Giving birth when you're an expatriate

I returned home to Gibraltar to have my baby, mainly because my health insurance didn't cover it, and also because where I come from the health services are free and very good. Plus, my father is an excellent paediatrician and experienced neonatal specialist!

The main issue for me was the time limit for airlines permitting travel in the late stages of pregnancy. Luckily, one of the two airlines servicing the route I needed to travel, Iberia, had no such limit. Most other airlines restrict travel after a certain stage, like 28 or 30 weeks (about seven months). For example, I travelled to Central America on COPA in my 5th month and was interrogated before embarking. Note - this is coming up to six years ago so rules may have changed. Check with the airline.

There are other issues, for example pre-natal classes, and cultural attitudes to pregnancy and babies that clash with your own. In the Dominican Republic the extended family is still strong, so childbirth preparation is not as common as in Europe/North America. I did go to a class, but this is not the norm, probably because female relatives fulfil the purpose of providing information and advice about the process.

Unfortunately, pregnancy is treated like a disability or illness - you're pampered which is nice, but also on the receiving end of lots of unnecessary mollycoddling and unwanted advice. Pregnant women get their own parking spaces and are allowed to go right to the front of the queue at the bank, as if their state made them too fragile to withstand a short walk across a supermarket car park or a 10 minute wait in a queue.

Exercise is not encouraged, to the detriment of pregnant women's health and that of their babies.

Caesarians are almost routine in the private sector, whether necessary or not.

Breastfeeding is not really encouraged or supported in the local culture, despite government and UNICEF-type organisations and their advertising campaigns.

The biggest shock for me was that even when I was pregnant, men directed predatory comments at me in the street. I'm used to that in Latin countries but in most places the rule is that if you have a child, a man or a pregnant tummy, you're considered off-limits because you're another man's property. I think the crudest 'piropo' I ever received in my life was when I was visibly pregnant, or maybe the hormones made me touchier than normal, but what that man said made me feel physically sick!

It would be interesting to hear from others who stayed to give birth.

We moved to Buenos Aires two months ago. Before we got here we set up private health care insurance, 516 pesos a month for two of us (roughly 168 at the current exchange rate of 3.10 dollars for 1 Arg. peso). Just after we got here I got pregnant.

So far the medical care has been excellent, and I've been very happy with the insurance we have, better than in the U.S. and more comprehensive. When a doctor calls for something here, the insurance company accepts it.

Here in Argentina also, pregnant women have their own parking spaces everywhere. This is a contrast to the U.S. where only women who have strollers have a parking space allocated. Tells you something about how they respect pregnant women here. If you're using public transportation and you are far enough along on your pregnancy, people get up and give you their seats (as a matter of fact they do that for people with women or men with babies as well).

Everyone here is helpful when you're pregnant and although people do this to some extent in the U.S., it's nothing like here. The doctors have great bedside manner as well, something sorely lacking in the U.S. where you are treated as a client and not a patient!

I'll post again later on to add some more info.

I gace birth to my daughter in the Philippines. Came to Singapore when she was 3 months old. It was easier to have the baby in Manila as company covered all costs, insurance etc!

Hugo is born in Chile - so he is a chilian too !

For me it was obvious to give birth in Santiago.
Ok, one important point is the health coverage, and as international staff we had no problem. I gave birth in a clinica not at the public hospital....

But I do not feel at all the necesity to give birth in France. I was living in Chile at that time (since 4 years), the baby was part of the life I had there, and so it seemed to me normal to stay in Chile.
Morever, with the restriction in airplane after 6/7 months pregnancy, it's almost impossible if you are working to go back to your contry ! I think that my employer would have not appreciate a pre-natal leave of 3 months !

Today, I'm really happy to have a chilean boy. I'll try to give to him as inputs as I can about where he's coming from.
I continue to speak in spanish with him, and I want to find people here, from Chile, to share all this history with them

I am 4 months pregnant and living in Almaty, Kazakhstan.  I will return to the US to have my baby.  I will leave in December due to airline restrictions (no flying after the 7th month).  I have a Doctor in the US and a Doctor here as well.  I have several reasons for going home to have the baby.  Home is where my family is and my parents and sister asked only that I be there so they could bond with the baby.  My insurance is paying 100% of all cost if I have the baby in the US.  Here, I pay about 200 USD a visit.  My Doctor here is great, she gives me the same quality of care as my Doctor in the US.  Money is not the issue.  Women have been having babies forever all over the world.  Here or there it's all the same, famiy is my reason for going home.  I'm just wondering how the 22 hour flight back to Kazakhstan will be with a newborn baby.  Any thoughts or comments on that?  Thank you.  Kristal

Just don't do it in Japan!

http://www.ippoippo.net/blog/archives/2006-10-18/dis/

I agree !!
Japan, USA, Hong Kong and Switzerland are probably the most expensive countries for maternity and delivery cares !

I didn't have private health insurance at the time and gave birth twice in Italian public hospitals in Rome -- fewer creature comforts for the mother, but fine medical assistance.  Here public hospitals are more highly considered than private clinics for high risk pregnancies. I have heard some horror stories from expensive private clinics, so it is a toss up between creature comforts and emergency expertise. 
Elizabeth

That's a very interesting thread!
I'm far from having a kid (not even found the potential father!), but I wouldn't mind giving birth wherever I'll be at the time.
One of my sisters was born in Brazil, another sister in Cuba, one of my brothers in Portugal. It's part of my tradition/background being a nomad, and being born with those genes!
And I think it could be such a +++ in the child's life!

Beurredemani>>> it's great you still talk in Spanish with your son!! He will have more easiness learning other languages as he grows up

I'm nearly 4months pregnant and will give birth in the NYC . As of Sunday I am an illegal until I get my status adjusted in late March. In NYC they have  PCAP, a Prenatal Care Assistance Programme. It's for women with no healthcare or those on a very low income and is designed to catch the poorest women in NY and ensure they receive adequate medical care.. It covers the babies medical needs for the first year and mine for the duration of my pregnancy and the birth.
So far my experiences are all positive, I've had my scans and medical examination, blood tests and smear, had access to nutrition counseling and received vitamins. Although the clinic is oversubscribed and totally no-frills , it's been so reassuring to be able to get this care at such an important time.
It's expanded my knowledge of Spanish too!

(sorry, I did not see there were a French Forum. I am now going there).

J'ai donné naissance à Laure à Dakar, dans une clinique privée, et ça s'est assez bien passé. Je  n'ai jamais pensé retourner à Montréal pour accoucher, j,aurais été éloignée de mon amoureux trop longtemps - au moins deux mois. Or, je voulais fonder une famille, ne pas être éloigné, surtout durant la naissance du bébé.

En fait, tout dépend sur quel médecin on tombe. le mien était excellent.

I recently gave birth in Dublin, Ireland. As I found out I was not covered for maternity care through my private health insurance (needed to read the fine print a bit more carefully and pregnancy was a surprise!), I went through the public system which on the day was fine. The mid wives were fantastic. Pre natal care was a bit hurried and crowded for a first time parent. For an expat though it can be difficult being away from family and friends to share that special time with. Having a child can also be a great way to meet new people and form friemndships which has been difficult so far to say the least. ( 4 years here)

My first two children were born in Thailand and Vietnam respectively.  My husband and I, both Americans, were teaching abroad in Vietnam the time.  For our first child, we had good prenatal care at an international clinic with foreign doctors in Ho Chi Minh City.  We had to travel 6 hours by bus to get there from where we were living in the highlands.  We were advised not to give birth in HCMC, and concurred after visiting the "International" hospital there.  This was in 2003, before the French-Vietnamese hospital had been open long.  So we took a few weeks off in October and stayed in Bangkok, Thailand.  Our daughter was born at Bumrungrad hospital in Bangkok, which is a top-of-the-line but competitively priced private hospital.  Our experience there was good, and I gave birth to a healthy girl without using any drugs, which was my goal.

For our second child, we decided to stay in Vietnam, since we were living in Hanoi by then.  Hanoi French Hospital is where I had my prenatal checkups and delivered my second daughter.  I had mostly French doctors, who did internal exams at each monthly checkup (not fun) and whose bedside manner did not impress me.  However, since it was my second baby, I didn't let it bother me too much.  I did, however, make sure not to get to the hospital too soon before my child was born, since I wanted another natural delivery.  And in fact our daughter arrived so quickly that it took everyone by surprise--including the Vietnamese midwife who was still waiting for the French doctor to appear. 

Out third child was born on U.S. soil, in a Chicago hospital.  By comparison, the doctor was very uptight and created a frantic birth experience.  Insurance companies rule all in America, and in my opinion, they helped turn my last birth experience into an emergency.  My son was healthy, though, for which I am thankful.

first child born in france,in normal public hospital, great service,great doctors, better than private clinics.
second one in Beira/Mozambique,even though the plan was to go to South Africa for comfort, but sometimes cant predict things ahead (that time was hating husband job, escpecialy his " british boss"). i consider myself the luckiest woman gave birth in mini mozambican "private " clinic, stayed there only 24 hours, next day was ready to escape through window with baby... for both babies had medical insurance, but i have chosen to be with husband at that time to give birth rather to be separated... what one would not do for "love"...
i guess for giving birth better to be in safe and comfortable place as u never know what may happen during giving birth to your child. in different countries different ways practiced, like for me i was young mom for 1 st child and in france i stayed 1 week in hospital where the nurses teaching mom how to care abt baby but only for first 2 days, the rest of the time you must do all alone ...luckily i had my mom and sister helping me after i left hospital. but great thing abt first delivery, is peridural injection, french doctors really take time to wait till baby born. not like in africa, in Mozambique my  God, 200 KG giant NURSE was pulling me from bed" MADAME... you must walk not sit... Madame crying from pain" i cant walk, plz help, i'm dying from pain.... Nurse: oh no no no pain, walk walk walk... I was nearly losing  all liquid, then monster nurse realised baby is coming, doctor was still on the way....
After kicking my head on the wall continiously from pain for few min, baby was born 5 min after doctor showed up at  last. i was nearly to kill all of them in clinic, but was so weak physicaly...
Voila my african story abt giving birth in Beira...

Not good idea in my opinion..

I gave birth in France almost 2,5 years ago. The thing we found strange (compared to Belgium, where we're from) is that the gynecologist who follows you during your pregnancy isn't present at the hospital for the birth.
We had two mid wives and no doctor. He only comes in case of problems. Although everything went fine I have to admit it didn't feel very reassuring. 
The hardest part for me came after the birth: a colicky baby and a post-natal depression and no family or friends to support me. My husband did his best, but he had to go to work... It was the hardest year of my life.
I always wanted two children, but living abroad changed that. But now the worst is behind us and we are happy again.

Quite separate from the issues of medical costs and quality of pre-natal/delivery/post-natal service every foreign birth has legal considerations that are very important. These revolve around not only the birth, but also the issues of citizenship.

You must check with your home country's regulations regarding reporting or registering your child's birth while abroad in order to insure that he/she gains citizenship at home.

You need to know if BOTH your home country and host country (where the birth takes place) permits dual citizenship.

Since almost all nations in the world operate based on the legal concept Jus Soli that means anyone born in their national territory is a citizen by virtue of birth (some minor exceptions for diplomatic staff and military personnel in some countries).

Some countries operate based also on the legal concept Jus Sanguinis which means even though your child is born on foreign soil he/she will gain your citizenship if you follow the rules regarding reporting/registring foreign births.

You may also find that you have acquired the right to apply for permanent residency in your host country, by virtue of being the parents of a citizen. Also something worth thinking about.

Cheers,
William James Woodward - Brazil Animator, Expat-blog Team

wjwoodward wrote:

Since almost all nations in the world operate based on the legal concept Jus Soli that means anyone born in their national territory is a citizen by virtue of birth (some minor exceptions for diplomatic staff and military personnel in some countries).

this is news to me that jus soli is the general rule. Maybe I'm just lost in scandi world, but none of the countries up here grant citizenship simply as a virtue of being born in the country.

Almost all of Europe and Asia and many countries in Africa use Jus Sanguis (and most don't allow double citizenship). I don't know about the situation in America, but these are certainly the majority in the world!