Unless you’re having a complicated pregnancy that requires specialist care, you’ll be looked after by midwives all the way through your pregnancy and delivery. Your first appointment is called the ‘booking-in’ appointment. The midwife (you may see the same one for all your appointments or bounce between different midwives at the same practice) will take all the pertinent info on your and your partner’s health, as well as some family history, and carry out some routine checks, like taking your blood pressure and drawing blood to test iron levels and such. Once you’re in the system, you’ll be scheduled for your first scan after 12 weeks. For that, you typically have to go to a hospital or other centre where they actually do ultrasounds. At the first scan, they’ll give you an official due date, and if you choose to run the tests for Down’s Syndrome, they’ll do that during this appointment as well, mailing you the results a week or so later. You’ll have another scan—the rather frighteningly named anomaly scan—around 20 weeks, when your baby will be checked for issues like spina bifida. You can also find out the sex, if you choose. If your pregnancy is progressing normally, these are the only two scans you’ll have. If you want more, there are private clinics you can visit, but you’ll have to pay out of pocket (usually a couple hundred quid, from what I hear).
If you’re having your first baby, you’ll have around 10 midwife appointments (if you’ve already had one without any complications and this pregnancy is progressing normally, you’ll have fewer appointments). Appointments are scheduled more frequently as your due date nears (about every week to 10 days close to the end), and as things progress, the midwife will measure your bump and check the baby’s heartbeat.
In your last couple of months, your midwife will tell you about NHS-provided antenatal classes, which are brilliant for a couple of reasons. One, they’re run by midwives, so they’re a great opportunity to get some questions answered. Two, they’re the perfect place to meet other local parents. I still meet up with some of the other mums from our antenatal class. And in case you’re worried about having to burn vacation or personal time on all these appointments, fear not: employers have to give you the time off to attend antenatal appointments and classes, penalty-free.
At some point, obviously, you’re going to have to let your employer know that you’ll be taking time off to nurture the next generation, and that’s when you’ll start planning your maternity leave. As someone coming from the US, this was a seriously eye-opening time for me. You’re entitled to up to a year off work after you have a baby, and many women take the full time. I don’t know anyone who’s taking less than six months. By law, you have to take off at least two weeks. Dads are also entitled to two weeks off, though that’s typically unpaid. The laws are changing to allow parents to share the leave, if mum wants (or needs) to return to work and dad wants to take a few months off to be the full-time parent at home. During most, or possibly all, of your maternity leave, you’ll be paid in some way. The organisation I work for offers an enhanced maternity leave which pays full salary the first few weeks, then switches to either half pay or statutory maternity pay for most of the rest of the leave. There are only a few weeks at the very end of the leave during which I’ll be receiving no pay, so it’s a pretty sweet deal overall. Companies that don’t operate like this offer statutory maternity pay, which is 90% of your pre-tax pay for the first six weeks, then £138.18 or 90% of your pay for the next 33 weeks (whichever amount is lower).
As an added bonus, even though you’re taking time off work, you still accumulate your vacation days for the year. You can then either tack those onto your leave (so you get another few weeks of leave, at full pay) or you can make them part of the leave itself, so you have fewer weeks of pay-free maternity leave.
I’m not going to lie: there’s a bit of social pressure to go natural with childbirth here, so that’s the route a lot of us choose to go, if possible (I don’t think anyone in our antenatal class admitted to planning on getting an epidural, though surely some ended up going that route in the end). When it comes to giving birth, you have a couple of choices: you can give birth at home, with the assistance of a community midwife; go to a midwife-led unit in or near your local hospital (the Lothian Birth Centre, in my case); or, if you are having any medical interventions like a c-section or epidural, the nearest hospital maternity unit. Obviously it’s an entirely personal choice, but I can say from experience that they do all they can to make the birth centres the most attractive option in the hospital. This is what the rooms at my birth centre look like:
No joke, they all had lovely giant tubs, pull-out sofa beds, flat-screen tvs, birth balls, giant private bathrooms, the works. The midwives there were also trained in aromatherapy, which was nice and all, but didn’t seem to make much difference for me. If you go the natural route, your pain-relief options include the birthing pool (which helps a lot more than you think it will), gas and air (useless for me, but I hear others liked it), the aforementioned aromatherapy, and a morphine shot, which was awesome right around labour hour 50. The midwives at Lothian were brilliant, though I do recall bickering with mine over the lighting levels (I wanted it bright, she was inclined to turn the lights down). Just make sure you stand firm if you feel really passionately about something, ask all the questions you want, and make your partner your advocate, because at a certain point you’re not really going to be in the best shape to be speaking up for yourself.
I should mention that before you go into labour, you’re usually encouraged to write up a birth plan. Definitely do it, if for no other reason than it gives you and your partner a chance to really think about what this is going to be like and how you’d ideally like to see it go. But accept the fact that at some point, the plan is likely to go off the rails. You may decide you need more pain relief, or something might happen that necessitates further medical intervention. Don’t get too attached to the plan and get upset if you have to deviate from it.
Also: bring snacks. And reading material. You need to keep your strength up. I recommend trail mix and nuts, and maybe something starchy like pretzels or rice cakes in case you need something to settle your stomach. As for the reading material—you’ll have some lulls to fill every once in a while. Reading aloud is something you can get your partner to do. Which reminds me: give your partner things to do. Obviously they’ll be holding your hand or whatever through contractions (hopefully, anyway), but in between times, they can sometimes feel a little helpless. I put my husband in charge of music (I obsessively made both a soothing and a motivating playlist, which both got some great use) and had him reading aloud to distract me.
You’ve had your baby, congratulations! If you’re home, you’re probably going to just relax in bed or wherever. If you’re in hospital, you’ll be moved to a recovery ward. In my hospital, it was a tiny ward with four beds in it, all curtained off for privacy, and a communal table in the middle where we could have meals and frequent snacks of tea and toast brought round by the midwives (which seemed so amazingly British to me. I’m pretty sure from now till the end of time, the taste of toasted white bread spread with Flora buttery will remind me of having my son). The ward is staffed by midwives, as you can imagine, and they’re constantly circulating to help you out and provide advice, which is particularly great in those early days of breastfeeding (which is hard, don’t let anyone tell you otherwise!) Each midwife has a different trick to share, so take advantage of that, it’ll help! And no question is too silly, ask away!
Once you’re discharged, you’ll have a day or two at home to regroup before one of the community midwives comes around to give you and your baby a checkup. Yes, that’s right, they come to you. Does anyone in the US do that anymore? The midwives typically come around periodically over the next 10 days to make sure everyone’s doing ok, that you’re healing up and baby’s eating well and putting on weight. You can have them come as often or as little as you like. If all is well, the midwives will then be replaced by a health visitor, who similarly will come by to weigh the baby and make sure mum is doing well both physically and mentally. If everyone’s healthy and happy, the visits will taper off and you can start attending weekly free clinics in your neighbourhood. There, you can weigh your baby and ask staff nurses any questions you may have. And meet with other parents, which is important.
Astonishingly (to me) every last bit of care I received was completely free. No copays, no hospital bill to deal with at the end. And I absolutely can’t fault any of the care. Socialised medicine is actually pretty brilliant.
As I mentioned before, breastfeeding is hard. Yes, it’s natural, but it’s also a skill both you and the baby need to learn, which is why the midwives in the hospital are so helpful. After you leave the hospital, the visiting midwives and health visitors can help you out with issues you might be having, and if they can’t help, there are free breastfeeding clinics you can go to, where experts can give you advice and ease your fears. For me, the most helpful thing was to keep reminding myself to stay calm and not immediately get frustrated if it took him a little while to latch on or whatever. If you get all tense and upset, the baby will too, and that’ll just make things harder for both of you.
Out and About
It’s great spending tons of time with your little one, but you do want to get out of the house at some point, so definitely look into things you can do with him or her. Ask other mums you know about classes and activities in your area—in some areas you’ll actually find plenty of free things you can take your baby to, like yoga or playgroups. In others, you may have to pay a couple of pounds for these. Some cinemas (in the cities, at least) also offer baby-and-carer viewings of the latest films, so you can go see X-Men without feeling badly if your baby starts crying in the middle of it (the Odeon near me does a particularly good baby cinema—they come around to your seat to take concessions orders and then give you biscuits before the show starts!). Local libraries also run biweekly Bookbug (Scotland)/Bookstart (rest of the UK) sessions for babies and toddlers, which are basically music and rhyme time and are totally free (the Bookbug and Bookstart programmes also gift free books to all babies and small children in the UK, which is pretty awesome). If you can’t find any classes you want to take, get in touch with some of the other parents from your antenatal class or get together with friends who have had kids. It’s enormously helpful to be able to chat with others who are or have recently been in the same boat as you. It can ease fears and provide a lot of answers to questions or concerns you might have.