Parents are 'taking out loans' to pay for private midwife services as NHS pressures continue

• Midwife Katrina Cotterrall left the NHS last summer to go private

A private midwife has told ITV News expectant parents have been "taking out loans" and using savings to pay for her services amid increasing pressure on neonatal services.

Katrina Cotterrall said she is "fully booked and inundated with emails and texts all the time" asking for her skills, "which is amazing but it's also really sad."

She said she is currently the only person in Wales offering this kind of service.

It comes as NHS midwives are reportedly "exhausted" and "overlooked" as negotiations continue over their pay."When I went into it, I thought it was just going to be people from affluent areas seeking my help. But actually probably around 70-80% of them are people who can't really afford the care. "They get loans, they get family support, they use their savings - it's not something that they've planned for. So I was shocked and in a conflict when I know that it's not something that someone can actually afford. "I've had clients that bob back and forth for months, can they afford it, can't they, knowing that they're out there in the background thinking how am I going to make this happen? Mum and dad come in and help out, friends, family, that's the majority of the clients - those that have to go and find the money."Katrina said the majority of the people she sees have either had previous birth trauma or they cannot get the experience they want through the NHS - this could be wanting more support or continuity of care.

Florence Boyd Williams is 34 weeks pregnant with her first child. She said she made a "really difficult decision" to go with a private midwife. "We went back and forth a lot, my partner and I. The main reason that we decided to go private in the end was because we were both really keen on a home birth and at that point, the home birth service in Cardiff had been shut for several months so that created a lot of anxiety, feeling that I couldn't plan the birth that I wanted."The staff at the NHS, the check ups that I've had have been amazing but from what I understand due to underfunding and understaffing, that's why the home birth service was shut and because of that, I felt like there wasn't the support available - through no fault of anybody's at the NHS - that we needed at this time."Florence said she never imagined that private healthcare would be something she and her partner would need to access. She said despite their decision to go private, they fully support the NHS and the ongoing strikes. "We've needed to use some savings to access the care that we feel can give us as much support as we need."It does mean we'll have to make other adjustments and it's not something that we were expecting to spend but this is something we decided we needed to invest in. Luckily we had that option available to us. But we were really conflicted with having to make this decision."

Last year, Cardiff and Vale University Health Board temporarily suspended its home birth service due to pressures on maternity services, and has since recruited new midwives to help address this.

Katrina said she was also very conflicted about leaving the NHS.

"A lot of my friends still work there and I see what they're going through and it's a difficult one. I feel really guilty for not being there with them. But the environment that I was working in, I couldn't be the best me. For me to be the best midwife that I can be, I've got to work in an environment that I can give the best me. I absolutely love my job. "With the pressures that the NHS is under, I couldn't give myself wholly."Katrina added that if she was still working in the NHS, she would be on strike. "I've got friends who can't afford to take the day off to strike and they want to strike. I fully support the strike. I'm just in a lucky position that I don't have to because I made a big, big choice, a very conflicted choice to leave and work this way instead. "Knowing that I've still got friends in that environment, I feel like I should be in there supporting them and I'm not sure that will ever go away. It's just a choice that I've got to learn to live with."

The Royal College of Midwives (RCM) has paused strike action to consult members on a new pay offer from the Welsh Government.

The original offer was to give midwives and medical support workers (MSWs) the 4% pay increase recommended by the NHS Pay review Body. The latest offer will give NHS midwives and MSWs a consolidated 1.5% on top, plus a non-consolidated 1.5%.

Katrina charges around £7,500 for a full package of care - this could be from six weeks pregnant until birth and then a month's postnatal care after. Or for a smaller package of care, from 34 weeks with one week's postnatal care, it costs around £4,000.She said: "Within that package, you've got a midwife on call... I had conflict with the pricing as well but when you break it down, you do get the support and continuity you're paying for."

Katrina added: "You don't go into a vocational job like nursing or midwifery or teaching to cause distress or harm or not provide the best care that you can give. "But there's no way the staffing levels would be able to allow for 16 anti-natal appointments that ladies get when they book private. It's not even half of that, it's probably four or five appointments. The postnatal care is known as 'the Cinderella service'."I was just frustrated and heartbroken because I could see what was needed and I'm sure all midwives out there feel the same. But you can't give the best you can."The Welsh Government said it is investing to improve programmes and provide safe, quality, equitable maternity services for families in Wales.