Special Delivery!

When last we visited with CasaPope we were a wee family of three.  Since then-going on 9 months now- there have been some slight changes and lots of hubbub going on at CasaPope.  We've since taken on a new member to the Pope Clan with a new wee little one joining us in early March. Baby Z reminded us that we know nothing about being parents.  One forgets that one forgets everything after you've endured any pregnancy.

Being far, far away is never easy, least of all when you have kids, or when you're about to have another one.  Luckily, my mom was incredibly generous and planned her Spring Break around my due date.  With that said, her flight literally touched down in Scotland and James was already waiting at the gate to pick her up to drive her straight to the hospital where I was "waiting around" to bring forth life unto this world.  Sorry, but you get no break or rest from the jetlag when you visit CasaPope. 

So crisis averted, as we actually showed up to the hospital with our 3-year-old, as our previous child-minding plans had fallen through.  The midwife was quick to chastise us for the inappropriateness of bringing a child onto the Labour Ward-shocker.  We were likewise quick to remind her that it was also quite frowned upon to leave a child alone at home.  Silence.  The midwife later warmed up to Stella since she is just pretty awesome and incredibly well-behaved for her age, or really any age.  

HAVING A BABY IN THE UK

So having had one pregnancy/birth experience fully in the US, the entire pregnancy/birth experience was completely new and foreign (no pun intended) to me again.  It was actually made worse by the fact that I did have a previous experience and set of expectations for the whole process engrained in my brain.  My midwife(ves) tried not to find this irksome as I constantly referenced my previous American experience, but I'm sure she rolled her eyes on more than one occasion.  I tried to make it clear that I held no preference, or sense of superiority, towards one or the other, but simply it was my only frame of reference and I needed to constantly ask questions, like a new mom (or worse I'm afraid), to reset my expectations for an entirely new experience and wholly different process.

So a little Compare & Contrast is useful for explaining some key differences with birthing in the US v. UK. Disclaimer: this is all to the best of my recollection and best case scenarios as we were incredibly fortunate to not have any subsequent issues with baby or mum in either instance in the US or UK.

US	UK
Pregnancy Test: had confirmation by patient history and ultrasound at the OB/GYN	Midwife took my word for it and just proceeded with basic line of questioning for medical history and records.
OB/GYN: with variable options for midwife utilization depending on personal preference	Midwife- never ever saw an OB/GYN for any part of pregnancy
Pre-Natal appointments are often and frequent especially as you near you due date.	Ante-Natal appointments are every 4-8 weeks up until your due date and only after that point are they weekly/bimonthly. I had to travel with my own urine sample from home. There's not really much more to add to that other than at least you're provided with a sterile container at each visit for each subsequent sample.
Ultrasound: had one on my very first visit at about 7 weeks to confirm pregnancy, then again a few weeks later (possibly-I can't recall), and another at about 22 weeks, which is when all the measurements, NT, sex determinations were performed.	Had 2 ultrasounds-once at about 13 weeks, called the dating scan as that's primarily just measurements for, you guessed it, dating the pregnancy.  The second was done at about 20-21 weeks for an anomaly scan which is self explanatory.  At no point are you supposed to ask the sex of the baby, it's considered rude and irrelevant to the true task at hand which is assessing health of the fetus.  Should one want to know the "gender," one is instructed to contact any of several local and private sonographers that primarily function in such "gender reveals."  I did find that medical personnel in the UK were much more personable, less haughty, and more receptive to questions in general.
PRENATAL TESTs: Glucose Tolerance Test-yet another thing to make women feel like they are the worst mothers on earth before even being mothers.  Had to do the short version AND the 3-hour version.  After enduring that misery, I had to call after several weeks delay to check the results.  It was normal. Thanks for the reassuring call telling me all was alright.	GTT: Eh.  Asked about it. Was told might need to be done, but not likely.  Was never done.  No better, no worse for it either. Strep B:  is not a standard test and therefore not performed with in the NHS.  If you want it done, you must order yourself, collect the sample yourself, then return by mail to a central lab in London to await your results which generally are 2-3 days and you have to pay if you want the results.  The test kit itself is free.  If however, you test comes back positive, the NHS is required to treat you and baby as needed.
Medical Records: mainly electronic then transferred, as needed, once admitted to hospital	I was given a standard issue booklet in which all my notes were documented at each midwife visit and anytime I went in to hospital for testing, ultrasound, etc, until about 4 weeks post-natally.  I was responsible for hand-carrying my notes to any and all appointments.
Pain Management: Whatever you want or can afford or is covered by your insurance.	Standard tends to be air & gas, occasionally you can have morphine, some women try a TENS unit that you have to purchase on your own and operate independently.  Epidurals are possible, though not favored or encouraged.  If however, you know that this is what you want, you have to make it explicitly clear early on, and throughout the process, that this is what you want plus the timing is much trickier.  In the maternity hospital, there is only one on-call anesthesiologist.  If he is unavailable because he's in surgery for c-sections or emergencies then you're out of luck and either have to wait or do without.  With that said, if you want to labour a bit before slowing down the process with an epidural you may have to ditch that plan and get the anesthesiologist in for your epidural the minute he's available.
Epidural: Full numbness from waist down with no motor control making body awareness difficult when it came to the delivery process and "pushing." Had an incredibly painful recovery and mobility was difficult for several weeks post-delivery.	While I had issues with the dispersion of the anesthetic (too high and poor coverage over the pelvis-where I REALLY needed it) it was a much easier recovery and I still had some movement and feeling to LE's.   Was able to walk around more easily within 2 hours or so post-delivery, mobility was not an issue this time around. Oh, and they let you still have food once in the hospital even if you're having an epidural—probably not the best option as I actually threw up right after Baby Z graced us with her presence-no fault of her own though.
In the Hospital: Had a private room where James was able to stay overnight and help care for and bond with our newborn.  We had great food for both of us and were catered to by the dietary department.  Were able to stay for up to 2 nights AFTER giving birth, which for us, at the time, was nice and welcome.  Were able to have the baby sent to the nursery as needed.  Had a baby lojack on her ankle to prevent kidnappings.	Post-birth we were transferred to one of 4-5 wards in which I was in a room shared with up to 5 (FIVE!!!) other moms and their babies.  Only separation was ceiling-hung curtains.  We had one toilet and one shower between all of us. James was allowed to go down to the ward with me when I was transferred, but had to leave after a few minutes of settling as this was outside the normal visiting hours. No baby lojack.  They give you your baby after delivering and it's now your responsibility.  They do not ever take the baby away from you.  If any tests need to be done, you will always go with your baby (under normal circumstances, again). SLEEP IS IMPOSSIBLE It is run like a prison (I imagine). Lights go out and come on at very specific hours. I would say it is borderline torture, where all the forces within the hospital conspire against new moms to keep them sleep deprived, by putting them with other moms and visitors, and not one, but many crying babies and lights coming on and off at the whim of whoever. There is too much hallway noise anyway to sleep ever even if you didn't have 5 other moms AND 5 other babies in your room. Plus, the unit secretary constantly insists on pulling open your curtains even when you’re in the midst of juggling a baby and your bits in an attempt to get comfy breastfeeding. Never mind the fact that all these other people may or may not have family, husbands/partners visiting and all in full sight of you difficulties.  Never you mind, one must always be social.
Post-Natal Care: Mum: I recall an appointment at about 6 weeks and then nothing again for another yearly well woman exam Baby: had to go into the pediatrician each time starting early on for us because of weight issues and for subsequent immunizations.	I didn't have to leave my house for a few weeks for any appointments.  The midwives & health visitors (essentially pediatric nurses) came to check up on myself & Baby Z several times a week until we were discharged from their care at about 4-8 weeks, at which point my now tattered medical record booklet was finally taken away and stored. Didn't have to go in to the health clinic until about 8 weeks, or so, for Baby Z's first shots (jabs).

To avoid learning about the reality of the miracle of birth stop reading here.

38+5 Ready to go in for my "birthing" appointment.

Unbeknownst to me, my water broke on Saturday morning, or so we found out in the early morning hours of Sunday which took ages to confirm.  In the US, I went in to hospital in labour which was confirmed within a few minutes with a basic test.  The same "basic" test in Scotland took nearly 5 HOURS!!!! Only to be told, "Oh looks like your water did break after all, let's make you an appointment to have your baby next week."  "Seriously?! Next week?  OK. Fine by me since I won't have childcare until Monday mid-day when my mom flies in from the States." So I admitted myself to hospital the following Monday morning and finally had a baby early Tuesday Morning-nearly 72 hours later.  In the US, the on-call OB/Gyn was freaking out that I get to the hospital ASAP when my water broke 20 minutes earlier. Such a HUGE & drastically different attitude and philosophy towards child birth. Though it's fairly easy to recognize how much of our US practices and guidelines are steered by the overly litigious nature of our society.

Regular appointments are not as frequent as in the US. Midwife appointments generally occur every 4 to 8 weeks until you get to your due date, at which point they are 1-2 weeks after your due date it reached, with additional appointments at the hospital around 12 & 20 weeks for your US scans. Again, I never saw anyone other than my midwife except for the anesthesiologist for my epidural. You're never really "examined" in the same way you would be in the States until you are actually in labour. Every visit to the midwife consisted of my handing over my homemade urine sample, a BP check, verbal Q&A, and measuring my belly.

You have to pretty much pack your own supplies for baby and for yourself for the hospital…not even Kleenex is provided let alone any sanitary products.  No towels, no shampoo, no soap.  You do get fed and you do get water, plus tea and toast since that makes everything better, including labour pains, apparently.  Baby Daddies cannot stay in the hospital and are only allowed during specific hours as are other visitors (during shorter hours).  You're not allowed baby wipes in the hospital.  If caught with them, you will be reprimanded, or if American, they'll just roll their eyes at you and tell you you're wrong. Instead, you're supposed to clean newborn baby bums with cotton balls and water, only using each cotton ball for one, single directional wipe then tossing and replacing until done.

You don't get a hospital gown. You deliver in whatever clothes you show up in.  Caveat: If you deliver in what's referred to as the Labour Ward, you get a gown.  Only a small fraction of women deliver in the Labour Ward: DRUGS or more medical intervention/monitoring required.  I made it clear I wanted drugs, so much so it was written on every page of my Ante-natal (pre-natal) birth record-which again resulted in lots of eye-rolling.  But that's fine. I know myself best and was able to articulate my desires and rationalizations quite easily, which avoided any attempts to sway me otherwise.

Cell Phones are not allowed.  If you want to make a call you have to use a payphone.  If you want to watch TV you have to pay for it.

In the UK, typical hospital discharge happens within 6 hours of delivery. Once I wrapped my head around that, I was on board and charging at the door to get out about 2 hours after giving birth only to hear, "Oh you have to stay for 2 more nights because you went so long after your water broke before delivering."  "What?!?!?! You let me go that long!!!!" Needless to say I wasn't too thrilled about the thought of spending 2 more nights in the hospital.  A stark contrast to how I felt in the states where I enjoyed the food, the care, and the privacy along with the help from James round the clock with baby.  He changed a diaper before I ever did!

Your husband/partner is allowed to help you settle into whatever ward you're transferred to post-delivery, but he has to leave within a few minutes if it's outside visiting hours, which it was at 5 in the morning.  Being our second child, and having another kid waiting at home for a parent, this wasn't too much of an inconvenience, but I can't imagine having to do that with our first baby. Shared misery after our firstborn was a great bonding experience for us as parents.

Just as not much is provided for Mum, not much is provided for baby except a clear bassinet similar to the states and a blanket which you cannot keep.  They will provide a few cotton balls (see above on nappy changing), but nothing in the way of food or clothes, etc. for baby. 

They don't bathe the baby at all. Sometimes they ask- if you're still there a few days in the hospital-if you'd like the baby bathed.  Everyone else in my room was asked except for me. So on the last day, when I was desperate to leave and everyone else's baby was being bathed, I didn't bring it up since I didn't want to delay our discharge only to have to wait until 6 pm to finally be allowed to leave.  The baby never leaves your side.  There are no ankle lojacks attached to baby.  They basically hand your baby over to you once you've delivered and she never leaves your sight.  It is very bare bones and basic, but competent and respectful…for the most part.

When I had my first baby in the US, I loved my personal experience. I had no major complaints.  I also had no other comparison.

When I had my second baby in the UK, I loved my personal experience. I had lots of minor complaints since I had a comparison.  The midwives were great, even though I had seen 6-7 midwives throughout my labour process.  The post-natal care was incredibly convenient.  Who wouldn't want house calls after just giving birth?  The approaches and attitudes towards pregnancy and birth are drastically different. Recognizing these differences and their existence goes a LONG way towards setting your expectations appropriately and making the process incredible along the way.  

Big Sister meets Baby Z

Finally home from our sleep deprivation experiment at the hospital.

Also can't stress enough how great our American Women's Assoc. of Aberdeen and Moms & Tots groups were in visiting and bringing meals for the family and sweets gifts for big sis.  It would have been so terribly isolating without them.