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 England and care for them while living in the country as an expat.
Where to give birth in England
In England, 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've had complications during the pregnancy.
Giving birth at home
You can choose to give birth at home if you feel this is where you'll feel more relaxed. However, in England, this is usually only recommended if you have had a straightforward pregnancy and both you and your baby are well.
The advantages of a home birth include being in a familiar place, where you may feel more relaxed and better able to cope, and you won't have to interrupt your labour to rush to the hospital. If you have older children, you won't need to worry about leaving them, and you won't need to worry about being separated from your partner after birth.
There are also things to consider if you're thinking about a home birth in England. You may need to transfer to a hospital if there are complications, first and foremost. Epidurals are not available at home, but other relaxation techniques may help like gas and air, a warm bath, TENS.
Ask your midwife whether a home birth is suitable for you and your baby. If this is your birth plan, your midwife will arrange for members of the midwifery team to help and support you.
Good to know:
Every birth in England must be recorded within 36 hours. If you have a free birth, you should inform a GP as soon as possible.
Giving birth at a midwifery unit
Midwifery units or birth centres are generally more comfortable and homely than a maternity unit in a hospital. You can find these as part of a hospital midwifery unit, where pregnancy, newborn and anaesthetic care is available, or separate from a hospital, without immediate care available.
The advantages of giving birth at a midwifery unit include being in surroundings where you may feel more relaxed, you're more likely to be looked after by a familiar midwife, and the unit is potentially closer to your home. Plus, if your pregnancy is low risk, you have a lower likelihood of having an intervention like forceps or ventouse than giving birth in a hospital. But remember, you may still need to be transferred to a hospital if there are any complications.
To plan a birth in a midwifery unit or birth centre in England, you should ask your midwife if there are any midwifery units or birth centres in your area first. There may be others you can use if you're prepared to travel, too.
Giving birth in a hospital
Most births in England happen in an NHS hospital maternity unit. If you choose to give birth in a hospital as part of your birth plan, you'll be looked after by midwives, but doctors will also be available to help if needed. You'll also have direct access to anesthesiologists (who give epidurals), access to obstetricians (if your labour becomes complicated), as well as specialists in newborn care (neonatologists) and a special care baby unit if needed.
Your midwife can help you decide which hospital feels right for you. Though it's unlikely you'll be looked after by your midwife while in hospital. You should be able to tour the maternity facilities before your birth, and during labour, you will have access to pain relief like an epidural, TENS machines, birthing pools, and more.
Useful links:
Where to give birth - the options from the NHS
Private vs. NHS hospitals in England
As we've mentioned, in England, most births occur in hospital maternity units run by the NHS, where maternity care is free under certain conditions. Due to the high number of patients and the often understaffed hospitals, however, the NHS can't 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 3D or 4D), 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 England, 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 and £6,000 for an overnight stay at the hospital. If a Cesarean section (or C-section for short) is wanted or needed, the bill will increase by at least £1,000. Also, note that many additional charges (such as an 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 England
You're entitled to free NHS maternity care in England if you are ordinarily resident in the country. If you paid the immigration health surcharge when you applied for a visa that allows you to stay in England for more than six months, then you are entitled to free NHS healthcare.
For those not ordinarily resident or without immigration health surcharge coverage, NHS maternity care charges now start from £7,500 and can be significantly higher depending on the complexity of care required. However, before the NHS charges you, staff members will enquire about your immigration and residence status and confirm with you the charges.
NHS coverage for EU nationals
EU citizens should check current reciprocal healthcare agreements between their country and England, or whether they hold the UK Global Health Insurance Card (GHIC) or a valid EHIC. Healthcare coverage varies depending on your specific circumstances and nationality.
Good to know:
You can't 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.
Also, 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 England
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 £2,000 for birth and £10 to £35 per hour for postnatal services. You can access a list of doulas in the UK through this link.
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 England
Pregnant employees in England 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).
Also, the partner of a pregnant employee has the right to take unpaid time off work to attend at least two prenatal appointments.
Useful links:
Maternity pay and leave, GOV.UK
Check if you can get Maternity or Paternity Leave or Pay, or Maternity Allowance
Baby's citizenship in England
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. As of 2025, the citizenship registration application costs £1,214, 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.
Your child cannot obtain a UK passport before obtaining British citizenship.
Useful link:
We do our best to provide accurate and up to date information. However, if you have noticed any inaccuracies in this article, please let us know in the comments section below.
