Pregnant in the UK – Part 4

We were crazy enough to get pregnant in the UK.

Well, I say we were crazy, but we were blessed, too. I’ve told you about the routine antenatal care we received; it’s overdue that I explain what care is available for birth.

As standard, NHS midwives lead 8 hour courses (usually broken into 4 classes over 4 weeks, covering birth and baby’s first month) to educate parents on the facts and their options. You might be surprised to learn the options. There is also a non-profit organisation called National Childbirth Trust which offers a range of services, including classes, for a fee.

For those who want very little medical intervention, and for whom there are no contraindications, a home birth can be arranged (by week 37) with the community midwives in most areas. The midwives will bring supplies like a baby heart monitor and oxygen tank to your home at 37 weeks so that you are ready when the moment comes. Two midwives attend the birth, but they are in your home so you have quite a bit of control over the big event at the same time that you have personal medical attention (which doesn’t change for the duration of the birth as contrasted with hospital births) and someone to advise should anything out of the ordinary occur.

For slightly more access to medical intervention, in situations where there have been no complications in pregnancy, most hospitals have a step down unit or birth centre near by or on site. These facilities are set up for natural births, some having birthing pools. Each room is equipped with birth aids like a walk in shower, railings, cot, yoga ball, and birthing stool. Laughing gas, diamorphine, and pethedine (rarely used) are available. Midwives lead these units, but their attention is split between patients as mums get on with labour. Mums ready to push get priority of course! Midwives in these facilities work in shifts, but they usually have a small number of patients, maybe two or three. After birth, mum and baby are transferred to the maternity ward if staying overnight; the stay after birth is usually between 6 hours and three days.

Hospital labour wards offer access to the full range of medical staff and equipment. On the labour ward mums can opt for natural birth, laughing gas, oral pain meds, induction hormones, and epidural. Equipment assisted birth and Caesarian are available if required and can be requested if physician/mum can justify their use in a non-emergency situation. Primary care through labour is still provided by a midwife, but physicians are available when required to administer medications or perform procedures outside the remit of the midwife. In addition to any amenities in the room to aid natural childbirth, equipment is available to revive, warm, and measure a baby. Operating theatres and a neonatal intensive care unit are nearby. After birth mum and baby are transferred to the maternity ward; the stay after birth is usually between 6 hours and three days. Dads can’t stay overnight in the hospital unless the use of an amenity room is purchased.

No matter where birth occurs midwives are meant to see you through birth, assist with breastfeeding, and ensure that you are ready to be on your own with your new baby. After birth a midwife will visit you at home–if you were in the hospital they visit you on your first and fifth day at home. Then, a health visitor will check on you around day ten. Mainly these visits are aimed at ensuring the baby is feeding properly (weight being checked at the second midwife home visit) and that you are comfortable caring for them. You can also ask the midwife to check your incision/stitches/etc. Until babies return to their birthweight they are checked weekly by community midwives in a nearby clinic; once that milestone is reached, babies are discharged from midwife care to the care of the health visitors who run weekly well baby clinics at your GP’s office. Health visitors can weigh your baby and answer routine questions any time you drop in to the well baby clinic.

The GP will see the baby at 6-8 weeks for routine checks, after which the GP sees you as needed. A nurse administers immunizations as required.

It seemed confusing at first–I admit that I still ask for clarification about who to see when and in what order quite a lot… We are so fortunate to live in the borough of Islington where the free services on offer are extensive. The local tax I pay is certainly coming back to me.

Coming next: our birth story. Stay tuned. I am typing with one thumb.