Having a baby in the UK
Navigating pregnancy and welcoming a new baby is a life-changing event. Parents-to-be naturally seek a sense of preparedness and control as they plan for the various aspects of pregnancy, labour, and childbirth. Being aware of the key considerations will help ensure a smooth and nurturing experience during this special time in your life. This article aims to help you get organised to have your baby in the UK and care for it while living in the country as an expat.
Where to give birth in the UK
In the UK, you can give birth at home, at a birth centre run by midwives (i.e., a midwifery unit), or in the hospital, depending on your and your baby's health, pre-existing medical conditions and whether you have had complications during the pregnancy. Some women choose to give birth at home because they feel more relaxed being in a familiar environment and surrounded by their families. They also don't have to stress about rushing to the hospital. Suppose you want to give birth at home, you will receive the support of two National Health Service (NHS) midwives while you are in labour unless you opt for a private midwife or unassisted birth (i.e., free birth).
Important:
Epidural injections cannot be given at home. However, you can use other relaxation techniques at home, such as a warm bath, prenatal yoga, etc.
Attention:
Every birth in the UK must be recorded (notified) within 36 hours. If you give free birth, inform a GP as soon as possible.
Giving birth at a midwifery unit is cosier than a hospital, even though it may be part of a hospital maternity unit. If the midwifery unit is separate from a hospital, there won't be immediate obstetric, neonatal, or anesthetic care (e.g., epidural). In the UK, most births occur in hospital maternity units run by the NHS. In a hospital, you will be in labour with a midwife. However, doctors are available if intervention is required due to complications. Also, you will have direct access to anesthetists and neonatologists. If there's more than one hospital in your area, you can choose which one you want to give birth at.
Good to know:
If you have decided that you want to give birth at home, it doesn't mean that you cannot change your mind later on in your pregnancy and go to a hospital when you are in labour.
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Find maternity services near you
Private vs. NHS hospitals
In the UK, most births occur in hospital maternity units run by the NHS (National Health Service), where maternity care is free under certain conditions. Due to the high number of patients and the often understaffed hospitals, the NHS cannot consistently deliver what it promises or aspires to, which you should keep in mind when giving birth.
Unless required differently due to your medical condition, the NHS offers ten prenatal appointments with a midwife (most likely, this won't be the same midwife that will be with you in labour), blood tests, two free ultrasounds (not the ones giving 3D or 4D images), and about four postnatal appointments. If you've already had a first child, you will only be entitled to seven free prenatal appointments. While you are giving birth, the NHS secures you a private room. However, when you enter the postnatal ward, you will share the room with other new mothers and their babies.
There's also private maternity care available in the UK, usually selected by families looking for more extensive and personalised services. If you choose to give birth under the care of obstetricians and midwives in a private hospital, expect to pay between £5,000 to £6,000 for an overnight stay at the hospital. If a cesarean is wanted or needed, the bill will increase by at least £1,000. Also, note that many extra charges (e.g., anesthetist, routine checkups, etc.) may appear on the final bill while under private care.
Good to know:
You can give birth at an NHS hospital, but hire an independent midwife who will offer you private and personalised care during labour.
Important:
Regardless of whether you are receiving public or private healthcare, you have the right to refuse procedures meant to speed up labour. Also, you can refuse certain drugs and insist on having an active birth unless there are complications that require a different action.
NHS cover for expats in the UK
You are entitled to free NHS maternity care in the UK if you are an ordinarily resident in the UK. EU nationals who are not ordinary residents but are insured by a European state and are holders of a European Health Insurance Card (EHIC) will not be charged for "medically necessary treatments". If you paid the immigration health surcharge when you applied for a visa that allows you to stay in the UK for more than six months, you are entitled to free NHS healthcare. If none of these applies to you, you will be asked to pay for the prenatal (antenatal), birth, and postnatal care you receive. These charges sum up to anything between £4,000 and £9,000. However, before the NHS charges you, staff members will enquire about your immigration and residence status and confirm with you the charges.
Attention:
You cannot be refused prenatal, birth, and postnatal medical care based on your inability to pay. Maternity care must not be delayed or denied due to charging or payment issues.
Attention:
No other person except the patient is liable to pay a debt for their NHS care. Before signing a joint agreement with your partner, for example, consult a debt advisor. Also, the NHS cannot pressure the patient to provide a guarantor. In such a case, you should seek legal advice.
Get support from a doula in the UK
A doula is a person who has been trained to support expectant parents, pregnant women, and new parents. A doula doesn't have medical knowledge or training and cannot replace the midwife or other health professionals. Hiring a doula can cost £500 to 2000 for birth and £10 to 35 per hour for postnatal services. You can access a list of doulas in the UK through this link.
Important:
Choosing a doula is a highly personal decision. To determine if a doula is the right match for you, it's essential to research various types of doulas and have meetings to assess compatibility in terms of personalities, communication styles, cultural awareness, and experience.
Professional duties and pregnancy in the UK
Pregnant employees in the UK are entitled to paid time off for prenatal care (e.g., medical appointments, parenting classes, etc.), maternity leave (at least two weeks and up to 52 weeks), and maternity allowance. Also, they have the right to report any unfair treatment or discrimination against them due to their pregnancy. A pregnant employee is typically required to notify their employer about their pregnancy at least 15 weeks before the expected due date. However, it's worth noting that in certain exceptional circumstances, this may not be feasible, especially if the employee is unaware of the pregnancy themselves.
Statutory Maternity Pay (SMP) lasts for 39 weeks. During the initial six weeks, it equals 90% of the employee's pre-tax weekly earnings. For the subsequent 33 weeks, it's either £172.48 per week or 90% of their weekly earnings (whichever is less). SMP is disbursed using the same frequency (e.g., monthly or weekly) as the employee's regular salary and is subject to tax and National Insurance deductions. If you are not eligible for SMP, check whether you meet the government's conditions for maternity allowance. Also, some companies have maternity schemes, which, however, should not offer less pay than the statutory amounts calculated above.
Even though you agree in advance with your employer when you want your SML and SMP to start, the leave and pay will begin inevitably if you are absent for a pregnancy-related illness in the four weeks before the baby is due.
Lastly, you can share up to 50 weeks of shared parental leave and up to 37 weeks of shared parental pay with your partner when you have a baby or adopt a child. These 50 and 37 weeks are meant to be divided between the two of you. You can choose to take this leave either in blocks or all at once within the first year following the child's birth or placement in your family. You and your partner can also decide whether to take the leave simultaneously or at different times.
Good to know:
The ordinary maternity leave is 26 weeks after you give birth, but it can be boosted by 26 more weeks (additional maternity leave).
Good to know:
The partner of a pregnant employee has the right to take unpaid time off work to attend at least two prenatal appointments.
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Baby's citizenship in the UK
If you have the legal right to reside permanently in the UK (such as settled status, indefinite leave to remain, or the right of abode for Commonwealth citizens) at the time of your child's birth, your child will automatically acquire British citizenship.
However, if your baby doesn't acquire British citizenship automatically, you can apply to register your child for British citizenship, provided that you or the child's father meet specific requirements. The citizenship application may cost around £1,200, and this fee is non-refundable.
Important:
Births in England, Wales, and Northern Ireland must be registered within 42 days of the child's delivery. This can be done either at the local register office for the birthplace or at the hospital before the mother's departure.
Attention:
The child cannot obtain a UK passport before obtaining British citizenship.
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