PregTASTIC Online Radio - Featuring pregnant women for pregnant women » c-section

Pregnancy Care and Birthing Options – US versus UK

Christiane Williams — Thu, 22 Dec 2011 03:31:35 +0000

We are an international family – I’m German, my husband is American and we currently live in England! I gave birth to my first two children in a suburban Chicago hospital and now we are expecting again! As my pregnancy progresses, I am amazed by the difference in care and options between the US and the UK!

Since PregTASTIC is gaining more and more international followers, I thought it would be interesting to share some of my observations!

Babies are born all over the world and while it is obvious that pregnancy and birth in Somalia will differ very much from the US or India, we expect the Western world to have comparable standards of care. While the US and the UK share a language (well, sort of…) and Western health care standards, the one big difference between the two is that the UK has a National Health System (NHS)!

This means that expecting mothers will not pay anything out of pocket for their pregnancy care – including blood tests, ultrasounds, amniocentesis etc – or their birth (including all anesthesia, the hospital stay etc). In addition they get free prescriptions for the duration of their pregnancy as well as free dental work until the baby is 1 year old. In the US most people are insured through a plan at work or privately. Regular co-pays are the norm and while most doctors do not charge every time you come for a pregnancy check-up, you certainly get a bill for an amino or the hospital stay. Depending on you insurance plan, the birth of your baby can cost you as much as a month of groceries to a semester of college!

In the UK pregnancy care lies completely in the hand of midwives. You only see a doctor if there are complications. Ultrasounds are carried out by technicians, but you would see an anesthesiologist if you get an epidural or a surgeon if you need a C-section. I was sent straight to the midwife when the pregnancy test was positive and I don’t expect to see a gynecologist at all. In the US most women sign up with an OB-GYN, which they see for their check-ups and certainly for the delivery (even if a nurse coached you during labor and the doc just breezes in to catch the baby). When I was in the US, I had to search for a doctor that worked with a midwife and had to travel 30 min to their associated hospital! All other hospitals in the area did not allowed midwives. And while I was signed up with the midwife, I had to see the doctor at least twice during my pregnancy, since he was the main responsible care giver for insurance purposes.

While the NHS system sounds pretty wonderful from a monetary point of view, there are certain draw backs: in urban areas with big midwife teams, you might not see the same midwife for your visits and therefore have no idea who might deliver you. It is hard to develop a personal relation with your care giver that way and it is a bit worrying if you have a very specific birth plan you want them to follow. Pregnant women are seem MUCH less frequent here than in the US, which does not bother me since this is baby No3, but if I were a first time mother I’d be slightly worried if the midwife said “See you again in 6 weeks” after a 15 min consultation! There are less tests than in the US, too – if the NHS does not consider it essential, you don’t get it! For example, there is no routine glucose test unless there is a family history of diabetes. While some people find these test annoying or even invasive, for me they were always reassuring that somebody was keeping an eye on me and my baby!

The biggest draw-back by far this time for me is the fact that you only get two ultrasounds your entire pregnancy in the UK – week 12 to determine the due date and week 20 to check the organs. That’s it (unless there are complications)! And the ultrasound technicians are less than forthcoming with information about the gender. I totally expected to be able to ask whether it was a boy or a gilr at the 20 week scan, but a grumpy technician said that it was not her job to check for that, but only for the health of the organs! So we actually booked a private ultrasound at week 27 to check for the gender and assure us that everything is all right – which will cost us £100 ($160) for the cheapest package! (There is a whole industry here that covers services the NHS deems unnecessary, but people feel they need or want!). I really miss my US doctor’s office that had its own ultrasound machine and you could have a “quick peek” at the appointment!

In the UK, you have three official options for birth: at home, at a midwife-led centre or at a hospital. (A midwife-led centre is a birthing centre without doctors for low-risk women who want a natural birth). If you opted for a home birth or a midwife unit and you change your mind and want an epidural or need a c-section, you will be transferred to a hospital by ambulance. (There was a recent study that many first time mom needed such a transfer and the NHS was worried about this rising cost factor…). I was amazed that a home birth was officially offered to all low-risk women and was an adversised option in all the brochures and books! In the US it is only legal to hire certified professional midwife (CPM) in 27 of the 50 states. CPMs who continue to attend mothers in the 23 states where it is illegal, and can be arrested and prosecuted. (However, no state prosecutes mothers for giving birth outside a hospital, which sometimes happens unexpectedly!). Most insurance companies will only cover your birth if you are officially registered with a OB-GYN office. So most women in the US deliver at a hospital and only rarely are the births attended by a midwife!

When it comes to pain relief during labor, the UK has a couple of options that are very unique: before the epidural women are offered a TENS-machine that stimulates nerves with small electric shocks or “gas&air”, nitrous oxide (also know as laughing gas) mixed with oxygen, that women suck out of a gas tank during contractions. Finally there are also shots of pain killers offered (pethidine or diamorphine). So there is a whole spectrum of things to try before the epidural, if you want to! In the US, I always found the decision very harsh – nothing or epidural! On the other hand, in the US you have the option of a selective C-section – only last month did the NHS begrudgingly and with much protest from the midwives allow the possibility that women without medical indication could chose a C-section. You are really expected to birth naturally with a midwife if you can – it’s so much cheaper than a c-section with a doctor!

(So which option will I chose? We will try to go for a home birth. More about that in a future post!)

Being Open to a Flexible Birth Plan

Tracy Manty — Fri, 16 Sep 2011 18:44:58 +0000

I’m coming down to the wire as I have only 3 weeks left in my pregnancy. This second pregnancy has been different from the first – although not vastly so – there have been clear distinctions. First, I’m having a girl. Not sure if this is THE differentiating factor in what I’m experiencing this second time around but it’s definitely different. Second, I am “healthier.” While I continue to be reminded that I’m a mother of “advanced maternal age” (41 years old – I was barely 37 when I had my first), this time around, I haven’t experienced any high blood pressure or low amniotic fluid, which was what sent me to to get induced and what led to the slippery slope of an “emergency” c-section with Henry (high fetal heart rate I was told). Even my low placenta, which was a concern in my first pregnancy seems to have moved up to the arbitrarily so-called safe zone of 2+cm (away from the cervix).

So, am I in the clear to have a VBAC? Not really. One of my goals this pregnancy was to try for a VBAC since I never experienced real childbirth. With Henry, I was induced, on a pitocin drip for 12 hours, yet, still never felt any true, active labor. Heck, we weren’t even sure if my water had broke! My belief is that I ended up with an emergency c-section because the doctor-on-call was getting off shift and just wanted my baby to come out (I checked in at 7am and delivered at 12:15am the next morning). Even the L&D nurse didn’t concur that my baby’s heart-rate was abnormally high, but when you have emergency papers shoved in your face to sign and a doctor telling you “go,” you just bite the bullet. The c-section was tough. You know this when the chatty anesthesiologists get quiet. Henry didn’t want to come out (I attribute it to my tight abs). But whatever the case, he had to be vacuumed up and out. The stitching took about an hour and I was just drained afterward. The next four days in the hospital were fine but on the evening I went home, my stitches opened up and and I had to have a visiting nurse come daily to my home for the next month to dress my scar.

Given this experience, it’s probably easy to see why I wanted to try for a VBAC (I also changed medical practices and hospitals!). However, a VBAC still may not be in the cards.

During this pregnancy, I’ve had the pleasure of having 7 ultrasounds (plus, if I go to term – two more are scheduled). As early as 20 weeks, we’ve been monitoring my low placenta. The hope was that it would move up so the cervix wouldn’t be blocked and restrict a vaginal delivery. I have been borderline on this measurement throughout my third trimester. Today, however, although I was deemed ok with regard to the low placenta risk, I was told that there still was some placenta tissue that was not “normal” and most likely related to my first c-section. So, what to do with this information?

I’ve decided to be practical (for me). Unfortunately, I know personally more than a couple of moms who have had complicated deliveries that resulted in tragic or almost tragic consequences. A key driver for me is to not to put myself in a situation where such risks may outweigh the annoyance, yet relative “ease” of my first caesarean experience. Even after watching Ricki Lake’s “The Business of Being Born,” and concurring with a lot of what she had to say, I believe I am erring on what I know. As a result, my doctor and I marked a date on our calendars (September 27th) for a scheduled c-section.

If, however, new baby Manty decides to come early, I’ll just have to make a decision on that day. While I would love to hope that all goes well and I could experience real contractions and real labor (am I crazy for wanting to be in pain?), and a real vaginal birth, again, the prognosis on that day will drive the pros and cons of a vaginal vs. c-section delivery.

Are you committed to your birth plan or have you built in flexibility for “practical” circumstance?

_________________________________________

Learn more about birth plans by listening to PregTASTIC, Episode 33.

Mercedes’ C-Section

admin — Wed, 24 Aug 2011 06:26:44 +0000

PregTASTIC panelist, Mercedes, is back to share her birth story at age 40. Did her boy arrive on the 4th of July like everyone wanted? What song was playing in the operating room the moment her son was born? Plus, what happened to make it impossible for Mercedes to encapsulate her placenta?

In this episode: Sunny (host), Michelle and Maia
Special Guests: Mercedes, Matt and baby Mateo

Maia, Sunny, Matt, Baby Mateo, Mercedes, Michelle

Mercedes and Michelle

Top 10 Labor and Delivery Fears

admin — Wed, 17 Aug 2011 04:56:33 +0000

Nobody ever said childbirth was going to be easy. In fact, most of us probably think about the worse case scenarios as our due date draws near. That’s exactly what TheBump.com explores in their recent article. So, what’s your biggest fear when it comes to labor and delivery? Today we’re checking in with our PregTASTIC panelists and our facebook fans to find out.

In this episode: Sunny (host), Kate, Michelle, Maia and Amy
Resource: The Bump, Top 10 Labor and Delivery Fears

Theresa’s C-Section

admin — Wed, 03 Aug 2011 06:01:05 +0000

PregTASTIC Panelist Theresa is back to share her birth story. Did she succeed at a planned VBAC? What was her husband’s clever way of sharing the birthing experience with family and friends around the country? How is their older son adapting to the family’s new addition? And why did Theresa feel like she was starving her baby?

In this episode: Sunny (host), Kate and Patrice
Special Guests: Theresa, Owen (hubby) and Baby Jameson

Kate, Patrice, Theresa, Owen and Sunny

Owen, Theresa and Baby Jameson

The Fears and Facts of VBACs

admin — Tue, 24 May 2011 07:07:50 +0000

You had a cesarean section with your first baby, and now you’re hoping for a VBAC. Is there anything you can do to improve your chances? What are the risks to both mom and baby? And how do you find a hospital that will perform the procedure despite possible legal issues? Dr. Colleen McNally, OB/GYN at Sharp Mary Birch, explains the important facts to help you make an informed decision.

In this episode: Sunny (host), Mercedes and Kerri
Special Guest: Dr. Colleen McNally, OB/GYN at Sharp Mary Birch Hospital for Women and Newborns

Resource: American College of Obstetrics and Gynocology, http://www.acog.org

C-Section Secrets: The Truth About Delivery and Recovery

admin — Tue, 17 May 2011 09:01:22 +0000

C-section deliveries are on the rise, so it’s best to be prepared before your big day. Today we’re exploring the top c-section secrets! What does the surgery feel like? What can and can’t you do in the operating room? And what can you do to reduce the dreaded c-section scar? Dr. Colleen McNally, an OB/GYN at Sharp Mary Birch Hospital for Women and Newborns, reveals the top things no one tells you about having a c-section.

In this episode: Sunny (host), Mercedes and Kerri
Special Guest: Dr. Colleen McNally, OB/GYN at Sharp Mary Birch Hospital for Women and Newborns

Kerri, Dr. McNally, Sunny, Mercedes

Dr. McNally, Sunny, Mercedes

Heather’s Twin Birth Story

admin — Tue, 26 Apr 2011 09:14:52 +0000

PregTASTIC Panelist Heather is back to share the birth story of two beautiful twin girls. Learn more about her planned c-section. Would she do it all over again? What’s a cervical cerclage and how does it impact labor and delivery? Plus, her struggles with feeding her newborns and her big battle with the baby blues.

In this episode: Sunny (host), Jenna, Jane, Theresa, Mercedes and Jenn.
Special Guest: Former PregTASTIC Panelist, Heather

Mercedes, Heather, Sunny and Theresa

Jenn, Jane, Mercedes and Heather

Heather's Twin Girls, Ava and Mia

LaShonda’s C-Section

admin — Wed, 20 Apr 2011 06:28:24 +0000

She spent weeks preparing to deliver her baby naturally, so what ultimately happened at the birthing center? How many hours of labor was too many? And why did she try to escape from the hospital in the middle of the night? PregTASTIC panelist, LaShonda, is back to share her birth story.

In this episode: Sunny (host), Jenna, Jane, Theresa, Mercedes and Jenn.
Special Guests: LaShonda and Baby Luke

Luke and Sayer playing together

LaShonda, Luke, Sayer and Sunny

LaShonda and Baby Luke

Betsy’s Twin Birth Story

admin — Tue, 22 Mar 2011 22:12:30 +0000

Betsy, our first PregTASTIC panelist to be pregnant with twins, is back to share her birth story. Was she able to avoid the dreaded mixed delivery? Is she able to breastfeed both twins? What was the worst pain of her life that she was not prepared for? Plus, her advice for other mothers expecting twins.

In this episode: Sunny (host), Jane, Jenn, Deborah, Theresa and Jenna
Special Guest: Betsy and her twin boys, Judah and Asher

Jane, Betsy (and baby), Sunny and Jenna

Betsy (and baby) and Sunny

Jenn, Deborah, Jane and Betsy