Being pregnant, giving birth, or caring for an infant is a big task even in your own country; doing it overseas adds all kinds of extra challenges. I’m excited this week to welcome Ruth Greene to The Prepared Expat in the first part of a series designed to help you survive and thrive as an expat during pregnancy, birth, and after birth. Ruth is co-owner of a website dedicated to helping expats give birth abroad, a certified doula who has assisted hundreds of expats in their birthing journeys, and a mother who has given birth to three of her children abroad!
In today’s article, Ruth not only shares her expertise about evaluating where to give birth, but is graciously giving away a resource from her paid birthing course. Read on to learn and find out how to get the free resource!
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When I was pregnant with my first child, I thought it was a given that I would travel to a larger city to give birth at an international hospital. Prior to my pregnancy, the experiences of expats giving birth in the city we lived in left much to be desired. Due to this, it had become the common practice of expat moms to travel to Beijing a few weeks before the birth to await the early signs of labor. Closer to the time of the birth, husbands would hop on a train or plane, hoping to make it before the baby was born.
It was actually my boss who encouraged me to look for options closer to home—she didn’t want me to take a month off work before my due date! Amazingly, a new hospital opened during my pregnancy, and they were eager to provide me with top-notch, patient-focused care. They knew that if I was pleased with their services, I would be likely to recommend them to my foreign friends.
It turned out that for our family and priorities, staying in the city was the best option, but it didn’t come without its sacrifices. On the one hand, I didn’t have the costs of travel, my friends were close enough to visit me at the hospital, and my husband was able to be with me every step of the way. However, English language translation was limited, and, as one of the first births at a brand new hospital, we didn’t have a reference for the quality of care they would provide. Additionally, luxury items like Western food choices and coffee were nonexistent. While this option worked for us, I knew other families that chose differently.
As I have worked with hundreds of pregnant individuals and families over the years, I am repeatedly reminded that every family’s situation and values are different. There’s no “one size fits all” for having a baby abroad! So, as one plans the birth of their baby, it’s important to consider several factors:
Local Laws
Before you even get pregnant, it’s a good idea to research the laws and policies set by the government under which you live. Never assume that because you are a foreigner the laws don’t apply to you. For example, in the UAE pregnancy outside of marriage has historically been illegal. It doesn’t matter if you are a local or not. In the country I live in, home births are effectively forbidden. If you find the restrictions set by your governing authority don’t align with your family situation or expectations, it may be necessary for you to travel outside of the country to give birth.
Additionally, look into the process for obtaining a birth certificate, passport, citizenship, or other legal documents for your newborn, as this may affect your decisions.1 I remember my parents telling me they chose to give birth to my brother on the army base in order to eliminate any questions of citizenship! Another consideration may be how soon you will need to apply for the baby’s passport and visa (if required). Traveling long distances postpartum can be hard on both Mom and Baby, so some families may choose to give birth in a hospital nearby their embassy or consulate.2
Birthing Priorities
Consider your birth preferences. Is it essential that my partner be able to attend the birth? Has it been my dream to have a water birth, or to be surrounded by my family members? Do I want to be able to communicate in a language I am fluent in? Next, research how your values align with your possible birth locations. Are you willing to compromise on any of your preferences in order to meet other expectations? For example, I might prefer to have a water birth, but if that requires traveling to another city or country, that might compromise the possibility of having my husband at the birth.
Evaluate each birth location in light of your ideals and choose which one makes the most sense for your family. At HavingaBabyinChina.com, we have created a worksheet to help birthing families choose a birth location factoring in their personal birth priorities. This worksheet is part of our “Having a Baby in China-The Course”. Sign-up for the course here, or download this FREE worksheet. This worksheet is designed for anyone, not just expats in China, and will help you process and decide which location will best help you accomplish your birthing priorities.
Manage Expectations
It’s important to have realistic birth expectations. Don’t simply read one or two books on natural childbirth and then walk into a brightly lit hospital environment expecting to ‘breathe out’ your baby! (I may be speaking from personal experience on this one…) Find out from those around you what it is like to give birth in your chosen birth location. Will you be free to move around during labor? Will the labor or delivery rooms be private or shared? Will your partner be allowed to stay with you at all times, or only at certain points? Take the information you’ve gathered and make a plan for how you will respond during labor.
A note on this: it is important to be aware of, but not live in terror of, “horror stories.” Try to discern between unexpected one-time events vs. patterns of unwanted or harmful practices. Did one person have something go sideways and need an emergency cesarean, or are you seeing a trend of families treated in a certain way? If you are seeing a pattern that does not align with your priorities, you may want to look elsewhere. If that birth location is truly the best option you have, sit down and have a deep conversation with your partner (and hopefully your doula-more on that later!) about what you will do to work within the system while still supporting your birthing goals.
Build Your Community
It can be uncomfortable and humbling, but seek support from those around you. Have an older child (or children)? Ask a neighbor or friend if they can accompany you to appointments to watch over them (and maybe they can help with childcare during the birth as well!). Let friends bring you meals, help with translation, and be sounding boards. Welcoming a new baby into the world is an exciting time, and it can be made all the richer when surrounded by a caring community. Conversely, a feeling of isolation is a reality for many expats.
It can be a lot of work to create a community around you if it doesn’t happen naturally through your work or neighborhood. Many cities have social media groups for families living in their area. This can be a great way to meet people in a similar phase of life. It will most likely be easier to connect with other moms during pregnancy than after the birth, so work now to set up coffee dates, attend events, etc., to build those connections before you are overwhelmed by life with a newborn
Get Professional Help
Hire an international doula! I can’t say this loudly or often enough (and not just because I am one). It’s invaluable to have the support of someone who is familiar with both the local birth world and the stressors (and benefits!) of giving birth cross-culturally. International doulas can provide both in-person and online support. In addition to answering your questions and offering emotional and physical support, they can inform you of possible factors you may not have considered. They can connect you with support groups, help you find resources, research options when something unexpected comes up, and just be a listening ear when you are struggling. Especially in the unpredictable life of an expat, a doula can enhance the pregnancy, birth, and postpartum experience and help families reach their birthing goals.3
Conclusion
Birthing in a foreign country is likely going to be vastly different than if you had stayed in your home country, both positively and negatively. It’s important, however, to avoid the “victim” mindset and instead evaluate what is most important for your family. Don’t accept what “has always been done” but seek support in finding a birth location that suits your family, your values, and your health. By understanding local laws, setting your priorities, managing expectations, building your community, and getting professional help, you can help make your birthing experience abroad a positive one.
Thanks so much, Ruth! If you’re interested in contacting Ruth with questions, or want information on her birthing course for expats, you can reach her via the Having a Baby in China website.
Read Part 2 of this series here: Babies Without Borders, Part 2: Dispelling Birth Assumptions
Ruth Greene CD(CBI) is an expat and a full-spectrum doula with over a decade of experience supporting birthing families. She is a founding member of the International Birth Workers of China Annual Conference, Mom to four children, and co-owner of Having a Baby in China, a licensed company which offers doula, breastfeeding, and consulting services.
The Having a Baby in China website offers a variety of resources, including a birth vocabulary list, local hospital listings, a course for expectant parents, the beloved HABIC Podcast, and much more.
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Footnotes
- Mark’s note: Another factor to consider is the steps you’ll need to go through in order for a local birth certificate to be recognized by your home country. Some countries may require a birth certificate to be issued in a local language/script, which could cause difficulties when trying to use the birth certificate internationally or when applying for a passport. ↩︎
- Mark’s note: Another consideration to make is whether your child would gain citizenship or permanent residency just by being born in your host country. In some places, those benefits the child gains can be transferred to the rest of the family, which can be a great benefit. In other cases, that automatic citizenship can entail responsibilities (e.g. military service) that you may want to consciously avoid. ↩︎
- Mark’s note: I want to echo this advice of considering a doula for an international birth, especially if you’re relatively new to the language and culture. For our first international birth, we hired a doula and it was incredibly helpful. Having a guide who understood the local hospital system and their typical birthing process helped alleviate our nervousness and concern with a foreign birth. It was a great experience, and our doula was a large part of that. ↩︎
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