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Pregnancy

Talk about every stage of pregnancy, from early symptoms to preparing for birth.

Moving back to UK at 30 weeks

15 replies

RedJeans · 06/02/2020 11:13

Hi all,

I'm currently 12 weeks pregnant and living abroad in Asia. We are due to move back to the UK mid-June when I'll be around 30 weeks and I had been fairly blasé about just turning up and asking to give birth somewhere as this is my first baby and I have no idea how the whole birth thing works!

I've just been reading some threads about births at Kingston hospital as we are planning on moving to South-West London and it seems that you can't really just pick where you go and that hospitals might be full, so feeling a bit naive Blush

Anyone have any idea what I need to when I get back and what my choices are likely to be?? Or has been in a similar position? I'm guessing that in the moment, a hospital would have to let me give birth somewhere if I rocked up in labour but obviously would prefer to have a plan and some pre-natal care in place.

My doctor here is fab and is aware of the situation so will be preparing my notes etc for me in advance.

Thank you for any responses!

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1Micem0use · 06/02/2020 11:25

I arrived back from South Korea at about 6 months pregnant. Went to sign up to the doctors and said I was pregnant, but nothing will be on the system as I've just returned from living abroad. They booked me in an appointment really soon.
You'll need to show proof that you're back to stay for good, or they'll charge you for nhs care. Even if the paperwork side of things takes a little while its illegal for them to deny a pregnant woman care.
I brought a copy of all of my medical notes translated into English, but they redid all my blood work anyway.
I found the midwives were fascinated, asking questions about how the healthcare was in S Korea.

RedJeans · 06/02/2020 11:39

That's so useful, thank you! Do you remember what you had to show to prove you were back for good? I'm not sure what our living situation is going to be, worst case scenario we'll be living with parents but I'm really hoping we'll have our own flat sorted fairly sharpish... We have UK bank accounts still open so I suppose I'll have statements?

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Pollaidh · 06/02/2020 11:47

When you arrive in the UK you will need to find your local doctor / GP and register with them as soon as possible. You may find they have overlapping catchment areas so you can choose between 2 or more different GP surgeries, especially in London. You could try asking neighbours what the GPs are like, or how many appointments are available. It's quite common in the UK to wait 4 + weeks for a non-emergency appointment. If the surgery has multiple GPs you lose the continuity but there may be more flexibility.

Once you've chosen one, (and make sure it's NHS, there are private GPs in the UK, especially London, but unless you are seriously rich, they're not an option for every day care, and private health insurance doesn't usually cover them) then go into the surgery, ask the receptionist if you can register. Take along proof of address, ID like passport, and in this day and age, anything you have that proves you have a right to free treatment here. NHS number would be useful if you've had one previously.

As soon as you are registered ask for a 'booking in' appointment with the midwife, and explain you are 30 weeks and have just moved to area. Hopefully you should get an appointment quite quickly - preferably within the week. Take your partner with you as they may be asked lots of questions on family medical history.

Maternity care is usually midwife-led, assuming there are no more serious issues, with you seeing the community midwife at your GP surgery, increasingly frequently as you get close to due date. You'll probably be sent for a scan and they may want to redo tests like bloods, glucose tolerance etc.

If you have any serious medical problems, or the pregnancy is complicated (multiples, previous issues, diabetes, heart issues, anything picked up in the scans) then you will see both a community midwife and be referred to either the nearest hospital, or possibly a specialist hospital if required, to be "under" an obstetrician and specialists from any relevant medical areas.

If you have an uncomplicated pregnancy then your birth options are:
(1) at home, very popular in the UK, you can hire pools, the midwife brings gas and air which is the UK pain relief of choice in labour. You may be able to get pethidine too at home, not sure, but if you'll want an epidural then you'll need hospital. Usually you'll get 2 MWs during the labour, and if things aren't going well you'll be transferred to hospital - local or specialist depending. You won't necessarily have met the MWs before, it's difficult to get continuity except in rural areas or if you pay for a private MW but NHS birth.

(2) midwife-led birthing centre - a halfway house between home and consultant led birth. Again for uncomplicated pregnancies only. You go when in established labour, and a midwife will deliver your baby. They're usually attached to hospitals in case a transfer is needed, but they tend to be a bit more relaxed and about non-intervention. Birthing pools, gas and air, not sure about more advanced pain relief.

Or there is Hospital care. Can be either for complicated pregnancies, or because you prefer to be in a hospital. Advantages are consultants and doctors ready to assist with forceps, c-section, epidural etc and paediatricians ready to help a sick baby, disadvantages are that it can be more clinical and a less natural feeling birth experience, and may lead to more medical interventions. There will be birthing pools and gas and air still and with careful planning you can still have a relaxed birth in a hospital. Your MW will be able to advise on which hospital you will be going to.

Hospitals try to keep the number of c-sections down, so generally you will only get one if medically required - either in an emergency or because of complications identified earlier in the pregnancy.

Worth knowing that in the UK pregnancy is calculated from the date of last period, which is different from some countries. You are classed as 'overdue' from 40 weeks since last period, and at 41 weeks they usually intervene. This is different from other countries.

Culturally, and especially in London, there's been quite a movement towards natural births. It's not standard, as it is in say France, to give most women epidurals, though you can request them. You usually start with paracetamol, then gas and air at hospital and a birthing pool/bath, then possibly pethidine later. French woman I know find this barbaric!

After the birth if you and baby well you are both well then you might be discharged the same day, or next morning. It's unusual for people to stay in more than 3 days unless there are serious complications. Then a MW visits you at home the first few days, and then switches to a health visitor (nurse specialising in babies and families in the community). You'll have a "6 week check" of your health at GP or possibly in hospital, when baby is 6 weeks old.

Join a local NCT course (book well in advance) to meet people in your area who are also having first babies, you get trips to the labour wards etc too. Hypnobirthing is very popular and works well.

You can go private but the costs for a full private birth are extortionate - It think it's in the tens of thousands. Private Health Insurance doesn't cover maternity care.

RedJeans · 06/02/2020 12:02

Thank you Pollaidh, lots of useful information!!

I may actually still be registered with my GP in Twickenham as we only left 2 years ago but were not sure if we'll be back in the same exact area so I suppose I need to re-register with a new one.

I think I'm most worried about not having a flat sorted until really late on and then not being able to register at a GP without proof of address and then not being referred to a hospital... Again, worst case if we're still living with parents I could register there I suppose. Do they let you transfer hospitals?

What would happen if I turned up really late on? Would they still need to sort me out and would I get much choice on the hospital?

Sorry for all the questions!! No one I know has been in a similar situation!

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Pollaidh · 06/02/2020 12:17

I'm not sure about in London, to best to ask at whichever doctor's surgery you register at. Btw the NHS did a big clear out of old patients from surgeries a couple of years ago - sent letters out and if they didn't hear back within a certain time they took you off their lists, so you might not be on the old GP's list.

I think you could use mortgage or letting agent letters as proof of address. Not sure about transferring hospitals. I suspect if you had a reasonable amount of time left you could register at another GP and then get referred to whichever their usual hospital is. In an uncomplicated pregnancy it wouldn't be a major issue.

If you've any complications and need consultant-led care, or arrive very late, then you might be better sticking with your parents' surgery and, assuming you can travel quickly to that hospital, staying with that hospital. But then you'd have issues with the MW who comes after birth, because you might be out of their area. It might be an idea to actually phone maternity ward of the likely hospitals - the one near your parents and the one near your new place, if you know which part of London.

It is probably reassuring to know that if you go into labour and are shopping the other side of London, on holiday etc, then either you are ambulanced to whichever hospital is nearest, or you might be able to phone the ward and turn up. You will have a massive file of NHS maternity notes you start to carry with you everywhere as you get late on in pregnancy, and you'd need to carry your hospital notes from the other country too. As long as you turn up with your notes, in an emergency then they won't turn you away.

Typically your hospital is decided by area - so which GP surgeries refer into that hospital, and also by specialty. So if your baby was showing a heart defect on a scan, you would be under both your local hospital and the specialist heart hospital, and it may not be decided until very late on, whether you need to give birth at one or the other, depending on how high the risks are.

London is a slightly odd case because there are so many hospitals, and the big ones have specialties for trauma, heart, respiratory, stroke etc. More and more people with serious problems are referred to the specialist hospital as outcomes are better, even though it's less convenient. In a normal pregnancy you would expect to go to the nearest hospital with maternity wards; any complications and it would depend on how severe.

Sorry I can't fully answer, too many factors to take into account.

Pollaidh · 06/02/2020 12:20

P.S. Even if you turned up in an emergency without your maternity notes, they obviously wouldn't turn you away, but it'd be riskier because they wouldn't know your history. Don't expect GPs and different hospitals to actually share notes! The IT isn't up to that in most cases, so those paper maternity notes are the only place everything is put together.

RedJeans · 06/02/2020 12:26

That is so useful Pollaidh, thank you for taking the time to reply! And a weight off my mind knowing they would need to take me wherever I was if it was an emergency.

No complications as yet but my mum had some late complications with 3 of her 4 pregnancies so who knows.

Like you say, might be best just registering at my parents and then aiming for the hospital closest to London. Luckily they're only about an hour away and think people near them tend to go for St. Peter's which isn't toooo far from where we're aiming to be. Not ideal but I suppose we will just have to wait and see how it pans out.

So can you actually phone a maternity ward and speak to someone about this sort of thing?

I'm a real planner so this level of uncertainty is very unusual for me, I'm trying to be as laid back about it all as possible as there's not really much more I can do at the moment haha.

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Pollaidh · 06/02/2020 12:37

You can certainly try to call the maternity wing and ask. Go for what looks like an administrative number, not the labour ward. The labour ward line is usually staffed by midwives and is for people who think they might be in labour to call and be assessed over the phone.

Remember you might not even need a hospital, but you'll certainly need midwives both before and after so the key thing is to be registered with a GP and on their maternity list to make sure you have care for the last few weeks of pregnancy. At this point I think check ups are weekly to fortnightly - they'll be checking your bloods for protein, glucose etc, checking your blood pressure, checking bump size, listening to baby's heartbeat, all even in a 'normal' pregnancy. The aim is to identify any issues early.

HappyDinosaur · 06/02/2020 12:40

Depending on your county rules you won't need to already be registered with your GP. Where I live in South Gloucestershire you can do your booking in appointment online with the midwife, they also didn't require any proof that I was remaining back in the country, but did ask me to confirm it.

zsazsajuju · 06/02/2020 12:40

I came back from overseas with my second at 36 weeks. I planned to stay got trouble with the NHS (they insisted I was not entitled to care and I had private insurance anyway). It’s not insurmountable though- I was told whether or not I would be treated at a particular hospital depends on my postcode. Good luck with it all op.

RedJeans · 06/02/2020 14:42

Thank you all, lots of food for thought... HappyDinosaur that sounds like it would be perfect if that's what happens in my area too

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squee123 · 06/02/2020 22:30

A lot of London hospitals allow you to book directly with them and you don't have to live within a certain catchment. I chose to book with St Thomas's despite there being two other hospitals closer and it being several boroughs away. I just filled in a form on the website. They might require you to register on with a GP first though. From memory there was a maternity booking line you could call who were helpful

RedJeans · 06/02/2020 22:40

Ooh squee, that's useful to know! Kingston also appear to have an online self-referral system but you do need to put down a GP, will have to see where I can register when I get back.

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happychange · 06/02/2020 22:55

Is it morally sound to use the nhs when you haven't paid into it?

RedJeans · 06/02/2020 23:22

Fair question happychange but I will have only been out the country for 2 years, paid into it for 8 years prior to that working full time and am not intending to live abroad again. Have never had any prior health issues or hospital admissions at all so I've possibly paid in more than I've used so far in adult life.

Also can't afford private so don't have any choice really!

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