'His knowledge of obstetrical practice turned out to be about thirty years out of date. He clearly hadn't changed a thing about the way he did things since his training.'

My daughter, Charis, was born at 5.24pm on December 23 - on the same day as numerous women were having labour induced, in order that they, (and, incidentally, their obstetricians) would be home in time for Christmas.

Consequentially, the maternity wing was full to overflowing and frantically busy, and not so good for me, who hadn't actually had a choice about when to go into labour.

Prior to the last few months I had experienced private health care precisely once, when as a teenager I had a minor operation under my father's work-related health care plan. It was as good an experience as an operation can be. The medical care was excellent and the hospital room was luxurious. I therefore had high hopes of private health care in the US.

The big practical difference between US and UK health care is that in the US you can choose your doctor. It is apparently common when you discover you are pregnant, to interview several obstetricians and then make your choice.

Which is great in theory. In practice, however, once you have eliminated the doctors that your health insurance doesn't cover, the doctors that don't accept your type of insurance, the doctors that your GP equivalent doesn't make referrals to, the doctors that only work at the hospital your insurance doesn't cover... well, you aren't left with many.

Obstetrician

We arrived in the US when I was about four months pregnant, so we were naturally concerned to find an obstetrician as soon as possible, and went with the first referral we were given. Big mistake. His knowledge of obstetrical practice turned out to be about thirty years out of date. He clearly hadn't changed a thing about the way he did things since his training.

He and I had some differences of opinion concerning appropriate treatment, and finally, just two weeks before my due date he told me to go and find another doctor! Can you imagine the uproar in the UK if a doctor "sacked" a patient in such a summary fashion?

Fortunately we did find another doctor who was a bit more with it, and, moreover, I immediately liked and trusted. By and large, the actual medical care I received was very good - except in one or two instances when the hospital was so very busy.

I have come to the conclusion that, in many cases, the health insurance companies and the litigation culture of the US conspire to keep many aspects of medical practice very conservative - hence, doctors like my first obstetrician are able to get away with being old fashioned.

Doing things a new way involves, of course, risk. This culture also makes medical intervention in childbirth more likely. Rates of Caesarean births are higher in the US.

NHS

I polled friends both in the UK and the US about the treatment they had received pre - and postpartum, and, except where those in the US had circumvented the health insurance route and paid for "alternative" care directly, in every case the care in the UK was more in line with up-to-date research on good obstetrical practice. I never thought I'd say it, but hoorah for the NHS.

Not that my observations hold true in every medical instance. My husband has been prescribed a new kind of treatment for eczema that is not yet available on the NHS - and he can get it on his insurance even though the cream costs $300 a tube.

So - some things are better, some things worse. No surprises there, I guess. But I shan't be so quick to criticise the NHS in future.

As for other comparisons - well, one waits just as long in the doctor's surgery here as one does in Britain, and as far as my experience extends, the hospitals are of a similar standard.

And one thing seems to be a constant in hospitals the world over - the food is always lukewarm by the time it reaches your bed. I was offered an ice-lolly with my lunch - and even that arrived lukewarm.