I went to my 16-week checkup with the midwife recently, which gave me an opportunity to understand some of the basic differences between U.K. and U.S. healthcare, and generally experience how birth care is in the U.K.
 
In the U.K. it’s really nice that there are no out-of-pocket fees at medical facilities, especially if you do need to have procedures that are quite expensive; for example, a cesarean. All this is covered as obviously we pay taxes (NHS fees); we don’t receive any bills for services rendered at clinics or hospitals.
 
Taxes and government fees here in the U.K. are 40% for us. In the U.S. our all-up tax burden was like 25%-30% so here in the U.K. it’s significantly higher. For a healthy person who doesn’t necessarily need the NHS very much it doesn’t seem to be that beneficial–but the idea is we’re paying into a system that will continue to work for us when we do need a lot of care. In this sense it is great for the peace of mind in case there’s an accident; you don’t have to worry about taking out a loan or spending your life savings to pay exorbitant hospital fees.
 
I was excited to hear the heartbeat as it’s reassuring to hear that the baby’s still there. The first trimester was really pretty terrible compared to my first. I was feeling consistently nauseous, though I didn’t vomit. I couldn’t eat well, I didn’t want to eat well, I had very specific tastes, and I would suddenly get hungry, or get a craving for something. Now that the second trimester has settled in, I have been feeling great and, sometimes that worries me because I feel like I should have more pregnancy symptoms just to feel like the baby’s okay.
 
The midwife was so nice and suggested that I take my phone and record the heartbeat which meant that my daughter got to hear it. The heartbeat was 150bpm, which is perfect. The midwife is really home-birth supportive and she loves attending home births, so it was just nice to talk with her about that, however I am probably not going to go with the NHS for my home birth.
 
Due to me being of Chinese descent, the midwife said that I should take the glucose tolerance test which is a test for gestational diabetes. I took that test during my first pregnancy and I hated the test, so I do not want to take this test again. According to the referral my midwife filled out, the only reason I was flagged for this test was because she marked me as being of “South Asian, Black Caribbean and Middle Eastern” decent. These ethnicities are considered at risk for “high prevalence of diabetes”. Well, Guess what? Chinese people aren’t South Asian. I brought it up to her and she basically said no, you don’t have to take it. This trait in medical workers cuts across the U.K. and the U.S.: both are populated by paternalistic-leaning people.
 
This referral was included in my Maternity Care Record (MCR), which every mum gets. The MCR is fantastic because it has all of your things here: antenatal notes, blood test results, how much you weighed and your blood pressure from every appointment, some obstetric notes, notes from after the birth, letters, reports, investigations, and scan results. I also got my Maternity Exemption Form which allows me to apply for a card that gives me free swimming access, free dental, and free prescription drugs.
 
Looking through my documents, I paid particular interest to a letter about my blood results. It says, “Following your haemoglobinopathy screening result we requested a blood sample from the father of your baby. If a baby inherits this gene from both parents it may have serious life long health implications therefore it is important for the father to be screened.”
 
My husband and I are against all these screenings; not because we want to be uninformed, but because we don’t believe with the common way of dealing with these scenarios. Let’s say your baby does have a serious issue. What options are they gonna give you? Most of the time they are going to say “Well, the baby will suffer, the baby might not live very long, so we think you should terminate this pregnancy”. For us, abortion is a no-go: we believe that life is precious. I don’t want to be the reason or the cause of death so getting it tested now and worrying about it, stressing about it, opens the door to saying, “maybe you should terminate your pregnancy”. If that kind of thing does occur we’ll approach it as it comes.
 
Overall, the visit went well, and I appreciate the NHS.