NHS Midwives: (An American Gets High on Gas & Air)

Krystal Evans
The Haven
Published in
6 min readMar 8, 2021

“What the bloody hell does a Yank know about the NHS?” I can just hear Boris Johnson, Nicola Sturgeon, Theresa May, Frasier and Niles from Frasier, the Queen, Queen (the band), and The Band*, all of whom are the most British people I can think of and will definitely read this article, collectively shouting from their respective rooftops. It’s true; Americans are loud, arrogant, and we say things like “Twenty bucks my ass!” and “My ass is falling out!”, and “Get ready dude, when you hear this, you’re gonna shit, out of your ass!”

Well, let me firstly tell you this: I know one thing; and that thing is; this; I know how to use colons and semicolons correctly; Also: a thing or two about the NHS. I’ve spoken to many a staff member from the NHS at great lengths, mostly about my own health issues, and they’re demeanours have ranged from life-changingly empathetic to slightly annoyed. Their dementors have ranged from ghostly to wraith-like.

“Ugh. How DARE a member of the NHS be slightly annoyed when I tell them about my weird poos?” I hear you, a British Person, say. “How dare someone who is overworked and underpaid, doing a job that they feel passionate about, sometimes act like a human being when I pay zero monies for the pleasure?” -Me pretending to be you, British Person.

“Ah, but it’s not free! I’ve paid into the NHS all my life!” I imagine the real You shouting in reply, your spit angrily flying into my eyeball region.

Ok, sure. I’ve been paying taxes my whole life too. It’s a bummer. It varies, of course- but in the US, we get approximately 1/3rd of our paycheck taken out. For taxes. And… other things; I don’t know exactly the breakdown but what I do know is that when I was in my 20s, I would be hired for a job that, on paper, makes $12.50/hour only to have it be spliced down to something like $8.98/hour after all of the deductions. What the almighty hell? I mean sure, I take great comfort in the fact that in America 1/3rd of our money is going to super important things like building tanks, expanding highways, tanks, planting wheat, and buying wheat fields in which to park our tanks.

And of course, here in the UK, it’s much much MUCHO more, like something like 55% or something taken out of your paycheck, which is a killer, but shucks, you have great social services here like this free healthcare service that’s just the price you pay for-

What’s that? Brits get about 1/3rd of their pay taken as well? Pretty much the same amount as us? Also, you don’t have to worry about going into lifelong debt when your butt bleeds for unknown reasons?

Look. All I know is, when my dog got ill, I took him straight to the animal hospital near my house, the one with the nice paint job and adorable pictures of happy cartoon dogs and cats on the front, and the staff were so friendly and smiley, and so was I!

“I mean what a country that me and all my loved ones are taken care of for free”, I thought whimsically, and then as I was whistling the melody to “America, My Country Tis of Thee” and “God Save the Queen” (which have the EXACT same melody. Seriously. Go listen to them both. What the ass?) on my way out, my newly bandaged pup trotting along beside me, when giving me his meds the desk lady smiled Britishly and said “And here’s your total bill” “Bill?” I said. And I’ll tell you this, British Person: my ass nearly dropped out of my ass. “£880 my ass!” I said. NHS for Pets needs to be a thing, asap. For a country that loves animals so much, you charge a hell of a lot to fix one that just loves to eat so many secret rocks and not-ok plants that his tum tum has imploded on itself.

I digress.

If I could get personal, folks. I recently gave birth to a live human. I had a home birth. Yes, on purpose. Most people hear this and think “she doesn’t care about her baby or her home”. What can I say? I have a gambling problem.

I’ve had two children here, under the Scottish NHS. One at the hospital and one at home. Like all pregnant people here, unless high risk, you’re under the care of midwives exclusively. The maternal death rate here is super low- unlike the US where it’s the highest in the developed world — quadruple that if you’re a woman of colour.

It’s not a mystery why this is the case- over medicalisation of births, a lack of education and empowerment of women when it comes to our own bodies plus systemic racism have put American pregnant women at a huge risk. But has it always been like this? And why can’t we fix it? I think the best place to start is to look at where the UK has succeeded.

“Hey Krystal! You haven’t made a joke in like two paragraphs! Are you having a bloody stroke?!”

Look, I know the NHS isn’t perfect. There’s a lot of inequalities and unfair pay and budget stuff that definitely need to be addressed. But the thing is, is this. This is the thing:

The midwife system of the NHS is a long standing tradition of Women Looking After Women. I don’t know if it happened on purpose or not, but when I went into labour, I’d never felt so looked after in my life. These women know what the fuck they’re doing. They have a deep, collective knowledge that has been passed down from generation upon generation of midwives before them. I could just feel their confidence and competence in the way they spoke to me (with respect) and cared for me (genuinely). The NHS midwife tradition is the perfect union of the latest, scientific evidence-based knowledge and training, mixed with experience, empowerment and Trusting Your Gut (something women are told by society not to do).

I had a gigantic blowup pool set up for my homebirth. It was fucking LIT. Seriously. Candles, a warm pool in an Edinburgh flat, me butt naked**, sucking on gas and air. (For those not in the UK, Gas and Air is Nitrous Oxide; also known as laughing gas. 100% proven to not hurt the baby and to relax the fuck out of the mother). As a former pot head, I couldn’t have been happier. I didn’t end up giving birth in the pool, but that was fine. Also, my water never broke. A lot of times, medical professionals will break it for you to “get things moving along”. My midwife suggested not doing this. She said that since the baby was quite a ways past the due date, there would be a slightly higher chance of needing to be transported to hospital if she broke my waters early, and she knew that wasn’t the birth I wanted to have. So we just let everything happen at my body’s own pace.

She was thinking ahead, and she was right; my waters didn’t break until the baby came out. She made the right call. I remember being in the throws of contractions and saying “This is really labour, right?” she said “Well I think so, unless it’s something you ate!” Then she and her Irish 2nd midwife laughed and laughed. They were so fucking great.

You see, because of my very specific mommy issues, having two confident, intelligent, caring, middle aged women telling me what to do was extremely comforting. Don’t let the Tories burn it down. And do more than just clap.

Right now you might be thinking “Krystal. How the hell are you so incredibly poignant yet hilarious?” It’s a curse, I tell you! (Follow me on social media and give me writing/comedy/voiceover work please)

*Canadian, but they’ll still read this, even the dead ones.

It has since been pointed out to me that Veterinarians get shit all the time for how much they charge, from morons who don’t understand what shit costs and comedians who use the pain and suffering of others to get laughs. Doggies and kitties deserve the best of care, so pay your vet bills and shut the fuck up about it because vets are great! Apologies to vets everywhere -KE

**I know it’s technically “buck naked” but language changes, deal with it, and butt is officially funnier than buck

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Krystal Evans
The Haven

(She/Her) Comedian who does dark, sweary jokes in sarcastic tones. As seen on BBC’s Bad Influencer and BBC Scotland’s The Comedy Underground.