38 weeks

Two weeks to go today (and fervently hoping it won't be much longer than that)!

   

Where have those two weeks of maternity leave gone already! I'm happy that while I haven't done anywhere near the crafting or outings that I intended to do, at least I am much more organised for the baby with the essentials purchased. I now have baby-grows and nappies, surfboard sized pads and big pants. We're still waiting for our cot and pram to arrive - I wish they would hurry up - then I'll feel totally ready. In the meantime I'm going to get a moses basket for backup.

Two of the six of us in our antenatal class have now had their babies so its starting to seem a bit more real but still impossible to imagine. I think there are so many variations of what can happen in labour that I can't imagine what it will be like. I have been doing lots of surveys of birth stories from my friends who range from four days labour ending in a c-section to one of my friends who arrived at hospital in the early morning and baby was born 11 minutes later! No time for any pain relief there obviously. Barely time to get her trousers off either apparently. Which partly answers one of the questions in my mind - "at what point does one take one's knickers off?"

And I just can't imagine what the bean will be like and look like either - even though we seem to have lots of communication through physical foot to belly contact at the moment. I woke up with a visible bruise on my belly this morning where a heel or something else quite sharp had been poking me during the night.

I think from my surveys and talking with a lot of friends here and in Australia my experience here is quite different from over there.

Warning: If you are not currently pregnant and living in London you will probably find this epic post completely irrelevant so apologies to most of you who aren't in that category for that.

Differences start with the healthcare system - in Australia you can take out private insurance for pregnancy and birth and therefore see a private obstetrician and have your baby in a private hospital. Although there is also the option to go through the public system (Medicare) noone I know has done this and most people who are working will take out private insurance when they start to plan a family.

Whereas in the UK, while you can have private health insurance it isn't an option to insure for standard maternity care. However, they will pay for emergency medical care. But given that you will most likely be in an NHS hospital at that stage anyway I'm not quite sure how that works. Some people who have expat health insurance will be covered - so if you're thinking about coming to the UK and starting a family soon after it could be worth looking into this beforehand.

So usually in the UK, if you want to have private antenatal care and birth in a private hospital you have to pay a ton of cash. For example, one of the biggest names in London for private births is the Portland Hospital and midwife led care is £8,000 while consultant led care is closer to £11,000 (if there's no comlications). While this is probably one of the more expensive hospitals and you can pay less if you only go there from later in pregnancy, you can get some idea of the costs of going private here.

Which leaves the public system - the NHS. When I first learnt all of this I was a bit horrified as it wasn't what I was used to at all. I heard about only seeing midwives throughout the whole process if all goes well, the completely oversubscribed facilities for antenatal care and on the labour ward and the 6 bed + babies maternity wards, and it all sounded a bit terrifying. I even had people asking if I would go home to have the baby - which I thought was a bit weird given that we live here and have been for several years. No, I thought there was nothing for it but to find out what I could about the system here and make the most of it.

So if anyone is remotely interested and still struggling through this post, here is my experience of pregnancy so far in the UK (with some commentary from friends experiences thrown in!)

When I first got pregnant and went to the doctor I wasn't actually allowed to see a doctor - I had to see the practice nurse. She aksed me if I had done a pregnancy test (yes - one or two!) and took my blood pressure then looked at me like "ok, bye then" without saying anything really. Luckily I was expecting this kind of response - one of my friends said their doctor had said to them when they went for a visit at about 6 weeks - "Why did you come in now? - we can't do anything til you're 10 weeks".

That was the first time. After having two miscarriages (words of advice from the doctor - "I'm sorry there's nothing we can really do until you've had three") I got slightly more attention when I went to see the doctor on the third occaision at about 6 weeks. Actually she was very nice and sent me straight up to the hospital for an early scan. They were having a busy day and in the end I waited there for six and a half hours but it was worth it to see the little heartbeat. I clutched my blurry little scan and rang Smithy in tears.

I think I might have had just one checkup with the doctor between then and the 12 week scan. I remember asking about hospitals available locally. Dr says looking suprised, "Kings College Hospital". I asked if there were any other options I should consider. "Not really" was the answer.

In the first few months it seemed a bit vague what was meant to happen next but I found that I was given the appropriate information at the right time. Some wheels must have been put in motion by having the scan as I recieved a letter to attend the "booking in" appointment with a midwife at the hospital. This was accompanied by the following letter entitled "Going Home After the Birth".

"If you feel confident and supported at home, and all is well with your baby, it is Suggested that you go straight home from the labour ward after your baby is born. It is Advisable that you arrange foe someone to be home in the first few days if you feel you Will need extra help."

Wow. OK! I asked the booking in midwife if this really happened. She said "Oh yes, lots of people go home after a few hours. Most people would rather go home than be in the maternity ward with five other new mums and their babies. But if you're not up to it you can stay. But your husband has to go home at 10pm" Right.

If you have a C-section they like to keep you in for 3 or 4 days apparently. Compare this to first time Mums in Aus (in the private system) who would typically stay in hospital for 4-5 days, in a private room of course - and that is for a normal birth.

Since then I have realised that the Doctor was right about Kings College Hospital being the place to go. The maternity wing is relatively new so although it was built for about 3,000 births per year and they currently have over 5,000 births per year, the facilities seem quite nice. Also at Kings you are offered the 12 week scan plus the 20 week scan as a matter of course whereas I have friends who went to three different hospitals around London where they only offer the 20 week scan as part of the routine. This is the only scan available to them during their pregnancy unless they pay for a private scan. BTW at Kings they like to do the 20 week scan at 23 weeks so its a bit of a misnomer. Also some hospitals won't advise you of the sex of your baby if you want to find out due to local cultural demographics. In contrast, an Aussie friend said she had a scan every time she went to see her obstetrician (which was about fortnightly towards the last couple of months) and that it got a bit routine.

I was going to a fairly small medical practice which was conveniently located on our street. I was advised when to make midwife appointments, but because there was only one midwife at the practice she was constantly booked up (and I was probably a bit slack only calling to make appointments 3 weeks in advance) so I ended up seeing a GP for several monthly checkups.  At first I thought this was a good thing but then realised I wasn't getting much information and started thinking that it would be better to see a midwife.

When we went to antenatal classes and I compared notes with the other girls I realised that I was at a particularly bad practice for availability of appointments. One of the other practices in the area has 7 midwives and they visit you at home for your checkups. They would also come and see you at home when you're in labour and then go with you to hospital to deliver your baby. Whereas at the practice I was at obviously one part time midwife wouldn't be able to do that and you just rock up to the hospital and see whatever midwife or several are on shift at the time. I transferred to that practice the next week and have been so happy I did. That would be a big tip for anyone at the beginning of this journey in London - there is a vast difference between hospitals and medical practices so it is good to do your research and shop around as you are free to choose where to go as long as they accept you. I had read that somewhere but hasn't really realised the difference or the impact it could have on my experience. And it was also quite difficult to find out this information so it has been invaluable going to the NCT (antenatal) course and meeting other people in the area.

So now I see a lovely midwife who is really practical and I feel amazingly positive after my appointments which are usually every two weeks when you get to 36 weeks. She said that once you are a week overdue they will do a checkup and a scan to see if everything is functioning well and you would usually be booked in for an induction at around 10 days although you can ask to be left to go to about 42 weeks if everything is ok. I REALLY hope it won't come to that.

I also went to a four hour breast feeding workshop that the hospital conducts which I thought beforehand was a bit long on the topic but turned out to be really interesting and informative.

Anyway, to wrap up this epic post - overall I am really happy with the service I have recieved and remind myself that I don't have to pay a cent for it (except for those hefty NHS contributions deducted from my salary of course). Once I got used to the system and its differences, I found it really positive and actually prefer the idea that there doesn't need to be a huge amount of intervention or appointments or letters after peoples names to get good maternity care. All the doctors and midwives I've had contact with have been excellent and friendly. I think that for higher risk situations the system kicks in to give you the level of care you need, but if all is going smoothly then you are pretty well left to get on with it without too much fuss. I am curious to see if my thoughts and opinions change after the birth part of things....

Good grief that was a bit longer than I intended! Congratulations if you're still with me!

Comments

[Rachel L]

Your bump looks great! Good luck!

[SparklyGreenKnickers]

I found that fascinating! I have a friend in the UK who is 37 weeks pregnant with her 4th child (the 1st to be born in the UK, others born in NZ and Australia). I'm amazed at the differences in the systems, the funniest being that she was advised to bring in disposable knickers during her labour! That cracked me up!

Good luck! I hope it is all a positive experience for you :) Can't wait to see pics of a healthy babe at the end of it all.

[kat]

That is an awesome bump! Can't wait to hear about the big day and see a pic of your little girl. Loved your post about maternity care in England - so fascinating! I might do one about Japan. BTW, I have no idea when my knickers came off - dealing with contractions was the ONLY thing on my mind. Also my sister went public in Australia and had her two babes at the Birth Centre at the RBH - she raved about it!

[SparkleyC]

I'm really interested to hear about other people's experiences in London as (you may recall) I'm also pregnant (30 weeks).
When I went to my local GP to tell her I was pregnant (and get confirmation I thought), I was told they didn't do tests, that the ones from Boots were better, and that it cost them too much money anyway. Okay fine. So then why did my doctor get me to pee in to a cup and do a test? And then why did she not tell me what the test was for, let alone what the result was? At that point I decided that I wasn't going to go back there for any maternity care if I could avoid it. And luckily I haven't had to.
I looked around at a couple of hospitals, asked some friends in the area where they went and ended up with the Whittington and I have to say – they've been great. I have had monthly appointments with the midwives (so far) and I've had both a 12 and a 20 week scan. The baby was moving too much for them to see everything at the latter scan, so they did a repeat the following day – no appointment necessary. And at one point during a midwife appointment, even though we could both see my belly move from the baby kicking, the midwife couldn't find a heartbeat. So she sent me for another scan – just to reassure me.
At every stage, they tell me what they're doing and why. I went to see my obstetric consultant on another issue and he was useless – he panicked me about a blood disorder according to my notes without checking if the notes were even mine (they weren't).
So here's my humble opinion – doctor-led pregnancy care = bad. Midwife-led pregnancy care = very good.

I'm really glad that you're experience has improved – and I'll keep fingers crossed that it stays that way! Best of luck with the bean!

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