What an interesting discussion on pregnancy care! I have been comparing a lot since many friends are pregnant in Italy at the mo.
But before I go general, let me answer MM's very precise question. The advice I have had from my maternal medicine consultant in the UK, from his junior (what are they called here? In Italy it would be an aiuto- mid-level specialist) and from my GP is to have the swine flu vaccine as soon as it is available. See here for the reasons. I have already had the seasonal flu vaccine and am on the priority list for the swine flu one- but my surgery does not have it yet. Received exactly the same advice in Italy from, amongst others, the head of infectious diseases at our local university hospital, neonatologist (if I am protected, baby gets protection after birth and for as long as I breastfeed- helpful as s/he won't be able to be vaccinated before 6 months) and various assorted other doctors (whom I see for social /family reasons- not because I am a hypocondriac!).
On pregnancy care: mine is a high risk pregnancy, so, even in the UK, they are keeping a fairly close eye on me (5 scheduled scans rather than 2, plus two extra ones in the early months when my GP was concerned). Also, I am followed by the high risk team at a major London teaching hospital, so I guess my experience is not typical. The care I have is excellent and every little concern is investigated BUT I too have noticed the more laissez-faire attitude here in the UK.
For example, on weight I was asked my weight at the booking in visit (the earliest they had ever done, at 4 weeks 6 days) and then never again. The dietary advice was "try to eat healthily, avoid [long list of things]". Yesterday, at 29 weeks, I asked the midwife whether it was ok to have gained almost 9 kilos by now and the answer was "baby seems to be growing fine, so yes". I was concerned I had put on too much, she thought I was worried about too little. I guess that, since most of the other women in the waiting room were frankly obese, or at least overweight, they do not worry too much about those in the normal range like me.
What I do find a bit annoying here is the "get on with it" attitude (maybe I am one of those delicate flowers MM does not like??): whenever I see the English midwives and ask about one of those pregnancy "discomforts" that actually have quite a negative effect on your day-to-day life, the answer I get is a variation on " Yes, it happens" with no suggestions on how to avoid it happening. Fortunately most of the time I see a doctor- who does offer solutions- or Greek midwife (working for the NHS) who is more sympathetic and does have helpful suggestions. Practical example: I have pelvic girdle pain that is on some days quite invalidating. English midwife at week 16: "Yes, it happens, it will probably get worse. Nothing much to be done" [does not even consider it worthy of my notes]. Greek midwife at week 20: "I am so sorry to hear that- it must be quite painful. Here is a referral for the physio, make sure you get an appointment this week and let me know if you do not."
Comparing with Italian friends, it seems to me that care from specialists is more or less the same (as it should be, if they practise evidence-based medicine) while at the midwife/GP level the UK attitude is more laissez-faire and "get on with it". With the obvious difference that in Italy almost everyone is under the care of a specialist for most of the pregnancy.
On the recurrent miscarriage point that one of you raised, I think it is an example of how the UK approach can sometimes be hard on the woman. A friend of mine (with one child) had two miscarriages fairly close to one another and difficulty conceiving no. 2 and was quite bluntly told by her GP that nothing would be done to look into the miscarriages before she had had 3. Friend in question already suffers from anxiety that is serious enough to be pharmacologically treated and was quite upset. Doctor friends in Italy to whom I mentioned this were quite surprised as, they said, there were fairly simple investigations that could have helped, and the psychological impact of difficulty conceiving and miscarriage is serious, so it should have been looked at earlier, in their opinion.
Maybe it is a problem of money (NHS does not have enough) and of the rationing that has to follow, coupled with the British stiff upper lip...
And in Italy there is a lot of difference between North and South: Caesarians and interventions generally much more common in the South.
On the other hand, as many of you have said, maternity is very well safeguarded in Italy, the rules sometimes get exploited (with a negative impact on the employment of women of child-bearing age) and often Italians do not realise how good they have it.
I was stunned when a few days ago a male Italian friend was complaining that wife only got 80% salary for 5 months of compulsory maternity leave and then 30% for the next six months. He thought this was terrible and very harsh on families, state clearly does not care, etc. I explained about the 6 weeks at 90% and 39 weeks at more or less £120 a week in the UK- and no pregnancy at risk provisions- and he was then a bit less annoyed about Italy. Note that his wife was put on pregnancy at risk at 8 weeks (pregnancy actually normal, but she works with the mentally ill, ob/gyn concerned about stress and about patients assaulting her), so she had 5 months pregnancy at risk (I think on full salary), 5 months at 80%, 6 months at 30% and then still was able to take aspettativa for another bit if she wanted...
Sorry, long rambling post, but I think you get the gist. Off to get some Gaviscon for the mid-afternoon heartburn (another one of those things for which the English midwife said "get on with it, maybe have some milk"- which is advice about 30 years out of date and actually makes it worse, for reasons which I can go into if anyone is interested- versus kindly Italian doctor who was adamant I should treat- with Gaviscon- to improve quality of life and avoid problems with esophageal lining).