America vs. Britain: Which Country’s Better For Expectant Mothers?

Which side of the pond is better for expecting mothers? (Press Association via AP Images)

Reassuringly, whichever country you pick to pop out a little person, it’ll most likely go well and you’ll come away with a healthy, fat newborn.

But if you’re a bump-bearing Brit settled in the U.S., you might find yourself simultaneously reassured and irked by what you’ve heard about having a baby in America. Possibly, it’s your friends and family back home who’ve got you panicked. After congratulating you and offering unsolicited advice, perhaps some of your blunter Brit associates started with the Yank-knocking. “Oh, so you’ll be having a C-section, then,” one friend informed me over Skype when I first announced I was pregnant. “I’ve heard that American doctors are way too worried about getting sued to let you have it the normal way.”

Although she drastically overstated it, my friend did have a point. The Caesarean rate is significantly higher in the U.S. than in the U.K. — one-in-three births compared to one-in-four. Most U.S. births are attended by a physician, so if you want a midwife, you’ll need to seek one out. American obstetricians tend to be — and I’m generalizing here — more risk-averse than your average NHS midwife or GP. In the U.S. you’ll likely have your first ultrasound at your first six- or seven-week check, while in the U.K. they’ll probably leave it until 12 weeks. And it’s normal here for your doctor to perform a pelvic examination on your first visit, whereas at home they tend not to “interfere” with your innards at such an early stage of the pregnancy.

If you prefer your medical personnel cautious and somewhat overbearing, you’ll get on great in America. As a borderline hypochondriac, I’m always quite grateful for the extra attention. But being bundled off to see a cardiologist in my 30th week because I reported breathlessness (a normal third trimester symptom) was, I suspect, overkill. On the plus side, I got to watch my (perfectly fine) heart do its thing on a screen, and who doesn’t want to see that?

Think carefully about how you’d like to proceed with the birth itself and pick your practitioner accordingly. U.S. doctors and midwives have privileges at certain hospitals in the area (usually one or two), so if you’ve got your heart set on a specific venue, you’ll need to find a practitioner who’s allowed to deliver there.

But you may decide a hospital birth is not for you. Hospital staff here are more likely to steer you away from non-medical pain relief options, like water birthing or intermittent monitoring, which allows you more freedom of movement during labor. That these routes aren’t readily available in hospitals might help explain why the epidural rate is higher in the U.S. compared to back home (nearly 40 percent in Britain versus 50-70 percent in America). So if you’re determined to have a drug-free delivery with all the non-pharmaceutical frills, you’ll probably do best in a birthing center. Some hospitals have them attached but most don’t.

Britain gets another big tick in its baby box for offering good old-fashioned gas and air (a blend of nitrous oxide and oxygen) as first-resort pain relief; the vast majority of American hospitals do not offer it. On the flipside, you may find yourself having to ask — or beg! — for an epidural in the U.K., where budget-conscious NHS staff are less willing to dispense the costly good stuff.

Which brings us round to money — yours to be precise. Having a baby in the U.K. is free of charge, unless you opt to go private. In the U.S., what you pay comes down to the type of insurance you have. Some of the best policies will leave you barely out of pocket while others cover scarily little. Depending on what care you and your baby require before and after the birth, your bill could run into five figures. So, check your policy thoroughly before bulk ordering ovulation kits on Amazon.

Have you experienced childbirth on both sides of the pond? Which was the better experience? Tell us below.

Ruth Margolis

Ruth Margolis

Ruth is a British freelance journalist who recently swapped east London for Brooklyn. She writes about TV for Radio Times and is working on her first novel.

See more posts by Ruth Margolis