What is it like to be pregnant in London? To some extent, the same as anywhere else in the world. Your pregnancy hormones go up and down and you look forward to the arrival of your baby. And, if you are lucky enough to have family support and a great partner, these can be some of the most beautiful days of your life – when you are not held captive in your bathroom due to pregnancy sickness. But what is it like to be pregnant in London specifically? What are the approaches of British obstetrics? Is it true that the British health system – the famous National Health Service or NHS – is really ´on its knees´ and that maternity care in Britain is in a desperate state?
In this article, I will share my honest experience with giving birth to my 10-month-old baby. I hope that my story will help some women on their journey through pregnancy in the UK or inspire them to pursue a natural birth without the need of external intervention. Lucas was born during a summer heatwave, when the temperature in London reached nearly 40 degrees Celsius, and my pregnancy had far exceeded the usual 40 week limit.
In the 42nd week I was looking forward to the birth as well as some rainy days. However, still it did not rain and Lucas did not want to come out. Finally, 24 hours before I was to be induced, I was very lucky and I gave birth spontaneously and naturally at the Birthing Centre of Elizabeth Garrett Anderson Wing at University College London Hospital.
Happy pregnancy and natural birth in a very British way
Before I begin to describe my very personal experience, I will summarise the main specifics of British obstetrics. If the approach of British obstetrics were to be summed up in one sentence, it would be something like this: pregnancy and childbirth are seen as a completely natural biological process and not as a disease – so, unless there is a necessary reason to deviate from this, you are under the regular supervision of experienced midwives, not doctors.
Britain is one of the few countries in the world that allows a woman to choose between delivery in a hospital, in a maternity centre or a home birth. Giving birth at home is seen as a full and responsible method of childbirth. Moreover, homebirth very often takes place in similar circumstances as childbirth in the maternity centre. For example, there is a midwife present, who provides not only psychological support but also maternity equipment, such as a maternity pool, monitors and other necessary things to manage a successful natural birth.
The human individualism and right to choose where your baby will be born is therefore core to British obstetrics, unless, of course, it interferes with the child’s human rights to life. In addition, every pregnant woman in the UK is entitled to free dental care, which is covered by the NHS for a full year after giving birth.
It is also standard that you will receive a so-called ‘birth-book’ when you attend the first appointment with your midwife, which you should carry with you everywhere after that. The birth book includes detailed information about you, your health condition, baby growth charts, ultrasound extracts and results of all medical examinations. At the end of the book is your birth plan, which is really worth filling in carefully. Try to think about what you really expect from the birth, because during labour it is precisely this record from which obstetricians will draw and follow your wishes. In my case, my midwives at UCL Hospital were able to fulfil 90 per cent of the wishes in my birth plan, simply because it was impossible to cover all of them given my particular circumstances.
Maternity homes and birthing centres in Britain might be independent from or part of hospitals. For example, the birthing centre at UCL Hospital is part of the extensive Elizabeth Garrett Anderson Wing maternity ward. More than 6,000 babies are born there each year, and it has all the necessary equipment for both natural and physician-required births. The UCL Hospital birthing centre offers the possibility of water births, each room is equipped with shower and toilet, birth ball, bed and the necessary monitors.
To relieve labour pains, it offers aromatherapy (relaxing lavender oil), acupuncture, or gas and air. If a woman is in really severe pain, a midwife can offer opioid drugs (although this is unusual). In cases where the mother-to-be is feeling considerable exhaustion and weakness, despite all the described relaxation and pain-relieving techniques, and wishes to have an epidural, she is transported to a classic maternity ward in the same building. Epidural analgesia is provided in the presence of an experienced obstetrician.
Obstetrics in the UK therefore places considerable emphasis on a woman’s spontaneous natural processes during childbirth. Natural childbirth occurs when a woman is in a calm, safe and familiar environment, in a place where she feels relaxed and natural. When she feels calm, intimate and secure, her body releases the hormone oxytocin, often called the love hormone, during childbirth. This hormone is absolutely essential for indicating natural birth processes, such as uterine contractions, placenta expulsion, and uterine wrapping, but also for establishing a close relationship between mother and child, which arises immediately after birth, due to the placement of the new-born on the mother’s chest.
During bonding, oxytocin further triggers the mother’s subsequent lactation and is essential for the entire period of breastfeeding and the formation of a maternal bond. On the other hand, if the mother experiences a stressful situation during childbirth, the release of oxytocin decreases and adrenaline is flushed into the body. It follows that the subsequent birth slows down and there is a higher probability of external interventions being required in the birth process.
But that’s enough theory, so now let’s look at how pregnancy and childbirth actually looks like in London.
First trimester: Hooray for an ultrasound!
The first trimester of pregnancy began the day I held the pregnancy test and received a clear first message from the baby: “Hi, I’m on the way!” My head went into a spin with how lucky I was, and endorphins flooded my body. Thoughts flashed through my mind about whether this was really true and whether the pregnancy test was wrong or not, and so I did another test. It was clear: nine months on I would be a mummy and my dear hubby a daddy.
From that moment on, I felt like I was on a rollercoaster, which in the first trimester was punctuated by the initial round of hospital appointments and the first assurances that the baby was happy and healthy in my tummy. I made my choice of hospital, had a first consultation with a midwife and, most importantly, underwent the first ultrasound!
From my experience, I can recommend that you choose the hospital according to your wishes and ideas for the whole birth. As a first-time pregnant woman I wanted a natural birth without any medical intervention, but I also knew that I was not ready for a home birth. The idea of delivering my baby at home, in a relatively busy London street, with two energetic dogs in the house, stressed rather than reassured me. However, I did not want the classic hospital labour and my pregnancy to be perceived from the very beginning as a kind of illness where the presence of a doctor was needed.
For these reasons, I took up the option of filling out a ‘self-referral form’ and, on the recommendation of my friends, I chose UCL Hospital. Soon after completing the form, the hospital contacted me and sent me an invitation to the first appointment with the midwife, and three weeks after that, for the first ultrasound. I can’t forget how I counted the days to the ultrasound and how I was so excited, but also nervous that everything was okay.
The appointment with the midwife at UCL Hospital turned out very well, and because my pregnancy was classified as ‘low risk’, I was assigned (with my consent) to a birthing centre under the supervision of midwives. Although you should theoretically have only one midwife throughout your whole pregnancy until the birth itself, a different midwife was waiting for me at each new consultation.
At the first meeting with a midwife in the UK, you will receive various leaflets and brochures with useful advice and information to make your pregnancy as comfortable and healthy as possible for you and your baby, as well as a gift bag for pregnant women with various promotional samples, for example a leaflet with one of the most used mobile apps by pregnant women. I used this app, called Bounty, right away, because it usefully counts down the pregnancy weeks until the expected birth, displays weekly animations of the foetus in the womb or the size of the baby’s foot, and also offers mothers countless interesting articles and useful vouchers.
The midwife also explained to me at the introductory meeting what I could expect in the coming weeks and months and what would happen in the subsequent appointments. At this meeting I was also informed that all pregnant women in the UK are entitled to free dental care and was assured I would not have to worry about flying for the time being. So, in the 9th week of my pregnancy I flew from London to my home town of Prague, to attend a master’s degree graduation ceremony.
My husband and I spent the Christmas holidays in the beautiful Lake District National Park in Northern England, and the baby began to make itself more felt. For example, it sent me clear messages about what food would and would not be tolerated, so I had to adjust my diet. Fortunately, there are countless high-quality organic local foods available in the UK.
However, the most beautiful gift was waiting for us not under a tree in the Lake District but at UCL Hospital on 11 January. I was in the 13th week of pregnancy and we learned on the first ultrasound that our baby was completely healthy! Few things it the world can compare to this feeling when you know that your baby has nothing to worry about, and you can see him or her and hear the heartbeat.
The first ultrasound is called the ‘dating scan’, and the approximate date of delivering our baby was calculated to be 19 July. At this appointment the test was also carried out to check for possible developmental defects. The first successful ultrasound was also a reason to share the happy news with our whole family and close friends who didn’t know anything yet. With a growing belly, I had a beautiful and happy period of pregnancy to look forward to, filled by preparations for welcoming the baby, concentrating on caring for my mind and body, and also mindful preparations for a natural birth.