Giving birth in England vs Ukraine — 10 differences to know in advance

When a Ukrainian woman finds out she is pregnant in England, the joy often comes with confusion. Everything we knew about antenatal care and birth back home works differently here. There is no doctor, fewer tests, fewer scans — and after the birth you may be sent home the same day.

I work with Ukrainian women in the UK, and I see that the biggest source of anxiety is not the system itself but not knowing what to expect. So I have gathered the main differences between giving birth in England and in Ukraine, so you can prepare and ask the right questions with confidence.

This article is a guide, not medical advice. Details depend on your hospital (NHS Trust) and your situation, so always check them with your midwife.

1. A midwife leads your care, not a doctor

In Ukraine, pregnancy is usually followed by an obstetrician-gynaecologist, often one you choose personally.

In England, if your pregnancy is straightforward, your care is led by a midwife. She does your check-ups, arranges tests, answers questions and makes a birth plan with you. You will be referred to a consultant obstetrician if there are risk factors: a long-term condition, complications in a previous birth, twins and so on.

This is not "lesser" care. It is how the system works: midwives in England are highly trained and deliver most babies on their own.

2. How to register your pregnancy

In Ukraine you go to a women's clinic or to the doctor you are registered with, ideally before 12 weeks.

In England you refer yourself: through the maternity service website of your local hospital (self-referral) or through your GP. Do it as early as possible — ideally before 10 weeks. Your first long appointment with the midwife is the booking appointment, usually between 8 and 12 weeks.

3. Fewer appointments, tests and scans

This is probably the difference that worries Ukrainian women most.

• In England, a first straightforward pregnancy usually has around 10 planned midwife appointments, fewer in later pregnancies.
• There are two routine scans: around 11–14 weeks (dating and screening) and around 18–21 weeks (a detailed check of the baby's anatomy). Extra scans are offered only when there is a reason.
• In Ukraine there are traditionally more visits, more tests and three screening scans.

The English approach is not to intervene without a reason. If something worries you — your baby's movements, pain, bleeding, leaking fluid — do not wait for your next appointment: call your hospital's maternity triage line, which is open 24 hours a day.

4. What it costs

Maternity care in the NHS is free for those who are eligible. If you are in England on one of the Ukraine visa schemes, NHS care is generally free for you. If your status is different, check it early.

In Ukraine, antenatal care and birth are free under the state medical guarantee programme, although many women sign paid contracts with a doctor or maternity hospital. Private birth exists in England too, but most women give birth in the NHS.

5. Where you can give birth

In England you will most likely be offered a choice of:

• a hospital labour ward — doctors nearby and epidurals available;
• a birth centre or midwife-led unit — a homely setting, often with a birth pool;
• a home birth — with NHS midwives, if your pregnancy is straightforward.

In Ukraine, women give birth in a maternity hospital or perinatal centre. Home birth is not part of the state system.

6. Pain relief

In England, "gas and air" (Entonox) is widely used — a gas mixture you breathe in yourself during contractions. Pain-relief injections, a TENS machine and water birth are also available, and on a hospital labour ward you can have an epidural.

In Ukraine, epidurals are available in many maternity hospitals, but gas and air is rare. Talk about pain relief with your midwife in advance and write your wishes into your birth plan.

7. Your birth plan and your rights

In England a birth plan is standard. In it you describe how you would like to give birth: who will be with you, pain relief, skin-to-skin contact, delayed cord clamping, feeding.

Staff take your wishes into account, and any intervention should be explained and done with your consent. You have the right to ask questions and to take time to decide.

8. Going home and the first weeks

In Ukraine, women usually stay in the maternity hospital for a few days after the birth.

In England, after a straightforward birth, mother and baby are often sent home within a few hours or the next day. Support then comes to you:

• a community midwife visits you in the first days;
• a health visitor takes over from around day 10–14 and supports the family after that;
• a GP check at around 6–8 weeks, for you and for the baby.

You will be given the "Red Book", your baby's personal health record for weight, vaccinations and check-ups.

9. Registering your baby

In Ukraine the birth certificate is often arranged while you are still in the maternity hospital, including through the "eMalyatko" service.

In England a birth must be registered within 42 days at the local register office — appointments are usually booked online. For your baby's Ukrainian documents, contact the Embassy of Ukraine.

10. Language and emotional support

The language barrier is one of the biggest worries about giving birth abroad. Know that in the NHS you have the right to a free professional interpreter. Ask for one in advance so it can be arranged for important appointments.

Pregnancy as an emigrant is a double load: a new system, your mother and friends far away, the usual support missing. Anxiety, tears, the feeling that "I'm not coping" are not weakness. Tell your midwife how you feel emotionally: the NHS has specialist perinatal mental health services.

In short: how to prepare

• Register your pregnancy early — before 10 weeks.
• Save your maternity triage number.
• Ask for an interpreter if your English is not yet confident.
• Write a birth plan and discuss pain relief.
• Plan support for after the birth — who will be with you in the first weeks.
• Do not stay alone with your anxiety.

If things feel hard right now — in pregnancy, after birth or in emigration — I am here. You can book a session on my page or join our free community, where Ukrainian mothers support each other.