We just moved from Houston, Texas (4th largest city in US) to Bentonville, Arkansas (pop 20,000). My 2 1/2 year old was born at St. Luke's Hospital in the Texas Medical Center, a cutting-edge facility to which patients travel from all over the world for various procedures. I had an incredible birthing experience there - I did not want or get an epidural and my female doctor was wonderful in being present and doing everything that a midwife normally does. I labored for 48 hours and a C-section was not in her plan.
I think in a large city like Houston, you can easily find whatever kind of birthing experience you might want, and hospitals like St. Luke's are not "maternity ward" experiences. All manner of support options are available. In a small town like this, however, my insurance has greatly limited my options - the midwife in this area, for example, isn't covered; all female OB/GYNs who are covered by my insurance are on "rotating call", which means I would be seeing one of them throughout the entire pregnancy and then probably finding one of their male colleagues in my hospital room at the hour of need; Of course, their practice encouraged me to see all 8 of their doctors - 6 of whom were men - and I said "no thanks." Even here though, I got in touch with a doula who recommended my current doctor, who doesn't do "rotating call." Unfortunately he's a man, and this made me nervous at first as I've never before this had to have a male OB. However, he has an excellent bedside manner - gentle and professional. I have the option to hire a doula for the hospital - but since I've been through all of this before, having my dh with me should be enough.
If I am able to find a doula for support here, there should be one almost anywhere in the US. If anyone is worried about having the "Maternity Ward" experience, they should definitely enlist the help of a doula - if only for peace of mind.
There are only two things about the US birthing experience that have bothered me - one is the practice of waiting until a woman is in her 11th week to schedule a visit for her with an OB. As if the foetus isn't even real; as if the systems weren't all forming! A little guidance, please ... they might do it that way b/c 1/5 of the pregnancies end in miscarriage before that stage; I don't know. But very frustrating while you're waiting for your "ghost" pregnancy to become "real"! Is this done in the UK??
Also, this business of rotating call is new to me - wasn't done in Houston, but is apparently common in other areas. Very emptionally difficult, I would imagine, to see one doctor the whole time and not know if they'll be delivering - or to have to get to know all of the doctors in a practice so you'll know the face who walks in the hospital door.
But even here in Bentonville I don't anticipate anything near the type of experience you saw on T.V. (And what are you doing watching those scare tactic shows while pregnant anyway? I have to say, before having my first, they only made me more and more nervous, and for nothing as it turns out!)