• Joanna Brown

Three births in India - Kasey's Story


I have lived in India for almost 6 years and chose to give birth to all three of my precious babies here. When deciding to have my babies away from my home country, the United States, I was nervous, especially when I was a first-time mom. I barely knew what to realistically expect with labor and delivery plus postpartum, so factoring in the India aspect was an extra challenge for me. The biggest obstacle in India is finding a trustworthy doctor. There are plenty of good, hygienic hospitals in my city. However, the cesarean rate in India is almost 70% and my state recently ranked the highest in the country at over 80% of births being cesarean deliveries. Let me preface this by saying, I have nothing against C-sections. In fact, I think it is an amazing, life-saving procedure under certain circumstances. However, I did not want to have an “unnecessary cesarean” which is wildly rampant, so I had to really search to try to find a trustworthy doctor.

Unfortunately, for my first birth in 2016, I ended up having a traumatic experience. At my 32-week appointment, my doctor told me that I had borderline low fluid and that my placenta was not functioning well. She asked me to come every 3 days for an updated ultrasound to check on my baby which was mentally taxing in itself. Ultimately, at 35 weeks exactly, my daughter was born via emergency C-section. They placed me under general anesthesia and I was not able to meet my baby until 9 hours after her birth with hardly any communication about her wellbeing from doctors. It was very traumatic and even just typing this out makes me sick to my stomach. I will honestly never know if the way she was born was necessary. I have shown my medical reports to doctors in the US and India and been told that there was no justifiable reason that my daughter was born when and how she was. India does not have much in terms of malpractice laws, so I wasn’t able to do much except heal. My experience also propelled me forward into researching and becoming very passionate about helping others around me, both local and expat alike, to never experience what I went through in my birthing experience. The feeling of helplessness and lack of control over what was happening to me or my baby was something I want no woman to ever have to go through. Women deserve to birth in a safe and supportive environment.

Birthing trauma aside, there were several challenges for me during my first birth that I think every expat should consider when choosing a hospital in their host country. First, language and communication. Thankfully, my husband is a native, but he was unable to be with me every step of the way. I had doctors, nurses, lactation consultants, all of them mostly unable to communicate with me well, especially the nurses with whom I spent most of my time interacting. If you are unable to have hospital staff that you can communicate with effectively, make sure you have a translator. This will save you loads of unnecessary stress and anxiety. Birth is stressful enough without having to play charades or the medical staff just doing whatever they want without consulting you. Secondly, food. I actually enjoy Indian food, however, it was not my top pick of food to eat after giving birth and not feeling the greatest. Thankfully, my husband was able to get take out at local Western restaurants, but I couldn’t rely on the hospital food nutritionally. I wish I would have brought more snacks to help me.


Next, I was not given any proper lactation support. As a first time mom, I was clueless and didn’t have anyone to help me. I remember getting on YouTube trying to figure out my daughter’s latch. Because she was born premature, there were some additional challenges with feeding. Ultimately, I ended up having to formula feed her which broke my heart. I know if I would have had the support I needed, it probably would have been a different story. Next, it was also very important to me that my husband be allowed to be with me during labor and delivery, especially keeping language in mind. That majorly narrowed down my hospital choices because most hospitals do not allow a birthing partner. Lastly, initially before birth, the hospital had said they would accept my US insurance, and we had also confirmed this with my US insurance company. However, at the time of billing, they had absolutely no idea how to file with an overseas insurance company, so we had to pay everything out of pocket about $2,500 total. Always be prepared and triple check all the financials!

Okay, now onto the more positive experiences.

Before even thinking about having another baby, I had a lot of healing to do. My daughter was born healthy, and as dramatic as it may sound, that was about the only positive thing I could say about my birth experience. Yes, it was the most important thing, and I will never take that for granted, but I was so depressed and had so many emotions I had to process in the months to follow. India also offered very little in terms of mental health support for postpartum moms. I ended up having to go back to the US when she was 8 months old because of my emotional health.

When I found out I was pregnant again in 2018, I was actually visiting the US at the time. I asked my American doctor if he would consider allowing me to try for a VBAC when I was weighing my options of having my baby in the US or going back to India. He simply said, “Let’s see.” I didn’t feel confident that he would give me a fair chance. I started doing my research both about the pros and cons of a VBAC as well as looking for supportive doctors. I happened to find that one of the most recognized doctors for VBACs globally was located back in my city in India.

Once we returned to India, I was about 12 weeks and went for my first consultation with the doctor I had found. This hospital was completely different from the corporate, multispecialty hospital where I had my daughter in 2016. It was a natural birthing center mostly run by midwives. The additional bonus for me was that one of the head midwives was an American! I was so excited to have someone from my home culture walk through my pregnancy and delivery with me. My pregnancy went fairly smoothly with no big hiccups. I went into labor naturally on my due date. My water broke at 3am, and I had my son via VBAC the following day. It was 32 hours of labor, but I was given a safe, supportive environment to go through my labor and delivery experience. Most of the staff spoke sufficient English, including the nursing assistants. Being able to communicate, to me, eased so many of my anxieties. I was also given fantastic lactation support and breastfed my son for 15 months.

In 2019, I found out I was pregnant again! I was so relieved to have had such a positive experience with my son that I had no concerns about having my third baby. I confidently went back to my same natural birthing center and saw all the familiar faces. I had my daughter in the middle of India’s nationwide lockdown. Despite the external stress of the pandemic and going through multiple police checkpoints to just go to my prenatal visits, I had a great experience. My daughter was born in the same room as my son after 19 hours of labor.

After having such diverse experiences both in the same city, I am a huge advocate that it not so much matters where you have your baby geographically, but where you feel the most supported. My doctor in the US may not have given me the birthing experience I truly wanted even though I was in my home country. I was mentally prepared to have a repeat C-section ,if medically required. All I wanted was a fair chance to have my babies naturally with as little medical intervention as possible. I found that support in a small, natural birthing center in India, and I am forever grateful for this strong group of women who have made it their mission to support moms throughout the most vulnerable time in their lives.

I often get questions about what the process was like to get US citizenship for my babies. It has always been a very simple process for me. A five-minute interview at the closest US Consulate or Embassy showing a few documents and my babies received their US passports within 10 days. I would never let citizenship be a hinderance to choosing to give birth in your host country!

I hope you enjoyed reading about my experience giving birth in India as an American feel free to reach out to me if you have any questions or need some support with making a decision for your overseas birth!

You’ve got this, Momma!


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