Giving Birth in the US: A New British Mum Tells All

The royal baby was born to great fanfare in the U.K. this month. But what's it like for a British mother to give birth in the U.S.? (Photo: AP/John Stillwell)

The royal baby was born to great fanfare in the U.K. this month. But what’s it like for a British mother to give birth in the U.S.? (Photo: AP/John Stillwell)

I gave birth to a 7 lb. 2 oz., hirsute and screechy baby girl at New York University hospital late this February. It took 18 hours, some magic numbing medicine (see below), six signatures (more on this later), two obstetricians and a sturdy nurse to get the job done. Plus great insurance, which still, somehow, left us two grand in the red. It also took three months and a dozen calls to the hospital’s finance department to straighten out various billing issues.

I had a vague idea that I’d try to give birth naturally (no drugs, lots of essential oils and screaming) and even took some touchy-feely, shoes-off-at-the-door type birthing classes in Brooklyn in the weeks leading up to my wonderful epidural. Incidentally, I nearly ditched the final session because I couldn’t handle the hippy homework. Moms-to-be were asked to make a “birthing bundle.” What’s that, you ask? It’s, ahem, an “important” piece of fabric — what, like the Turin Shroud? — which you use to wrap objects that “speak to your energy, your partner’s energy and the energy of your baby.” Yes, they really said that. And they totally weren’t joking. At eight and a half months pregnant, I had no energy to speak of so opted to sneer in the corner while other people unwrapped meaningful bits of rock and twigs.

But anyway, back to the delivery room. Deliriously numb from the waist down and merrily guzzling the tub of jelly they give you instead of meals when you’re laboring. (They don’t allow real food because they’re worried you’ll suffocate, should you need surgery with a general anesthetic.) I was merely agitated when the hospital administrator stuck her head round the door and asked me to sign some forms. Were these disclaimers? More insurance stuff? Adoption papers? Who knows? I wanted this person gone so scratched a squiggly line on at least half a dozen official looking documents and bid her good day. Would she have done this if I’d been writhing in agony? Because honestly, contractions, no matter what country you’re having them in, feel like a lot like being murdered slowly from the inside out. If she’d approached me pre-drugs, it’s quite possible that I’d have mowed her down with a birth ball.

Speaking of pain relief, there’s no gas and air option in the U.S. So it’s an epidural, opiates or whatever endorphins and placebos you can chuck at the situation. Other popular birthing tools in the U.S. include paid-for birthing partners called doulas. If you want one, see here for more information. Also, as a rule, U.S. hospitals offer fewer alternative-type bells and whistles (birthing pools, etc.) than their U.K. counterparts. For these, you may need to find a birthing center. Sometimes these located within a hospital, but more often they’re independent, so you’ll be transferred to an affiliated maternity unit if something goes wrong or you’re “risked out” in the weeks, days or hours leading up to the big push.

Anyway, an hour or so after I’d given birth, my gal was sent off for sprucing up while I was wheeled to a tiny shared room (private rooms cost $$$ and aren’t covered by most insurance plans). Afterwards, she was allowed to “room in” with me because NYU is a certified baby-friendly hospital, which means they let you keep your kid by your side whenever possible, and they encourage breast-feeding. But those creepy newborn nurseries you’ve seen in films where babies are lined up behind glass like they’re in a museum do exist.

My hospital stay was a mandatory two nights — not including the time it took to give birth. This is pretty average in the U.S., and it’s usually four days if you have a C-section. In the U.K., it’s possible to be discharged the same day if you’re both well because they send a midwife to check on you later. Here, there are no home visits so they’re more cautious about releasing you. A day or two after mum and baby are discharged, you’re told to check in with a pediatrician or GP (a.k.a. a primary care physician) — one you’ll have signed up with pre-baby. This person may also have privileges at your delivery hospital, so he or she might have already visited you there. If not, you’ll be assigned a baby doctor on staff at the hospital who — and it’s worth checking this — will be covered by your insurance. For some reason pediatricians — and the anesthetists who’ll put in your epidural — tend to bill separately from the hospital. Mammas, meanwhile, get seen in their obstetrician’s office usually six weeks post-birth. And you’re done, until the next time.

Join us Friday, August 2 at 1 pm ET on Twitter for a chat on differences between U.S. and U.K. births. Follow @MindtheGap_BBCA on Twitter.

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.
View all posts by Ruth Margolis.
  • expatmum

    Feeling very lucky as my insurance gave me a private room on all three occasions. (Though “lucky” is a relative term here.)

  • gn


    We had a private room for both births, so we must have been luckier than you with insurance (is the BBC being stingy?) Had a doula for the first — she was absolutely wonderful.

    Now get off the computer and enjoy your baby!.

    • frozen01

      Actually, I was thinking $2K wasn’t that bad. I’m pretty sure friends of mine (I’m child-free) paid more, and since the average birth with no complications can easily run $12K, depending on your copays/deductibles, $2K isn’t really that high.

  • niamh17

    Glad I got to have my babies in the UK before we moved as they have certainly cost me enough since without being handed a bill for their arrival as well, especially as they were all complicate deliveries!

  • Anna Buttimore

    Gosh, it’s like another world! With all three of mine I had gas and air for pain relief and that was all I needed. Why on earth don’t they offer it in America? Could it be that (shock horror) it’s much cheaper than an epidural?!? With my most recent baby I left the hospital with her an hour after giving birth, and was visited at home by my lovely community midwife (who had also delivered her) every day for two weeks. And, of course, it all cost me nothing at all. I pay about £1,000 ($1,500) a year in National Insurance which covers all my medical bills and those of my children, with no such thing as a “deductible”.