10 December 2011

All I Do is Think about Babies

Someone asked me several months ago how I feel about the differences between maternity care in the UK versus the US.  I don't know.  I've never received maternity care in the US.  I'm sometimes surprised about the maternity/birth proceses here, but I don't know if my expectations come from books and movies or actual practices in the US.

My only first-hand experience with birth in America is as a visitor who pops along to see her sister and new niece/nephew in the hospital several hours after the baby is born.  In that capacity I can state with authority that after giving birth, one's sister will be in bed claiming that the baby she just had is the best baby that's ever been and that her older children will be climbing on her bed to drink her juice boxes and poke their new sibling in the eye with the straw.

One thing that is notably different in the UK is that maternity care is handled almost exclusively by midwives.  I consider this a positive thing, because I would lean toward midwifery in the States, too, but here it is my only real option.  If I had medical problems that complicated my pregnancy, I would be referred to a doctor, but my default healthcare provider during my pregnancy is the midwife at my GP's office.  She's based at the hospital but holds appointments at my health center on Thursdays.

I'm giving birth in a hospital, but the hospital has two different birth wards--the labour suite and the midwife unit. The labour suite looks like the birth wards I've visited in the US.  The midwife unit has birthing pools (large enough for dads to hop in too) and showers, birth balls, and low, padded resting/sleeping areas, but no beds.  Active birth is encouraged there and the only drugs available are gas/air and diamorphine.  Anything stronger (like an epidural) is available in the labour suite.

Yesterday in antenatal class we were informed that after the baby is born, they no longer whisk him away to weigh and clean him first thing.  They prefer that we snuggle him up for an hour or so and let him eat first.  There are no hospital gowns; I give birth in whatever I feel like wearing (if I feel like wearing anything at all).  I leave 6-24 hours after a normal birth and then a health visitor comes to our flat periodically over the next 10 days to check on me and the baby.  All of these things were new information to me, but maybe they happen in the US, too.  I don't know.


eliana23 said...

This is fascinating. The many clothing choices are something you can start obsessing over...
You do realize that you are so much more interesting in Scotland?

Nemesis said...

Those things do NOT happen in the US, unless you give birth in a birthing center, in which case your insurance will most likely NOT cover it and you'll have to pay for all the costs yourself. (Of course, your costs could end up being less than what your portion of a hospital birth and subsequent two-day stay bill would be.)

For my prenatal care I went to a clinic that had both doctors and certified nurse-midwives (CNMs). You could choose an OB or you could see the CNMs. If you were with the midwives and your pregnancy became high-risk, the OBs became involved. This group of midwives only delivered out of two of the local hospitals. The hospital I delivered in is billed as a "natural-birth friendly" hospital, but I feel like there were some serious f-ups with my care there that resulted in things going the way they did (I almost had to have a C-section).

I'm excited for you--it sounds like you have some great options! (And this is where I make my plug for Hypnobabies--it was awesome.)

Lady Susan said...

So I have to second what Nemesis said--it sounds almost exactly like my experience in a birth center. (Which was AWESOME!) Our insurance covered at least 80% if not all (I am hazy on the details), and I think we have pretty standard coverage.

There is a huge difference in birth centers vs. hospitals (no matter how natural-birth friendly they may be). I am so glad I had the choice and the health to do the former.

Nemesis said...

Lady Susan, you are luckier than you know! I was with PEHP insurance when I had TDL and now I am with Select Health. Neither of them will cover birthing center services. :-(

MBC said...

Eliana--I'm pretty set on giving birth in one of Steve's terrible t-shirts that I couldn't convince him to toss. Then it will be ruined and he'll have to get rid of it, but it will have been for a good cause.

Nemesis & Lady Susan--Ah, yes, I left out the biggest difference in my care, which is that it is entirely free (hooray!). We're planning on a water birth, so I'm really pleased that it's so well-supported here. Sadly, our next babies will be born in Canada and, apparently, midwifery is practically outlawed there.

I've been reading a Hypnobirthing book, which I'm hoping will be helpful, and we're planning to start going to meditation classes at our local run-by-Buddhists-but-not-Buddhist center. Steve's friend works there and says we should also speak to their self-hypnosis expert. My biggest problem, so far, is just that I'm too lazy (or maybe exhausted) to even practice breathing techniques.

Steve said...

I did a bit of digging. As it happens Nova Scotia has just passed a Midwifery Act (2009) which makes midwifery legally regulated and funded by healthcare authority. Most provinces have acts now, but it's all been since I've lived in Scotland.

The only problem is/will be that because it is so new there are only 3 'model' sites operating, Halifax at the IWK/Grace maternity hospital, Bridgewater and Antigonish. I guess we'll have to lobby our health district to hire a midwife.

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