Giving birth in the US vs UK?

[Fannibal]

DH, the DC's and I will be moving to the US at the very beginning of April (visa approval pending)

I will be 29 weeks pregnant with DC3 at this time.

Does anyone know how different the whole process of labor/delivery is in the US, anything I should be aware of or things they don't offer in the US that they do here? Obviously aside from free health care!

I'm really nervous about it, my biggest fear being my sister not flying out in time and having to give birth alone as there will be no one else to look after the DC's.

Any advice, experiences would be really appreciated

I find it offensive having my country and also my place of work (an NHS hospital) compared to the 3rd world. That is all.

I've had two babies in the US (will a third in June). I don't have "great" insurance, just decent.

Private rooms both times. Good food. (Dietician called me from the grocery store to ask which gluten free bread I liked :o) Sterile bathrooms with tubs I could labor in if I wanted. No stirrups. I was overdue with both and a C-section was never mentioned, nor was it when DD was sunny side up and wouldn't move.

I had epidurals but there are other things they could do. No G&A.

My town is small (less than 2000) and I still could have chosen a midwife and a home birth if I'd wanted. I was considering it for DD but I loved my obgyn so much that I went with the hospital.

Not sure if it has been mentioned upthread but you may be offered Pethidine in the U.S (as apposed to gas and air.) During delivery, Pethidine made the baby & I a bit doolally. I ended up taking photos of the whole situation instead of concentrating on pushing, my husband had to have stern words, and I joined back in with the whole proceedings but upon delivery, baby needed an antidote.

Well I've given birth in both countries and here's my comparison:

DS - Scotland:
Pros:

• clear, standard system, no need for me to chase stuff up, was just in one integrated, transparent system from the beginning
• no attempts to push treatments on me

- free at the point of use - midwife coming out to do home visits for first 10 days was very reassuring

Cons:

• saw about 7 different midwives through pregnancy, no continuity of care

• no relationship built up with one caregiver who knew me and history

- unsympathetic hospital staff, arsey attitude to new mothers apart from one lovely Irish midwife who was old-school - no choice, assumption that patients are uninformed and need to just follow NHS procedures, not ask questions - whole childbirth system infested with the NCT pro-natural birth agenda which did not suit me. Would have been great if I wanted that type of birth but I didn't.

DD - USA (and yes, she is automatically a citizen)
Pros:

• great relationship with my OB-GYN who came in off duty to deliver my daughter, Stanford trained and really expert at her job. She was very professional and competent.
• great insurance covered everything, nothing to pay from us except for a few hundred dollars

• on tap expert medical care, no questions asked

- lots of choice, coukd have had midwife led care if I wanted (my friend did) or could have had elective C-section, totally up to me - great follow up care with pediatrician for DD - much better postnatal care in the hospital, thorough checks, caring staff etc.

Cons:

• a bit over the top on medical tests and screenings but that suited me as I'm a worrier
• bewildering bureaucracy, everything was down to us to follow up and join up all the different systems. Hospital didn't have my records for example even though I had registered with them in advance. Very hard to get clear view of what was going on.
• mainly great because I had great insurance. Would HATE to go through US system without good insurance.
• bias towards OB-GYN led care which suited me but if you are of an NCT-type mindset you would probably hate it.
• postnatal care much better in the hospital but afterwards it was up to me to be proactive in accessing care

My care when I had my DS (no insurance) was no different when I had my DD (decent insurance), both in the US.

It was a bit more rushed but that was due to the size of the hospital (large one in bigger city vs tiny town where I was treated like a celebrity due to being the only one giving birth.)

I had no insurance (public patient) for one of mine too, Cheerful, and again, there was absolutely no difference in the level of care or where in the hospital I delivered or stayed afterwards. I had the same pristine ensuite bathroom and same nice food and kind staff.

Heya, I also moved to the U.S. at 35 weeks pg for my husbands job. I coordinated carefully with his company's HR/benefits administrator to ensure that I'd be covered by insurance at wheels down in the US. She was very helpful also in finding me a doctor ahead of time so that I already had an ob/gun and hospital for delivery upon arrival. I suggest you do the same if possible.

Because the health system here is all privatized, you have loads of choice but be aware that not all practices/doctors will agree to take you on at such an advanced stage of pregnancy so that may limit your choice, which is why it's good to have it sorted ahead of time.

Re: citizenship - yes your child will gain citizenship by virtue of being born on US soil, and at age 18 will be responsible for the universal tax implications that it entails. You'll also be able to get him/her UK citizenship via the British Consulate.

Thanks all. Had a chat with the lovely HR woman and the insurance seems quite good (expensive but good). Everything will be pretty much covered.

So now just waiting to see if our visa gets approved. I don't know how often or for what reason this kind of visa would be rejected but there's always a chance it will be I expect. I'll just have to hope for the best! .

Thank you all again

A point above about private rooms- I'm really puzzled as to why they built all these new nhs maternity hospitals but then didn't make the rooms private!

How are new mums meant to rest when you are sharing a room with 5 screaming newborns?

Totally agree. The last time I got 9 hours of sleep with zero interruption was the first night after DS was born. The following night they wheeled him in for feeding!

It's such a simple difference that has a huge impact. Also huge water jugs you could drink from that were kept topped up. Obn instructed nurses that I was to have warm lemon water to prevent constipation. I was very impressed at the nursing staff also taking the initative to then suggest menu items that would be better for me. Who knew black coffee was a laxative?!?

At our hospital (NW England) the midwives used to take fractious babies out at night :)

I've always been given topped up jugs of water regardless of the reason I've been in hospital! The food has never been much to write home about mind. Now, in a private hospital, a friend (who follows a special diet) had a chef who used to come every night to plan her meals!!!!

There's an excellent documentary on YouTube called 'the business of being born' which is all about how birth in the US is designed to be more convenient for the medical staff over the needs of the mother, and essentially most cost effective rather than conducive to a problem free experience... it's quite hard hitting but also shows the resurgance of midwifery, homebirth and midwife led birth units, and they do look very good, similar to the U.K., though I have no idea about insurance and what you can get covered. It might help give an overview for you of the system anyway x

SnailsInLove I love that documentary and think it's excellent and I'm sure a completely accurate depiction of some parts of the country.

But it was in no way my experience.

I have seen that documentary too and have the same comment as Cheerful.

Glad to hear that, some parts of that doc are enough to give you nightmares! Though did introduce me to the wonderful Ina May Gaskin, reading her guide to childbirth at the moment and its amazing

Have three of my four here in the US and it is very state and hospital specific, here in Alabama home birth and midwives are illegal, a lot of my friends drove twenty minutes up to Tennessee to have natural labour and midwife care. I had all mine that were born here naturally, one two weeks early, one two weeks late and one on time, no talk of C-section at all, I had a range of pain care options if I had chosen them, nurses and doctors were fabulous, the only problem for me was that after three and four I wanted to go home by the next day and they wanted me to stay four days (7 days in Germany!) I ended up signing myself out "against medical practice advice" Check with others in the state where you will deliver and take tours of the possible Hospitals in your area to make yourself more comfortable with the situation. I know this is number 3 for you but I would also enroll in a pre-natal class to learn the terminology and meet other women who you can get advice from. Most women labour in a labour room and then have a private or at the most two sharing in a room, which is different from the wards in Europe. Husbands can stay in the room if you want them too for the whole stay. They don't cater well here to special diets (Im veggie) so you ay want to bring food! There is always the choice of having your baby with you or taken to the nursery so you can sleep, mine never once left my sight ,they even bathed them in the room so I could be there, but I have friends who want to sleep off a heavy labour so they are rested to go home and love the nursery option. Meds given after birth are state specific too, just check before hand to be comfortable with what is going on.

I've had a child in the UK and the US. Both experiences were pretty good - and food was dire in both! Circumstances were different, DD was a vaginal birth in London, DS was an emergency c-section in DC. The only thing I didn't do in the US was have the eye solution applied to DS as (1) I knew I didn't have an STD and (2) he didn't come out vaginally, so there was no risk anyway. I had to sign a lot of paperwork/waivers.
I think it's very hard to compare as there can be so many variables. I'd certainly second genning up on the terminology. In the DC area, there's a group called PACE, which is the closest thing to NCT I could find. Lamaze was all a bit too airy fairy for me.
Post birth, many US women go back to work very quickly so initially I struggled to find American friends with children of the same age. Library story times and so on would be full of nannies. Consequently, I have a lot of expat friends, which sort of seems a shame when we are here living in the US.
You will be fine wherever you are. My insurance copay was $20 for the whole US thing, so pretty bargainous! Real costs were around $45,000 so def check your coverage. There's a lot to be said for a system that's familiar but if I had to do it again, I think I'd prefer the American way. Maybe I'm just used to it now but I never once felt rushed, they scrambled together a c-section team from nothing at 3:15am on a Sunday morning and DS was safely delivered at 4:25. And my OB/GYN is almost like a friend now - she's roughly my age and we always have a chat when I go into the office!