In August 2011, a few months before my 29th birthday, I packed three enormous suitcases and set off to live in London. Having spent 10 years in New York, I was ready for a change, and a Frenchman living across the pond was the perfect excuse for an escape.
In the five years since, I’ve encountered my fair share of cultural differences. I quickly mastered the fine art of weather chat, and learned the hard way to never make a cup of tea without offering to make a cup for everyone else at the office.
Over the last few years, I’ve also come across criticism in the U.S. about Britain’s National Health Service, their universal healthcare system that’s been around since 1948. My first experience with the NHS was basically something out of an SNL skit. Plagued with a horribly sore throat, I stumbled into my local general practitioner for an emergency appointment. Upon leaving, I asked the receptionist where to pay. They looked at me as if I had three heads. I backed out quietly, certain that it was some sort of joke.
I went to fill my prescription in scenic Surrey Quays, which was just a five-minute walk down the road. When I was asked, "Do you pay?" I thought to myself, These people must be kidding me. In England, not everyone has to pay the standard 8.40 pounds (about $10) for prescriptions. Pregnant women and new mothers are exempt, as well as people on Income Support, people over 60, and a few other groups.
So, this is socialized medicine. Since I’ve moved to London, it’s taken some getting used to. Despite having insurance in America, there was always something to pay. Going to the doctor was often an expensive adventure, whether there was a co-pay, or a large chunk was being taken from my salary. But the NHS is different: I pay for access through the taxes on my paycheck. I originally qualified for NHS care through a work visa, and later through my husband, who is a citizen of the European Union.
Fast forward to April 2015 — in the midst of opening a bar and writing a book, I discovered that I was pregnant. What timing! I turned to my dear friend Google and found out that having a baby in the U.S. (with employer-provided, commercial insurance) could range from over $32,000 for a vaginal birth, to more than $51,000 for a Caesarean section, according to a 2013 analysis of medical and drug claims by Truven Health Analytics. I could expect my out-of-pocket costs, according to the same study, to be around 12% of that for a vaginal birth and 10% for a Caesarean.
Meanwhile, we were told that going private in London could also set us back thousands of dollars. I very quickly came to the conclusion that the NHS, which would cost me nothing, was best. I mean, it’s just a baby and not brain surgery, right? Still, I was far from the comforts of home, and not having my dearest friends or my own mother close by was difficult. I weighed the cost of a U.K. birth with a U.S. one, and wondered if I should go home. Instead, I decided to stay in London.
When we started this adventure of two-becomes-three, I wasn’t sure what to expect from socialized medicine. Would I give birth waiting in line, as some critics often threaten? I spent hours researching labor, delivery, and postnatal recovery. Finally, I felt ready for my first appointment.
Ahead, photos of my birth story in the U.K. — and why I chose not to go back to the U.S.
Julie Padovani is a mom, author and director of events and communications at the Experimental Group. The views expressed here are her own.
At 12 weeks, we ventured to the hospital where we had our dating scan to find out my estimated due date. I wasn’t sure what to expect with the whole process being free, but it was far better than I expected. I had visions of grimy rooms and old equipment, but I couldn’t have been more wrong. Everything, from the woman who did my scan to the equipment used, was top notch.
We had our second and last scan at 20 weeks, where they measured the baby’s legs, arms, head, and everything in between. When she wouldn’t flip over to measure her spine, I was asked to come back the following week to make sure they got everything measured. I would have loved another scan, but it wasn’t something offered at my hospital as long as my belly grew and I kept feeling her kick.
Photo: Courtesy of Julie Padovani.
Unlike with most prenatal care in America, I was assigned a midwife. I met with Calli eight times at a children’s center. I would have met with her a few more times, but I wound up going into labor 10 days before my due date.
Because I had a "textbook" pregnancy with no issues, I never met with an obstetrician, and to this day, I don’t know if the one assigned to me was a man or a woman! I loathe doctor visits and the idea of being poked and prodded makes me queasy.
For me, having a midwife meant I had a woman who would have an honest conversation with me, offering insight on everything related to childbirth no matter how ridiculous. She measured my belly, we listened to my daughter’s heartbeat, and she tested my blood more often than I care to remember. We discussed breast-feeding versus formula feeding, vaccines, and the changes my body would go through. Some women are not as lucky, and under the NHS, they have a few different midwives. I was lucky enough to only see Calli, who also made herself available by phone and email.
Photo: Courtesy of Julie Padovani.
When I was pregnant, Google became my best friend. I still rely on it, probably too much. What else is there to do during those 4 a.m. feeds other than look things up? Months of searches that started with “Should I be worried if…” and “What happens when…” littered my search history.
A few times, when the results provided unclear and downright worrying answers, I picked up the phone (something I should have done from the beginning) and called the midwife support line. The NHS provides midwives to answer any question — no matter how ridiculous — with an honest, objective answer and no judgment. As I was a first-time mom, this was a small but amazing resource that put me at ease.
Photo: Courtesy of Julie Padovani.
There are a few things I chose to pay for throughout my pregnancy. I hired a doula, Alison Edwards, on the advice of my midwife. Without family here, having a woman who came to our house armed with advice and books, and who would accompany us through the birth, felt like a good option for us.
I also joined a group called Bump & Baby, where we spent two days talking about labor, delivery, and everything that happens afterwards. Although the class was brilliant on its own, the fact that I came out of it with eight new friends having babies at the same time as me has proved invaluable. We meet up for lunch and a walk, or we commiserate over texts during cluster feeds, growth spurts, weaning, teething, and everything in between.
Photo: Courtesy of Julie Padovani.
A month before we welcomed our daughter to the world, the NHS provided four classes for expectant parents at the hospital. Having gone to a private class already, we attended just the first and the last class.
My primary interest was to see where everything would go down. At Homerton Hospital, there are two options: the birth center, which is midwife-led, and the delivery suite, which is doctor-led. As long as the mother has no complications, she is free to choose where she would like to give birth. She is also presented with options of choosing a birth center where there is no hospital unit, or the option of delivering at home. This visit was invaluable to me, as it meant I didn’t need to stress about where to go on the big day.
Photo: Courtesy of Julie Padovani.
When the day came, I cursed my pregnant belly for going rogue. I was still working, and at 3 a.m. on December 17, as contractions rumbled through my body, I still thought I would make it in for my last day of work, the meeting I had seven hours later, and the event I had that afternoon.
In reality, the day was spent pacing around the house, gathering things for the hospital and the fateful car ride (thanks, Uber!) that I will never forget as we took the back roads with speed bumps, which don’t pair well with back labor.
After we arrived and they determined I was in active labor, Emily, the midwife assigned to me, led us to the birth center. I realized fairly late in my pregnancy that Calli would likely not be with me during the birth. Under the NHS, the midwives work on rotation, so they will spend some time working in the hospital or birth center delivering babies, some time working with pregnant women, and also some time working in home birth. The likelihood of seeing Calli on D-day was small, though she assured me that I would be in good hands.
The room was huge, one of the ones we saw on our tour. In the birth center at Homerton, rooms come equipped with a double bed, a massive birthing pool, and loads of other contraptions you can use during labor and delivery.
Armed with my "birth plan," which all pregnant women are required to write but often never wind up using, ("have baby" is not an appropriate plan, apparently), we asked for the lights to be dimmed and the pool to be filled. Emily calmly obliged and put me at ease. My husband put music on, and I tried to relax. For me, it was a relief to not be surrounded by bright lights and the clinical ticks of the hospital.
Photo: Courtesy of Julie Padovani.
Sparing the gory details, six hours after setting foot in the hospital, I was holding our daughter in my arms. I went in being nervous about all of the options you have during labor. I wanted skin-to-skin immediately; I delayed the cord clamping; and I wasn’t sure about the vitamin K shot. I had a million other questions. Never was I made to feel stupid, and there was never impatience, which part of me feared there would be, knowing that I wasn’t shelling out thousands to have a baby.
One of the downsides to having a baby on the NHS is that you do most of your recovery in a ward with lots of other new mothers. Privacy goes out the window, the lights are bright, and the thin curtain separating you from the next family doesn’t keep out any noise. The other downside is that you can be discharged six hours after delivery.
I worried endlessly about both of these things. I was given the lesser of two evils, and we made our way to the ward where we spent the night, forewarned by the midwives in the birth center that it would be a different experience. When our sweet little newborn had an accident mid-diaper change, the attending nurse rolled her eyes at us.
The women around me buzzed their call buttons throughout the night, often waiting a fair amount of time to be seen. Breakfast the next morning was down the hall, and I was meant to collect it myself. I thought, They do know what just came out of me, right? By that point, I was begging to get out, but we had to wait for the head nurse to arrive that day and go through all the more pressing matters.
Finally, at about 2 p.m., she apologized profusely and discharged us.
Photo: Courtesy of Julie Padovani.
In the days following, the NHS sent a midwife three times to make sure we were recovering well, weigh the baby, take some blood, and to answer any questions. Although not terribly reliable when it came to the day they were supposed to come, it was nice to know that they didn’t send us on our merry way, baby in tow, and completely clueless.
After the third visit, I was discharged by the midwives and assigned a "health visitor" who will check in on us for the first few years of our daughter’s life, doing everything from weighing and measuring her to providing advice, checking on her milestones, and assessing my well-being. A lactation consultant also came to my home when I was having trouble getting started. She stayed for at least an hour and was a HUGE help. My council also has weaning courses offered for free, as well as drop-in breast-feeding help groups, sensory baby classes, and more.
I’m neurotic about the little one’s weight, as she was quite small upon arrival. I have fond memories of clapping at our first health visitor appointment, when we found out our tiny baby had jumped from the 25th to the 50th percentile in weight. A small victory for a breast-feeding mother, as I thought, I did that all on my own!
Photo: Courtesy of Julie Padovani.
As a first-time mom, I can’t compare my experience to actually having a baby privately in London, or in America, but every step of the way, I felt that every NHS doctor, midwife, and nurse treated us with respect, and never once did I feel that this "free service" was subpar to one that I could have spent thousands of dollars on.
At the end of the day, we returned home with a new member of our family and continued with the support of the NHS midwives and health visitors at home. And the care has continued: Just as I did during my pregnancy, I receive free prescriptions for the 12 months after. I also have free dental care from NHS dentists for the duration of my pregnancy and 12 months following. My vitamins — and my baby's vitamins — are also free for the first year.
What I came to realize, as I’m sure many other new mothers do, is that birth is birth, whichever way the baby comes out, whether you elect to take pain medicine or have a C-section; a private hospital or the NHS; or any other of the hundreds of options offered.
It’s one of the least glamorous but most empowering experiences I have ever been through, and along the way, the NHS provided me with other women, some mothers and some not, to cheer me along the way and to offer words of support.
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