Baby in UK or US? Plus some antenatal queries..

[eandz]

Hello everyone!

We're due with our first in September (hopefully find out if its ds or dd next week!) and are trying to figure out where to have the pregnancy.

After some bleeding a few weeks ago, we have been private (via AXA PPP) with Dr Economides (delivers at the Portland), who we have been very happy with following some unpleasantness at St Mary's (they get really angry when you suggest you're considering private and told us we'd miscarried before an ultrasound ).

For the actual birth, our Blue Cross, Blue Shield US insurance will cover us fully (although by reimbursement only for the UK, has anyone else used this?). The Portland also seemed a bit dark and dingy compared to the maternity wards in Texas, so financially and for environment we're considering delivering in the US.

Has anyone else flown abroad for delivery and if so, how did you find it? We're considering going at 30 weeks to get to know the obstetrician there.

Also, in the meantime, although we've switched our consultant over to private for scans etc, should we be receiving any service from the NHS for ante-natal queries/classes etc? We haven't heard anything since our gp referred us and feel kinda bad asking him questions at random times that end up being standard things.

Thank you all for your help!

The other difference I found between the two countries is that in the UK, you are very much treated as an individual, whereas in the US, you are expected to want and do the same as everyone else. There seems to be a fair bit of indoctrination in the US and it is portrayed that there is only one way to give birth and doctor knows best.

I was made to feel a freak for wanting to do things in line with research, and my OB took no notice of my obstetric history. I found this totally shocking. Fortunately, my midwife was more enlightened, but she tread a fine line between pleasing me and pleasing her boss.

When I had an 'emergency' in labour, no doctor responded to the stat call for at least 20 minutes (and 18 minutes after the baby was safely born). It's not paradise in the US, by any means.

I should maybe add that I feel I stacked the odds in favour of having a good birth by listening to natal-hypnotherapy CDs before hand, deciding on a home birth and booking independent midwives. That way I knew who was going to turn up and I knew I was going to get one to one care throughout the labour and birth.

The NCT have also released a DVD called Happy Birth Day that looks like it should be quite positivie. You can get hold of a copy free.

I'd prefer to have a midwife deliver my baby, rather than a doctor. I watched 'knocked up' and was shocked at how she was treated. They shave you FFS!
If you have the money or insurance to go private in this country I'd recommend private birth in the UK.

I should add that a friend of mine had her baby in the US and wanted an epidural, but it wasn't available. It was her third, so obviously the birth went a bit faster than a typical first labour, but I wouldn't say that an epidural is guarenteed in either country.
But then, you might not need or want one.

I have experience with both health care systems. In the US, you are treated as an individual and your pain coping and birth preferences are respected. Plus, the hospitals are clean and if you want an epidural, you'll get one promptly. You will have consistent medical care, which, by the way, includes an obstetrician of your choice (mine was quite into acupuncture and holistic care, as much as possible). If you want to store cord blood, they don't look at you like a freak. You don't have to worry that your birth fits their targets, the medical choices they are making are for you, not to save the system money or save the midwives time.

In the UK, at least on the NHS, it's a factory and some of the common practices are considered backwards in much of the Western World (and glorified as more natural and less medicalised).. You'll encounter hostility to any suggestion that you might supplement their services with private care (even for scans, about which they are stingy on the NHS) and you'll get the party line about "less interference is better" -- and they'll try to ply you with heroin (aka entonox) or gas and air, which will cloud your judgment. They'll give you misleading information to keep you classified as low-risk (vs high risk ... this has been my experience at Queen Charlotte's) and ignore your clearly stated preferences about pain coping. Forget about getting their cooperation in collecting cord blood. In fact, forget about getting straight information from anyone in the hospital, because even at a supposedly fine hospital like Queen Charlotte's, you'll get three different stories when you ask fairly basic questions about hospital policies.

I am not saying the hospital care I had in the US was perfect, far from it, but they saved my ds1's life. Not sure what would have happened in the UK given how incompetent and zombie-like a lot of the NHS people are. If you do it in the UK, go private.

Aren't these unfair comparisons? Isn't it fairer to compare US healthcare with UK private obstetrician-led healthcare? Which is I think what the OP is asking about - because she has insurance anyway, so is not considering an NHS birth in any event?

OP is still considering the NHS for some of her care.

Maybe a comparison between the NHS and a Third World country would be more appropriate, given how low some of the standards are.

I'm a bit confused as to how entonox can be compared to heroin? Surely the first is out of your system within minutes whilst the latter is an adictive opiod, which you'll remain under the influence of for hours.

I'd go for the US myself.

I've only had children in the UK, though.

I don't have experience of being pregnant in the US (although I'm American and I've had gynelogical care in the US) and I was only pregnant for a few months in the UK due to miscarriage.

So my thoughts might not be worth much, but I was surprised by the NHS care I received in the UK. I told my GP I was having mild cramps at my first appointment and she sent me to be scanned right away - I was sure they'd tell me it was nothing and I wouldn't have any scans until 11-12 weeks here. But I was even made to come back for a follow up. There are some things that I think are lacking - ie I never had a blood test even when I was miscarrying, which I think was weird - but in terms of feeling that I was being looked after, I was pleasantly surprised.

If you want to compare US, UK and Third world statistics....hmm - not pleasant with US eyes.

How would a blood test prevent your MC, prepg?

I think she meant pethidine. I actually had a great experience with pethidine (hm, perhaps not the best choice of words!). It was the only thing that relaxed me enough to fall asleep, which after 3 days of contractions and no sleep, I really needed. I had no after effects, neither did DD (I only had a half dose and she wasn't born until 8 hours later).
Entonox (gas and air) did nothing for me, and I didn't want an epidural as I knew that my OP birth would progress slowly enough as it was, without being stuck to a bed.
Horses for courses, and I wouldn't rule out anything. You never know what will happen/what will work until you're actually in labour.

SofiaAmes,
I am so sorry that happened to you. I actually cried a bit and am so scared of ever having children...even though my first is on it's way in just 5 months.

SofiaAmes, I am sorry you had such and awful experience. No-one should ever experience what you have. But please, eandz, read the good stories too - there are tons of them on here.

eandz, I think the best thing you can do is research your hospitals well - both in the UK and the US. Check their nicu provision, c-section rate (many US hospitals have a rate of over 50%) and ranking of the maternity services. Find out how often they are full. And what they do about it if it ever happens. It's also worth thinking about if your US hospital is a teaching one. They often have higher intervention rates than non-teaching ones. Talk to people who have given birth there.

Some hospitals have amazing facilities and many do not. Like Sofia said, it can be pretty much luck of the draw, where-ever you deliver. And can even vary from shift to shift depending on which doctor/ midwives & nurses are available.

Hi, I've only read a couple of entries on this thread, but if I were you I'd read Naomi Wolf's 'Misconceptions' - all about the US birthing industry. She's incredibly scathing of conventional maternity care there. In a nutshell, she says if you plan to give birth in a hospital in the US you are basically placed on a conveyor belt of interventions which will most likely lead you to have a caesarean, whether or not you actually need one.

Why does she think this is the case? (a) if you're poor and have no insurance, it gets you out of the hospital more quickly; whereas (b) if you're not poor and have insurance, it means the hospital gets more money for doing more stuff to you.

If you'd rather have a c-section, this is clearly not such a prob for you; but if not it's certainly worth considering.

Also a WHO report showed that the USA ranks lowest in maternal mortality rates compared to other developed countries. I don't know what were the typical causes of mortality but this seems to show another level on which things are not necessarily as they should be in US hospital maternity care.

You could always seek out Ina May Gaskin - an amazing and inspirational woman who has specialised in natural birthing. She runs a community in a woodland area somewhere in the US!

Best of luck!

eandz, I am so sorry for scaring you. I truly did not mean to do that. I am entirely sure that the vast majority of the awful things I encountered were the result of an overburdened nhs in the London area. Please do do not let it put you off childbirth in general. I just get a little heated up when people criticize the american system based on a movie or a tv program and no personal experience. I have experienced both the nhs (in London and the Northeast) and the us system (in 3 differents US States) and in my experience there is absolutely no comparison: I would always choose the usa over the nhs for medical care. I'm sure it makes a difference where in the uk you are and where in the usa you are and what your options area in each place. I have a friend who had no health insurance and had a truly heavenly experience giving birth in a county hospital (where the poor and uninsured go for medical care) in Los Angeles. She had a choice in medical care, a private room and breast feeding consultations all paid for by the State.
Anyway, best of luck whichever system you choose.

ScienceTeacher Of course a blood test would not have stopped my miscarriage, but there was no monitoring of my HCG levels to make sure they've returned to 5. I've had some heavy spotting since, and I would've appreciated the insight that a blood test would've provided. Also I would've liked to have known my rhesus status

SofiaAmes,

no no, don't worry! I've always been petrified about child birth...and children themselves were something I've never really thought of.

Your experiences just made me feel terrible that it had happened to you, and that it had happened at all...

Just to correct my typo and sorry for the negative tone. What I meant to point out is that diamorphine (similar to pethidine) is also known as heroin. The terminology depends who gives it to you, a street dealer or the NHS.

Anagram, given you described all NHS workers as "incompetent and zombie-like" and compared UK care to a Third World country, I think "negative tone" is probably the understatement of the year!

That's right, heroin and pethidine are both in the opiate family. But what I'm saying is that even though I had my concerns about pethidine, it was actually a good form of pain relief for me. I had no bad side-effects, neither did my baby. It wasn't cut with goodness-knows-what, it was a one-off occasion, I certainly didn't get high, and I didn't fund terrorism or organised crime.
Would you suggest that people who have had operations and have morphine for pain relief are the same as drug addicts too?

EandZ, I've just read what I wrote to you at 5.45am a few days ago. Good gracious, I can't believe I was talking about maternal mortality - I'm really sorry. That was a horrible thing to write about. Clearly my head was not switched on and sleep deprivation was taking over me.

However if you have the time to read it, the Naomi Wolf book is very good. I'm sure there will be other well-informed opinions to counter it, but I read it twice and both times felt it was a thorough appraisal of her experience. I also know some other American women with British partners, who would choose to have their babies here for reasons of quality of care.

What a difficult decision you have ahead of you. From what I know, the Portland is excellent, and in my experience, if you're happy with the care you've received I'd stick with it. Do you know what conditions/ medical staff will be like at your chosen hospital in Texas? Will you have a chance to visit well in advance of the birth?

You'll never find anywhere that hits all the right buttons, so if you feel that the Portland does or doesn't hit all the important ones that might help you decide.

Good luck!

EandZ - I've just read that you said you've always been terrified of childbirth. I was too! Always! Would run out of the room if anyone started a conversation about birth!

However I took pregnancy yoga classes which combined teaching about natural birth. I also listened to a hypno birth CD. The transformation was amazing. By the time I came to give birth, I was so confident that I could do it, I ended up managing at home up to 7cms dilation. All I'd had was a single paracetamol to 'take the edge off it' (yeah, right!). Then at hospital I had a little bit of gas and air.

I mainly relied on a tens machine which was a bit crap, and singing/ humming low (so that it vibrated in my belly) - this counterbalanced the feeling of contractions. Sounds weird, but it really worked. I was able to remain positive and jolly throughout, and even forgot to squeeze the crap out of my DH's hand (damn! wasted opportunity!).

I had a lot of stitches after the birth, but while they were fixing me I was so high from endorphins that I was singing! Honestly, after all my years of terror, if I could do it, anyone can - just prepare yourself mentally beforehand (mental prep is key as it makes you feel empowered) and whatever intervention you may or may not have, you'll surprise yourself no end.

Go, get 'em!