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?

I don't care if gas is a placebo: it did pretty well for me. And had the definite advantage that I was able to walk straight into the shower after giving birth.

I thought that was whole point! Relaxing you does ease the pain - if the pain is caused by muscle tension (ie the womb contracting painfully). I think that pethedine works the same way - muscle relaxant not a pain killer.

I agree - I would have loved the option of gas and air or pethedine as I wanted to try and do it without an epidural. But at 8cm I just couldn't go on anymore. I'm hoping DC2 won't be back to back!

Oh yes, G&A was amazing for me!

ToPushOrNotToPush, I am with you there - I am also from continental Europe and in my country the norm in childbirth sounds exactly like what you describe. In my country it is also normal to have a physio visit you for a number of weeks post-birth to help with things like pelvic floor exercises, recovery if you have an episiotomy, etc. Here I had to go private to get that level of care - consultant-led with the same obstetrician who then delivered my babies, blood test including toxo etc (which my consultant did as standard here), strep B testing, 5 or 6 scans as and when needed, one-on-one midwife assistance during labour and delivery, epidural and top-ups on demand, excellent post-natal care, private room and bathroom, post-birth follow up with obstetrician, etc. Luckily my insurance covered a big chunk of it. The outcome was that I had two vaginal deliveries, with epidurals but no intervention, two really good birth experiences, and felt I was getting the best level of care all the way through (and it's not about the "nice" rooms - it is a hospital after all, it's all about the quality of care). I have a number of European friends here who ended up going back to their home countries to give birth for the very same reason.

You can get international insurance policies that will cover private antenatal care and delivery even for vaginal births, but they don't normally cover 100% of the costs so you will still be out of pocket between £2000-£5000 with insurance (you may get higher coverage if you are getting it through work).

Thanks ToPush. It's odd that other countries don't consider it even if it does only work as a muscle relaxant. That sounds like a good thing if you are climbing the walls with muscular pain. As far as I know, it's cheap and low risk too.

"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."

Interesting thread... I get the feeling some people might be confused about what a midwife actually is, however. A midwife is never there "just to support" in a normal birth - she wouldn't ever call in a doctor to 'catch' in a normal delivery. It sounds as if people in other countries have had experience of labour and delivery nurses, and are unaware that this is a different job.

Ah, I stand corrected. I've just researched midwifery in Belgium and indeed midwives there just seem to assist the OB. Sounds like they are more like obstetrical nurses with additional responsibilities.

A lot of it is a matter of perception. My sil is Spanish, and she has such very different views on birth and maternity care to me that we could be different species! For example, she is convinced that our local hospital was criminally negligent ( she actually suggested that we sue them) because I was allowed to deliver ds vaginally at over 10lbs. Despite the fact that it was a simple, easy labour. She insists that I should have have had a c section at 38 weeks. She also believes that NHS hospitals are incompetent because they can't predict birth weights reliably. Apparently in Spain they are never wrong about a baby's weight.

Bue I think that midwives in other European countries work similarly to midwives in the private sector here in the UK. I gave birth privately, and although I had one-on-one care from my midwife throughout my labour and birth, and I had very straightforward normal births, she was there to support and did call in the obstetrician at the crucial moments (when I came in and to "catch"). She was extremely qualified and I'm sure could have delivered the baby on her own, but I opted for consultant-led care so that is what I had.

Oh I don't know how I forgot this one: EVERYONE in France gets 10 sessions of a kind of pelvic floor strengthening training regime with the MW after birth otherwise your womb pops out - really! They looked at me like I was nuts when I said I didn't want it!

Re. Gas & Air: absolutely unheard of in Germany. Tried to find out why, but all I seem to come across is that "it is not done any more" and "it crosses the placental barrier". I know it is more than common over here. Strange one.
But I have also learnt that a lot of things that are gospel in one country are totally unacceptable in others and yet babies on both sides survive quite happily....

This is really interesting. The NHS has many failings but when I had DD the midwives made what could have been really scary a wonderful experience. I'm so grateful for the kindness, frankness and care we received-and though there were times things weren't perfect, overall I felt very lucky to be giving birth in the UK.

If you feel like this is a private midwife an option for you? If so, you'll get that continuity of care you want (sorry - I haven't read all the other threads so I'm sure this has already been suggested).

I would also do your homework. I chose to go to a highly-rated midwife-led unit in a general hospital (so if anything went wrong the medics were only upstairs), and had a great birth experience as a result. It was my 2nd birth too and I had my first in the US, so I was a bit concerned about the different care available here, but I was very pleasantly surprised in the event. Midwives were great, very supportive and professional, birth was straightforward. I know you hear horror stories, but there are plenty of women in this country who also have great births. I did.

I'm an ex-pat and gave birth at an NYC hospital three months ago. I was actually more terrified about giving birth in the land of interventions and c-sections, and decided to go out of network with my insurance, swapped an OBGYN for a midwife (and you will not believe the number of people that asked me what a midwife does...) and had a fabulous natural birth in an in-hospital birthing centre. Had three scans12 weeks, 16 weeks and 21 weeks, fortnightly appointments until week 28, and then weekly appointments until the day I gave birth, after which the postpartum nurses were fantastic and taught me how to swaddle/sponge bath/breastfeed/change a diaper (seriously, I was clueless!).

Likely I will give birth at the same place, but I would not hesitate to have a midwife-led, NHS birth if I moved back to England.

oh dear. i hope you haven't been reading my threads op.

dd1 was born in germany by elective c-section (the ob-gyn decided at my 39+3 check up that it would be unsafe for me to give birth vaginally so i was booked in for elcs at 6am the following morning) - all fine, private room etc. stayed in for a week.
ds1 was born in canada (vbac1) really long back to back labour and really hard going, but 1-1 obs nurse throughout. ob-gyn suggested c-section in 15 minutes and i managed to get him out 5 mins later. i was in a complete state and had to stay in for 5 days, but he was fine.

dd2 is my nhs baby (in scotland) and they broke her. born on her due date and 9 lbs, vbac2 as there was 'no clinical necessity' for a c-s. she has cp due to birth hypoxia (not noticed due to lack of monitoring. she was born with hr of 28 bpm and no-one knows how long it had been that low. i had a student mw and her tutor/ mentor).

i would suggest my story isn't typical. that said, it was the same midwife that did all my ante-natal care, and she stayed on past the end of her shift to assist in the birth, so it should all have been perfect really...

and i would never go for gas and air again. it hurts your teeth because of all the biting on the stupid mouth thingy. (or is that just me)

OP: I too am from a European country and, unlike you, had a baby on the NHS. It is very scary, mostly because so much is left to the midwives, who often think they know much more than they do and make it difficult for you to see the ob-gyn. I have had plain stupid ignorant advice more times than I can remember- e.g.:

1. that heartburn was caused by eating gluten, why did I not stop all wheat products
2. that I had no clotting problems (having just told her twice I had trombophilia and was on aspirin)
3. that you cannot breastfeed while pregnant
4. that homeopathic tablets would help heal my scars/stitches (was and v insulted by that)
5. that my yellow, screaming lethargic baby was breastfeeding beautifully ( he was not and had to be readmitted urgently via a&e less than 18 hours later)
6. that having lost half my blood and not yet having been transfused, I should be walking about, looking after my baby and myself on my own as if nothing had happened Etc, etc, etc. The doctors, when you get to see them, are usually ok, but even on consultant-led high risk care way too much is left to the midwives.

PS I have seen one great consultant midwife and very competent Greek midwife: but 2 great appointments over two pregnancies isn't a great strike rate...

I think some people forget that midwives are more than just doctors assistants. I get a little sick of the midwife bashing on here, I'm not saying that many of you haven't had bad experiences, indeed some of you have but it saddens me that after three years training to do the job, midwives are discounted as 'stupid and ignorant' because of a few bad experiences, we're actually a highly skilled bunch who can save yours and your babies life.

OP, the birth you pregnancy and birth you describe probably isn't available on the NHS, yes we have dedicated anaesthetists for the obstetrics dept but they can still be busy in theatre, with elective or emergency cases, you would not have a consultant deliver your baby unless something was going seriously wrong (however if you did have a consultant it would be whoever was on call but the liklihood is they would come and see you afterwards because it's a bit of a rarity).

I wish you all the best but I think if your medical history lends itself then a midwifery led unit or birthing centre would be best, private rooms, one to one care, breastfeeding support, husband able to stay (in oirs at least. Good luck. MrsJRT

MrsJRT: I did not say the midwives themselves were stupid or ignorant but their advice was. If they had said they did not know and went and asked somebody who did know, I would have had no issue. But when you see obvious errors such as the ones listed below, it makes you wonder what else they do not know or are getting wrong. That is what makes it so scary: when you have seen so many errors or examples of bad practice you cannot trust that the next person will be any better. And pregnancy and labour are scary enough without having to add lack of trust in those who care for you.

Sorry, my mistake. I just hate it when we all get tarred with the same brush. Maybe I'm fortunate but I work in a large training hospital and work with some absolutely fantastic midwives, people who I'd trust with my life any day of the week, over the junior doctors etc. Yes we're overstretched and understaffed but I'd never answer a question I wasn't qualified to answer or make false reassurances I wasn't entitled to give.

In general I had a positive experience in France but I did have to fight to opt out of a lot, e.g. I didn't want scans at every appointment - monthly all the way incidentally, I saw noone between 36 and 40 weeks. Home birth not , 3 day stay and no private room until the last day because there wasn't space (but they wouldn't let me go home?!). The OB would have been whoever was on call too.

Norms vary from hospital to hospital and country to country. The NHS would have suited me better than where I am, but that's just me.

OP: Don't think you'll get anything of that sort on the NHS. Firstly you can't just opt for consultant led care. Secondly you'll see different people at every antenatal visit. The chances of you knowing the person delivering your baby are slim to none. Be prepared to have to wait quite a bit for an epidural, especially if the anaesthesiologist is busy.
I don't know of a single UK hospital with a no forceps policy (unfortunately).
Normally the midwife and not the consultant stitches you up post birth. Oh and forget about a private room with an ensuite. It's not going to happen. Neither can your hubs stay with you at night.

Like you, I prefer to have a consultant, all the scans possible, the security of knowing the person delivering my child, a 'no forceps' hospital, access to pain relief, the privacy of my own room and bathroom, and DH staying overnight.
This can happen if you go private, but it will cost around £7000 for a normal birth.
Go back to your home country.

Don't mean it like 'Get the hell out of uk' just that your country's level of care sounds very good, so go back there :)