Several months ago I took a sabbatical from blogging, mostly because I found I was well settled and there were very few things that were new to me anymore. Well all that changed in mid-May when I found out I was pregnant with my first child. I’m 13 weeks pregnant today, and already have been thrust head first into the thick of the NHS.
I should preface this series of posts by pointing out one thing, each woman’s experience will vary quite a bit depending on which NHS Trust is treating them through their pregnancy and what facilities and services are available in their area. While one of the big advantages of the NHS is that a lot of the advice and care is similar, my experience could be very different than a woman living in a different NHS Trust.
I’ll start at the beginning, after taking a pregnancy test (okay, three) I rang my GP, and they referred me directly to the midwife service. Here in the UK, most antenatal care is given by midwives. For women who have no risk factors or need for any extra consultations, they may never even meet an obstetrician. This is probably the single biggest difference between antenatal care in the UK and the US. After the brief call to my GP, I called the midwife service and booked a date for an “early bird” appointment the following week.
My “Early Bird” Appointment
When I was only 5 weeks pregnant I had my “early bird” appointment. Depending on where you live in the UK, your appointments with your midwife could be at a Children’s Centre, in the antenatal unit of a local hospital, or wherever your local midwife service might be located. In my case, my appointment was at a Children’s Centre which is such a different vibe than a doctors office. I quite like it, instead of going in and sitting on an examination table, my appointments with my midwife are in a very comfy and laid back setting. This first appointment was just a 20 minute intro where I was given lots of stuff to read and the main purpose of this visit was to meet my midwife and also for her to explain to me about the Down’s Syndrome screening test, identify the section of the information packet I needed to read and to prepare me for my “booking appointment” where I would need to make decisions about what tests I wanted.
One thing that is paramount in NHS antenatal care is choice. Women are encouraged to make informed decisions and must consent before pretty much anything is done. The early bird appointment is just to make sure the mother has enough time to consider all the information and make informed decisions at the booking appointment when the tests must be ordered and scheduled. Not a single scan will be taken or vial of blood drawn without the mother being completely aware of why and giving consent.
Another thing I was given at this appointment was the NHS packet on pregnancy. This booklet was extremely informative. It would be a great tool for a woman who maybe can’t afford to go out and buy a bunch of baby books, this packet has all the information needed from a week by week guide of pregnancy, to information on different options for birth plans, and explanations about each appointment and what to expect. It is incredibly well written and illustrated and I found it great to have early in my pregnancy before investing in my own baby books, and I still refer to it as a resource along with other books I’ve purchased.
The other thing that is included in the packet is the NHS list of what woman should and should not eat during pregnancy. I found this especially helpful because there is just one list, and every pregnant woman in the UK will get this same list. I have heard so many of my American friends going around and around about the list from their OB, and I’m glad it isn’t something I have to worry about. Every OB seems to have their own recommended list of foods to avoid, and it can be very confusing for a woman. They often are left thinking “Well, my friend can eat this, why can’t I?” or else the even more worrying question “My friend has been advised by her OB to avoid this, should I be eating it even though my OB says its fine?” I don’t envy women who are left with these types of contradictions and its nice that the NHS makes this simple for women and its quite black and white.
My Booking Appointment
My booking appointment took place when I was 8 week pregnant, again with my midwife at the Children’s Centre. At my booking appointment (the name comes from a time when women had to literally book their bed in the hospital to give birth) my midwife took a full medical history of myself and my husband and asked all the relevant questions. All of this information was entered into my handheld notes. This is a binder that I will carry with me to every appointment from now until well after the baby is born, so instead of the midwife and hospital staff passing around information, I carry around one folder and they all fill in the information at each appointment to build my file. It is definitely a new concept to me, but I like that I’m in control and not reliant on the various people who I will see to communicate with each other.
After this she took blood samples (again explaining to me what each vial of blood was testing for and asking me to sign off on the tests before taking the blood) and after about an hour of questions and tests and generally getting to know me and my husband, my booking appointment was complete and I was left to await a letter in the mail confirming when I would have my first ultrasound scan.
The Twelve Week Scan
After what seemed like the longest four weeks, my husband and I finally showed up for the twelve week ultrasound scan last week. It was one of the most amazing experiences of our lives. The ultrasound scan took place in the women’s wing of my local hospital, I brought my handheld notes with me for the ultrasound techs and midwife assistants to fill in all the necessary measurements and sign off on tests that were run after I had blood drawn. We were also given the expected due date of January 25, 2012! And of course, we got to take home the first photo of our little one.
After about three months now in the NHS antenatal care system, I’m left with a few conclusions. First of all, the approach to antenatal care is a very natural one. For women who need extra care it is there, but for women who have low-risk fairly typical pregnancies, care consists mostly of regular appointments with a midwife and very little time spent in a hospital or doctor’s office.
Also, pregnant women are very well taken care of through both the NHS and other government agencies. During pregnancy and for a year after the baby is born pregnant women receive free prescriptions and NHS dental care. Also, policies regarding pregnant women in work are excellent and go to great lengths to protect women and their jobs, and maternity leave is also excellent, something I’ll touch on more in later posts.
I’m really looking forward to sharing my experiences with you over the coming months!