Wednesday, February 20, 2013

Having a Baby Abroad (7). NHS. Midwives. Birth choices.

Now that I've finally been feeling mildly social, I've talked with many of you about my blog. Apparently the most interesting posts were not about music tours or backstage with Elvis Costello ... they are about my experience as an American living and using the National Health Services of Scotland. I've had loads of blogs in draft about it, but haven't managed to get away from the baby long enough to make sense of them. Here is my most recent attempt.

A quick refresher: Maternity Care in the UK is led by midwives. If a midwife decides a patient is high risk, she is referred to an obstetrician and is supposed to give birth in a hospital. All other women (the majority) have the option of a home birth, a birthing centre, or a hospital.

My last NHS Maternity Care post was written six days before the baby was born. Here's the link, if you'd like to catch up. It was a basic overview of all of the prenatal appointments I had, and about receiving the good news from my obstetrician that I was not, in fact, high risk, as suggested by my mother's history.

If you had asked me before I was pregnant what kind of birth I was interested in, I would have told you I wanted to be completely knocked out -- 1950s style -- and feel nothing and remember nothing. Modern medicine is an improvement, right? Women no longer have to feel that whole pain of childbirth thing.

The minute I saw that positive pregnancy test, however, I
  1. was completely terrified of childbirth
  2. knew this creature was going to have to come out of me somehow
  3. remembered that I hate taking medicine of any kind, even ibuprofens
  4. eat organic and non-processed foods the majority of the time
  5. wondered how I could balance #3 & #4 with a having a standard hospital birth.
The whole "standard hospital birth" was, of course, the American in me. The British system, being midwife led, does not automatically assume you want an epidural (though they offer them to anyone who wants one and who qualifies medically). Oddly (to me anyway), the midwives seemed to assume I would want to use the new Lothian Birthing Centre -- a spa-like facility connected to the Edinburgh Royal Infirmary that opened in October of 2011. I was still confused.

As with anything new I attempt, I turned to my favorite adviser: the library. I am not kidding when I say I read twenty-five books on labor and childbirth, from the Jenny McCarthy book to the Ina May books. I could write a dissertation on the subject, from one extreme to the other. Some books heralded the benefits of epidurals and hospital interventions; others wrote of natural childbirth. (Maybe I'll do a literature review in another blog.)

If you research something long enough, you eventually come to your own conclusion. Mine was that there was no way in hell I wanted any sort of unnecessary medical intervention.

How very UnAmerican!

This series of blogs is not intended to be a graphic description of childbirth, but to show the rest of the world how the NHS actually worked for me -- a self-employed American who has been fed the same stories about universal health care that the rest of us had. I attempt to be unbiased, but with every doctor/dentist/midwife appointment I had, I grew more and more impressed. And this blog grew more and more biased. Sorry. But it turns out the NHS was amazing. I promise to tell the downsides too though ... Previous blogs:


  1. Thanks for posting and sharing a bit more of your experience, Brigid!

    1. Many more to come:) Sorry I'm behind in emails!

  2. My experience in the US was a good one when a Scottish friend suggested a doula since midwives are not allowed in hospitals in Kentucky. The doula made good suggestions and helped me have a wonderful, quick birth. Also, suggest the book "Preparing for the Marathon of Labor". But... people here can't fathom it. Think you are trying to be a hero too if you don't get an epidural. Love following your blog. Looking forward to your contributions at the International Women's Day event on the Avenue!

    1. See you next week at the event! I imagine a doula is a great help in the US. We had one in Scotland, and she was amazing. It was a bit different than I imagine it would have been in the US, though, in that she was sort of like just having an additional midwife. We hired her because we wanted someone we knew at the birth, mostly because we didn't have any family there, and you don't get to choose which midwife attends the birth.

  3. thankyou for your positivity about the nhs-which on the whole is made up of lots of worker bees trying to do our best for the patient [which i think is the whole idea about healthcare],& almost an equal number of managers wondering why we can't fill out all the audit trails at the appropriate time so they can prove that we are doing ok to the press & the government [usually in that order],often we're looking after the patients & it's just not possible!