Having babies: the UK way

When I first moved to London nearly 5 years ago, I had no idea what a midwife was. I had heard the term before, but had some old-fashioned vision of hippies and candles. The thought of having a baby without ever seeing a doctor was completely foreign (and freaky) to me. I thought that surely a midwife could not be as knowledgeable as a doctor.

Here in the UK, if you are sick, you see a doctor, if you’re pregnant, you see a midwife. Midwives have been delivering babies for ages and ages, and doctors are only involved if there is a complication or a medical reason for them. Because of this, it happens that midwives in the UK tend to be more experienced than doctors in the field of childbirth.

I was assured of all of this when I got pregnant for the first time, but being an American I was still not entirely convinced. However, five years (and two babies) later, I am a huge advocate of midwife-led pregnancies/deliveries!

Because I had two uncomplicated pregnancies, both of my babies were delivered by a midwife. I spent a total of 19 months being pregnant and never saw a doctor (unless you count the ultrasound scans). I found the whole process to be much less medical, much less invasive and much more natural than I had always imagined it to be. During my pregnancies, my midwife was more concerned with how I was feeling (physically and emotionally) than whether my urine results were slightly above the norm, etc.
Don’t get me wrong — I received all the necessary tests, but it wasn’t as much of a focus as it seems to be in the States. Being a low-stress kind of girl, this system really worked well for me.

Another big difference between the U.S. and the U.K. is the amount of time you stay in the hospital after the baby is born. After both births, I stayed no longer than 12 hours in the hospital. In fact, after my second birth, I only stayed the minimum 6 hours. Hospital care (for straight-forward deliveries and healthy babies) is less important here in the UK because they offer home visits by a midwife for the first week post-delivery. A midwife comes to your home to check on you and the baby, weigh him, help with breastfeeding, etc. Doesn’t it sound lovely? You don’t have to leave your house — they come to you! And you can share a cup of tea, stay in your pjs, and be cozy in your own home.

I really loved having a midwife guide me through my pregnancies.  But I should probably clarify that I paid for a private midwife (rather than going through the NHS), so I had the lovely experience of really getting to know my midwife.  If you go through the NHS, you are treated by numerous midwives, and are never assured that you will even know the midwife who delivers your baby. So I can imagine that this midwife-led system might not have been as enjoyable for other mums in the UK.

*Of course, if you live in the U.K. and really want a doctor, you can always ‘go private’ and dish out the £s! (A private doctor costs on average £10,000)!

-Courtney

12 COMMENTS - Add your own

1. Victoria | March 19, 2008 | Reply

We had been living in the UK for almost 5 years when I became pregnant with our first daughter Ella. I must confess that our dealings with the NHS were far from satisfactory. I think the difference was that in Australia you discuss with a doctor, you are a participant in the process. In the UK I found that I was expected to take their word for things, without question. I remember the results of my Downs Test were delivered as “acceptable”. I asked the question to who are the acceptable, what were the actual numbers? I actually had to petition for a hard copy of the exact results, I had to ask the permission of my GP to get them from the hospital – my results. Perhaps it’s my pushy Australian or Victoria attitude – I’m not sure which – that I found that so surprising.

I was at the same hospital as Esther and must admit to having had a bad experience so we decided to go private. We went with the referral of a friend to a Dr at the Portland but had always intended to birth back in Australia with my well known gynaeo who was also an OB. My dear friend, who is Danish, had both her children at St Mary’s in Paddington, but having had difficult emergency csections both times found their lack of support after delivery without family on hand really difficult. It’s so interesting how we all have such different personal experiences – I had a gynaeo procedure at St Mary’s and they were amazing – go figure.

2. Courtney | March 19, 2008 | Reply

I didn’t go into detail about all of the NHS hospitals vs. private ones because I could probably write an entire essay! Both my babies were born in an NHS hospital. They were certainly NOT posh, and not all of the midwives were friendly. What I also hated was that they ’stuck’ you in a room with 7 other moms and their new babies and expected you to try to ‘catch up on sleep’. (This probably explains why I stayed so shortly in the hospital)!

The problem is, that I saw some of the other private hospitals (like the Portland) and still wasn’t very impressed. (This is why I wanted to have my babies at home).
I probably should have gone into detail in my post, but I paid for my own midwife (which was WAY less than paying for a doctor). Because I had my own midwife, it was an enjoyable experience. But I can imagine that if you had to see a different midwife each time (and didn’t always like the ones you saw) how it could be an entirely different experience!

3. Steph | March 19, 2008 | Reply

I had my baby at the Royal London Hospital in Whitechapel East London. I had the same midwife throughout my pregnancy but then a different midwife for the birth and would you believe I had a young hot male midwife?! Juan from Spain :o )
Anyway I stayed the required 6 hours after having my baby before hot footing it out of there. The staff were great but the hospital was in much need of some repair.
I had three different pregnant friends in London at the same time I was pregnant and we all had different midwife/hospital stories. Every part of London does it differently.

4. Barbara | August 6, 2009

Yes amazing!!! I had the same midwife and it was a great surprise! really hot guy! :) But very profesional at the same time…I cannot wait to get pregnant again!

5. Emilie | March 19, 2008 | Reply

I had my first baby in London and got very lucky with Queen Charlotte’s in Hammersmith. They had a birth centre there run by the NHS that is brilliant. I had a lovely midwife that stayed with me throughout the whole birth. Both my husband and I were able to stay overnight in our own room and all the midwives knew us by name and were very helpful and took their time with us. So you are absolutely right, every part of London does it differently…

6. Molly | March 19, 2008 | Reply

I live in the states but my sister is using a midwife for her second and she says she loves the whole process so far, so much less medical than seeing an OBGYN. I plan on using a midwife for number three {whenever that may be}. Also since I like to go drug-free, midwives are the more friendly route to take.

7. Esther | March 19, 2008 | Reply

I also gave birth in the birthing center of UCLH. The first time I had a lovely midwife who stayed with me throughout and guided me though it.
The second time around, I’m sure the midwife was nice, but I hardly saw her as she understood she wasn’t really needed – she told me to listen to my body and left my husband and me alone in the room most of the time. Perfect!

8. Lindsay | March 19, 2008 | Reply

Such an interesting debate! We had the option of private or NHS and I went with NHS and had my daughter at our local hospital in Hackney. I had a great experience, the active birth I longed for and my own room and bathroom for my one night stay afterwards. It wasn’t posh, but I had the same wonderful midwife throughout, who was one a of team who I received my antenatal care from, then the community midwifery team who visited us at home afterwards for 3 weeks were great too. So much depends on luck, is it a busy night, how many agency staff are working etc etc. I run postnatal groups for the NCT and everyone’s experiences are so different. But for the management of my daughter’s on-going illness we have gone privately and the doctors at The Portland are wonderful.

9. Gail | March 20, 2008 | Reply

I am constantly shocked when I read of birthing experiences in other countries. I assumed everyone had the same level of care normal to us in New Zealand.
I had my last baby 2 years ago. I had a midwife which is also usual in NZ, although its not uncommon to choose to receive maternity care from your family doctor or a OB/GYN
You have the same midwife all the way through, you might be referred to a specialist if need be – I was seen by a doctor for hypertension in late pregnancy but my midwife came with me to all those appointments.
Midwives come to your home during your pregnancy. They usually have several birthing options – home birth, water birth, hospital support delivery etc.
I had to birth in the hospital due to my hypertension however my midwife stayed with me and was in control of the process. I was also induced, she was in control of that too.
In the end my blood pressure shot way up, my baby’s heart rate dropped way down so a paeditrician was called into the delivery room to stand by, as was a surgeon, but the midwife controlled the delivery. The process wasn’t what I had planned (my baby needed a ventouse extraction due to my blood pressure), but it was what needed to happen and I will always be grateful to have one steady person throughout the whole thing.
I too was put in a room with 3 other new mothers and babies. The hospital was FULL, but I left as soon as we were given the okay. My midwife came the day I arrived at home to check the baby, me and breastfeeding etc. She came everyday for the first week, and then came 3 times a week for the following 6. After 6 weeks you are handed over to another agency (Plunket) who follow you through until your child is 5 years old. With regular check ups, and access to a multidisciplinary health team. They do well child checks in the community with all health disciplines represented and you take your kid to make sure they are in the “normal” range for everything. if not, all the team of healthcare professionals are there for advice and setting up appts etc
And everything is free in NZ from conception until the child is 6.
We are very spoilt in NZ. Perhaps it has helped our country by having female national leaders. Women’s health is a HUGE deal in NZ.

10. Kaz | March 20, 2008 | Reply

I gave birth to my son 3 months ago at Chelsea and Westminster in London. Despite the low rating the hospital received recently for their labour ward services, I thought my experience overall was great. Everything was done on NHS, and I had alternating checkups with midwives and GP throughout my pregnancy. I thought it was really great that for the first checkup + blood/urine test, a midwife came to my house to do all of that.

During labour, I used Gas and Air (50/50 Oxygen and Nitrous Oxide mix), a birthing pool and finally epidural. Using Gas and Air until I was 6cm dilated made my labour rather short for being the first timer, I think (about 15 hours).

A midwife delivered my baby. I tore badly (2nd degree) at the very end and needed a surgery, but 2 consultant obstetricians, an anesthetist (anesthesiologist), and a bunch of nurses were there to take me to the theatre (operating room) right after my son was born.

And of course, a team of community midwives visited me and the baby at home for the first 10 days after we got discharged from the hospital (due to the trauma, I stayed at the hospital for 2 days). And then a couple of visits from a dedicated health visitor (just one person you get to know). Also my GP’s surgery (office) has once a week baby clinic (walk-in) where you can talk to this health visitor about any questions/concerns you may have about raising your baby. This service is great for first-time parents.

I had such a wonderful experience with the NHS (especially the home visits, the nuchal translucency (NT) scan, and the use of Gas & Air during labour), I’m kind of worried about giving birth to potential future children in the US (I’m going back next year). I wonder if NT scans and Gas & Air are available at any hospitals in NYC!

11. Barbara | March 20, 2008 | Reply

wow, great blog, great comments! I am half british and might be moving to the UK this fall, so this is exactly the kind of stuff I need to be looking into. And goodness, NZ sounds great!!

12. marta | March 20, 2008 | Reply

I gave birth 10 days ago at UCLH in London. I had a great experience, all with NHS: very professional midwives (in birthing centre first and labour ward for the last 2 hrs with an epidural), all on long shifts, so no changes/discontinuity of care. The delivery was smooth and the midwives really helped me through it. We even had a good 2 hrs on our own in the delivery suite after the birth, which was priceless. I guess I was lucky that it was not a busy night, but still, I was very surprised given all the horror stories I heard. I did get to see the same midwife throughout my antenatal visits and she was excellent too.

As for the postnatal ward, glamorous it ain’t, but again great midwives/staff + I was so taken by my new little wander that I could not care less. Plus, UCLH will soon move to the new hospital building so I guess the standards will improve.

All in all, a much more positive experience than what I anticipated: yes, I did have a straightforward pregnancy, labour and birth, but I also believe that it is a matter of levels of expectations. As far as I can tell, people exaggerate when it comes to the shortcomings of the NHS. The only real problem is that the staff is simply not enough to cope with demand.

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