Pregnancy in the UK
When a couple comes to the UK, they plan to have a family in a few months/years once they are settled.
PREGNANCY
The journey throughout pregnancy is very well supported - both medically and at the workplace.
Here are some points which parents to be might find useful:
1. You get free prescriptions and free dental care:
https://www.nhsbsa.nhs.uk/help-nhs-prescription-costs/free-nhs-prescriptions
You will need a maternity exemption certificate for this:
https://www.nhsbsa.nhs.uk/exemption-certificates/maternity-exemption-certificates
4. Get things like:
- Prams
-Car seats
- Baby cots and other accessories on Christmas, Easter sales.
Check for prices online as every shop has its own prices. Most things are available on 50% discount on Christmas
Baby shops:
https://www.mothercare.com
I have just found out that I am pregnant. What should I do?
Contact your GP who will refer you to the antenatal services. In some cities, patients can refer themselves directly to the antenatal clinic by filling out a form online.
How can I get this information?
By searching on Google - search for antenatal service of your local hospital and contact them.
What will happen next?
You will be sent a letter with an appointment
After this you will be sent regular appointments:
https://www.nhs.uk/conditions/pregnancy-and-baby/antenatal-appointment-schedule/
I have heard that specialty nurses run these antenatal clinics.
Yes- that is correct and they are very good. I know that in our home countries, nurses have limited knowledge but in the UK, I have personally experienced that specialty nurses are better than some doctors in that specialty.
So you can completely trust them.
What if I do not feel right?
You will be given the relevant phone numbers to contact your midwife on working days and the antenatal/maternity department/labor ward during out of hours. There is an on call obstetrician available in the hospital 24/7 and the midwives always refer patients if they are concerned. Remember, it is always better to be safe rather than sorry. So if you are concerned ring your midwife, if she is not available, ring the antenatal ward in your local hospital, if they do not respond then go to A and E. Always play it safe!
Do not take any medications on your own and consultant the relevant professionals if you are worried about anything.
I think I can manage alone and do not wish to bother anyone.
This is not a wise idea. If your mother/sister are unable to come from your home country to help you, then you must call someone else whom you trust will help you through your initial few weeks. It is best to call someone whom you are comfortable with- be it a childhood friend, a cousin or aunt.
What about air travel?
That is up to you. It is best to avoid it.
Should I consider going back to my home country to deliver the baby?
You have come to the UK not only to work but to live and enjoy the healthcare privileges (as you have paid a hefty fees for your health surcharge). It is not a good idea to go to your home country and then bring your baby here. However everyone has a different situation. So discuss this with your family members.
They have done an ultrasound scan only twice. Should I get it done privately in my last trimester?
There is no clinical indication for a third scan if you are well. However if you are worried then you can get it done privately. This is not advised by the midwives though.
How good are the maternity services in the UK?
Very good. It also depends on your hospital. You can read the reviews on the rating of the department by searching on Google.
What sort of analgesia would they offer me?
If you are working in the NHS, you would realize that here everyone listens to the patients. So you will be given various options with the benefits and risks and you can decide.
Read this:
https://www.nhs.uk/conditions/pregnancy-and-baby/pain-relief-labour/
I work in the NHS. I am worried that I may not be able to return to work after my delivery.
That is fine - You should take an extended maternity leave if required. Discuss everything openly with your supervisor and HR. They are very supportive.
1. Get a UK birth certificate.
https://www.gov.uk/register-birth
2. Get NICOP made. You will need your marriage certificate for this.
http://www.phclondon.org/nadra/nicop/apply/nsrc/
2. Get a passport made for the baby from the Pakistani consulate.
http://www.phclondon.org/mrp/requirements/
3. Apply for a dependent visa for the baby and pay IHS till my visa expiry date.
https://www.gov.uk/tier-2-general/family-members
Will my baby be a British National if (s)he is born here? We are both foreign nationals.
Not unless you are both British nationals.
Please read this:
"If you were born in the UK on or after 1 January 1983 You don’t automatically get British citizenship if you were born in the UK."
https://www.gov.uk/types-of-british-nationality/british-citizenship
Are there any allowances we can get?
https://www.gov.uk/marriage-allowance
D DAY - DELIVERY DAY
When should I go to the maternity unit?
Your midwife would have explained everything to you already.
These are the indications:
https://www.nhs.uk/conditions/pregnancy-and-baby/hospital-birth-centre-labour/
What should I take?
https://www.nhs.uk/conditions/pregnancy-and-baby/pack-your-bag-for-birth/
1. A case (could be a small cabin size suitcase with wheels which is easily maneuverable) in which you have your clothes, toiletries. Make sure you have slightly extra sized slippers as some mums have edema post natally.
2. Baby bag containing diapers, changing mat, a few exchanges of clothes, wipes, cotton balls, nappy disposal bags.
3. Car seat (ensure that it can fit in your car and you have already tried it out).
4. Travel system if that is what you have bought - you can put your baby in the car seat and attach it to the pram chassis making it easier carrying the baby to the car. You would not need the carry cot or the pram seat initially.
5. Clothes and toiletries for the partner.
6. Chargers for phones, camera.
What about pain relief?
https://www.nhs.uk/conditions/pregnancy-and-baby/pain-relief-labour/
You midwife would have already discussed your birth plan with you. You can have the following:
1. Regular paracetamol
2. Entonox
3. Oral morphine
4. I/M morphine - please note that opioids are not given near delivery (ie a few hours before delivery). But the protocols vary from trust to trust.
5. Epidural
What will happen when I am admitted?
This varies from trust to trust- I am describing our experience.
Once you have called the midwife and informed her that you meet the criteria for admission, you will be admitted to the observation unit initially. Your OBS will be done regularly and a CTG machine will be connected to your tummy to monitor the fetal heart rate and uterine contractions.
Once the contractions start regularly you will be moved to the delivery suite.
A midwife will be in the delivery suite all the time - leaving only for short breaks and to discuss anything with the nurse in charge.
The consultant and registrar will come see you on a regular basis.
When the cervix is dilated enough, epidural will be administered (if you have opted for it- you can even opt for it at that time if you did not consider it as part of your birth plan). This will be inserted by the anesthetist.
What if I need a C - section?
If that is the case, the consultant and registrar will discuss everything with you. The anesthetist will discuss anesthesia (which is usually spinal) and you will be wheeled down to the theater which is attached to the delivery suite.
Will my birth partner be able to come with me for that?
Yes. Birth partners are given scrubs and can sit with the spouse during the operation.
What will happen after delivery?
https://www.nhs.uk/conditions/pregnancy-and-baby/your-baby-after-birth/
Once the baby is delivered (in the delivery suite or theater), they will do some tests, hand the baby to the birth partner ASAP. Then the baby will be weighed , given I/M vitamin K injection and then given to the mum for breast feeding (which is advisable- https://www.nhs.uk/conditions/pregnancy-and-baby/breastfeeding-first-days/)
The mum and baby are transferred to the baby unit where the pediatricians do a newborn screening test:
https://www.nhs.uk/conditions/pregnancy-and-baby/newborn-screening/
The hearing is also assessed.
The midwives come and assess the breast feeding techniques, discuss any concerns the mum may have.
Once everyone is satisfied, mum and baby can go home.
What will happen next?
The community midwife will visit mum and baby the following day and address any concerns (Day 2, Day 5 and then day 10). Then the health visitors will take over.
The health visitors will advise about vaccinations, registration with the GP, etc.
https://www.nhs.uk/conditions/pregnancy-and-baby/baby-reviews/
Do I need to register the birth of my baby?
Yes.
https://www.gov.uk/register-birth
PREGNANCY
The journey throughout pregnancy is very well supported - both medically and at the workplace.
Here are some points which parents to be might find useful:
1. You get free prescriptions and free dental care:
https://www.nhsbsa.nhs.uk/help-nhs-prescription-costs/free-nhs-prescriptions
You will need a maternity exemption certificate for this:
https://www.nhsbsa.nhs.uk/exemption-certificates/maternity-exemption-certificates
Your midwife will provide this.
2. You get maternity leave:
http://www.nhsemployers.org/your-workforce/pay-and-reward/agenda-for-change/nhs-terms-and-conditions-of-service-handbook/parents-and-carers/maternity-leave-and-pay-section-15
You get paternity leave:
https://www.bma.org.uk/advice/work-life-support/working-parents/thinking-of-having-a-baby/paternity-leave
Every trust has its own rules. In my trust it is 14 days paid paternity leave.
3. Join this app:
http://www.bounty.com
2. You get maternity leave:
http://www.nhsemployers.org/your-workforce/pay-and-reward/agenda-for-change/nhs-terms-and-conditions-of-service-handbook/parents-and-carers/maternity-leave-and-pay-section-15
You get paternity leave:
https://www.bma.org.uk/advice/work-life-support/working-parents/thinking-of-having-a-baby/paternity-leave
Every trust has its own rules. In my trust it is 14 days paid paternity leave.
3. Join this app:
http://www.bounty.com
And get free discount vouchers
.
.
Become a member of :
https://www.bestbeginnings.org.uk/baby-buddy
https://www.bestbeginnings.org.uk/baby-buddy
Boots parenting club :
http://www.boots.com/parenting-club
http://www.boots.com/parenting-club
You will get points and rewards when you spend.
4. Get things like:
- Prams
-Car seats
- Baby cots and other accessories on Christmas, Easter sales.
Check for prices online as every shop has its own prices. Most things are available on 50% discount on Christmas
Baby shops:
https://www.mothercare.com
Other shops and your local grocery stores as well
5. Make sure that the car seat fits in your car. Some cars have IsoFix option - To which the car seat base can be attached. This avoids complicated seat belt mechanisms especially if you have a travel system (ie car seat which can be removed and attached to the pram chassis).
6. Make sure the pregnant spouses mother/elder sister comes to stay with her for the first few weeks when the baby is delivered. As we have to do everything on our own and paternity leave is limited, the new mum will need some assistance. And the best (and non political) help can be provided by her own family. So ensure they have valid family visit visas.
7. Make sure you talk your GP if you are planning to conceive so that you be prescribed folic acid and vitamin D.
https://www.nhs.uk/news/pregnancy-and-child/pregnancy-supplements-dont-help-just-take-vit-d-and-folic-acid/
8. Consider buying clothes and all remaining accessories from the following shops in the 3rd trimester. It is best to get everything before the pregnant partner is limited to walking a few steps (this can happen in the last few weeks).
FREQUENTLY ASKED QUESTIONS
5. Make sure that the car seat fits in your car. Some cars have IsoFix option - To which the car seat base can be attached. This avoids complicated seat belt mechanisms especially if you have a travel system (ie car seat which can be removed and attached to the pram chassis).
6. Make sure the pregnant spouses mother/elder sister comes to stay with her for the first few weeks when the baby is delivered. As we have to do everything on our own and paternity leave is limited, the new mum will need some assistance. And the best (and non political) help can be provided by her own family. So ensure they have valid family visit visas.
7. Make sure you talk your GP if you are planning to conceive so that you be prescribed folic acid and vitamin D.
https://www.nhs.uk/news/pregnancy-and-child/pregnancy-supplements-dont-help-just-take-vit-d-and-folic-acid/
8. Consider buying clothes and all remaining accessories from the following shops in the 3rd trimester. It is best to get everything before the pregnant partner is limited to walking a few steps (this can happen in the last few weeks).
FREQUENTLY ASKED QUESTIONS
When is the best time to plan for a baby?
When you are settled in a training post and have a plan in the long term regarding your career.
For fathers to be - You should not have any exams to give during this time. You should be available at all times to support your spouse, do shopping and enjoy this time.
For mothers to be - Do not worry about any exams at this stage. Take time off when required. If you find it difficult doing on calls, talk to your supervisor and HR earlier. Do not stress about anything. Do not think about career progression - take a break and enjoy this time.
When you are settled in a training post and have a plan in the long term regarding your career.
For fathers to be - You should not have any exams to give during this time. You should be available at all times to support your spouse, do shopping and enjoy this time.
For mothers to be - Do not worry about any exams at this stage. Take time off when required. If you find it difficult doing on calls, talk to your supervisor and HR earlier. Do not stress about anything. Do not think about career progression - take a break and enjoy this time.
Make a list of things to do and whenever your partner is free, try to do as much as you can so that at the end (ie last trimester) you have bought everything and you have a plan for someone to come and stay with you after delivery.
The shopping is the most enjoyable part of this journey - so spend the maximum time and effort on it.
The shopping is the most enjoyable part of this journey - so spend the maximum time and effort on it.
I have just found out that I am pregnant. What should I do?
Contact your GP who will refer you to the antenatal services. In some cities, patients can refer themselves directly to the antenatal clinic by filling out a form online.
How can I get this information?
By searching on Google - search for antenatal service of your local hospital and contact them.
What will happen next?
You will be sent a letter with an appointment
After this you will be sent regular appointments:
https://www.nhs.uk/conditions/pregnancy-and-baby/antenatal-appointment-schedule/
I have heard that specialty nurses run these antenatal clinics.
Yes- that is correct and they are very good. I know that in our home countries, nurses have limited knowledge but in the UK, I have personally experienced that specialty nurses are better than some doctors in that specialty.
So you can completely trust them.
What if I do not feel right?
You will be given the relevant phone numbers to contact your midwife on working days and the antenatal/maternity department/labor ward during out of hours. There is an on call obstetrician available in the hospital 24/7 and the midwives always refer patients if they are concerned. Remember, it is always better to be safe rather than sorry. So if you are concerned ring your midwife, if she is not available, ring the antenatal ward in your local hospital, if they do not respond then go to A and E. Always play it safe!
Do not take any medications on your own and consultant the relevant professionals if you are worried about anything.
I think I can manage alone and do not wish to bother anyone.
This is not a wise idea. If your mother/sister are unable to come from your home country to help you, then you must call someone else whom you trust will help you through your initial few weeks. It is best to call someone whom you are comfortable with- be it a childhood friend, a cousin or aunt.
What about air travel?
That is up to you. It is best to avoid it.
Kindly read this:
https://www.nhs.uk/conditions/pregnancy-and-baby/travel-pregnant/
https://www.nhs.uk/conditions/pregnancy-and-baby/travel-pregnant/
Should I consider going back to my home country to deliver the baby?
You have come to the UK not only to work but to live and enjoy the healthcare privileges (as you have paid a hefty fees for your health surcharge). It is not a good idea to go to your home country and then bring your baby here. However everyone has a different situation. So discuss this with your family members.
They have done an ultrasound scan only twice. Should I get it done privately in my last trimester?
There is no clinical indication for a third scan if you are well. However if you are worried then you can get it done privately. This is not advised by the midwives though.
How good are the maternity services in the UK?
Very good. It also depends on your hospital. You can read the reviews on the rating of the department by searching on Google.
What sort of analgesia would they offer me?
If you are working in the NHS, you would realize that here everyone listens to the patients. So you will be given various options with the benefits and risks and you can decide.
Read this:
https://www.nhs.uk/conditions/pregnancy-and-baby/pain-relief-labour/
I work in the NHS. I am worried that I may not be able to return to work after my delivery.
That is fine - You should take an extended maternity leave if required. Discuss everything openly with your supervisor and HR. They are very supportive.
Will I get paid if I take an extended maternity leave?
As international medical graduates, we may not be entitled to getting a paid extended leave. Kindly read through the guidance here:
http://www.nhsemployers.org/tchandbook/part-3-terms-and-conditions-of-service/section-15-maternity-leave-and-pay
When should I start buying things for the baby?
http://www.nhsemployers.org/tchandbook/part-3-terms-and-conditions-of-service/section-15-maternity-leave-and-pay
When should I start buying things for the baby?
After the second scan (ie around 21 weeks), you would have an idea of the gender of the baby and can then start buying things.
It is advisable to get the major expensive things like pram, car seat and base, cot and mattress, other electronics during Christmas/ Easter sales as you save a lot. Then slowly continue buying small things whenever you are free.
Is there a timeline and list of things I should have when the baby is born?
Yes- it is here:
http://www.bounty.com/pregnancy-and-birth/baby-essentials
http://www.bounty.com/pregnancy-and-birth/baby-essentials
What documents will I need to get a visa for my baby?
This varies from nationality to nationality. For Pakistanis, this is what is required:1. Get a UK birth certificate.
https://www.gov.uk/register-birth
2. Get NICOP made. You will need your marriage certificate for this.
http://www.phclondon.org/nadra/nicop/apply/nsrc/
2. Get a passport made for the baby from the Pakistani consulate.
http://www.phclondon.org/mrp/requirements/
3. Apply for a dependent visa for the baby and pay IHS till my visa expiry date.
https://www.gov.uk/tier-2-general/family-members
Will my baby be a British National if (s)he is born here? We are both foreign nationals.
Not unless you are both British nationals.
Please read this:
"If you were born in the UK on or after 1 January 1983 You don’t automatically get British citizenship if you were born in the UK."
https://www.gov.uk/types-of-british-nationality/british-citizenship
Are there any allowances we can get?
https://www.gov.uk/marriage-allowance
Laws to remember:
https://www.legislation.gov.uk/ukpga/1989/41/contents
https://www.gov.uk/healthcare-immigration-application/who-needs-pay
https://www.gov.uk/healthcare-immigration-application/who-needs-pay
D DAY - DELIVERY DAY
When should I go to the maternity unit?
Your midwife would have explained everything to you already.
These are the indications:
https://www.nhs.uk/conditions/pregnancy-and-baby/hospital-birth-centre-labour/
What should I take?
https://www.nhs.uk/conditions/pregnancy-and-baby/pack-your-bag-for-birth/
1. A case (could be a small cabin size suitcase with wheels which is easily maneuverable) in which you have your clothes, toiletries. Make sure you have slightly extra sized slippers as some mums have edema post natally.
2. Baby bag containing diapers, changing mat, a few exchanges of clothes, wipes, cotton balls, nappy disposal bags.
3. Car seat (ensure that it can fit in your car and you have already tried it out).
4. Travel system if that is what you have bought - you can put your baby in the car seat and attach it to the pram chassis making it easier carrying the baby to the car. You would not need the carry cot or the pram seat initially.
5. Clothes and toiletries for the partner.
6. Chargers for phones, camera.
What about pain relief?
https://www.nhs.uk/conditions/pregnancy-and-baby/pain-relief-labour/
You midwife would have already discussed your birth plan with you. You can have the following:
1. Regular paracetamol
2. Entonox
3. Oral morphine
4. I/M morphine - please note that opioids are not given near delivery (ie a few hours before delivery). But the protocols vary from trust to trust.
5. Epidural
What will happen when I am admitted?
This varies from trust to trust- I am describing our experience.
Once you have called the midwife and informed her that you meet the criteria for admission, you will be admitted to the observation unit initially. Your OBS will be done regularly and a CTG machine will be connected to your tummy to monitor the fetal heart rate and uterine contractions.
Once the contractions start regularly you will be moved to the delivery suite.
A midwife will be in the delivery suite all the time - leaving only for short breaks and to discuss anything with the nurse in charge.
The consultant and registrar will come see you on a regular basis.
When the cervix is dilated enough, epidural will be administered (if you have opted for it- you can even opt for it at that time if you did not consider it as part of your birth plan). This will be inserted by the anesthetist.
What if I need a C - section?
If that is the case, the consultant and registrar will discuss everything with you. The anesthetist will discuss anesthesia (which is usually spinal) and you will be wheeled down to the theater which is attached to the delivery suite.
Will my birth partner be able to come with me for that?
Yes. Birth partners are given scrubs and can sit with the spouse during the operation.
What will happen after delivery?
https://www.nhs.uk/conditions/pregnancy-and-baby/your-baby-after-birth/
Once the baby is delivered (in the delivery suite or theater), they will do some tests, hand the baby to the birth partner ASAP. Then the baby will be weighed , given I/M vitamin K injection and then given to the mum for breast feeding (which is advisable- https://www.nhs.uk/conditions/pregnancy-and-baby/breastfeeding-first-days/)
The mum and baby are transferred to the baby unit where the pediatricians do a newborn screening test:
https://www.nhs.uk/conditions/pregnancy-and-baby/newborn-screening/
The hearing is also assessed.
The midwives come and assess the breast feeding techniques, discuss any concerns the mum may have.
Once everyone is satisfied, mum and baby can go home.
What will happen next?
The community midwife will visit mum and baby the following day and address any concerns (Day 2, Day 5 and then day 10). Then the health visitors will take over.
The health visitors will advise about vaccinations, registration with the GP, etc.
https://www.nhs.uk/conditions/pregnancy-and-baby/baby-reviews/
Do I need to register the birth of my baby?
Yes.
https://www.gov.uk/register-birth
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