Transfer to NHS for late pregnancy from USA

[mlhp]

Hi! We're relocating to London mid Oct when I'll 32-33wks!
Looking for all your advice and insight into transferring antenatal care to GP, NHS hospital, booking c-sec, etc.
I'll be relocating as a dependent on my husband's work visa.
Thanks in advance! Look forward to anything I can learn from you all

My fiancée is moving here from overseas while pregnant. When I spoke to the GP surgery, they told me that you self refer to a local hospital of your choice.

Regarding care under the NHS, as long as you have a valid visa and have paid the Immigration Health Surcharge, you'll be fine. If you haven't paid it, you will be charged 150% of the cost to the NHS.

Just a thought, will you be allowed to fly? Have you checked with your airline?

Also check your up insurance carefully, as if your baby is born mid flight, you may not be covered (there was a case in the UK where a baby was born in the US prematurely and the insurance company didn’t initially pay up, because the baby wasn’t covered, only the pregnant mum).

I would def call your proposed gp practice for advice and get on the case as soon as you arrive.
you may well get a c-section but the threshold for c-section will be lower here. As pp have said low intervention births are encouraged here. I never saw a doctor at all when my last son was born and only briefly when I had my first. That first time I had no pain relief other than gas and air (very common here, epidurals much less so)

while you don’t need to worry about care during birth you may find post natal care to be pretty chaotic. Several mums and screaming babies in the same understaffed ward is imminent, though in some cases you are able to pay for a private room. They also like to chuck you out as soon as possible, generally within 24h (sometimes much less) for a vaginal birth and not much longer for a CS. You will however get regular home visits from a midwife once home which is nice.

It doesn’t have to be that way though. Most of the big central London NHS hospitals do private maternity care, so you get all of the benefits of private care with none of the risks you’ve mentioned as you still have access to the NHS emergency facilities and NICU. I had mine privately at Chelsea and Westminster after moving from the US and the private maternity wing, NHS labour ward and NICU are all on the same floor. So win-win. US to NHS would be a big shock I imagine!

Imminent=
the norm!!!!

I am not sure why so many people are assuming the OP can afford private health care at the Portland! This is out of reach for the vast majority of women.

@mlhp hello OP. I can't comment a lot on registering (though this seems pretty covered already), but in regards to recent c-section they may well recommend going for VB over a repeat one. Not exactly the same situation but in September last year I had extensive surgery that has left me with the same cut and scar marks as csection plus some additional ones and I was really worried about birth (due Oct this year) and my GP/midwife were unsure. But gyno told me they would still try for vaginal birth in the first instance and that it may be safer given surgery would involve recutting through scar tissue and may be more complicated.

Does vary though Dr to Dr. Some prefer 18 months gap as my friend was told before they would consider another c-section. As PP said it may not be a simple case of electing for it.

Good luck OP and hope all goes well!

I'm British but live abroad. Loads of ex pats go to the U.K. to have their kids, just turn up for a couple or months and go back abroad afterwards. It seems that if you are (in their case, appear to be) resident in the U.K., not many questions are asked. The NHS staff generally aren't trying to catch people out. That said, of course you'll want to register and lots of people have posted good advice already about that.

(Before you just me: I came to the U.K. to give birth, but I didn't use the NHS (felt too much of a piss take)).

I did access NHS post natal care: visiting midwives and health visitors. I was up front that I'm not a resident but they didn't care: they said basically as the baby is in the U.K. they consider the baby to be entitled. I guess it's partially a safeguarding / social issue and very sensible approach.

You will find the maternity care in the U.K. different. Care is often midwife led (which I think is actually better). Water birth is allowed in appropriate circumstances (unlike in the US). Some areas support home birth. Our maternity system is less medicalised than in the states (although still pretty medicalised). So might be worth doing a U.K. based course like the positive birth company to get an idea what to expect. I think the general care is a bit stretched (e.g. you might not have dedicated one on one care throughout), but if there is a serious problem you'll be in great hands.

In London, there are also some free breastfeeding clinics and places you can go with your baby.

Good luck with the move, and enjoy your pregnancy!

Yes, important to check. British Airways let you fly up to about the end of 36 weeks I think (but obviously check the airline website!). I flew long haul at around 34.5 weeks, clutching a fit to fly letter, but no one even asked me for it

Don't worry OP. As mentioned in a previous post, I know quite a few people who have travelled at about 34, 35 weeks. It'll be fine!

I did this but at a slightly earlier stage. GP booked me in for dating scans and 20 week scans and I was dated slightly differently from the US. I remember feeling bemused when I asked for a scan photo and they brought out a rusty old tin and asked for a cash contribution towards the cost of the printing paper. The photo was rubbish anyway as the scanner was outdated. Quality of care and aftercare was great though. And nobody demanded my credit card at the door.

Under the NICE guidelines they now have to give you a C section as maternal request. Lots of incorrect info on C sections on this thread. However, you would need a referral to a consultant from your midwife. Timing wise that might be a rush especially if you went into labour early.

Thank you for the info! You’ve all given me and hubs a lot to discuss and prepare for. Wonderful insight. Much appreciation🙏🏼🙏🏼

Under the work visa you are definitely entitled to full NHS care just as any other UK resident. I would suggest referring yourself to a hospital of your choosing (you don't need to go to the one closest to you, you can choose whichever hospital) and registering with a GP at the same time due to time constraints. You will need to GP registration for later when baby will need shots etc plus elements of postnatal care. I live not far from North Finchley and I believe your closest hospital would
be Barnet. However I was choosing between Whittington and UCLH because their ratings are better and they are still not too far. Ended up going with UCLH and so far quite happy with it (they are actually especially meant to be good for c sections I believe). It would only be probably about half hour drive for you I'd assume so really not too bad

If you can afford it, there is a private wing at UCLH as well but you would probably be looking at 10-15k which it sounds like would be out of pocket :/

You have two main options here: Private or NHS. Private you need to budget at least £15-20k for esp if having a c-section. you may also struggle with getting on the books of some of the better ones that late but not impossible. this is probably more what you are used to in the US with a consultant taking charge etc

Otherwise the NHS can be great but you're not going to get the level of service and individual care you got in the US. From Finchley you probably want to look at the Wittington and the UCLH. both self refer. You have the right to have either a c-section or try for a VBAC if you want one. You will find it's much more midwife led and a lot less personal than you had in the US. if you go for VBAC you're unlikely to have a consultant on hand (obv you will for a c-section). You won't get epidurals automatically - you sometimes have to fight and wait a really long time for them. they will take excellent care of you in labour though but the aftercare is very hit and miss.

Great...you would be paying for care in the states why should you get it free here not having paid into the NHS C section is 15k cost to the tax payers
I'm sorry but you should pay not expect it free

Her husband will be working. The fact he has obtained a visa means he is doing a specialist job that the U.K. needs. They will contributing to our society, including paying tax.

Sorry OP unfortunately the U.K. has a bit of a problem with anti immigrant rhetoric at the moment. Most of us are lovely and welcoming, though!

Popping on to say you shouldn’t need to register with gp to register with midwives although may need to pop not yet registered in the box on online referral forms as usually it does ask for your gp, just search maternity services self referral online + the area. You could even get the ball rolling now in preparation by popping them a referral and putting in notes section that you’re moving in the next week or so over to their trust to avoid confusion. Especially as I’m unsure how transferable the information is with maternity care as I’m unsure if you have physical notes and I’m assuming the information they need here vs there would differ slightly so your first appointment may be a long one as they may have to go over typical booking in questions, birth plans etc if the information isn’t easily accessible to them via you being able to bring it with you. You should also be able to register with most gps online now and may also be able to do this now rather than once you move but may require NHS number which I’m unsure when you get if moving over and coming onto nhs.

You can definitely have another c section! Especially if you’ve already had one. And even then they have to listen to you.
It will be very different but the actual medical care is good. Pay for a private room after if you can.

You can request another c section! Had GD and that was massive factor in me having one and requested and was booked in for 38+5 with no battles :)