Using EHIC card for short term antenatal care in UK

[Anonapapple]

Hi all,
I am pregnant and living abroad in an EU country. I will be going home to visit family in the UK during the summer from my 9th-16th week of pregnancy.

Myself and children are registered with a doctor in my hometown, under my parents address. I last accessed care through my GP surgery just under 3 years ago (smear test).

I am officially resident in an EU country (have been living here since 2018) and am pretty sure I am not entitled to NHS care. I investigated private care and it's very complicated (compared to where I currently live).

I recently came across some info saying that you are entitled to short term NHS maternity care as a tourist using the European Health Insurance Card, which I have. From what I have read, I can use the card for this purpose up until it expires, regardless of Brexit. The clause seems to be that you cant use it to plan to give birth in the UK, but some continuation of antenatal care is fine.

Does anyone have any recent experience of having done this? What obstacles are in my way and can anyone think of an alternative if this doesnt work?

I am planning to have a private in depth NIPT scan and Harmony test at 10 weeks, which takes care of the '12 week dating scan' issue. I guess I just dont want to be pregnant with nobody to check on me and the baby to make sure everything is ok.

Do I access this care through the hospital directly, or should I just contact the midwife at the practise I am registered at?

I absolutely do not want to be a burden on the already stretched NHS, but all of my enquiries for short term private care have had so many barriers...one clinic said they cant offer me private care if I am not eligible for free NHS care. Or am I? I dont know! I am happy to pay for whatever care I receive but not sure how to approach this. If I can seamlessly access free NHS care through the EHIC that would be the best scenario. Any advice?

If you were living in the UK permently, then the only antenatal care you would be getting between 9 + 16 weeks would be your Booking visit and your 12 week scan. The Booking visit is mainly getting your baseline obs and bloods, and giving you information about your pregnancy and ensuring you are aware of your choices ad that any risks are identified in good time. So you don't really need a booking appointment. Most places won't listen to the fetal heart before 16 weeks routinely anyway because it can be hard to determine and can cause more anxiety. As you are having a private scan anyway, I would suggest if you have any worries or want reassurance during your stay, that you see the GP. They can check your blood pressure if needed and refer you for emergency care if you need it.
Enjoy your trip!

What care do you need? During those weeks it's just bloods and 12 week dating scan which can be covered by the NIPT. Any emergency you would go to a and e and they would advise if you need to pay

Do you get travel insurance?

As others have said, your only check in that time would be the 12 week scan. You wouldn’t get a check up in that period anyway so you won’t need extra care. If there’s a problem, go to A&E

As others have said i don't think there is any antenatal care at that stage other than a 12 week scan. It's been 13 years since my last pregnancy though so things could have changed

If your EHIC card has not expired, it can be used for emergency care. So if something went wrong, you would be covered. This is really not a good substitute for travel insurance.

The 12-week scan, if I remember correctly, needs to happen at a fairly specific time in order to measure for Downs screening. This is worth double-checking with your private scan provider, just to make sure that they will provide the same level of screening you would receive from an NHS 12-week scan.

Although previous posters are correct that there is little, if any care offered by the NHS in that part of pregnancy you are always welcome to contact a private midwife directly. Most of us offer one off appointments which can be very reassuring, An internet search for the area you will be in , or contact the Private Midwives organisation & they will find someone for you. You are welcome to PM me if you wish

I'm nearly 13 weeks pregnant - you won't see anyone for routine short-term antenatal care in that time. There is just your booking in (usually over the phone at the moment) around 6-8 weeks, and then your 12 week scan. After that, there is no more contact until a phone call with a midwife around 16/17 weeks, and a second scan at 20 weeks.

Are you thinking of emergencies? Your EHIC would cover that; but nothing standard. Or is there more care between those weeks where you now live?

You could pay for a private midwife but I don't believe they routinely do a lot at that point either.

You could get a private wellbeing scan if you wanted - they tend to be around £79 depending on where you are. They wouldn't do the screenings, but your NIPT will have taken care of that.

What care do you need? I was in your situation when I needed my 12 week /nuchal fold scan. I paid for it privately and gave my EU address without a problem.

I'm not actually sure what care I need to be honest. I had my previous first trimester antenatal care in the Middle East and felt like I had an appointment every month, so not quite sure what the deal is now. If all I am missing is the scan and I can get that privately, then I'm sorted! I just thought at 9 weeks there was the booking in blood tests and at 16 weeks there was another check up. I guess I could do that on week 17, where I currently am. Just dont want to be too blasé about it and miss something important.

My understanding is that the EHIC cards are solely for emergency health care. When I've been in Europe and baby DD had suspected pneumonia all care had to be paid for by me and then I claimed a large portion of it back via the UK govt (not NHS) but it took a long time to get the money back. The suggestion to contact a private midwife if you have any concerns is a good one.

@Anonapapple That may well be standard in the Middle East - not in England, though.

The booking in should be before 9 weeks if possible, you'd probably do that where you are now. It wouldn't be worth booking in here - it's more to get you on the system for everything else and meeting your midwife.

If you also do the NIPT where you are, then you'll be covered for the 12 week scan - but you could also get the private scan for less than £100, if you wanted to see baby around then.

16 weeks is a midwife appointment where you have urine and bloods taken, but they've only just stopped being phone calls where I am, and it's usually booked for closer to 17 weeks.

Then the 20-week scan.

For any emergency care, the EHIC would cover you - but everything above would be routine antenatal care so it wouldn't cover that.

You could also use a private midwife, as others have suggested, or opt for private maternity care - looking at a hospital near to me, it appears that they'll see you monthly if you prefer, and are happy to pay for it!

Travel insurance is going to be a must, too, I'd get that sorted quickly and attempt to get the best Covid coverage possible.

Enjoy your trip!

Just remembered that I also went for an emergency scan with my first pregnancy when I was visiting the UK and that was fine (although it took them a whole day to scan me!) I would suggest that you book privately for any scan/screening test you need around 12 weeks and then wait until you get home for anything else. Unless you need an emergency appointment of course, in which case you should be fine to use the NHS.

According to maternityaction.org:

The EHIC covers maternity care, including antenatal and postnatal care, provided the reason for the woman’s visit was not specifically to give birth or receive maternity treatment and the treatment is necessary before her return.

Is this not the case anymore? A recently updated expat website said the same, but I'm literally just checking to see if anyone had done it. The card is apparently not just for emergencies but for short term continuation of normal medical care, eg kidney dialysis. Think I will just get the private scan and be done with it!thanks everyone

Thank you so much everyone- in work at the minute so not had much of a chance to reply.

@Sussexmidwife thanks for your offer. Would you say I could get away with the NIPT in depth scan around 12 weeks that's I'm booking privately?

For some reason I thought I needed blood and urine tests done more regularly.

No. In fact, although my urine was checked, I cannot remember having blood tests in pregnancy after the initial booking in lot?

@Anonapapple so much depends on exactly how many weeks you are before you leave home and therefore what you have been able to get done there. Can you have the booking appointment and inital blood tests before you travel?
Re the scan, you don't need to be registered with the NHS to get a private scan. Timing is worth thinking about. If you are only just 10 weeks, sometimes there is not enough fetal DNA to give a result for the NIPT. Also the "12 week" scan is timed then because that is a time we can make use of the nuchal translucency (NT) as an indicator of issues more broadly than the NIPT does. The time frame we use in the UK for this is 11+2 to 14+1. Other aspects of physical development may also raise a question at just 10 weeks, and benefit from being checked at 12-13 weeks. I suggest you aim for a scan a little later than 10 weeks. There are plenty of scan clinics around that you can self refer to, but do make sure you go somewhere that offers medical scanning not just what are described as bonding scans . it is not required that you have any formal qualifications to set up a scan facility!

The booking appointment, including a review of your personal and family health history is important to identify any special factors which need care. Ideally get that done, and the basic bloods, before you travel. You may also want to have an early scan to check that it is a normally developing, single baby pregnancy.
I see my clients once a month in the early months, getting more frequent as time goes on. The NHS does much less, which is part of the reason I left because I feel the gaps between appointments are too long. Urine and blood pressure checks are important. The booking blood tests and consultation can flag up issues that need extra checks etc.
Everyone's situation is different, but I hope this helps

@Sussexmidwife it helps immensely! Thank you so much. Is it too early to get booking in blood done at 7 weeks? Thanks for the info about waiting until I am 12 weeks. The place I am looking at is a Babybond clinic but they are all qualified sonographers and have passed NHS standards. They offer the NIPT scan alongside the Harmony blood test. Yes I will have an early scan here at around 7 weeks. Where I am in the EU offers much more regular care than the NHS offers too.

How often would I need urine and blood tests?

Thanks again.

The booking in bloods are only looking for anaemia, infections.
NIPT is the Harmony blood test not a scan; the scan is separate - it’s usually just a quick look to see if the baby is growing. I had a private scan with the Harmony test and they didn’t do measurements for Nuchal Fold or anything like that. The Harmony is more accurate so you technically wouldn’t need a scan as well.

@Anonapapple booking bloods are ideally done before 8 weeks, so that is perfect! I test urine and check blood pressure monthly, the NHS in many areas doesn’t currently do it between booking and 20 weeks (sometimes not even until 28 weeks!)
If booking bloods are all normal, next routine one would be around 28 weeks. I suggest you discuss this with your provider where you are now & see what they suggest

Can't help with the pregnancy specifics, but it seems simplest and wisest to get travel insurance. You should also deregister with the British gp if they haven't already deleted you.

@Tibtab oh very good to know!
@Sussexmidwife thank you!
@murbblub definitely getting travel insurance for sure!