Having a baby in London: NHS maternity care

If you've paid the Immigration Health Surcharge, NHS maternity care in London costs you nothing. The catch is that you run it yourself, from the first referral to the Australian passport.

The short version

You don't need a GP to start. Refer yourself to NHS maternity services as soon as you know you're pregnant. The booking appointment is at 8 to 12 weeks [1].
First-time parents are offered at least 10 antenatal appointments and two scans, at 11 to 14 weeks and 18 to 21 weeks [1].
Visa holders who paid the IHS get NHS care free. Visitors can be charged for maternity care, often after the birth [2][3].
Register the birth within 42 days [4]. A baby born in London to Australian parents isn't automatically British, so the Australian citizenship by descent application matters [5][6].
Statutory Maternity Pay is 90% of your average weekly pay for six weeks, then £194.32 a week or 90% (whichever is lower) for 33 weeks [7].

Who pays: IHS, visitors and the rest

Most Australians having a baby in London are on a Skilled Worker, Youth Mobility, family or student visa. You paid the IHS when you applied, and that lets you use the NHS free from the date your visa starts [2]. Maternity care is part of that: midwives, scans, the birth, and postnatal checks.

It's a different story if you're in the UK as a visitor. GOV.UK says overseas visitors who aren't exempt are charged 150% of the cost of NHS treatment. Urgent and immediately necessary care, which always includes maternity care, is given without waiting for payment, but you'll be billed afterwards [3]. The UK–Australia Reciprocal Health Care Agreement is aimed at medically necessary care for visitors. Don't plan a birth around it. Talk to the hospital's overseas visitors team early if your status is unclear.

Your situation	Maternity care	What to sort out
Work, Youth Mobility, family or student visa (IHS paid)	Free on the NHS [2]	Self-refer early, get an exemption certificate
British citizen or settled (ILR)	Free on the NHS	As above
Visitor, no IHS paid	Charged, usually after the birth [3]	Contact the hospital's overseas visitors team
Visa application pending	May be charged until decided [2]	Keep proof of your application

Booking in and the antenatal schedule

In London you don't have to see a GP first. The NHS says to refer yourself to maternity services as soon as you know you're pregnant [1]. Each hospital trust has an online self-referral form. Pick the hospital you'd like to give birth at, usually the closest one, though you can choose another.

The booking appointment happens between 8 and 12 weeks and takes about an hour [1]. The midwife takes your history, blood pressure, bloods and a urine test, and talks through your options. Bring your Australian medical history, especially past pregnancies, vaccinations and any conditions.

Stage	What happens [1]
As soon as you know	Self-refer to your chosen hospital's maternity service
8–12 weeks	Booking appointment with a midwife
11–14 weeks	Dating scan. Screening for Down's, Edwards' and Patau's syndromes offered
18–21 weeks	20-week screening scan of baby's development
Through to birth	At least 10 appointments for a first baby, at least 7 if you've given birth before

Most of this care is midwife-led. If you're used to the Australian private model, where an obstetrician sees you all the way through, this is a big change. On the NHS you'll only see an obstetrician if there's a medical reason.

Ask your midwife for a maternity exemption certificate (MatEx) form. It gives free NHS prescriptions and NHS dental treatment during pregnancy and for 12 months after the birth. Given London dental prices, that's worth having.

Where to give birth

London NHS trusts generally offer three settings. What's available depends on your hospital and your health.

Labour ward in the hospital, led by obstetricians, with epidurals and theatres on hand. Recommended for higher-risk pregnancies.
Birth centre (also called a midwife-led unit), often next to the labour ward. More homely, with birth pools, for low-risk pregnancies.
Home birth, supported by community midwives, for low-risk pregnancies.

Big London maternity units include St Thomas', the Royal London, University College Hospital, St Mary's in Paddington and King's College Hospital. Hospital tours and antenatal classes are usually listed on each trust's website.

Hospital stays are shorter than many Australians expect. After a straightforward birth, going home the same day or the next day is common. Community midwives then visit or see you in clinic, and a health visitor takes over from about two weeks.

Some families choose private maternity care in London. That's a separate world with much higher costs. Check carefully whether any private health insurance through work covers pregnancy, as many policies exclude it or need a waiting period.

Maternity pay and leave basics

UK maternity rights are generous on leave and modest on pay.

To get Statutory Maternity Pay (SMP), you need to have worked for your employer for at least 26 weeks into the "qualifying week", which is the 15th week before your due week, and earn on average at least £129 a week [8]. SMP then pays [7]:

90% of your average weekly earnings for the first six weeks
£194.32 a week, or 90% of average earnings if lower, for the next 33 weeks

Many London employers top this up, so check your contract. If you don't qualify for SMP, your employer must give you form SMP1 within seven days, and you may be able to get Maternity Allowance instead [8]. Statutory maternity leave can run to 52 weeks.

A note for visa holders: some UK benefits carry a "no recourse to public funds" condition. Statutory pay through your employer isn't a public fund, but check before claiming anything else.

Australians sometimes ask about Parental Leave Pay from Services Australia. It's generally for people living in Australia, so it won't usually help while you're based in London.

After the birth: register, then make baby Australian

Register the birth within 42 days

All births in England must be registered within 42 days [4]. Some London hospitals let you register before you leave the ward. Otherwise you book an appointment at the register office for the borough where the baby was born. That's the borough of the hospital, not where you live.

Order the full birth certificate, the long version that lists both parents. You'll need it for the Australian application, the passport, a UK bank account for baby and almost everything else.

Your baby probably isn't British

Being born in London doesn't make your baby a British citizen. Whether they are depends on where and when they were born and on their parents' immigration status at the time [5]. If neither parent is British or settled (with Indefinite Leave to Remain) on the birth date, the baby isn't automatically British. They may be able to register later, for example if a parent settles. Check the GOV.UK tool for your situation.

That makes the Australian side even more important. Your baby needs a nationality and a passport to travel, and to stay on your visa as a dependant.

Australian citizenship by descent and a first passport

If one parent was an Australian citizen at the birth, your baby can apply for Australian citizenship by descent. It isn't automatic.

Get the full UK birth certificate.
Gather proof of the Australian parent's citizenship at the time of the birth, such as an Australian birth certificate, citizenship certificate or passport.
Lodge form 118 online in ImmiAccount. The fee is A$380, or A$160 for each extra sibling applying at the same time, according to the July 2026 fee schedule [6].
Wait for approval and the citizenship certificate. Citizenship starts when it's registered, not when you apply.
Apply for the Australian passport through the Australian High Commission in London at Australia House on the Strand. Both parents usually need to consent to a child passport.
Add baby to your UK visa as a dependant, if you're staying. Leave time for this before the first trip home.

Book flights to Australia only once the passport is in your hand. Australian citizens generally need to enter and leave Australia on an Australian passport.

A few London realities

Maternity units are busy. Write your questions down before every appointment.
Antenatal classes from the NHS are free but book out. Private classes are an extra cost.
Family from Australia can't easily drop in for a few weeks of help. Line up support early, from partner leave to friends and neighbours.
Get your GP registration sorted before the birth, so your baby can be registered too and get their eight-week check and vaccinations.

Mums and dads in London swap hospital tips, second-hand prams and late-night questions in Cooee UK, our Facebook group for Australians in the UK.

Having a baby in London: NHS maternity care from booking to birth