Having a Baby

babyAnte-natal Care (Pre-natal Care) – For those who have had other children in another country, it is helpful to know how ante-natal care may differ from your previous experience(s). Uncomplicated, low risk pregnancies are overseen by midwives, not obstetricians. You are responsible to bring your own ante-natal notes (chart) to each visit. You will not be weighed very often if at all. Visits will be scheduled less frequently than you may have been accustomed to. Tests, such as the glucose tolerance test or group B strep swab, will not be routinely administered. Towards the end of the pregnancy when you might expect frequent internal exams to determine dilation, this will probably not be done unless you are already due or overdue. The general attitude towards pregnancy is one of low intervention.

You are entitled to free prescriptions and dental treatment throughout pregnancy, and for 12 months after the birth.

First visit – The first visit with your midwife may not occur until closer to the end of the first trimester. They will take blood, test your urine, check your blood pressure, and give you your ante-natal chart/packet, which you are responsible to bring to each midwife and ante-natal appointment.

Follow-up visits – Visits for low risk pregnancies will occur every 6 weeks.  You can expect to give a urine sample at each visit. They will check your blood pressure, measure your belly, and listen for fetal heart tones. They will probably take blood at least one more time during your pregnancy.

Ante-natal classes – Aberdeen’s Maternity Hospital offers an early pregnancy class you can take between 14 and 20 weeks and then four additional ante-natal classes that you may choose to take in your 3rd trimester (from about 32 weeks).  The classes meet once a week, at varying times, and cover subjects such as: how to know when you are in labor, the different stages of labor, pain management, physiotherapy & breathing techniques, your spouse’s role, what type of things to include in your “birthing plan”, how to breastfeed, etc.  You will also receive a tour of the hospital (both the labour & midwife wards, birthing pool, etc.).  A “refresher” course is also available, in lieu of the other classes, if you are on a 2nd (or additional) pregnancy.  Contact the Parenthood department at the Maternity Hospital (01224 552615) or talk to your midwife for more information.

Breastfeeding classes – A breastfeeding workshop is held at the Maternity Hospital for those who would like more “how to” information on breastfeeding before their child is born.  Following the birth of your child, there is a Breastfeeding Center (also located at the Maternity Hospital: 01224 552615) where a midwife is available for your questions &/or further assistance with breastfeeding.  Calling ahead of time for an appointment is usually preferred, but you are welcome to stop in without one as well.

Other Organizations you might find useful – NCT (National Childbirth Trust) Breastfeeding Helpline: 0870 4448708 (8am-10pm, Mon.-Fri.), La Leche League (LLL): 01467 642414, The Breastfeeding Network: 0870 9008787

When you’re overdue – If your due date has come and labor has not yet started, your midwife may do an internal exam to check for effacement and dilation. If things seem to be progressing somewhat, she may perform a membrane sweep to get things started. However, labor induction, unless mitigating factors indicate the need for swifter intervention, will not be scheduled for another 14 days.

Maternity Hospital

Location – Cornhill Road, Foresterhill, Aberdeen, AB25 2ZL. Phone: 0845 456 6000

Getting there – The hospital is accessible via car, taxi or bus (#5, 14, 10, 3, and 59).  If it is an emergency, call an ambulance (999)!  For a general map of the hospital, please see the pdf file found on this website.

Visiting Hours – Guests may visit you at the Maternity Hospital between 2-4pm and 7-8pm.

Scans (Ultrasounds) – You will have 2 scans throughout a normal, uncomplicated pregnancy, one at 12-14 weeks and one at 20 weeks. You will be notified by post when your 20 week scan appointment is scheduled. It is advised that you arrange childcare for any children you already have. When you first arrive, you will check in at the ante-natal clinic, one floor above the scanning department. They will weigh you, take a urine sample, and then send you downstairs to be scanned. The scan itself will only take about 15 or 20 minutes. However, there is often a bit of a wait in the waiting room. The policy of the Maternity Hospital is not to reveal the sex of the baby. They request that you do not even ask your sonographer as it can cause them awkwardness. A number of reasons have been given for not revealing the sex, but the most likely seems to be an issue of time and therefore money. It is not always possible to determine the sex of the baby and spending time trying to discover it clogs up an already overcrowded schedule with an unnecessary procedure.

Finding out the gender privately – It is possible to find out the sex of your baby privately in Aberdeen. At Baby Scanning (www.babyscanning.co.uk) you can purchase a range of scanning options from the most basic fetal sexing package for 75 GBP all the way up to 3D images and 4D movies for much more.

Delivery and Hospital Stay

Midwife ward – If you have a straight forward pregnancy without any complications or special circumstances, you will automatically be assigned to the midwife ward–at least initially.  The midwife ward is set up to be as unintrusive & as natural as possible.   There is one midwife in charge of several rooms who will come in to check on you periodically and to take the baby’s heartbeat.  You have full access to balance balls, the TV lounge area, the hallways, etc. to walk around, take a shower or do whatever you need/want to do.  You also have the option of using the birthing pool if you wish, but there is only one, so it’s first come, first serve.  In the midwife ward, you also will have access to 2 different kinds of “pain management” drugs.  Either “gas & air” or a morphine shot.  An epidural can also be administered, but for that, they will move you to the labour ward.

Labour ward – In the labour ward, you will have a midwife attending to you at all times.  You will wear a belt that continuously monitors your baby’s heartbeat and your contractions are also monitored regularly by machine.  In general, the midwife will still oversee your labour, but a doctor will be nearby to deal with any complications that arise.

Pain Management – Here in the UK, Entonox, or what they call “gas & air”, is the first option recommended for pain management.  Is a gas made up of 50% oxygen and 50% nitrous oxide.  It is administered via a rubber face mask (or a mouthpiece) at the onset of each contraction.  It is a short-lasting drug (approx. 1-2 minutes), it doesn’t stay in your system and for many women it helps to take the “edge” off of the contraction.  If you’re not happy with the Entonox, your next option is a morphine shot.  If you don’t want the morphine or you still want something stronger, they will give you an epidural.  It is not something they particularly encourage you to do, but they will do it if you really want/need it.

General – One of the things they emphasize when you go into labor is that they want you to stay home as long as you can before coming in.  If you are really in bad pain (or if you are really “sore” as they say here!) and your contractions are 3-5 mins. apart, they want you to come in, but their philosophy is that you will be more comfortable in your own home for as long as you can manage the pain there.  This goes along with their philosophy that labor & delivery should be as ‘natural’ as possible.  In either ward, your husband is allowed to stay with you the entire time.  But they really don’t want you having anyone else in the room, except for your one “labour coach”.  Cellular phones cannot be used in the hospital.

Hospital Stay – After your delivery, they will towel off your baby, but not bathe him/her and you will get a sponge bath.  You have the option of a 6-hour discharge, but many women stay at least one night, if not two.  (If you have a C-section, it’s probably going to be more like 5 nights.)   Expect to have a “shared” room with up to six beds, and your spouse does not get to stay overnight.  Private rooms are usually reserved for those who have C-sections (but not everyone who has a C-section gets a private room either).  There will be several midwives on duty for whichever ward you are recovering in and they will willingly accommodate as many of your needs as possible.  Paracetamol (acetaminophen) or ibuprofen are routinely given to manage any pain or discomfort you are experiencing.  Before you are discharged, a pediatrician will look over your baby.  A midwife will offer to examine you if you want her to, but it’s not something they do automatically.

Home Birth

In Aberdeen you have the option to have your baby at home as long as you have a low risk pregnancy and do not want any drastic pain relief measures. If this is something you are interested in, you need to let your midwife know no later than 34 weeks, as there are a few things that need to be organized beforehand. Around 36 weeks your midwife will visit your home to make sure that home birth is not only a possibility for you, but for your home (enough space, emergency access, and so on).
If everything is fine, the midwives (two of them, see below) go on call for you at 38 weeks. Shortly before going on call, they bring to your home the birthing supplies they’ll need: a tank of oxygen, a tank of nitrous oxide (enough for 30 minutes of pain relief), and a couple large plastic bins full of various other supplies (sterile gloves, hazardous waste bags, etc.). They’ll also bring a small container of medicines that need to be refrigerated. Finally, you’ll receive a number to call when you go into labor, which is different from the main maternity hospital number.
There are a few things to note here:
•     If you happen to go into labor before 38 weeks, you’ll need to deliver at the maternity hospital.
•    Two midwives are present for homebirths, in order to assist one another, and in case you and the baby need attention at the same time. You’ll have whichever two midwives are on call when you go into labor. This may not necessarily be the midwife you’ve been seeing; however, if you give your midwife enough notice, she may be able to place herself on call at the time when you’re due.
•    You may have the baby anywhere in your home you please, as long as there’s enough space for you and the midwives to do what needs to be done.
•    The only supplies you need to provide for the home birth is something to put down on the ground to contain any mess. They recommended cheap plastic shower curtains and inexpensive cotton towels.
•    You may change your mind at any time and decide to go into hospital to have the baby. This decision doesn’t necessarily have to be an emergency: you could simply decide you  want (or need!) more pain relief than you can be given at home, for example.
•    There is a supervisor that may be called in case of any dispute between you and the attending midwives (for example, if the midwives think you need to go to hospital for some complicating factor during labor, and you disagree).
•    When in labor, don’t wait until the last minute to phone the midwives. Not all of the midwives live in Aberdeen—a lot of them live in outlying towns and need some time to get to you.

When you call the midwives after going into labor, they’ll ask various questions – how long you’ve been in labor, how far apart contractions are, how long they’re lasting, and so on – to ascertain if they need to come to your home yet or not. If they think it’s too early for them to come, they’ll tell you—and if you really want them to come anyway, they will. After arriving, they’ll take your blood pressure and vitals; they’ll only do an internal exam if you request it. They’ll also listen to the baby’s heartbeat with a Doppler about once an hour.

When the baby is born (Yay!), the midwives will weigh him/her and do the Apgar scores–the same types of things that would be done if you had your baby in hospital.The midwives are able to stitch you if you have tearing. If it’s extensive or internal, though, they’ll have you transferred to hospital. They also can assist with breastfeeding advice and assistance.

Here are a couple of websites that I found helpful if you are considering a home birth:
http://www.homebirth.org.uk/
http://www.midwiferytoday.com/articles/homebirthuk.asp

Labour Induction – In normal circumstances you will not have your labour induced until you are two weeks overdue. On your due date your midwife may schedule an exam with you and can sweep your membranes if you want her to. This process will be repeated again if you are still pregnant at one week overdue and an induction will be scheduled at that time for the next week (when you would be two weeks overdue).

C-section

Post-natal Carewpid463-benjamin-10-days-105.jpg

  • Post-natal Care – One of the great strengths of the NHS is its excellent post-natal care. Every new mother receives follow-up home visits by her midwife for approximately 7-10 days following delivery. Once the midwife is satisfied that the mother is recovering well and that the baby is gaining adequate weight, visits are assumed by the health visitor, who will continue to stop by for as long as the mother feels is necessary.
    • Lactation consultants – For women who are experiencing difficulty in breastfeeding or just need added support, there is excellent lactation care provided through the Maternity Hospital. Just call the Breastfeeding Centre on 01224 552615.
  • Circumcision

    • Through the NHS – Circumcision is not routinely practiced by the NHS. The general waiting time to have a male baby circumcised is 6 months at which time he will be put under general anesthesia for the procedure. Should you choose to go through the NHS for your son’s circumcision it is recommended that you discuss it with your health visitor very shortly after the birth as there will be a number of things you will need to do before the operation is approved and wait-listed.
    • Private – Circumcision can be done privately. There are several Jewish doctors in Newcastle & Manchester, England, willing to perform the procedure for approximately £150. They will require an overnight stay in order to inspect the surgical site the following day to ensure the bleeding has stopped. Circumcisions done privately will be performed without any anesthetic unless otherwise requested and can be performed on a healthy infant as soon as 8 days after birth.
      • In Newcastle:
        • Dr. Rutenberg (0191 477 1980 or mobile: 07920 515 354)
        • Dr. Bolel (0191 477 1176)
      • In Manchester:
        • R. Weinger (a rabbi) (0191 477 0443)
        • Dr. Hibbert (0161 792 2470)
        • Dr. Lieberman (0161 720 9794)

    Birth Certificate

  • Birth certificate – Your child’s birth certificate can be obtained at the Register’s Office. You will receive both a short and a long version of the birth certificate. The long one is needed for your child’s US documentation.  (It may be a good idea to get several copies.)
  • US Documentation

  • US Documentation – Once you have obtained your long form birth certificate, you can apply for your child’s US documentation. All information about reporting the birth of your child can be obtained here. After mailing in your forms and supporting documents, you will be required to appear in person with your child to complete the process. The nearest US Embassy is in Edinburgh. Occasionally, the Embassy travels to Aberdeen to provide American Citizen Services and Voter Registration. You can find out if such a trip is planned by visiting this page on the Consulate’s website.
    • Consular Report of Birth Abroad
    • Social Security Card
    • Passport
  • UK Visa

  • UK Entry Clearance – If your child is born in the UK, they will not have a visa the way the rest of the family will. If you are planning to leave at any time with the child & come back to the UK, you will need to make sure you have obtained a visa for them in order for them to re-enter the country. There are two ways to do this:
    • Obtaining one while in the UK – If you are renewing your visa, you are permitted to add your child onto your application for no additional fee.  If, however, you have to apply for your child’s visa independently, be prepared for it to be very costly!  It is much less expensive to do it while in the U.S. (see next bullet point).
    • Obtaining one while in the US – If you are planning a trip back to the US, you can coincide obtaining the visa with your travels. Apply online. Once you are in the US, mail your supporting documentation to your relevant UK Embassy. If everything goes smoothly, you should have your child’s visa back within 5-6 business days. You can also pay a courier service to hand deliver your application. This provides an additional level of comfort if you are operating under a tight timeframe.
      • Remember when filling out the application online that you will need to fill it out as though YOU were the child.
      • You will need to provide a US address as your residence in order for the visa to be mailed back to you.
      • The online application may or may not  provide the option of the UK as the place of birth for your child. If it does not, explain the discrepancy between your child’s passport place of birth details and that by including in the online application a cover letter that you send with your packet of supporting details.
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