A note from Pie Face: Pregnancy is a universal facet of any healthcare system, and so I have asked moms who gave birth in publicly funded systems to tell us about how they interacted with the systems, and whether they felt supported and prepared for the complicated and difficult medical process that is pregnancy and childbirth. Remember, this used to kill 1/3 of women, so it’s an important metric for the success of any healthcare system. Here’s one mom’s experience in Britain’s NHS.
As a pregnant woman in the UK, my first point of contact with the NHS was an appointment with a midwife at my General Practitioner (GP) surgery. Considering I was only 6-8 weeks pregnant (think blue lines on a stick rather than cute scan picture), this was far more thorough that I expected. It covered birth options, weight and blood pressure checks, nutritional advice and any concerns or previous complications. I came away with a big folder of acronym-heavy maternity notes to keep with me in case of emergencies and take to subsequent appointments. Pregnancy is confirmed and dated based on an ultrasound scan at around 8-12 weeks, which I had at a local hospital. I also remember blood tests around this stage. Personally, I felt no pressure from my midwife in relation to screening options or my choice of where to give birth.
My two pregnancies were both straightforward until the later stages; I went along for appointments with my midwife every few weeks and to hospital for a routine scan at around 20 weeks, at which the sonographer checks for abnormalities. Barring the odd appointment delay, the system ran smoothly. I had my midwife’s mobile number and contact details for the hospital maternity assessment unit in case of any concerns.
Despite regular contact with midwives, I didn’t see a doctor at all during my first pregnancy until the day I went into labour. Maybe this hands-off approach is one of the reasons National Childbirth Trust (NCT) courses are popular in the UK among those who can afford them. I agree with the general consensus that these courses are good for peer support, but can see why they are criticised as too middle-class and for glorifying low-intervention birth. There are free NHS antenatal (prenatal) courses, but provision seems patchy and our local sessions were run on a weekday morning, so not great for working parents.
After a complicated birth first time round, my second pregnancy included an appointment with a hospital consultant: a frank, unhurried, informative conversation. Later in my second pregnancy, I became ill and had appointments with my GP and midwife. Looking back, I think better communication between these two could have reduced or avoided complications.
When it comes to the actual births, my tendency is to wax lyrical about the amazing NHS hospital staff involved. Possibly this says more about the nature of my experiences than the quality of care, but the fact is that in another place or another time, the outcomes for me and my children would have been very different. My first child arrived via emergency c-section, my second was born prematurely and spent three weeks in a neonatal intensive care unit.
Among the many positives (aside from two healthy children), I gave birth in a clean, comfortable, private room with the support of thoroughly professional midwives and doctors. I was discharged at a reasonable time and felt informed about and involved in decisions relating to our premature baby’s care. I’m not saying our hospital experience was without fault; an accidental double-dose of antibiotics for our newborn baby, staying two nights on a crowded ward after surgery and conflicting advice about breastfeeding could all be perceived as symptomatic of a system under strain.
My experience of postnatal care was mixed. The community midwife visited a few days after birth and I went to a local clinic for a postnatal check-up: all fine. However, subsequent home visits are made by a health visitor (a qualified nurse or midwife specialising in public health). These checks are intended to support parents and ensure the baby’s development is on track, but I’m not the only parent to find them a bit intrusive. Something I did find helpful was a free six-week postnatal course run by health visitors at my local NHS clinic, but this has since been scrapped (presumably due to funding cuts).
Contact with health services has been a regular feature of early parenthood – from getting prescriptions for antibiotics to treat mastitis to accessing support for mental health issues, infant vaccinations, getting coughs and colds checked out and minor surgery for trapped fingers. It’s not always easy to judge the seriousness of children’s health conditions – especially before they can talk – and I feel fortunate to have access to decent healthcare without having to worry about the costs.