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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!)

Michelle’s Birth Story

admin — Tue, 06 Dec 2011 07:20:07 +0000

PregTASTIC Panelist Michelle is back to share her birth story. Did she get an epidural or go med-free as she fantasized about? What was the one question she never expected the nurses to ask? And what does grilled cheese have to do with any of it? Plus, how milk allergies make breastfeeding a little more challenging.

Featured Panelists: Sunny (host), Rachele and Florinda
Special Guest: PregTASTIC Panelist Michelle and Baby Dillan

Michelle and Sunny

Florinda, Michelle, Sunny and Rachele

Pain Relief: Helping You Through Childbirth

admin — Tue, 26 Jul 2011 07:23:45 +0000

Whether you’re planning to go natural or you prefer the medicinal route, we have some great pain relief options to help you throughout your labor and delivery. What are some simple ways to change up your room to make it more relaxing? What positions seem to help relieve the pain? What is a tens machine and how can it help? Plus, an anesthesiologist explains how epidurals impact your body, your baby and breastfeeding.

In this episode: Sunny (host), Amy, Kate and Patrice
Special Guests: Jessica Hillis, R.N. and Dr. Thomas Farrell, Anesthesiologist
Resources: Anesthesia Service Medical Group, http://www.asmgmd.com
Society for Obstetric Anesthesia and Perinatology, http://www.soap.org

Dr. Thomas Ferrell, Jessica Hillis, R.N., Sunny and Amy

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

Sunny’s Birth Story

admin — Wed, 25 Aug 2010 04:35:03 +0000

Sunny’s birthing story. Her birth plan, epidurals and recuperation after a 9.2 lb baby. How did she know she was in labor and where was she? The importance of packing your bags in advance; you won’t believe what she accidentally left behind! Plus, not all is well post birth, and why she’s vowed to become the spokesperson for epidurals.

Things That Make You Go… Ewwwww!

KC Wilt — Fri, 20 Aug 2010 16:27:33 +0000

In a society, as we get older we form opinions and judgments on things. They are based on our experiences, our beliefs and common thought amongst our peers groups. We make our assessments and do what we think is best (or normal) for us.

I’ve been thinking about this a lot lately. As our society has grown and changed, the things that were once taboo and sometimes used to be frowned upon, we have now opened our mind to accept and therefore adapt. Thereby, making it now normal. These range from cleaning products (What? Baking soda is not just for cooking?) to tampons (Can you imagine our grandmother’s first thoughts… you wanna stick that where?!).

Pregnancy and the upcoming birth of our child have made me do just that. The things that were once ‘gross’ to me, I am now having an open mind about; some of the options considered bizarre, I am now looking into. There are some choices in pregnancy and childbirth that are starting to cross lines. More and more people are doing it so they are becoming more and more popular and moms are inquiring about them. Including me.

My life thus far has always been extreme. With pregnancy it has just taken a sharp turn that make friends politely go, “Hmmm….”

Starting with our choice of birth. Once upon a time, I was all for a hospital, medicated birth. That was our hope and desire! I used to joke with people to give me an epidural as soon as I got pregnant! My husband agreed saying he wanted one, too. However, since getting pregnant we have decided on almost the complete opposite… a water birth at a birthing center. I have now become un‐normal amongst my peer group and get a lot of funny looks and questions from concerned people (and not just friends!)

Then the baby shower came. After spending 10 years on and off in childcare I decided I didn’t want anything new, I want to cloth diaper, and make my own baby food. Friends don’t know how to go about buying shower gifts for us. I now have a big sign on my forehead that says, “WEIRDO!”

Now, the stuff I am afraid to admit because it might ostracize me from those near and dear…. I’ve considered placenta encapsulation and breast milk donation. There! I’ve said it aloud! You might as well stick me in the bush to make friends with the animals, cause I’m off in the woods!

Honestly, my first thought was, “Ewwww. Really?! People do that?” I saw my dog give birth once, and her natural instinct was to eat every puppy’s placenta. I’ve also seen a cat suck a dog’s teats for milk. Now, I’ve also seen a dog eat poop, so I’m not necessarily going the route of the animal kingdom.

But it’s made me think, why not these options for my baby? I’m willing to eat the oil from a fish, algae, cod liver to name a few and whatever else that will help me and grow my baby to be a genius, yet I can’t even consider the strongest vitamins that helped grow the life inside of me because it sounds gross? We are also the only creatures that will give our babies milk that was meant for calves, but yet we find other woman’s breast milk disturbing.

What is ‘normal’ and who classifies it? Do we stand to be out‐casted from playgroups if we chose one way or another? Do we need to get a celebrity on board so our absurd becomes hip? Or our hip becomes absurd? If we claim to have open‐minds then why aren’t people talking about it and sharing? I think that’s why I like PregTASTIC so much. The subject is pregnancy and childbirth so everything goes. We talk about things with guests whom I would never have sought advice from before and I find myself intrigued with what they have to say.

I know the judgment only gets worse from here on out as we try to rear our children in a ‘normal’ society. I might have to go live in the woods with my animal friends and reemerge for my placenta capsules; or just grin and bear it with a smile on my face and a secret in my heart while pretending to be ‘normal’ while we all figure this parenthood thing out.

Now, I still haven’t wrapped my brain around a placenta teddy bear but let’s just say I’m trying to be open about all things…

Sayer’s Birth Story

Sunny Gault — Wed, 11 Aug 2010 04:39:34 +0000

I gave birth to my son, Sayer Ryan Gault, nearly two weeks ago. And I can honestly say it was the best moment of my life.

It’s strange. You have nine months to prepare for this moment, and still nothing can quite compare to seeing your child’s face for the first time. The overwhelming sense of pride and awe is almost too much to bare. That combined with all the extra hormones racing through your body makes for one roller coaster of an emotional ride.

And in my case, it was all caught on video.

See, this is what happens when you become obsessed with TLC’s A Baby Story…

For all the details, be sure to check out my birth story on PregTASTIC. My mom (who was there during the delivery) and I also shot a video where we discuss the birth story. You can watch it here.

Everything Epidurals

admin — Tue, 07 Jul 2009 06:02:46 +0000

Epidurals: 75% of women have one. What is the process? What is the epidural space? Does it affect the baby? The best position to make the insertion easier, epidural myths, patient controlled epidurals, and possible side affects. PregTASTIC welcomes back Obstetric Anesthesiologist and author Dr. William Camann. SHOW NOTES

PregTASTIC Pregnancy Podcast #145

Mindy’s Birth Story

admin — Tue, 21 Apr 2009 05:16:24 +0000

Mindy’s four-week early birth, epidural bliss, dealing with pressure to feed her newborn, must haves at the hospital and what’s with the weird toe comment from the nurse? Plus, your chance to win!