Births in Both Countries: My experience with hating, then loving, the NHS.

I wanted a home birth this time around but couldn't have it because I was classified as high risk.   

I was at a friend's home birth about 2 months ago.  Like racheeeee, I went to pick up their older son to watch him and by the time I got there (45 minutes later) she was fully dilated and pushing...so I got to see the birth.   

we had talked about a home birth and thought of changing our plan to have one this time around or having one for the next kid. but things didn't work out that way and honestly I'm glad things worked out the way they did because while the hospital birth was bad, a home birth would have been much, much worse.

Another difference I noticed was that the midwives were checking up on us much more often than the nurses when I was in the US.  The midwives came in every single hour and documented how mommy and baby were doing (I read this in my notes as we both slept pretty well through the night so there was a lot of 'mom is sleeping on her right side and baby's breathing is normal') but when I was in the US they only checked in every now and then...mainly just to take vital signs or tell me to wake the baby up and feed her  .  I guess because they know you have your family there to help you out, they don't want to disturb you or something.  I had 3 different midwives walking me to the bathroom and watching the baby while I was eating and doing things like that to help me out.  I thought I'd feel bad about asking them to help out but many of them offered by saying, "Would you like me to go get your breakfast for you" or "Do you need to run to the toilet and I'll watch the baby while I'm here anyway".  It is their job afterall.  I'm sure all of this just depends on your hospital...there weren't a lot of babies in at that time and there was plenty of staff...it was probably completely different at another hospital.

This shows how drastically it differs with every hospital. I had midwives check on me maybe twice during the night after my son was born. It may have been less actually. They came in and checked the c-section patient next to me more often, but never checked me.

My midwives here, in the US, stay with you throughout your labor. I think it totally depends on your provider!

My midwives here, in the US, stay with you throughout your labor. I think it totally depends on your provider!

Yes, I had a midwife for one of my births in the US and she was with me through the whole labor.  Mind you, it only lasted 45 minutes.

You need to have one over here for research! 

   I think I'll just have to trust the research of others on this. 

I have a friend who is a Doula in California and she's more of a trained birth partner rather than a medical practicioner as a midwife would be in the UK.

Doulas are different.  They are supposed to be an advocate for your birthing plan and a friend.  So like if you decided you didn't want pain medication they would help you remember that at the right time. 

I have heard they are growing in popularity here. 

Didn't we have a member on here who was a doula or training to be one?  Terri O'Neal or something like that her name was.

I have a friend who is a Doula in California and she's more of a trained birth partner rather than a medical practicioner as a midwife would be in the UK.

Doulas are different.  They are supposed to be an advocate for your birthing plan and a friend.  So like if you decided you didn't want pain medication they would help you remember that at the right time. 

I have heard they are growing in popularity here. 

These are great! Evidence shows that doulas help shorten labour simply by being there from start to finish and help to handle some of the stress and fear- they are your birth advocate and make sure you dont have to repeat your birth plan to every new shift of medical staff (in a hospital) and take the pressure of your husband/family so they can focus on the experience instead of worrying about other things! I've heard of stories where the mother was high risk and had to have a C-section and the couple loved having the doula there because she stayed with mom in theater while dad followed the newborn to the nursery and didnt feel guilty for leaving moms side.

Doulas are different.  They are supposed to be an advocate for your birthing plan and a friend.  So like if you decided you didn't want pain medication they would help you remember that at the right time. 

I have heard they are growing in popularity here. 

Yes, they are totally different than midwives. We have one in addition to our midwives, and she is there to support me, help me make it through with no meds (although if you decide to have meds they support you regardless) and to document the birth, meaning if you want they take pictures and they will write up your birth story afterwards. I am very excited about her.

Thanks for this post. I have a 5-month-old as well, my first, who was born in England. I mainly had good experiences with the NHS. I ended up being induced (which was not a good experience in my particular hospital) and finally an emergency c-section (which was fine--after I got down to the labor ward things were exceptional).

Anyway, I am thinking about number two now. We'd like to TTC when my daughter is about one, and we'll probably be moved back to the US. I am a little horrified about the costs of pregnancy and birth in the US.

Just curious how good your insurance was with your second baby? Sounds like you had to pay a lot out of pocket. Is this fairly routine even if you have decent insurance?

We had to pay so much because even though the insurance paid 90%, we had a high family deductible, and he was in hospital for 3 weeks so it was very expensive... once that was paid off though we had therapies and evaluations and surgeries etc to pay off, it was never ending! But each insurance company is different, as is each hospital... that is part of whats so frustrating actually. The lack of consistency etc...

It's a good point that I think people forget or overlook (and I say this as someone who has worked with people who had lots of medical debts in the US - not as someone who has given birth) - is like what Marlespo is saying about its being never ending.  It's not just one bill - it's lots & lots & lots of bills:  for the hospital bed, for the medicines - aspirin & prescriptions, for each doctor, each specialist, each test, each diagnostic, having tests/diagnostics read or interpreted, each technician, on & on & on & on.  Imagine someone who cannot afford to pay all that or who doesn't have insurance, then each bill gets referred on to a collection agency and then the next collection agency and the next and the next.  It's no wonder that I used to have clients arrive with grocery bags full of unopened post, because they were getting so many different bills they just couldn't face opening their mail anymore - didn't know who was collecting for what, etc.  Not good.  When I have explained this to friends, family & colleagues here in the UK, their jaws just drop open - unable to fathom such a system.

Compared to the NHS where you never see a bill & if you have to pay for a prescription (which I don't think you do for pregnancy stuff?) - it's £7.50.

Imagine someone who cannot afford to pay all that or who doesn't have insurance, then each bill gets referred on to a collection agency and then the next collection agency and the next and the next.  It's no wonder that I used to have clients arrive with grocery bags full of unopened post, because they were getting so many different bills they just couldn't face opening their mail anymore - didn't know who was collecting for what, etc.  Not good. 

My husband and I are dealing with this now. Everytime I hear a right-winged/tea-partier yell about 'evil socialist medicine' and a 'government takeover' of the healthcare system it makes me cringe.

A friend of mine in the US just had her baby 2 months ago.  She has fairly decent insurance but not at that great IYKWIM.  She *had* to have a c-section because it had been less than 2 years since her previous birth - an emergency c-section.  Her doctor's refused to let her try VBAC because they were afraid of complications due to the short amount of time in between births and the possibility of tearing the scar.  She wasn't too bothered about it so she didn't try to fight them on that (but she probably could have tried VBAC if she wanted to...she would have had to push for it though).

Her total bill was for $17,000...that included the c-section, the hospital stay, doctor's fees, all the tests/lab for the baby, etc.  Everything for her went really smoothly and she had no complications so there were no 'extraneous' bills in that total.  She will have to pay $7,000 of that.  Apparently if she had a vaginal birth it would have only cost her less than $2,000 out of pocket (she figured this up by deducting what she has to pay for the extra amount of days you're required to stay in the hospital and the cost of the c-section surgery...it might actually be less than that as she wasn't sure which labs and doctor's fees where associated with the surgery alone).

My first niece was born at 26 weeks gestation and she was in the hospital for over 3 months...most of that in NICU.  My brother told me that their total bill was for over $1,000,000.  Even though my brother has really excellent insurance, there was no way they would have been able to afford the out-of-pocket costs.  Luckily they were able to get Medicaid (I think that's the one but not positive) and they picked up the majority of the additional costs.  I just wanted to note that in some cases, you won't be left with huge extortionate bills that you need to pay all on your own...there is some help available (if you qualify of course).

Luckily they were able to get Medicaid (I think that's the one but not positive) and they picked up the majority of the additional costs.  I just wanted to note that in some cases, you won't be left with huge extortionate bills that you need to pay all on your own...there is some help available (if you qualify of course).

I think part of what gets to me about the US healthcare system (I haven't ever had to use it, so this is just my outsider's opinion), is that even if you won't have to pay much out-of pocket, you still have to worry about who will be picking up the costs afterwards (i.e. insurance will cover X amount of it, another scheme may cover Y amount and I will have to pay Z amount out of pocket).

It just seems like a lot of unnecessary hassle to have to deal with, especially when you've just been ill (or had a baby)! It's quite nice to know that if you are admitted to hospital in the UK, the costs will have already been taken care of through taxes/NI contributions so you can just concentrate on getting better and not have to worry about the money side of things as well.