Pregnant and moving to the US - help needed!

[timecop]

Title says it all really! My husband has got a job in Colorado and we are due to move at the end of September, when I'll be seven months pregnant. We have no idea how the antenatal/obstetrics system works in the US and could really do with some pointers. Ideally I'd like to get in touch with antenatal care providers etc before we go but don't know where to start. Any suggestions? Insurance is all in place and we've checked that the pregnancy, birth etc will be covered. So what now?

All antenatal care is great in the USA. They're way more open and honest and respectful of your wishes. There are very few midwives, though. Doctors and nurses. Is this your first or will you have other school age children?? Cuz u need to connect w other mums, so either at school gate or just go to your local park and go up to strangers. You'll be amazed at how friendly and open everyone is...and what a great excuse to start to make new friends. Where are you going in Colorado?

If you've got the insurance aspect covered, you'll be fine and I believe you'll find your treatment very different from what you'd get here; Kaelle is correct in her characterisation.

What you'll do is find an obstetrician within your insurance network, make an appointment and go from there. They will be able to answer most all your questions, provide you contacts with support groups, etc. You'll have options for hospital birth or birthing unit, but midwifery is actually illegal in some states, maybe not in Colorado.

Best wishes!

The typical way the US system works is that you contact an obstetrician and they take over from there. There will be loads of OBs offices, and you can visit several and 'interview' them.

Your choices depend on your insurance coverage. Will you have expat insurance, where you can use any hospital, or will it be an HMO which is restricted to specific hospital groups? You need to know this before seeing OBs.

Basically, the OB will do your pre-natal care, and meet you in the hospital when you are in labour to catch the baby (L&D nurses care for you in first stage). You stay in hospital for 1-2 nights and see your OB again for your six-week check. You should be able to have all your well-women care at your OB office. Some OB offices have a certified nurse-midwife (CNM) on staff who can provide all your routine care, and deliver your baby if there are no complications.

When you have chosen the hospital, there should be a tour available so that you understand the checking in procedures and the choices available to you.

You will need to sort out a paediatrician for your baby. If you don't take your 2 nights in hospital, you take your baby to see the paediatrician ASAP, and definitely at 1 week. The paediatrician will give you a well-baby schedule for you to come in for weighings and vaccinations.

It can be helpful to find a family health clinic where you have all the specialists under one roof, all compatible with your insurance system, but this is not necessary.

You should be able to make preliminary enquiries before you go.

Thanks so much everyone, that's really helpful. My husband's job is in Broomfield CO so we're looking at houses there and in the towns/villages nearby. This will be my third baby and the birth needs to be a caesarean because of complications with the previous two. So, looks like my first step is to start looking up obstetricans in the Broomfield area, check compatability with insurance and then have a ring-round. We plan to go out househunting next month so maybe I can arrange to meet up with some then. Thanks: feel more positive already!

While we're about it, I don't suppose you have some tips on the olders DCs? DS will be 5 in September so we're looking for kinderkartens for him. DD is 3.6 - is it normal for kids that age in the States to do preschool? She goes to one here at the moment but it seems harder to get a handle on what's normal in the US. Also is kinderkarten (and pre-school) usually for a full day or a half day? As you see, I have loads to sort out! Thanks for your help :)

Be very careful of how many tests you want to submit yourself to.

GTT is routine, as are frequent general bloods and GBS swabs. Your baby may not be allowed to stay with you in the recovery area; they're mad keen on whisking them off to the nursery for a bath. Eye drops at birth may also be compulsory

You will need to see a paediatrician ASAP for your older kids. It may be state rules for your kids to be tested for TB before entering school. They will also need to start Hep B vaccinations (a series of 3) and have the chicken pox vaccine. You need to see your practice nurse here and get her to give you a printout of the vaccinations they have already had, and any photocopies of relevent medical records (eg if you took them to the doctor with chickenpox.). Basically, your children's paediatrician has to sign off on them enrolling in school.

It is fairly normal to do pre-school but not universal. These are private and run from age 3 half-days for 3 or 4 days per week. They are often run in churches.

Have a Google to see if your prospective neighbourhood has a Newcomers' Club. These are wonderful organisations that see you through your first two years. They should have playgroups, as well as adult groups. If you get in quick, you might get new mom meals delivered after you have your baby.

With your Caesarian, try to take a copy of previous notes with you, or at least write down the nature of your complications. It can be quite hard dealing with obstetricians when you are used to midwives, and they can really treat you more like a walking pelvis rather than a healthy woman with a brain. If they pressure you into having tests you don't want, ask them for reasons or say you want to think about it. Nothing is compulsory and they will treat you with respect if it is clear you have thought things through. The protocols of the ACOG are actually very broad. A lot of hospitals are "baby friendly" where rooming in is the expectation. If your baby is a boy, be prepared for the circumcision talk and make it very clear - in writing - of your wishes.

Thanks again, this has given me loads to think about: it never occured to me that we'd need to get the kids registered with a doctor before we could sort out their schooling. Looks like getting a family health clinic might be a good plan and setting up some meetings when we head out next month. Also, really good to know about the rooming-in issues: I'd hate my newborn ro be whisked away to a nursery. Looks like I'll have to be really clear in my mind about what I want before I meet anyone. And the newcomers clubs look really reassuring - will be good to get and out and meet people at the beginning I think. So, all great advice. Thanks. I'll be back with more questions soon, I'm sure!

If you are just there for a few years, you definitely want to hit the ground running with making friends and getting involved.

Let us know when you have more questions.

Are you using a relocation agent to help you find a house and other logistics? They help you to find and view houses, sign contracts, hook up utilities, help you with school registration, hire cars, help open bank accounts, organise a limo from the airport, etc.

If you are doing these things yourselves, you will have quite a few more questions.

You asked about kindergarten.

These are usually half-days, either morning or afternoon. There may be a full day program in your school district, but you will have to pay for the extra hours.

Most kindergartens are part of the elementary school, so you enrol via the school district office and can have a meeting with the counsellor to go through you documents (visa and medical, and any school report you might have from the UK).

It is really important to find a house in a good school district. There are online league tables for school districts as well as other ways to assess this. You are guaranteed a place in school when you are resident in the school district, but you can't really choose the specific school, and they will provide bus transport if it is over a certain distance from your house.

Hopefully you school district will have a good website, where you can read the parent handbook and get a good handle on things before you go. Primary school can be a real social focal point for mums, with the expectation that you will come in and help out. There will be a couple of super-organised "class moms" eager to get you to fill in your spot on the rota. The good thing about starting in kindergarten is that most moms will be new as well.

Perhaps you have already done this but -- check with the airline you will be taking out there for their rules on pregnant women flying. For transatlantic, some cut off at 6 months, so you want to make sure you get out before then!