Anastasia is a freelance writer living in London with her husband, Nick. They have been married for 3 years and are expecting their first baby. This is Anastasia’s diary at week 22 of her pregnancy

As an American in London, I enjoy the differences between the two countries and, although I have been here for six years, I find new ones all the time. The way a woman is treated medically, during pregnancy, is a big one. Since I’ve never had a baby in the US, it’s all new to me, but I have friends and a sister-in-law in the States who have made the differences very clear.

In the states, the approach is very, shall we say, hands-on. Since there is no NHS, all medical care is private (provided at a cost to both the individual and his/her employer). Once you’ve got the positive pregnancy test under your belt, you get on the ‘pre-natal train’, which has about ten times more stops than the ‘antenatal train’ you’ll find here in England (at least in my experience). For example, when my little stick showed two lines, I immediately called my GP and asked to come in. My first appointment consisted of filling out a form and receiving an information booklet. Not even a confirmation of my pregnancy. I was out of there in two minutes flat – my next appointment would be eight weeks later. In Chicago, however, my sister-in-law was immediately scanned, had blood taken, a full exam, weight, medical history, nutritional advice and a given little card to note her next appointment – two weeks later. And the pre-natal primary caregiver is an obstetrician/gynaecologist – all doctors and no midwives.

The next time I had any antenatal contact was my first midwife ‘booking-in’ appointment. After several questions and a blood pressure check, she told me my next appointment was three months later. Meanwhile, my sister in law has visited the doctor at least every three weeks, moving up to every two weeks as of week 25. On every appointment, she’s given a urine test, blood pressure, weight, measurement of her bump, and a great long talk about how she's doing. That’s what I miss most of all. I’d love to just have someone to complain to legitimately. But every time I have had midwife visit (a grand total of two), they have seemed so rushed and overworked that, I wouldn’t dare waste their time asking silly questions (even though I have a long list of them).

I don’t necessarily believe that the American way is better. Pregnancy is not an illness and I think there’s a bit of overkill in having to visit the doctor every two weeks. However, it is a bit unnerving when my friends back home are horrified by the fact that:

1. I have never had a urine test
2. I have never been weighed
3. I have never had a blood test.
4. My ‘fundus’ (length of uterus/bump) has never been measured.

The part I prefer about birth in the UK versus America is the much more natural approach. The minute you walk into the hospital in the US, you’re hooked up to various machines (designed to prevent future lawsuits, I suspect) and are tethered to the bed and stuck lying on your back for the duration. They’re very quick to recommend an epidural (not that I object to that, but I wouldn’t want it as a matter of course, if I could cope without). There’s no gas and air, and no opportunity to give birth standing up with gravity on your side. They may have beautifully furnished private ‘family rooms’ with lovely wooden beds that even accommodate Daddy, but regular American hospitals have none of the ‘holistic’ elements that I really like (birthing balls, birthing pools). And the absence of midwives means that doctors, always on tight schedules, are probably more likely to intervene to ‘get it over with.’

So there are pros and cons to both approaches. The best one probably lies somewhere in the middle. I really would appreciate more antenatal attention. On the other hand, what a nuisance to have to waddle over to the doctor’s office so often. And I am secretly thrilled that I have never, ever had to step on the scales in front of anyone. My blood pressure is surely lower as a result.

See Josa's pregnancy diary for week 22.