Pregnancy is the same all the world over. And yet – there are differences in how pregnancy is approached from culture to culture. Some differences are stark, while others are subtle. I think it’s so interesting to learn about the norms for pregnancy and childbirth in various countries. One trivial thing that I still haven’t gotten used to is that you have to say ‘antenatal’ here instead of ‘prenatal’. I botch that one up all the time. Also, here in England, you don’t get pregnant, you fall pregnant. Very passive.
Anyway, once you’ve fallen pregnant, you need to organize some antenatal care for yourself. I thought maybe you might be interested to know how prenatal care is set up here. As with other health-related issues, the NHS entitles every pregnant person who is a legal resident of the UK to free treatment. (Well, it’s not technically free because if you’re a legal resident, you’re also a tax-payer in some form or another. So you’re paying for your healthcare, but there is no exchange of money at the point of service.) In fact, to add an extra incentive for pregnant women to have all of their health needs met, you are exempt from paying for prescriptions and routine dental care while you are pregnant and in the year following the birth.
Midwifery is at the heart of the whole antenatal care system in the NHS. I’m 26 weeks pregnant now. I haven’t seen an obstetrician yet, and if I’m lucky I won’t have to. I say ‘if I’m lucky’ because obstetricians only get involved with cases when they involve some sort of complication. If the pregnancy is healthy and straightforward, then midwives provide all the care right through to the postnatal stage. Personally, I like this orientation. I think pregnancy is a normal (albeit special) condition for the female body. Doctors are trained to diagnose health problems and treat them. Of course, pregnant women are more vulnerable to all sorts of health problems, and I am unreservedly thankful that doctors are available to treat women who need their expert intervention. It’s just that in and of itself, a normal pregnancy isn’t a health problem. I think it is a good sign that the NHS recognizes this. Midwives, on the other hand, are experts in normal pregnancies. Because they know "the normal” so well, they’re good at spotting cases that need additional attention from a doctor. Midwives are skilled at giving reassurance and advice, especially to new mothers, for whom all of the bodily changes seem so alarming. It’s so nice to hear a midwife say, ‘That’s normal.’ As it turns out, there’s a pretty wide spectrum of what’s normal in pregnancy.
I can’t say very much about antenatal care in the first trimester, because I was already 14 weeks by the time we left Texas. Once I got back to England, I made an appointment with a midwife at my GP’s office. She checked me out and referred me to the maternity hospital. I went to the hospital for a ‘booking-in’ appointment. A midwife went through my medical history with me, ordered blood tests, discussed my options for screening for genetic conditions, and gave me advice about how to stay healthy during pregnancy. I was given a set of hand-held maternity notes to carry with me when I see any medical practitioner. At 20 weeks, I had an appointment for an ultrasound. Usually the NHS provides two ultrasounds for a normal pregnancy, but I missed the first one. At the 20 week scan, the sonographer checks the baby head-to-toe for a whole range of abnormalities. If no red flags are raised at the 20 week ultrasound, then the next midwife appointment isn’t until 25 weeks. Every time I see a midwife, she writes her summary of the appointment and the key measurements (blood pressure, fundal height, results of the urine test) on the copy of the maternity notes that I keep with me. Appointments are set at 3 week intervals from 25 until 36 weeks, when they become a bit more frequent.
So far, I have been very happy with the antenatal care that I’ve received from the NHS.
I was keeping a secret when I went on my month-long Grand Tour of Beloved People back in October. My secret survived through a reunion of college roommates and ten days at my sister's house, where I also saw my mother and Khanjoe. It wasn't until the end of my trip that one very large dog let the cat out of the bag.
The last stop on my itinerary was a visit with my brother, Robert, and his family. Allison and "Ebug" picked me up from the airport. We went back to their house - which isn't actually their home, because they've got a long-term house-sitting gig. The house-sitting arrangement also includes pet care, namely dog-sitting for a massive Bernese Mountain Dog.
We had a nice lunch. I was enjoying getting to know my niece at her cute toddler stage, and she was warming up to me. After we finished eating, the three of us went outside for a little walk. Ebugloves to 'go fast' on the sidewalk, and she was showing off her new running skills. Eventually, it was time for Ebug's nap, so we went back inside.
When we walked through the door, Allison noticed a chewed up ziploc bag in the hallway. She wondered out loud what the dog, Albus, had gotten into. I took one look at the bag and knew just what it was. I checked my bag. I had left my suitcase unzipped, and Albus had nosed around in there to find my bag of vitamins. Then he gobbled up the vitamins, along with a healthy dose of plastic bag. I told Allison that my vitamins were missing, and Albus must have eaten a bag full of 15 or 20 vitamins. She was irritated but not surprised. Albus has a reputation for being a bit of a rascal.
We both got to thinking. A few minutes later we were googling 'dog ingested 20 human vitamins' and variants thereof. We found lots of warnings about the toxicity of human vitamins for canines. While Allison put Ebug down for her nap, I called the vet. They looked in their records and found that Albus weighed 145 pounds, and they said that we should call poison control. Given his weight and the exact brand of vitamin, poison control could estimate the toxicity for his size based on the chemical formulation.
When Allison came back downstairs, I told her what the vet had said. And I also told her that it was a bag full of prenatal vitamins because I was pregnant!! I wanted to tell her before she overheard me telling poison control that the dog had eaten 365 Brand Prenatal Vitamins. As it turns out, an XXL dog would have to eat 40 of those prenatal vitamins before he would show any signs of damage.
So that goofball dog blew my secret, but it was SO fun being able to share our happy news with Robert and Allison. When Robert got home that night, we were re-hashing the story. He asked me what kind of vitamins they were. I said, "Prenatal vitamins." And he said, "For just in case?" I replied, "No, prenatal vitamins for being 8 weeks pregnant!" I will never forget the giant, joyful hug that my baby's Uncle Robert gave me (us!)! Over the next few days, Allison and I talked a ton about pregnancy and babies, which was so interesting and enlightening for me. And we took turns taking naps, as good co-pregnant ladies should do. :)
At Thanksgiving, H and I told the rest of my family about our pregnancy when we were all together. We told my parents in the airport parking lot, minutes after H landed. I couldn't keep the secret any longer than absolutely necessary! When we got home, we told the rest of my siblings. I remember that Pumpkin was piddling around in the bathroom, and I went in there and asked her to hurry up and come out because I had a secret to tell everyone. She cocked her ear up at me and said, 'You can just tell me now.' Joe texted Khani the news in record speed. At our Thanksgiving meal, the next day, Abbie wrote (in her beautiful handwriting) everyone's name on their cups as in relation to our baby. The German side of the family found out over Christmas. It was such a treat getting to share such big news in person with all of our family. It feels amazing to think about how many people are eagerly anticipating the arrival of this little baby.
And now I am 21 weeks pregnant, due in late May / early June. I've felt the baby squirming around, and I'm developing the beginnings of a baby bump. All my examinations show that this baby is healthy and growing just as he/she should be. This all just seems like such a dream come true! We are so happy to be expecting a baby and are excited about all the adventures he/she will bring to our life!