Midwife's Musings - Top tips for birth abroad
Getting ready to become a parent, or to add a new child to your growing family can often seem daunting, particularly if you’re doing so in a country that is not your passport country. Here are some handy hint of things that might help you as you prepare:
1. Which country?
I know this sounds like a basic question but it is one of the most important. Have you decided which country you would like to give birth in?
If it’s your host country, that’s great, you can get started planning and researching (feel free to jump to number 2!) but if it’s your passport country there are a few things to consider. Have you made contact with maternity services in your home country? They will want to see your maternity records, so make sure you either take copies or originals with you. Do you know your airline’s policy about when you can fly? You may need a doctor’s note to confirm they are happy that you will be safe.
Even if you are planning to give birth in your passport country, it is still worth researching your options in your host country in case you end up giving birth early or being unable to fly. Pregnancies can have a habit of leading you to the unexpected, so it’s always best to be prepared.
2. Research, research and yet more research
As a midwife, which means ‘with woman’, my role is to advocate for my client, ensuring her and her baby’s safety, but hopefully assisting her in having a positive and empowering pregnancy and birth. I am a huge advocate of my clients taking time to do their own research. By looking into different options, it means that women are able to make fully informed decisions about their care, and to decide which options may be their preference. When you’re living abroad, this is particularly important. Finding a midwife and a doctor who you feel safe and trust is massively significant and options of pain relief, place of delivery, schedules for antenatal and postnatal care amongst others are likely to vary. This can even be the case in different hospitals in the same country. Knowing what your options are can really help you feel as prepared as possible and to feel more calm and in control throughout your pregnancy and labour.
Speaking to friends who have accessed local maternity services, going directly to speak to doctors, midwives and nurses, as well as accessing information from local health authorities (e.g. NHS Choices and Royal College of Midwives in UK) will be a great start. There will also likely be a tonne of information online and in books too. Just make sure that you’re reading from a reputable source. The brilliance and danger of the internet is that anyone can post anything at any time and it is so important to make sure that what you are reading is both accurate and up to date.
It is also worth researching maternity care in your passport country and being aware if there is something you’d like to request in your host country. It may be that you decide you’d like your baby to have the vitamin K injection after birth, or the heal prick test or that you would like the same pattern of ultrasounds. Asking whether these services would be available in your host country, even if it's not routine, but via request, will also help you to know whether it's possible to have the maternity care that you would like.
3. Consider your choices and make a plan
You may have heard of a ‘Birth plan’ or ‘Birth options list’ before. It may sound confusing but it is actually pretty simple. Once you’ve had a chance to do some research and found out what your options will be, it is really helpful to take some time to decide, in an ideal world, what your preferences would be.
Then all you have to do is to write this down. It can include things like where you would like to give birth, who you would like to be with you, what forms of pain relief you would like, if you would like to use things like a birthing pool, what types of positions you’d like to try and the list goes on.
These lists have two main purposes. Firstly, it helps you and your family think through what your preferences would be. Knowing this, can make you feel more prepared and in control. Secondly, it can help health professionals caring for you to know what you are hoping for or expecting.
4. Expect the unexpected
As much as it’s important to be prepared, it is also really important to realise that birth is a natural process but that it is not one that we can always control. There are many factors at play here and the most important thing for health professionals is to ensure yours and your baby’s safety. Things unfortunately don’t always go to plan. Baby’s can become ‘distressed’ with their heartbeats being effected, labour can be prolonged, or even short, and it's not uncommon for women to change their mind about their choices once they are in established labour.
Whilst it is good to know what your preferences are, it is also good to be realistic that this may not be possible or that things may change when you’re in labour. Health professionals can try as far as possible to follow your plans, but you may have to have conversations where they recommend changing the programme, particularly if emergencies develop. Knowing that this could happen, can again help to feel more in control and prepared and having done research about all options often helps women to better cope with last minute changes.
5. Birthing and parenting classes
Attending birth and parenting classes can be really helpful from a number of different perspectives. Firstly, they can provide great education and help you with your research, but secondly, many people find they help them form a social support network with other parents-to-be. Having people you can share moments like, “I’ve just jumped into the shower with a happy sleeping baby and its 3pm” can make you feel like you can share your victories, as well as your struggles with people who understand.
Ironically with the COVID 19 outbreak having limited many of our options surrounding physical meetings, many more options are opening up online. Again, make sure you’re getting information from a reputable source, but it is definitely worth checking out. Just be aware that if you access information from your passport country, or a country that is different to where you plan to give birth, that some of the information may be different.
6. Immigration status and finances
This is something that is hugely important. If you know that you are planning to have a baby, or you’ve just found out that you’re pregnant, this is something to look into as soon as possible. Every country has different rules and regulations over citizenship and immigration status and the earlier that you find this out, the better. You will likely need to provide information from your health professionals for applications for birth certificates, passports, visas, citizenship etc. Make sure you know what the situation is and that you get it sorted out as early as possible and that you give yourself plenty of time to make sure paperwork is sorted before booking flights.
Another thing to be aware of is the financial situation surrounding maternity care in your host country. Does your health insurance cover you or will you need separate cover? You may need to provide proof of insurance or your ability to pay for care privately prior to receiving any treatment so it is good to be aware of this.
A great place to start if you’re unsure what to do with any of these things, is to contact your country’s consulate. They will be able to direct you with where to start, what the processes are and what information and evidence you will need to provide and when.
7. Communication with loved ones
It’s normal for family or friends to feel a mixture of emotions when women are planning or expecting a baby and this is only heightened when they are separated. It is likely that they are hugely excited and fearful at the same time. We often fear the unknown, so if women are accessing care that is different to what their families are used to, it is likely that they will be worried or concerned for you. Open communication and reassurance for them can be really helpful, particularly if they are unable to visit or see you for a while.
It is worth thinking about how you can keep people involved in your pregnancy and birth, sending photos, whatsapp calls once the baby is born, making arrangements for visits etc. There is no right answer but whatever feels right to you and helps you to feel supported and connected to your loved ones!
Hope these tips help and best of luck as you start planning!