The Cayman Islands offers parents-to-be exceptional prenatal care, with highly skilled and compassionate doctors, midwives and nurses dedicated to making your pregnancy safe and enjoyable.
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You have two options when considering your prenatal care and delivery. You can opt to have your care and delivery through a private obstetrician/gynaecologist (OB/GYN) and deliver at one of the three local maternity units, or you can go through the Health Services Authority (HSA), where your delivery at the Anthony S. Eden Hospital will be handled by the hospital's midwives, supported by the hospital OB/GYNs.
Private OB/GYNs
The private obstetricians (OBs) are all qualified to deliver routine obstetric care and some have additional skills in obstetrics and/or gynaecology that enable them to manage high-risk pregnancies. The care they provide is consistent with any developed country and the clinics are generally well-equipped, e.g. with modern ultrasound equipment.
To choose an OB, it is best to research them which you can do by reviewing Cayman Parent's list of OBYNs and/or ask your GP, and then visit your shortlisted candidates to find the one best suited to you. Some OBs do not charge for ‘getting to know them’ visits, but it is worth checking when making appointments.
You should look into appointing your OB as soon as you think you may be pregnant or even when you are thinking of trying, if your medical history may affect your pregnancy. You can expect to have your first scan at around 6-8 weeks.
Your chosen OB will guide you through your entire pregnancy and deliver your baby, supported by the resident midwives at your birth centre.
Midwife Births
An alternative to a private OB is to opt for a midwife delivery through the Woman's Health Clinic at the Health Services Authority. You will then receive your care through a large team of midwives, who manage the prenatal care and deliver the baby, supported by a team of resident hospital OBs who are on call 24 hours a day should there be any problems. The midwives are highly qualified and trained to deliver babies.
Choosing midwife care is a lower cost option for having a baby in the Cayman Islands, while still offering world-class care. It’s suited to parents who are happy with, or prefer, a team approach, as opposed to having care led by the same physician throughout.
Prenatal Care
After your first appointment, OBs and midwives will typically see you every four weeks up until 28 weeks, every two weeks until 36 weeks, and then weekly until delivery, consistent with standard care in most developed countries. If issues emerge during your pregnancy, you will likely be seen more frequently. In some special circumstances you may have to go overseas before or after delivery for treatment, although thankfully, such cases are rare.
Early on in your pregnancy, you will be required to undertake some initial blood tests to rule out any infections or concerns. These usually include: full blood count, Hepatitis B screening, Rubella IgG screening, VDRL (tests for syphilis), HIV, ABO/Rh status. From nine weeks, you can also opt to have the NIPT (Non-Invasive Prenatal Test – a simple blood test) to screen for certain chromosomal and genetic conditions such as Down Syndrome. Your doctor or midwife will discuss this with you to help you make an informed choice, as well as seeking approval from your insurance company before conducting the test. Most insurance companies cover a portion of the testing fee if you are 35 years or older or if you have a medical condition warranting the test. Otherwise, you will be responsible for its cost if you choose to have it.
Between 18-23 weeks of pregnancy you will have a detailed anatomy scan of the baby to screen for congenital structural abnormalities.
Between 24-28 weeks you will be given the Glucose Tolerance Test to screen for Gestational Diabetes. It involves fasting before the blood test in the morning, then having a glucose drink, followed by another blood test an hour later. If your results show any cause for concern, you will be required to start controlling your sugar intake and may need further medical treatment, which can be administered in Cayman. In general, pregnant women should limit sugar intake during pregnancy.
Birth Plans & Paediatricians
As your pregnancy develops, you’ll want to discuss your birth plan with your OB or midwife, including your thoughts on pain relief during labour, to ensure your wishes are known. You will also want to choose the paediatrician who you’d like to care for your newborn. Cayman has both general paediatricians and some that are also qualified specialists in preterm or newborn emergencies and complications. Again, it is worth researching them, asking other parents or GPs, and visiting your shortlist. Given that infants can survive from 23-24 weeks gestation, some parents-to-be prefer to do this quite early in pregnancy. You may choose a private paediatrician or opt for the HSA paediatric team.
Birth Classes & Doulas
It’s recommended that you prepare for childbirth by enrolling in some prenatal classes. You may also wish to employ a doula to provide emotional and practical support and advice.
Hospitals
In the Cayman Islands, all babies are born in hospitals. Home and water births are not currently offered. There are two maternity wards in Grand Cayman and one in Cayman Brac.
The Anthony S. Eden Hospital (formerly George Town Hospital) offers three single delivery suites, eight maternity rooms (three single and five double rooms) plus a Level 2 Neonatal Intensive Care Unit (NICU). The standard of care is excellent and the recruitment of former NHS Consultant Neonataologist Dr Robert Bomont, the hospital’s first directly employed full-time neonatologist, has greatly expanded the care that can be offered to newborns.
Doctors Hospital offers private delivery suites which have been designed for your comfort and your birth partner is welcome to stay the night.
Health City's new state-of-the-art hospital in Camana Bay offers private labour and delivery rooms/suites and is home to Cayman's first Level 3 NICU. They offer specialised care for newborns from routine care to advanced life support provided by a team of neonatologists experienced in caring for critically ill or premature babies with complex medical needs. Birth partners can stay overnight in the spacious rooms.
Most high-risk pregnancies can be managed and delivered in Cayman. The NICU at Anthony S. Eden Hospital provides excellent care for premature babies from around 28 weeks or earlier if needed, and the NICU at Health City Camana Bay cares for infants born from 26 weeks gestation.
Sometimes it's necessary to transfer the mum-to-be or the newborn overseas, usually the US, for complex care. If the baby has been born, it will require an emergency passport to travel, and your own documents need to be in order too.
Discuss with your OB which hospitals they can practise in. It’s worth touring your chosen hospital beforehand to familiarise yourself with the space, staff and amenities.
Delivery
As most baby books will tell you, you don’t need to head straight to the hospital once you feel your first contraction. It is, however, advisable to discuss in advance with your OB or midwife when to contact them and how. Once you have made contact, be sure to follow their advice carefully.
When arriving at the hospital, head straight to the Maternity Ward. Don’t forget to bring your ID, insurance card if you have one and mask. Leave your hospital bag in the car, so that your partner or caregiver has both hands free to help you if necessary. They can retrieve it once you are settled.
Post Delivery Care
Once you have given birth, you will continue to receive care from the obstetricians, midwives and nurses at your chosen hospital. The midwives and nurses will provide lactation support, help you care for your baby, teach you how to gently bathe your tiny newborn and how to put your baby in the car seat ready for discharge. The midwives at Anthony S. Eden Hospital are happy to make a home visit to help with any concerns or issues that you might be having post-delivery. If you give birth at Doctors Hospital, you will receive a follow-up consultation to check on you and your baby's progress. Health City Camana Bay offers comprehensive postpartum care and guidance for mothers and babies, including lactation support and newborn check-ups.
Length of Hospital Stay
How long you stay in the hospital is a decision both you and your doctor will make. Some women feel more comfortable with a longer stay, while others prefer to go home earlier. Most insurance companies cover two nights after a natural delivery, and three nights after a caesarean section (the period in labour is not calculated in this). Hospital stays are quite expensive, so check your insurance and plan accordingly. Mum will be discharged by her OB/GYN, while the baby is discharged by their paediatrician.
