10 Tips for Giving Birth Abroad
Exactly one month ago, I gave birth to the most beautiful little girl I've ever laid eyes on (of course, I'm biased). My birth experience with my daughter was completely different than my experience with my son. To my surprise, I enjoyed my birthing experience abroad much more than my experience in America. I thought the opposite would be true. I'm no stranger to all the "strangeness" of living in a foreign country. People do things differently and, for the most part, I'm ok with it. But when it comes to the intimate experience of giving birth, I had a lot of concerns about doing it in another country.
There are so many reasons my experience is one that I will cherish for years to come. There are also some parts of the experience I won't cherish, like getting kicked off a plane for being a mere 29 weeks pregnant (more on that later in this post). While it's all still fresh on my mind, I thought it would be helpful to share some of the things I learned through this first-time experience. I've also asked Denise, who has given birth abroad three times, to contribute a few of her tips as well.
Maybe you're a first-time mom who doesn't have a previous experience to compare your abroad experience to. Maybe you already have 1 or more children and this will be your first experience to give birth in a different country. Maybe you've already given birth abroad but didn't have a pleasant experience and dread the possibility of having to do that all over again. No matter what stage of motherhood you're in, we hope this post will help you have the most pleasant overseas birth experience you could have ever thought possible.
Take note: Some of these tips are more applicable to expat moms who have to fly to another country for better medical care and/or visa & passport requirements.
1. Check flight regulations for flying while pregnant. I learned my lesson the hard way when it came to flying while pregnant. As I mentioned earlier, I was escorted off of one flight because I was 29 weeks pregnant and didn't have a doctor's note. That experience left me in tears. I ran into another speed bump a few weeks later. I actually had a note this time from my doctor and I planned on using that note for my return flight as well. As it turns out, my letter was no longer valid for my return flight because a week had passed. This meant I had to pay to go see a doctor in the airport clinic and prayed that she would give me permission to fly, lest I be stranded. Please learn from my mistakes.
If you are planning to fly to another country to deliver your baby, you must find out the airline's regulations for flying while pregnant. Regulations are not the same for all airlines and all airports. Airports policies are different depending on whether they have a clinic to do the pre-flight check. Some airlines let you fly with a doctor's note until you're 35+ weeks pregnant. Other airlines won't even let you on the plane (even with a doctor's note) if you're 33 weeks pregnant. Do your research on the regulations and make sure the note from you doctor is dated no later than a week before your flight. And just for good measure, whatever you choose to wear for your flight, make sure it doesn't draw too much attention to your bump.
2. Get your bags packed for the trip. Since you might have to fly out a month before your due date and then you're looking at another month or two after you deliver to take care of passports and visas, you're going to want to put a little more thought than usual into your packing. For clothes, I packed enough outfits to get me through 2 weeks because I knew I would have access to a washing machine. I packed outfits that would fit both my 9-month-preggo body and my postpartum body. This meant lots of maxi dresses and skirts and loose tops. I packed some of my toddler's favorite toys that were also small and lightweight. I packed a small carry-on suitcase just like I would pack a hospital bag for me and the baby. I'm not here to tell you how to pack a hospital bag (plenty of people on Pinterest have done that) but I will say that you should pack outfits for your baby up to the 3-month size. Your little one might be at least a month old by time you return home. Depending on how quickly he/she chunks up, you might be using those 3-month onesies sooner than you think. If this isn't your first child, then think through all the items you already have and don't want to purchase again. These are the things you'll want to be sure to pack as well (bottles, burp cloths, boppy pillow, breast pump, etc). Pack suitcases within larger, empty suitcases if you think you'll be bringing more back than what you came with.
3. Do your pre-birth research. Location? Out of the country? In your host country? What type of extended housing and transportation is available at the birth location? Also, remember to check your visa and make sure you won't run into unforeseen issues if you want to give birth in your host country. Ask around other expats, search the internet and don't be afraid to reach out to those expats bloggers with your questions (wink wink) even if you don't know them. I find the expat community always willing to share information.
4. Secure a place to stay. Remember the whole shebang will take longer than you hope. By the time you have passport and visa in hand combined with flying restrictions you may find yourself relocated for 2 to 3 months. You want comfortable and affordable accommodations. Check with other companies/organizations that have home offices in the city you will be staying. Maybe if they have vacancies in homes where you can get a cheaper rate than through a private rental. Also, check with the hospitals themselves, especially, if the country is known for medical tourism. The hospital may be able to direct you to a location close by. We have had good experiences renting through VRBO in the past and you never know what sort of deal you can score from Travelocity.
5. Have a birth plan ready. I'll be honest...I didn't have a birth plan for my firstborn. It might have been because I was too busy teaching first graders to ever have a thought about what I wanted the birth of my first child to be like. Fortunately, everything (for the most part) went the way I thought it probably would and I felt well-informed throughout the process. This time, I felt like it might be a good idea to have a plan. The city where I delivered is FULL of diversity. There are many different cultures and many different religions. This means that people have a lot of different cultural and religious preferences when it comes to the birth of a child. I wanted to be prepared to tell the hospital staff what I wanted and what I did not want. I had a wonderful doctor and he provided me with a pre-typed birth plan with checkboxes to mark my preferences. As I read through it, some really interesting things popped out to me. However, I was really thankful for this later on when nurses asked me certain questions because I never felt caught off-guard or uninformed about certain decisions. I even learned a few new things about different cultures. For example, some people keep the scabby part of their children's umbilical cords in place them in a bag together so that "the siblings will always get along."
For your convenience, I typed up the birth plan that my doctor gave to me. If you don't know where to begin when making a birth plan, this might help give you a jumpstart. You can download a copy for yourself here.
6. Ask for a hospital tour. This is the time that you can continue your investigation on the different practices of the country you will give birth in. If you are a first time mom, you may not notice; but if this isn't your first child, you may bring a bag of preconceived notions from your last birth experience. For example, what are the appropriate shoes needed in a medical situation? My western mind thought, “closed toe shoes, of course.” Wrong. When we started the tour we were asked to remove your shoes and slip on a pair of community sandals (have those been sterilized?). Street shoes were a big no-no. I then was able to make a note to bring sandals for my size 11 husband to wear during the birth because the too-small "hospital issued" sandals made him shuffle the halls like a geisha whose feet had been bound.
7. Have someone ready and willing to watch older sibling(s) when it's go-time. My husband and I were blessed to have his mom here to help us. We also had some friends lined up to watch our son in case I went into labor before my mother-in-law arrived. I was really thankful my husband was able to give me his full attention while we were at the hospital (and I didn't have to worry about a little toddler running around pulling on cords and unplugging important machines)
.8. Don't be afraid to pester people with questions. If you aren't sure what a nurse is doing, ask her. If you aren't sure why you were brought a container full of pre-soaked cotton balls, ask for some clarification (FYI, I was apparently supposed to wipe my little baby's bottom with those—side note: bring your own wipes in your hospital bag). Do you want to know when you'll be able to check out of the hospital or what time the doctor will be making his rounds to visit? Press that little call button. My husband asked three different people what we needed to do in order to get the birth certificate for the baby. "You have not because you ask not"—so just ask.
9. Report the birth to your embassy and apply for the baby's passport. Not many moms have to pack up and head to the embassy with baby in-tow a mere week after giving birth. Lucky you! It's not ideal but it has to be done. I'm an American so I found what I needed to know about reporting a birth abroad on the U.S. Embassy's website. You're required to make an appointment for this so don't just show up to the embassy unannounced. There are also a good bit of documents you need to have ready to turn in once you've made your appointment. I won't go into detail about those documents since I already referenced the website where all of that can be found. However, I want to highlight a few of the items you might need (especially if you're an American) which you might want to be aware of ahead of time:
Parents' marriage certificate (original copy)
Evidence of the citizen parent's physical presence in the United States (i.e. school report cards, W-2 forms, passport entry/exit stamps, etc)
Hospital records and records of pre-natal care
You also need to have a passport photo of your baby ready for his/her application. I was dreading the thought of having to take a photo of my newborn but it wasn't all that bad. Go here to find out all you need to know about passport photo requirements. There are even examples of good and bad photos. Apparently (according to the U.S. embassy), it's OK if a newborn's eyes are not open (or not completely open) in a photo. You can also use the photo composition template to size and crop your photo appropriately, or try PhotoAiD (which is also available as an app) to upload a photo, add a white background, and crop appropriately. I ended up with a great passport photo of my daughter by placing a blanket in her carseat, then placing her in the carseat while she was awake and happy. I walked into the kitchen where there was a lot of natural lighting and snapped a handful of photos with my iPhone.
UPDATE (08/20/2022): Since the Embassy now uses a computer to detect whether or not a photo passes the test, you really can’t have a single shadow in the photo. That’s why it’s best to make sure to use an app that adds a solid white background and to make sure your light source is directly on the baby’s face (not coming in from either side, which would cause half the face to have a shadow).
10. Ask a friend to "please, pretty please" pick you and your family up from the airport once you return home. Nobody wants to take a taxi (or maybe even 2 with all of your luggage) once you get back to your home city. Who needs that added stress? Don't underestimate how much others want to help you. When there's an opportunity to hold a precious little newborn baby, people are going to be quick to offer you some help. You might feel guilty asking someone to drive way out of the way to come and get you but trust me, people want to help. Don't rob someone of the joy that comes from helping others. Speaking as a person who likes to give, it really does bring me joy. So let the givers give and the helpers help.
If you've given birth abroad, what are some tips you would add to this list? Any questions or concerns? Voice those in the comments section. Feel free to answer other's if you have the answer! You might also enjoy reading this new mom's water birth experience while living abroad.
