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?

Canella - In Germany what percentage of your income do you pay in tax? And do you have to buy health insurance on top of that?

Care at the birth is fantastic I think. In my area care in pregnancy is fantastic, although I know this varies by area. But postnatal care in hospital was poor. But I think it is also about how you approach it - no-one is going to come and check on you in the postnatal ward so you have to buzz and ask for what you need. There is a bit of a British thing about not wanting to ask for help and not wanting to disturb others (especially at night), but you have to.

As other people have said care varies massively by area. I had first child 6 months ago - I saw the same midwife for all antenatal appointments, and she was flexible about times, days etc. But in the nearest city you just have to go and get seen by whoever each time, its totally random.

To get what you want you will have to go private. On NHS you don't have a named doctor who will manage the birth. But if you don't insist on a Dr, going to a maternity led unit would get you a private room, ensuite etc probably. If you go to one attached to a hospital you could be transfered if you need an epidural. I ultimately it is about how much the extras mean to you. We had 2 private scans in addition to NHS ones, so if it is the scans and tests you really want then you may be able to go with NHS but get these on top - a private scan was £100.

Too posh,

I really empathise with your predicament as I was in a similar scenario not so long ago and my husband and I decided to go private.

Unfortunately all of the points which you state that are very important to you (particularly being seen by one consultant) are simply not available on the NHS.

You will only be seen by a consultant if you are considered a high risk pregnancy. Otherwise it is a midwife delivering your baby and a midwife (not always the same one) at your appointments. If there are complications during delivery, an obstetrician will be called in but you will have no say in who he or she is and you are not guaranteed ever seeing him/her again after your delivery!

Extra scans and blood tests can be done privately. The 12 week nuchal scan is not available to all and you may well have to do this privately if it is important to you.

The cost of private care is very high. We live in central London and our care cost about £11,000. This was fortunately covered by my foreign insurance and included full consultant-led care, monthly appointments, all the scans and blood tests (early scan, nuchal scan, 20 week scan and 34 week fetal wellbeing scan), 24hr access to private maternity unit for any worries, any type of pain relief during labour, and a fully private room for recovery. I also had access to lactation specialists and physiotherapists for my pelvic floor.

I had a really fantastic vaginal delivery with epidural. It was breeze which one would hope would be the case with such expensive care!

Anyway, as others have said, I might consider delivering where you are currently as you won't experience the same level of pregnancy care here.

Just as an aside, the NHS may be lacking in maternity care but for many other conditions it is phenomenal. My closest friend was diagnosed with stage 3 breast cancer at age 30 and was seen by the top specialists in the field, had amazing reconstructive surgery and was offered very expensive medications to get better. Her level of care simply blew me away.

Only paracetamol or epidural???

My mum tried to insist that I should move home to give birth in my native (north European) country as she had heard so many scare stories.

I pointed out that this would mean that my children would not get citizenship in their own country and that dh would not be present at the birth, but she seemed to have got it into her head that giving birth in the UK= instant death.

In the event, I had two high risk pregnancies, care was fine and nothing untoward happened. Admittedly, this was a few years ago and conditions may have deteriorated- but shared toilets? Among the prudish Brits? Surely not.

You can pay to have a private room in many NHS hospitals but tbh I found being on a ward had its advantages: not least that women who had come easily out of the birth could lend a hand to those who hadn't and you could get a bit of advice and support from experienced mums.

I wouldn't want q gynaecologist delivering my baby- i would want a specialist whose job is delivering babies- ie a midwife.

Not sure being delivered by a consultant in a low risk pregnancy is such an advantage though; ime midwives are often better at listening to the mother and less likely to push you into procedures because they can.

And I would think it very unlikely that there would be any pressure on you to have a home birth; they are still not the norm in the UK.

cross-posted with seeker, there

It varies so hugely, even from shift to shift. I got what I think was adequate care when pregnant and excellent midwife/birth care with poor postnatal help.

The birth described in the OP sounds like something we could all have the promise of (if we wanted it - that's a whole other thread) if we all paid £850 for it but we don't.

I can't advise you how to get an epidural within 10 mins, but I can help with privacy: you can ask at many hospitals for an 'amenity room' ie a paid-for, private room with your own shower and toilet. Not likely to be lovely, but at least private.

squiby - I am really sorry to hear about your dad. But I could counter with the story of my dad who had emergency heart surgery a few years back and has wonderful treatment.

No-one is saying it is perfect. But your initial post did rather sweepingly dismiss the whole of the NHS.

I gave birth in an NHS hospital in April and I was very happy with mine and my baby's treatment. The doctors and midwives were efficient and caring, though admittedly overstretched. Whilst it's true you don't get private bathrooms or any other 'frills' the basic care was totally fine and I had no problems getting pain relief or help with breastfeeding etc.

My antenatal care was pretty good: I saw the same midwife for all appointments and had three scans at 12 w, 20 w and 38 w. I also had a consultant appointment at my own request to discuss some concerns I had. Postnatal care was a bit limited (2 midwife and 2 HV visits after leaving the hospital) , but I could have requested more help if I had needed it.

The chances are you have nothing to worry about.

I had 2dcs. Both times I got
1 blood test early on,
then at each antenatal app, once a month, I got my bP taken and my bump measured. I never heard their HBs or got to speak to the gp regarding any questions I had.
2 scans, 1 at 12wks, 1 at 28.
I went overdue both times. The first time, I was given a sweep by the ob, without my permission. (he was later struck off for his behaviour in general)
2nd time, at no point did I see an OB who could even speak clear English.
I was induced, both times with no discussion regarding the options, I ended up with drips, massive stitches and severe bleeding.
I was told tO go home, when DS had untreated jaundice, had a belly full of mucous and hadn't fed for 2 days because he kept vomiting.
Dd had a paediatrician with flaking nail polish poke her finger into her mouth to check her palate,
I didn't get a decent meal in 6 days total in post natal, I had to order Takeaway,
And the ward was so cold I had to steal blankets from empty beds to stop myself shivering in the night!
Yes, I had 2 healthy babies, but my experiences weren't enjoyable, I was very young, and didnt know what should or shouldn't have happened.
Antenatal care here is not great!

Squiby, I think your dad's care identifies a particular problem - that the NHS is not designed for long term care for people with chronic conditions, but that it isn't entirely relevant to maternity services other than as an example of how openly people offer up their bad experiences more quickly.

It seems that mums-to-be in the UK want a more homely environment, calling for more midwife led birthing units as oppose to more consultant care. The statistics on maternal mortality are misleading unless you count how much fatter and older we tend to be with higher IVF rates, than countries such as Greece. Again, reading mumsnet only you would think being overweight leads to no problems ever, so it is a case of looking at figures or listening to anecdotes.

I am high risk, technically, and do receive very similar care to that which you describe - I think the kind of model that offers appropriate levels of care depending on risk (especially given how opposed most people tend to be to any intervention) is the right one for this country. I also think the idea that giving birth or even having a cs should entitle one to a private room is ludicrous, given that people who are seriously ill and having more major surgery in other departments get on just fine. One problem the NHS does have is that the healthier you are, the more you can find to moan about and sometimes policy is dictated more by what the slightly ill want that what the seriously ill need. Your expectations, in my opinion, fall into the former category and I just don't think that fear from reading the internet should dictate where NHS money is spent.

I am sad to say this, as I am grateful for the NHS, but for what you are looking for, OP, it sounds like you would be better off in your present country. If you do decide to move pre-baby, I would think again about a homebirth and do some research about it. I had 3 dc at home, and received excellent 1 on 1 care (actually, 2 midwives present at each of the births), courtesy of the NHS.

There is no way you are going to get that level of care on the NHS.

Usual service is - 2 scans, 1 at 12 weeks, 1 at 21. Midwife appointment when you are told to go, every 4-6 weeks. MW very busy, never more than 10 minutes per appointment and not really any time to discuss anything. Never discussed a birth plan or anything. Apparently you are seen once a week in the last 10 weeks - never happened for me. Hospital sent me home saying I wouldn't give birth for at least 24 hours, well I gave birth 6 hours later after second hospital tried to turn me away. Totally MW care, stitches done by MW. Left hospital 5 hours after delivery (my choice). Never saw a doctor, was discharged by midwife with GP referral.
Apart from the hospital trying to send me 30 miles away (would have given birth in the car as I delivered 15 minutes after arriving on labour ward) I was happy with the care received.
I think this is pretty standard UK care. Make of that what you will.

I had a wonderful experience with the NHS for both my pregnancies and deliveries. I had two home births, both with two very experienced attendant midwives. Also, if I had any worries during my pregnancy, one of the community midwives would come and visit me at home. But I wasn't looking for consultant/gynaecologist led care, so I don't know what kind of luck you would have with that here......mind you, the UK is no 3rd world country and has extremely low rates of infant/maternal mortality so I wouldn't fret too much!

Withwoman makes a really good point - if you want to achieve a natural, intervention-light, midwife-led birth then the UK is one of the only places that is possible in a safe, medical environment.
If your concept of good care involves heavy medicalisation, plenty of pain relief etc then the UK is not going to be as good as countries where births are usually doctor-run like the USA or Spain. I guess it's all a question of perceptions. Lots of Americans consider midwives as charlatans and think that homebirthing women are reckless because that's what their healthcare system sets them up to think. For lots of British women that's exactly what they want.

Oh, and I had to have stitches 2nd time. Done at home with local anaesthetic by a nurse/midwife with 30 years experience. I healed perfectly, and TBH I have rarely heard of botched stitches......

seeker I lived in Belgium and gave birth to DD1 there. In Belgium gynaecologists are the ones delivering the babies, the midwives are just there to support. I had private hospital insurance and didn't have to pay anything to the hospital. That was on top of health insurance that you had to take.
I had a very similar experience to OP with regards to giving birth. Very medicalised, only pain relief option I had was epidural, which I took in the end. Stayed in hospital 5 days in private room with DH.

We moved to UK a year ago and since I've been pregnant and gave birth to my DD2 in an NHS hospital. Sadly DD2 was born at 20 weeks after they discovered at 20 week scan she had died. I can't fault NHS care, they were excellent!

We are ttc again and are very much looking forward to a home birth! or hospital birth if needed.

OP if you want similar experience to where you are... stay put and save money to pay for it!
Or try to adjust to other ways of giving birth :)

Hi, Ive had two births in SW, the first was in MW unit in Malmsbury, and was lovely (at one point three MW cheering me on!) after I had lots of BFing help, was told I could stay until I was ready to go home (three nights) was routinely brought hot chocolate during the night, and given hugs when I was weepy. They were unbelievable.
The second was in south Devon, Torbay. The MW who I had had all the way through came when waters broke, cleaned the carpet for me (!), played with DS1 for ages, helped cook, rubbed my back..... then when time to go called ahead to unit and got them to dim lights and fill pool in birthing room. I got there, and was only one in unit that night. The room was lovely, with candles, music etc. She coached me through the tough bits, making me hold eye contact, and giving some tough love when I got panicky. She still hugs my little boy 4yrs later when we see her in town.
I think its about the staff, and the time they have. For me, the people and the experience they had made it amazing, and I was so so grateful to them.
Highly recomend Torbay.... its got excellent reputation.

The only thing I would say is if you want to weigh up the pros and cons of private versus nhs maternity care, check out the stats. Having a baby isn't just about the 'experience'. Have had excellent nhs care (in the SW) for both mine and wouldn't touch private for maternity. I don't think a pretty room is the most important thing.

If you can afford an in dependent midwife - then I would go for it. Its the only way of guaranteeing someone you know being there for you.

As this thread has a few overseas ladies on it, I would like to ask why so many countries do not allow gas and air? It is such a staple of birthing here! Any ideas?

Wow, I really don't think we know how lucky we are living in Europe.

I have just been reading about birth in Bangladesh and in comparison worrying about sharing toilets seems quite trivial;

pregnancyandchildbirtharoundtheworld.blogspot.com/2011/11/10-birth-in-bangladesh.html

For the record, I had three births in Bristol, at NHS hospital and felt very well cared for.

Thanks again for the advice!

eurochick - when I told midwives and foreign friends that we use gas and air in the UK they were bemused and could not understand why we would use laughing gas when in labour. It doesn't have pain killing properties, rather it is meant to relax you and make you foregt about the pain. Thus they think it is a placebo.

TENS machines are used here, mainly by expats, but other than that it is epidural or nothing.