Baby in UK or US? Plus some antenatal queries..

[eandz]

Hello everyone!

We're due with our first in September (hopefully find out if its ds or dd next week!) and are trying to figure out where to have the pregnancy.

After some bleeding a few weeks ago, we have been private (via AXA PPP) with Dr Economides (delivers at the Portland), who we have been very happy with following some unpleasantness at St Mary's (they get really angry when you suggest you're considering private and told us we'd miscarried before an ultrasound ).

For the actual birth, our Blue Cross, Blue Shield US insurance will cover us fully (although by reimbursement only for the UK, has anyone else used this?). The Portland also seemed a bit dark and dingy compared to the maternity wards in Texas, so financially and for environment we're considering delivering in the US.

Has anyone else flown abroad for delivery and if so, how did you find it? We're considering going at 30 weeks to get to know the obstetrician there.

Also, in the meantime, although we've switched our consultant over to private for scans etc, should we be receiving any service from the NHS for ante-natal queries/classes etc? We haven't heard anything since our gp referred us and feel kinda bad asking him questions at random times that end up being standard things.

Thank you all for your help!

[Sabire]

Do you need obstetric care or is it something you just want? If your pregnancy is low risk and you can afford private midwifery care then there are fantastic private birth centres in London (I mean there are fantastic NHS facilities too, but it's not always easy to access them).

Re: antenatal classes - NHS hospitals run sometimes run superb antenatal classes but it's a bit of a postcode lottery. The biggest private providers of antenatal classes outside the NHS are the NCT but you'd have to get on to them quickly as they get booked up early on. Some people have described them as a 'dating service for middle class mums' - and to an extent that is a role they fulfil - they get you in touch with other women in your are area whose babies are due at the same time as yours. If you haven't got great social networks here and you want to make some friends with local women for support after your baby is born it's definitely something you should consider.
www.nct.org.uk

[ScienceTeacher]

I've had babies in both countries, and have to admit, I preferred the UK.

[eandz]

Sabire,
Well I'm supposed to have obstertric care since I was diagnosed with JRA at the age of 20 but have never really had any symptoms since then... and my own mother is an obgyn in Houston...the pregnancy has been a bit traumatic because I'm experiencing odd bouts of bleeding througout, but every scan proves our little shrimp is fine.

A dating service would be amazing for us since I've become socially awkward when hungry...and I'm hungry all the time. I offered to trade babies with someone for a taco. And in hindsight thats just terrible. . Am logging on to the nct website as I type, Thank you!

ScienceTeacher- is there a vast difference between the two countries? And where would you suggest for a delivery in the UK?

-Z

[Sabire]

What's JRA?

[ScienceTeacher]

The major difference is that you are treated as a normal healthy person in this country, and in the US you are generally treated as a sick person.

I had to really manage the birth in the US, so that I would not get medical care that I did not need.

[MrsTittleMouse]

The main advantage of the UK is that if you have a normal pregnancy and want an active birth, that you can opt easily for midwife care, and there are birthing centres designed for natural birth. The main disadvantage is that if anything goes wrong, that you will be dealing with an OB who has never met you before and may not give a stuff about your birth plan (happened to me).
The main advantage in the US is that you will choose your OB and you know that he/she will deliver your baby. You get to discuss your birth plan with them in great detail and make sure that you're both on the same page - calmly and well before the birth. You can also meet their collegues (in case you OB is ill/on holiday and can't be at your delivery). The disadvantage is that the hospitals aren't really set up for active birth, so you might have to fight to try different birth positions etc (most women give birth on the bed) and they tend to be more into the Go! Go! Go! form of pushing, which really got on my nerves (when I encountered it in the UK).

[eandz]

JRA- Junior Rhumatoid Arthiritis

All this information about the differences is really helpful! Thank you!!

[MrsTittleMouse]

Did I read right that you'll only be going out to the US at 30 weeks to meet the OB? I would get the names of few OBs if I were you - it's pretty normal to interview a few to find one who fits in with your ideas about the birth. Recommendations would be best. I do wonder if it's a bit late in the day though, I mean, if you don't like your OB, then time is running out to find another.
Also I would really research what kind of birth you'd like now, as you'll need to have everything set in place in your head, so that you can find someone like-minded. If you'd like some of the more natural stuff, like refusing foetal monitoring or using squatting to deliver etc. then you might have to fight the hospital's general policy.
Having said all that, if you give birth in a consultant led hospital environment in the UK, you might well have to fight stuff like induction, foetal monitoring and so on.
Do you know how long you'll stay in the US after the birth? I know from the experience of friends that getting a birth certificate and passport to get the baby back out of the USA is not very fast if you're not US citizens yourselves (don't know if this is the case for you).

[eandz]

Mrs.TittleMouse,
I was going to get my mother to pick a few out for me (she's an OB in Texas herself) and then meet them all the week I get in and then making a decision. I don't know much about what types of births are out there, I always assumed I'd have a normal delivery with an epidural.

I'm a US citizen, but my husband isn't and we want the baby to have a US passport.

[TravellingSuze]

We're in a similar situation; early threatened miscarriage dealt with by St Mary's. They were actually very good to me (sorry to hear about your experience) but H, who is American, was a bit shocked by the hospital itself and since we also have US insurance we have decided to opt for private here in the UK (also reimbursed). We semi considered flying back but to be honest, I'm 32 weeks now and the thought of doing a long haul flight now and then having to meet the medical team who'll deliver the baby for the first time etc just seems like a lot of work. Plus I love that I've built up a relationship with the place we are delivering.

We looked at loads of different options and have settled on St John and Lizzies. H's first comment when we walked in was that it 'looked like an American hospital'.... I like that this appears to be a good compromise for us; an environment he is comfortable in and for me, the chance to plan the kind of birth I want and to get to know the team who will be responsible for us. And to know that after the birth, the medical team will be there to support us for a while

[MrsTittleMouse]

Ah, so you have inside information. That will make it much easier.
If you have an epidural, then I reckon that you'll fit into the US style of birth anyway, as you'll not be getting off the bed. It's not a bad idea to at least think about doing without one though, just so that you know that you've made the right decision.

[eandz]

Yeah, I go to St. John and Lizz for my appointments since it's right infront of my door (literally)...but my Consultant is telling me I should deliver at the Portland because it has an scbu. I like going to St J&L because they are really bright and clean and I feel quite comfortable there, its where I'm having my scans at the moment...

TravellingSuze,
how are you guys finding the reimbursement thing for consultant visits etc? So far our UK Axa insurance has covered us, but now that thankfully everything is ok we'll be switching to the blue shield policy.

[TravellingSuze]

It's OK but it takes a while to get the money back. And since they're not small sums it can be a pain waiting. Effectively, it's meant that we've felt like we're paying for the whole thing at times - but on the plus side, it's kind of like a saving scheme when they do eventually reimburse us!

On a tangent; we must be neighbours then. John and Lizzies is less than 5 mins walk from us (another reason for choosing it). I don't know many other people with babies in this neck of the woods so if you fancy getting together after your little arrives, drop me a line.

[slinkiemalinki]

Hi eandz - have you thought about going private at a private ward of an NHS hospital e.g. St Thomas' Lansdell or C&W Kensington Wing. I shopped around for my first pregnancy and chose C&W over J&L because actually I didn't like J&L when I looked round it, but everyone's different. I felt reassured by the full obstetric/emergency backup of a major hospital but really liked the facilities at C&W. (They are actually being upgraded right now and should be finished by end of summer, from 6 to 16 beds I think, and a new ward). That said I have many friends who've been very happy with the Portland as well. Fair enough if you want to give birth back home but seems a little extreme although I can understand if you just want to be where you're comfortable. Good luck whatever you decide.

[eandz]

We live in Eyre Court and would be happy to meet up any time - our non-pregnant friends don't like to hang out with us any more

We'll have another look at st johns and lizzies this week and check with our consultant about it again - who are you with at the moment?

Good luck for these final few weeks!

[TravellingSuze]

Thanks. I'm with Dr Chow (always get spelling wrong so it may not be like that). He's been very good.
We're really close to you; we're moving this week but only from one side of St J's wood to the other (decided that a fourth floor walk up is probably not the most sensible idea once the baby arrives).

So let's try and meet up at some point. Next two or three weeks are going to be crazy with the move but after that it'd be great.

Hope it goes well with the consultant this week.

[eandz]

MrsTittleMouse - having seen the videos I don't think I want to go without an epidural for my first! Maybe next time

slinkiemalinki I haven't looked at C&W yet but will look into it.

[Tangle]

eandz - what kind of videos have you seen?

Before I did some ante-natal classes my experience of birth had been that potrayed by Casualty, ER and the like - ie all very dramatic and agonisingly painful. When I got pregnant I decided that if I didn't want to spend the next 9 months freaking out I needed to do some re-evaluation, so I kept reminding myself that if birth was REALLY that dangerous and/or painful the human race would have died out a long time ago. And we haven't. So it can't be. But even so an epi sounded like a good precaution. Then I read up on the pros and cons of the different types of pain relief and different birth positions (did you know that if you're NOT flat on your back your coccyx should move during the birth allowing your pelvic outlet to expand by upto 20%?) and decided that an epidural wasn't necessarily the best option for me after all.

In the end I gave birth to DD at home - it took 7 hours in total, she weighed 9lb 12 and I had no chemical pain relief. I wasn't being stoich - I just genuinely didn't feel the need. During the birth I felt very calm, very aware and totally in awe of what my body was doing. Oh, and very quiet - I couldn't see how vocalising was going to help me so I didn't bother. (All that said, I was very open to having drugs if I DID need them.)

Sorry - I'm really not trying to gloat or talk you out of an epi if it's what you want, just to say that whilst everyone's experience will be different it's not a foregone conclusion that labour will be incredibly painful. Anyway, enough waffle - good luck making your decision, and I hope you have a good birth experience

[Heated]

Do you have cable/satellite TV? There are both UK and US birthing programmes on there which show the differences in approach.

[eandz]

I've been watching dvds from the American channel 'The Learning Channel' and watching 'A Baby Story' which shows lots of different birthing experiences...

I've also been youtubing...

[UnderRated]

Have you watched The Business of Being Born? If you are considering a birth in the US, I would recommend watching it.

Where in the US would you deliver? Care varies vastly from hospital to hospital.

[SueW]

Is that the Ricki Lake film? It's on in South Ken in the next couple of weeks, I think?

[SueW]

14 April.

www.saveindependentmidwifery.org/content/view/225/55/#details

[UnderRated]

Yes, Ricki Lake's film. Is rather eye opening. And sadly, quite true, ime

[SofiaAmes]

As an american who has given birth to two children in the UK (one at st. mary's and one at Queen charlottes), and attended one birth (my best friend's) in the usa. I can unequivocably say that if I had it to do all over again I would have delivered both my children in the USA (even though my dh couldn't be there). My experience at st. mary's was abysmall and 7 years later, I am still traumatised by it. I looked into the portland for my second child, but was really put off by the dingy rooms and antiquated equipment and poor reputation for medical expertise and lack of facilities if there were any medical emergencies.
In theory you have a choice about your labor and birth in the uk, but in reality you do not and are victim of the luck of the draw. I did not see the same person (midwife, nurse, consultant or even receptionist) twice during my entire 1st pregnancy (and 40 hour labor!!!) and the first 6 months of my second pregnancy (I finally got myself onto the natural birth floor at Queen Charlotte's and it went better after that). I had midwife's give me completely wrong medical information, consultants who made me cry and filthy filthy filthy malfunctioning facilities at every step of the way. At St. Mary's at the prenatal class they told me to bring cleaning materials with me if I wanted to use the bathtubs (and luckily my dh had a wrench in the car, because he needed that too to get water out of the tap). At Queen Charlotte's they had a brand new birthing pool on offer, unfortunately, the hot water wasn't working properly at the hospital the night I was in labor, so there didn't end up being more than 6 inches of water in it by the time I delivered my dd. In the UK don't expect an epi when you ask for one as it's entirely dependent on someone being there to give it to you (I had to wait 5 hours for mine).
My summary of my experiences delivering in the UK were: They almost killed my baby during my first labor, and me during my second. I have a 9 inch crooked scar across my belly from the first delivery (my need for an emergency cs was entirely due to St.Mary's negligence and lack of staff) and Queen Charlotte's left me with 15 poorly done stitches in my vagina that still give me pain 5 years later.

As far as citizenship goes, your children will be entitled to both uk and us citizenship regardless of where they are born. (I am american and my dh is british and my kids both have dual citizenship). Only difference is that they can't become president if they are born in the uk. Also, if they are born in the uk, make sure you register the birth with teh us embassy immediately and DO NOT lose the REport of a Birth Abroad certificate that they give you as you need it for every passport renewal in the usa.