Scared of giving birth in the UK

[ToPushOrNotToPush]

I live in a European country and have DS aged 15 months. Heathcare here is excellent - it is based on a social insurance scheme. I outline my birth experience below to ask you how this compares to the UK. We are considering having a second DC and also moving back to the UK. However after reading some of the threads on here I am really worried and I am now considering getting pregnant asap in order to give birth here before we move.

When I had DS I had excellent antenatal care (consultant led as is the norm here). I saw the same female gynacologist each time and knew she would be the one who would deliver the baby. I got to chose the dates/times of my appointments. Scans as and when needed. GP appointment every month for blood test (for toxoplasmosis, thyroid etc - this means a lot to me as I have a friend who very sadly had a stillbirth as her baby's problem wasn't picked up in UK whilst the monthly blood tests would have picked it up here). Midwife appointments for fetal monitoring every 3 days in the fortnight prior to birth.

When I went into labour, I arrived at hosptial at 5cm dilated. In private room with DH and fetal monitoring. At 8cm I asked for epidural. Got one within 10 minutes. Gynacologist arrived when I was 10cm. I pushed a bit but heart rate dropped so had episiotomy and ventuouse (hospital has a 'no forceps' policy). DS born. Stitches done by gynacologist. I spent 4 nights in private room with midwife on call and DH sleeping on the camp bed. Midwife checks (BP and cleaned stitches) every few hours during daytime. Midwife on hand to help with each breastfeeding session if needed. En-suite bathroom.

All of the above cost us about 900 euros and social insurance covered all the rest. This was OK for us as we had 9 months to save up the money!

Now my fear is that this level of care is not the norm in the UK and we can't afford to go private. I had a back-to-back labour and simply could not have coped with a home birth with no pain relief. I am scared of being refused an epidural because the anaethestist is busy, I am scared on going on a postnatal ward after the birth (it took me a good hour of sitting on my toilet to do the first poo, how would I do this in shared toilets?) I am scared of the horror stories of botched stitches.

We are considering moving to south west UK - are there any hospitals to avoid? Do I have a choice? Do I just need to stop reading mumsnet and the horror stories on here?

Stay home if you can.

The thing with the NHS that I've found is that it's fine for most people because it's what they're used to. When you're used to private care, you will be very disappointed with the NHS.

Huddersfield royal infirmary birth centre. Own room, own loo, own bath. Little kitchen facilities to make meals ( well shove a frozen meal in microwave) when needed so no waiting several hours if you're up all night. I cannot praise it enough! And yes it's NHS. People only really post if they have a really negative experience so of course it'll sound shit only reading on here. And to the poster who suggested that NHS midwives would be total bitches based on nothing at all, I'd like to point out that the comment reflects far worse on you, what a strange and awful thing to say.

I had a good experience with my birth. I gave birth in the University Hospital of North Staffordshire, and I could not fault it.

I saw the same midwife for each appointment, except once when she was on holiday. All in all I had over 8 to 9 appointments, whatever the national guidelines are.

Whenever I was worried I could ring the Maternity Assesment Unit and get checked over. Because I my DD didn't move much I had an additional two scans to check everything was alright. It was at my fourth scan they saw her growth had slowed down and decided I needed to be induced. I was four days off my due date.

During labour I needed an epidural, which I had quite quickly. After I gave birth I went to a private room with an en suite bathroom. The only issue I had was they were understaffed to give the correct amount of aftercare. Personally I would have wanted my DP to stay overnight with me, as he could of continued helping me during the night, which would of helped the night staff immensely.

I think the trouble is its a postcode lottery as to what care you receive.

I didn't call them all bitches! Learn to read! There are plenty that have been described as a bitch/ thoroughly unpleasant and many of them by posters on this forum!

Depending on where you live you could continue flying back for routine appointments then either go back for the birth or bite the bullet and stay in the uk for the birth - second usually quick and easy if first was ok - maybe book homebirth if you can manage without epidural? Insurance idea sounded v good also. I would hate to have another here now - service v overstretched imo

We have one of the best Maternity care systems in the world. It is held up to be the gold standard model.

Yes its understaffed, and busy, but none the less you are more likely to achieve a physiological delivery here than any other western country.

With a second child, you are far less likely to require any intervention at all.

The question is - when you are used to a interventionist medical model of care, can you get your head around the fact your body can do this without help.

Have a homebirth if it is safe for you to do so!

Well blimey, I look forward to less intervention. I'm not sure that's physically possible. It was like being 'looked after' by the Scarlet Pimpernel the first time...

It's good by world standards, bad by 'first world' standards, sorry

Withwoman, how can you say it's one of the best maternity care systems in the world, when it's not even close? Maternal mortality rate per 100,000 live births is 12. (Greece is 2). There are 25 countries in Europe alone who have lower maternal mortality.

Stillbirth and neonatal mortality is 7 per 1000, but many, many first-world countries are lower: eg Spain (5), Switzerland (6), Germany (4), Finland (4), Iceland (3), Ireland (5), Belgium (5), Denmark (4).

These are WHO statistics.

My first baby was back to back. Looked after by two fantastic midwives and had a water birth. My second was not back to back. Thanks heavens. She was born in an hour and staff reacted brilliantly. After care rubbish. Live near Stroud that has fab maternity unit if low risk and no need of epidural. Perhaps check what you are entitled to and if you want more can you pay for those bits?

Honestly?

Have a baby now. THEN move. You will get nothing like that standard of care in the UK, you'll be lucky if the shower you have after the labour isn't awash with someone else's blood.

Are you in France by any chance? Just a guess because of the toxo thing, I have a good friend who is French. She had 2 lovely births on the NHS when living here. She then moved back to France and had DC3 there at the end of last year. She was utterly terrified at the thought of going through the highly medicalised French system. She got on ok in the end, though said it was a bit of a pantomime as the midwife didn't know if the hospital she was in had any gas and air. She much preferred the uk system though. I have another friend who had one birth here and another in Spain, and said much the same thing.

It's horses for courses though, if you'd feel better wherever you are then go ahead. They don't test for toxo here because it's really rare incidentally,it's far more common in southern europe

Withwoman,

I could not disagree with you more. The UK most definitely does NOT have the best maternity systems in the world. I come from Switzerland and the level of care here in comparison is incredibly lacking.

Every single friend I know who delivered on the NHS has some horror story. And I still can't believe that it is a postcode lottery as to who gets nuchal scans at 12 weeks.

And don't even get me started on the quality of post natal wards.....

Withwoman, I'm afraid that what you're saying simply isn't true. I know many young polish women who fly home for things like having tonsils out, seeing dentists, and certainly maternity care. Because they look at the NHS system and say "Fuck no!"

Personally I wouldn't have wanted either of my pregnancys or births to be that 'medicalised' (if that's the right term). But I can see the benefits of it and you're right that you won't get it on the NHS. However, my experience both times was pretty good, first one stayed in one night, not the best but clean and fairly well staffed. Second one in the same place which is now a midwife led unit and it was fab, so relaxed mainly due to the lack of intervention and medical atmosphere. Only there for about 3 and a half hours then home to my own bed which for me was perfect.
Is there something specific you would like, so a particular screening test for example? Could you just go private for this element?

"Stillbirth and neonatal mortality is 7 per 1000, but many, many first-world countries are lower: eg Spain (5), Switzerland (6), Germany (4), Finland (4), Iceland (3), Ireland (5), Belgium (5), Denmark (4)."

Having the fattest mothers in Europe doesn't help when it comes to maternal mortality rates.

My take on the OP's situation - if you want good care in the UK you're probably best to have a home birth, go to a really good birth centre or employ an independent midwife.

NHS care maternity care is hit and miss.

I don't see how having regular appointments with a midwife or doctor alongside having the requisite screening tests suddenly makes a birth so 'medicalised'.

I have had 3 DCs in 3 different hospitals in UK (having moved around) and I found the care excellent. People tend to post on MN with bad experiences, there isn't much to say if it all went well. (It is a bit like MIL-read MN and you think they are all dreadful, in RL people get on well in my experience)

Hoping, my comment about it being 'medicalised' was about the birth and the monitoring there. For me personally I would have found that too much as I liked to be able to move around / was in the pool and being strapped up to a monitoring machine would have prevented that. (Assuming I've read that bit correctly in the op). Agree that extra mw visits aren't medicalising the pregnancy as such but for me the number of appointments I had was fine.
OP, could you look into a private mw to 'supplement' your care or is it the labour and hospital experience which you're most concerned about?

Wow - thank you for all the comments. I will definitely look into the options of insurance and also having a private midwife to supplement the care.

I guess the most important things to me are:

• The regular blood tests and check ups during the pregnancy. This is because of the stillbirths that a couple of my friends in the UK have suffered and which could have been prevented by regular screening of the mother's thyriod function and other issues.

• The ability to have an epidural on demand if needed (all maternity wards here have a dedicated anaethetist so you won't be denied pain relief due to the anaethetist being busy in theatre).

• The knowledge that my chosen consultant will deliver the baby, stitch me up, come to see my the day after the birth for a chat/debrief and will do the 6 week check up. My gynacologist here came to see me after the birth to explain why she used the ventuose. It sounds really simple but it made me feel better about the birth.

Saying all of that, the care here isn't perfect (only pain relief available is paracetemol or epidural, in stirrups for the pushing etc.) but for someone who is petrified of stillbirth and of vaginal/rectal damage I am just scared by some of the stories I read on MN. And I do take the point on board that maybe I read here all the worst case scenarios!

Thank you for taking the time to respond to my question!

When I had my kids, they tried to take blood at pretty much every appointment, however by baby 3 it was very difficult so they usually only did the most crucial test.
However despite being very busy all 3 times, the standard of care I got was on the whole fine. Yes it would be nice to get a Doula like in the Netherlands, but we'd also have to pay the high taxes too (and you won't get others to agree to that).
I have been visited by the surgeon the day after for my CS, and my near CS. However the best experience was probably my very rushed 3rd delivery, which was not only delivered by a midwife I'd never met before; but was also nearly delivered by: paramedics on the steps/in the lift, my DH who hadn't read the section on emergency delivery, or my friend who came around to look after the older kids.
Birth really isn't that predictable an event. BTW my local hospital gives Epidurals on demand (just not in a labour that lasts less than 1 hour).

Do not scare yourself silly with stories you read on the internet.

I think the problem with the UK is that the level of care varies. I spent most of my pregnancy in France and had as standard and part of the free care:

• three scans, was also offered a first dating scan at the cost of 28 euros. This includes the 12 week nucal scan plus bloods and amnio if indicated.
• monthly appointments with the gyneacologist
• monthly blood tests
• diabetes test
• 24/7 access to specialist maternity A&E. If you are worried about anything you turn up, no queues, only MWs and OBs.
• copies of all my exams and medical records

Had I stayed in France I would have had a private room (the ward had 28 private rooms and two doubles) with own shower room, OH could have stayed with me 24/7.

As it turned out I found the paternalistic nature of French doctors insufferable so we went to Greece for the birth. In Greece we paid for a private hospital and the experience was superb, but I am not sure what public health care is like for births.

Sorry forgot to add epidurals are available on demand in both France and Greece.

I think there are definite pros and cons to giving birth in the UK and in other countries - i'll use Germany since thats where I am.

The consistency of antenatal care is definitely better in Germany as are the tests offered at each appointment.
But (and for me its a big BUT) the births are very medicalised - as you said its paracetamol or an epidural. You may have to wait a bit for an epidural in the UK but at least there will be other pain relief options while you wait.

But its the post natal care I find amazing in Germany. The same midwife comes to see you at home and has the time to spend with you to help with BF and to help you with your new baby. I've seen this care with friends here and it put to shame the token 10 mins I got for the first few days after my 3 dc were born in the UK.

But healthcare costs more here and until people are willing to pay more for healthcare in the UK then the services will always struggle to be comparable.