, and this can work well. Individual arrangements vary between Consultants and hospitals, so if this pattern appeals to you, the best step is simply to discuss it with the Consultant's office, who will explain what is possible in your circumstances.
No. Many private maternity units, including The Kensington Wing at Chelsea and Westminster Hospital, offer midwife-led private care as well as Consultant-led care. In midwife-led private care, a dedicated team of private midwives provides your antenatal care and delivery, with a named link Consultant reviewing you during pregnancy and available if Consultant input is needed. It is a popular option for women with straightforward pregnancies who want the private environment at a lower cost.
Mr Myriknas practices at The Kensington Wing and The Chelsea Wing within Chelsea and Westminster Hospital, located at 369 Fulham Road, London SW10 9NH. He also holds an NHS Consultant post at Chelsea and Westminster NHS Foundation Trust, which encompasses both Chelsea and Westminster Hospital and West Middlesex University Hospital.
Final thoughts
The NHS provides safe, expert maternity care to hundreds of thousands of families every year, and it deserves every bit of the trust the public places in it. Private care does not replace that; it builds on it, adding continuity, time, access, and comfort for families who value them enough to pay for them. The two systems work alongside one another, often in the same buildings and through the same Consultants, and the honest answer to "which is better" is that it depends entirely on what matters most to you.
Whatever you choose, choose it informed. Ask questions, request fees in writing, meet the people who would care for you, and trust your instincts about where you feel safest and best heard. A pregnancy is not the time for a decision made in the dark, and no good Consultant, NHS or private, will ever mind you asking.
If you would like to explore what private maternity care with Mr Myriknas would look like for your pregnancy, you are warmly invited to arrange a complimentary, no-obligation meet and greet. Please visit our private maternity services page or contact us directly.