It has been awhile since I’ve posted an update on my pregnancy. Things are so busy and I recently took a very long trip stateside, but now that I am back home in the UK and find myself taking a bit more time off my feet, I can finally make a little update! I’m glad I got to take a trip home and thoroughly discuss my antenatal care with friends and family, it has brought to my attention so many misconceptions about the NHS and antenatal care in the UK and I am happy to get the opportunity to clear up some of those misconceptions here.
Again, before I get started I think it is important to point out that 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’ve read many varying accounts of experiences with the NHS here, some very negative and some very good. However, I have found that most women who have had negative experiences find out after the fact that there is a specific problem within their NHS Trust and there are steps being taken to resolve these issues, so their experiences aren’t indicative of a system-wide problem. Even in some cases I have read, many women who have negative experiences having their first child find that by the time they have their second child the issues within their NHS Trust have been identified and resolved.
I also wanted to start out by clearing up a common misconception that I encountered quite a bit during my trip home, many of my friends who had heard me referring to appointments with a midwife assumed that midwife = home birth. This is most certainly NOT the case. In the UK all basic antenatal care is provided by midwives, they are medical professionals who provide the majority of care to pregnant women and babies in the UK, both in the hospital and at home. In my Third Trimester post I will go into more detail about different birth plans and options, but midwives deliver babies in hospitals, in midwife-staffed birthing centres, and at home. Most births the midwives oversee in the UK are in the hospital. Some women also see obstetricians, but only if there are specific risks and issues that require extra care. Basically midwives are the primary caregivers, and OBs are involved as consultants.
16 Week Appointment
During the second trimester most mums-to-be visit their midwife every 4 weeks. My 16 week appointment was amazing because it was the first time I got to hear my baby’s heartbeat. We got to see the heartbeat on the screen during the 12 week dating ultrasound, but it wasn’t until my 16 week appointment that I got to hear that miraculous sound. It was such a reassuring appointment, as many mothers will probably agree that the beginning on the second trimester can bring with it a bit of uncertainty. The first trimester symptoms have usually subsided, as they did for me, and you don’t “feel pregnant” since there isn’t much of a bump to speak of, the flutters and thumps of fetal movement haven’t started yet, and you pretty much feel normal. Hearing my baby’s heartbeat was such a wonderful reassurance as I looked forward to my 20 week ultrasound.
At this appointment my midwife also went through all of the test results that came back from screenings during my 12 week scan and my first appointment at the antenatal clinic. (I was referred to the antenatal clinic because of my above average BMI.) The obstetrician ran some additional tests and my midwife entered these into my handheld notes and explained the results to me.
This is another place where I have found my care very different from friends in the states. My friends have had A LOT of babies over the past 3 years and they all seem to know every little detail of every step of their pregnancy. Here in the UK, unless you are seeing a fertility specialist, midwives don’t typically get into the details of test results unless something comes back abnormal. Basically, I am told that my tests came back in the normal range, sometimes shown a chart of where I fall within the “normal” range and that is it.
Now some people might see this as a disadvantage, certainly more information should be better. However, I feel that in the hands of someone without medical training, these numbers and figures in many cases can be cause for unnecessary worry and comparison. I hear a lot of my American friends comparing hormone levels and other test results, and even though their results are completely normal, it can cause a lot of unnecessary worry if their numbers don’t match up with someone else’s. I think this goes back to the more natural approach to childbirth in the UK. Pregnancy isn’t treated as a medical procedure, so while some medical tests and checks are necessary to be sure the pregnancy is progressing as it should, I’m not burdened with medical details as long as everything is normal. I’m left to enjoy my pregnancy without obsessing over this or that hormone level.
20 Week Anomaly Scan
My next appointment was at the hospital maternity ultrasound department. Again I came equipped with my handheld notes so the ultrasound technicians could enter their findings. My husband and I decided quite early on that we wanted to know the sex of our baby if we could find out (and no, as much as people loved telling me I am going to ruin the surprise, I don’t think knowing is going to dampen the experience of meeting my child for the first time). This experience was one of the best of my life, the 12 week scan was great for peace of mind, but on this scan my baby looked like a baby and was moving around, squirming and wiggling. We were lucky to have a very clear shot of “the area in question” and the technician told us that she didn’t see anything between those little legs, so our baby is most likely a girl. Everything was checking out normal, but because she was curled up they couldn’t get the view they needed of the chambers of the heart so they scheduled me for a second scan the following week in hopes that she would move. We came in the following week and the technician was able to see what she needed to see and also got another very clear look and double confirmation that I’m carrying a baby girl! Most importantly though, all of the measurements came back fine and they did not find any abnormalities.
As long as everything continues to progress as it should, this was the last time we would “see” our baby girl until her birthday. Most women in the UK just have 2 ultrasound scans, one at 12 weeks to date the pregnancy and another at 20 weeks to do a thorough check for abnormalities. (Parents who want one of those new-fangled 3D scans can get one, but they aren’t provided by the NHS and you have to go to a special centre and pay for it.) Some women will have more scans if they previously suffered a miscarriage or are seeing a fertility specialist, or if early on if there are any complications in the first trimester, or a growth scan may be required later in pregnancy if there are any concerns about how the baby is growing. This is certainly much different than in the US, but for women with a normal pregnancy free of complications, 2 scans is really all that is necessary. From here on out my midwife will use palpation to check the growth of my baby as well as listening to the heartbeat and measuring my uterus.
My search for maternity clothes in the UK was pretty fruitless. I found a lot of stuff both unattractive and expensive. There wasn’t a single store in my town that sold maternity clothes, so I had to drive to a nearby retail park to look, and I still didn’t find much. Some major high street brands like Next and New Look do carry maternity lines, but they are pretty limited. I found a lot of the New Look stuff seemed geared toward VERY young mothers, tight fitting snug-to-the-belly tops that had tacky slogans printed across the belly, so I didn’t find much other than a couple very basic items. Next had a bit more mature styles, but the prices were just too much for things I was going to wear for just a couple months and the fit wasn’t great.
I decided to wait until I got to the US to buy maternity clothes and I am glad I did, I found plenty of stylish and comfortable maternity clothes in US stores and got enough to last me through. For pregnant expats I would definitely suggest finding a way to get some American maternity clothes shipped over from friends and family if you can!
24 Week Appointment
After returning from a 3 week trip the the US, and receiving tons of adorable baby girl clothes from friends and family, I had a glucose tolerance test to check for gestational diabetes and my 24 week appointment with my midwife. The glucose tolerance test was no fun, but my results came back normal so I am glad it is over with! At my 24 week appointment my midwife felt my uterus to make sure everything is growing as it should and we had another listen to Baby Girl’s heartbeat. Then we sat down and briefly went through the findings of the ultrasound scan and confirmed that everything is looking as it should. We also booked my next couple appointments, which after 28 weeks go from every 4 weeks to every 3 weeks and I will also have some additional appointments with a health visitor and at the antenatal clinic. I’ll also have a visit to the hospital maternity unit and then I can begin thinking more in detail about my birth plan. I’ll be updating on all of these appointments in the Third Trimester post.
Of course one of the first things my American friends want to know is how much maternity leave I can get. It is widely known that European maternity leave is typically pretty awesome. There are some variations depending on how long you have been working for your employer, your income, and specific policies, but I will try to break it down to the basics as much as I can, and how they apply to me specifically.
In accordance with UK law and my employer’s policies I could take up to 52 weeks off from work. Of these 52 weeks, the first 39 weeks are paid. The first 6 weeks are paid at 90% of my average earnings and the additional 33 weeks are paid at the statutory maternity rate which is adjusted annually by the government. It is up to me how long I want to take, but I am required by law to take the first two weeks following the birth of my child. My average earnings are determined using the wages I earned between my 17th and 25th week of pregnancy. If you would like to know more about maternity leave and Statutory Maternity Pay (SMP) in the UK, the UK government website has a very good comprehensive guide to all things related to pregnancy and maternity rights in the workplace.
I had to notify my employer by my 25th week of pregnancy when I planned to begin my maternity leave and when I planned to return to work. Since I work in retail I decided to start my maternity leave at 36 weeks (December 28th) and I will be taking about 32 weeks off, returning to work in early August. I’m really looking forward to spending the time I need with my child while still getting at least a bit of basic income until I’m ready to return to work!
Thanks for reading, in my next update I’ll tell you all about my first meeting with a health visitor, my visit to the hospital maternity ward and my preparations for the fast approaching big day!