Pregnancy and the NHS

I have been meaning to write this post for months now, and I'm finally doing it.  Hooray!

So, for those of you who haven't had a baby in the States recently, I'll try to detail my experience here as well as my experience there.  Granted, my experience there wasn't 100% normal since I used a midwife and delivered in an Alternative Birthing Center within a hospital.  However, the pre-natal care is pretty standard, so I'll focus mostly on that (since I haven't had my baby here yet anyways).

Upon finding out that you're pregnant in the US you immediately book an appointment with a OB/GYN or midwife and take a pregnancy test to confirm.  After that, you choose who you want to be your doctor or midwife and begin regular appointments.  I believe it's once a month for the first 6 months and then every other week until the last 4-6 weeks and then every week until delivery.  There are also ultrasounds at 8 weeks and 20 weeks unless you are having issues and then you get some more often.  You usually see the same dr/midwife or drs/midwives within the same private practice knowing that one of these people will be delivering your baby (or should I say helping you deliver your baby!).

Here it's a bit different.  Upon finding out that I was pregnant I went to my GP (General Practitioner) at the "surgery" that we are a part of.  Surgery is what they call a practice or medical group.  Balham Park Surgery is where we go.  So, I called and scheduled an appointment and was seen by a GP.  She gave me some paperwork that congratulated me, told me to take vitamins, told me what not to eat, told me not to drink "too much alcohol" and informed me of my choices for delivery.  Here you have 4 choices for your delivery: NHS Home Birth (where a midwife comes to your house when you're in labour), NHS Midwife Led Hospital birth (all straightforward labours and births are midwife led), NHS Elective Cesarean (which are never mentioned and until recently believed to be not allowed.  There is a very stringent process that you must go through in order to have an elective Cesarean through the NHS.), and "Going Private" (this means that you elect to use your private insurance which often covers very little of the birth.  People choose to go private because they get private rooms for aftercare and generally more catered treatment since the hospital would be making money off of them.)  Some people go through the NHS but ask if there are any private rooms available and then pay out of pocket for a private room once they're at the hospital.

I knew I wanted to have a Midwife Led Hospital birth so now I needed to choose the hospital.  People often go with the hospital near their house or one that they have had recommended to them by friends.  Since I didn't know all that many people when I found out I was pregnant I went online to do my research.  St. George's is the hospital near my house, but I had also heard good things about St. Thomas's and I had been there once while we lived in Westminster.  St. Thomas's has a very nice labour room where you can look out the windows onto the River Thames, Big Ben and Parliament, but I've been in labour before and I know what a waste that is.  A fantastic view like that should be saved for people recovering, not those in labour.  Labour is a time to turn inward, focus and shut out distractions... I had my blinds closed during my entire labour with Vivian.

The hospitals no longer allow tours because of the risk of spreading illness to the mothers and babies, but you can go to their website and get a virtual tour.  St. George's has a natural birthing suite with pools for water birth and it's close to our house, so I chose to deliver there.

At my meeting with my GP at 5 weeks she told me to choose a hospital and then schedule my booking appointment at 8 weeks.  At that appointment they take your blood and urine to check for abnormalities and ask you what type of birth you'd like.  I told them I would like the Carmen Suite (which is the natural birthing suite) and they noted that making sure I knew that I could do that if it's available.  (There are 5000 babies born per year in this hospital, so people don't always get what they want during labour and delivery.)  I expected to get to hear the heartbeat at this appointment but the midwife said no.  Apparently she would get in trouble if she tried to listen to the heartbeat so early.

At 12 weeks you have your first "scan" (their word for ultrasound).  The 12 week scan checks for likelihood of Down's Syndrome and checks to see the baby's size and how many are in there.  After the 12 week scan you wait to get the results of the Down's test in the mail.  It arrives and gives you a % chance that your baby has Down's syndrome.  Ours was extremely low.

At 16 weeks we went in for our first real midwife appointment.  The midwife just asked us questions, checked my urine and let me listen to the heartbeat.  It was all very straightforward and I didn't have any questions, so it was quite quick.  Mark and Vivian came to that appointment with me.  After realizing how quick it was, I told Mark he doesn't need to take time off work for that again.  It's 30 minutes of waiting in the waiting room and 10 minutes of talking with the midwife.

After the 16 week appointment there are no appointments until your 20 week "anomaly scan."  At 20 weeks they do an intensive scan where they check for any abnormalities in the baby's size or various organs.  The man who did our scan was extremely thorough.  He showed us every organ and commented on the fact that it was healthy and normal.  We got to see the heart and brain in detail and we got to know the sex of the baby if we wanted to... we did... It's a girl!

No appointments after the 20 week scan until 28 weeks.  At which time they just ask you questions, check your urine, measure your belly and listen to the heartbeat.  I had a few questions this time, but it still took about 10 minutes.

No more appointments with the midwife until 36 weeks, but at 34 you're supposed to go see your GP again.  I just did this on Wednesday and it was very straightforward.  I'm not sure why you do it, but it went just fine.

I have my 36 week appointment in two weeks and we'll see what happens there.  I'm sure it's more of the same.  They begin asking you questions regarding swelling and check your urine for sign of protein which indicates pre-eclampsia.  Pre-eclampsia is dealt with seriously here as it is in the states.  If you show signs of it in the states, they induce you.  I'm not 100% sure about here, but I believe it's the same.

There are certain routine tests that are done in the states that are not done here without some factors indicating high risk.  For example, gestational diabetes are only tested here if you show serious signs.  When I asked about that the midwife said I definitely did not show signs.  They also don't test for Strep B which I have heard can be a problem for the women who do have it.  I'm not 100% clear on what Strep B is, but I know that the mother can carry it and then pass it onto their baby during birth resulting in quite a lot of complications.  If you are known to have Strep B you have to be on antibiotics for 24 hours prior to delivery in order to prevent your baby from getting it.  I'm not sure how they handle that here.  I guess I should ask.  I didn't have it with Vivian, but I think you can somehow contract it during pregnancy.

The other thing they don't do here is internal checks.  During my pregnancy with Vivian they did routine internal checks to make sure that everything looked normal.  When I asked about that here the midwife said that multiple studies have shown that it doesn't do any good, so why not just leave well enough alone.  Sounds good to me!

So, there you have it.  I now have 5 and a half weeks to go.  I've not seen the labour and delivery ward or the Carmen Suite.  I have been to the hospital three times, so I know generally where to go, but no more than that.  I have a friend who used to work there and has friends there.  She told me this morning that she might be able to get me in to see what I'm working with.  Mark and I are doing a Natal Hypnotherapy workshop in two weeks.  It was recommended by a woman that has given me a few massages.  She said that I would benefit by it because of the fear that might be associated with labour and delivery after breaking my tailbone last time.  I agree.  I don't want to go into this feeling afraid.  That wouldn't do anyone any good.  In Natal Hypnotherapy they recommend touring the hospital before hand so you know exactly what you're dealing with.  Uncertainty brings fear and that causes all of your muscles to tighten and your adrenaline levels to rise, which is the opposite of what you're trying to do.  If I can get in to tour the hospital I will!

When I first found out I was pregnant I was really worried about what I'd do with Vivian when I went into labour.  A friend at church and playgroup soon after offered to watch her for me.  A few weeks ago another friend from church and playgroup offered to be a backup.  It's nice to have friends!  I will still be concerned that she's doing okay, but it's so nice that Mark can come with me to the hospital!

I'm glad I finally got this all down.  Sorry for the novel, but I know that several people were very curious.  I will keep updating the blog with information regarding the NHS as it happens.  Hopefully there won't be too much prior to the actual delivery!  Here's to a quick delivery this time!!!

British Accent

Ever since we announced that we were moving to London, people have been speculating about when Vivian will get a British accent.

Well... lately Viv has been doing this baby talk thing that has been driving me crazy.  Whenever she does it I tell her to please speak in a "normal" voice to me.  It turns out she is just speaking like most of the people that she spends time with (including the kids of American friends who also have accents).

Now that I know that I don't correct her anymore, but it still is quite annoying.  It's funny... I thought I would love it and think it was so charming, but the transition is a bit less charming than I anticipated.  She gets a different voice and speaks kind of funny, but nails the pronunciation of the vowels and everything.

I don't know if I've written a post about this, but when you call things "British" here, English people will often subtly correct you.  For example, at Christmas I mentioned that I was making a Traditional British Christmas dinner and people would say, "Oh, a Traditional English Christmas... How lovely."  It makes sense.  4 countries with their own history, culture and accents were brought together to form Great Britain, so of course they would distinguish themselves.  I have been here almost a year and I still make that mistake... I'm working on it!  So, I guess I should say English Accent rather than British.

Vivian starts nursery in September.  She'll be going 15 hours a week, so I'm sure this whole accent thing will become much more noticeable.  We'll see what happens when we visit the states at Christmas.  I'm guessing she'll switch it on and off.  We'll see.......

Our first British Birthday Party

This afternoon Vivian and I went to our first British birthday party.  Vivian's friend named Isabel turned two today.  They had a "birthday tea" at their house and it was quite nice.  We arrived late because Vivian napped a little late today, but we didn't miss any festivities.

I'm not sure that all birthday parties are exactly the same, but there is one obvious game that everyone plays that we were completely clueless about: pass the parcel.  So, they take one small gift and wrap it as many times as there are children and each time they wrap it they put a little gift inside.  Then they play music and when the music stops the child holding the parcel gets to unwrap a layer of paper.  In this case there were tiny board books in each set of wrapping.  It is quite fun.  Every child gets to unwrap a layer and they all do quite well passing the parcel (except Vivian who had absolutely no idea what was going on and what she was supposed to do).  At the end the final unwrapping stage landed on Vivian, so she got to keep the main gift!  Apparently Rosie (Isabel's mum) bought it specifically for Vivian because it was an English traditional video of someone named "Postman Pat."  I think it's a cartoon that has small episodes of classically known British stories or something like that.  We'll see once we watch it I guess.

After the treasure hunt, which involved all of the children finding chocolate bars around the room, and then another treasure hunt which involved the children finding eggs stuffed with gummy candy in a box full of packing peanuts, we played pass the parcel, the children had "tea" (which is just dinner), the adults (mums) had a glass of prosecco and then everyone had cake which also had gummies on top.  I'm absolutely positive that this is the most sugar Vivian has ever had in her life.  She was quite happy as we walked home and played energetically "splashing" on the couch for a while when we got home and then started getting really whiny.  Needless to say I put her to bed about 30 minutes early and now I'm sitting down to enjoy my freshly delivered Indian food.

I'm glad that we've been to a British birthday party!  It was great.  I'd like to incorporate pass the parcel into our traditions, because it's so fun and inclusive.  I don't think I'll incorporate quite so many opportunities to gorge on sugar however... but that's just me.

We got a dryer!!!

I wrote a whole post on laundry right after we moved to London.  We were still in corporate housing and air drying laundry was still quite charming and new.  It's been 10 months now and I've been air drying shirts, jeans, socks, underwear, sheets and towels this entire time.  I've also been ironing everything that we wear that you can see... it takes forever and gets really old.  I mean, there are obviously worse things but in anticipation of having another baby with all of her tiny little clothes and blankets and burp cloths and diapers we decided that we would spring for a dryer.

We found something called a condenser dryer.  It doesn't require venting because it stores all of the water that it pulls out of the clothes in a little bucket drawer that you pull out and empty after each load. It's really quite brilliant.  We were going to put it in our cellar but it wouldn't fit through the door so it's sitting in our kitchen/dining room/breakfast nook.  Not super classy, but who cares.  We're not that classy anyways!

We've had this dryer for a week now and it has changed my life in a few ways:

1) Our office is no longer our laundry room.
2) I didn't iron one thing all week this week leaving me time to do other incredibly important things like... not iron.
3) I did four loads of laundry in two days.  From the hamper to the drawer!  Four loads in two days!  That is absolutely incredible.  I feel like a new person.
4) It's not so hard to keep the house clean when there aren't clothes strewn about the house drying.  Now I just need to get better at keeping my kitchen clean!

So, some might say I chickened out.  Some might say I gave in.  Some might say I finally came to my senses.  I don't really care either way... I'm just thrilled that I can actually get laundry done in a reasonable amount of time.  YAY!