What To Expect When You’re Expecting.. In a Foreign Country

I found out I was pregnant one week after my husband signed a contract with his company to move to Sydney, Australia. As a couple, we were thrilled about the prospect of spending two years exploring a new city, but as new parents? We were concerned, but in retrospect we didn’t really know what to be concerned about. That’s the point of this article. Here are some of the things to think about if you are considering having your child in a country that is not home:

Quality of Medical Care: This is the most obvious one. Going from a developed to a developing nation where good medical care is a rarity is a cause for concern, as is being in one where you don’t speak the language. I know for certain that we would have opted out of the move if we were going to Japan or Korea or another country where i wouldn’t be sure the healthcare professionals could communicate with me due to the language barrier, regardless of how qualified they are.

If normal deliveries are difficult, you also have to think about the possibility of complications and whether you will feel comfortable there if you or your baby had to be treated for an extended time in hospital. I just braved the 24 hour journey back to San Francisco from India because my second is a high-risk pregnancy and I felt the equipment and care would be superior in the States if my baby were born early and needed to be in a neonatal ward for a while.

Understanding the insurance system and coverage is also important. Are there private versus public medical systems? Is one better than the other? For example, most people assume that higher costs equal better care but sometimes, specialty care (such as the best neonatal pediatricians) are covered under a public system. Are there government subsidies you would be eligible for? For eg. In 2008 the Australian government was giving AUD5000 to all families having babies as an incentive to grow the population. You can imagine the rush at the delivery ward around Christmas time!

Cultural Differences in Medical Philosophies: This one is harder to discern but important if you can. Every nation has a different philosophy towards medical treatments: some tend to be more conservative, others more preventative, some display a preference for early intervention while others wait for natural healing. You need to be comfortable with their approach. I had a premature rupture of membranes during my first pregnancy and was sent home after two days in hospital in Australia. In the US, I would have been hospitalized until delivery. My baby was born fine and healthy but there’s no telling if the outcome would hsve been better had I been in hospital instead of at home. Similarly, my friend in Singapore had an ectopic pregnancy and consequently a damaged fallopian tube. The local doctor tried to preserve the ruptured tube which ended up causing an internal haemorrhage a week later that nearly took her life. In the States, the tube would have been removed immediately. Despite the Singapore doc’s best intentions, his philosophy ended up in a wrong decision.

If you are not comfortable with the approach your doctor is taking, don’t hesitate to get a second opinion, from another doctor or your old one back home. It’s your body, it’s your call.

Social Norms and Lifestyle for New Parents: Try to learn about the lifestyle for families in your new destination. Is this the kind of place where men are expected to go drinking with colleagues after work while the wife takes care of the kids at home? Are there outdoor spaces and family-friendly entertainment? A good indication of the social value of families is the length of time new moms take off from work. Three months is crazy, in my opinion when compared to many European countries offering a year. It’ll be easier to get this information while you are on the ground there but you can definitely start some research online before hand by joining a local mothers network or expat community linked to your destination city.

Emotional Support: This is the one that I most underestimated. Having a baby and moving to another country are both major life transitions and combining them is a double whammy beyond your imagination. Plus throw in the additional complication of pregnancy fatigue and hormones sapping all your desire to be social or active in any way. Try to find a new moms group, or make sure you have close friends and family from home visit you to alleviate any possible isolation and loneliness. And most importantly, engage your spouse. Men, especially first time dads-to-be can be completely oblivious to your needs, some times out of fear of saying the wrong thing, but mostly because they are not privy to the hormonal roller coaster wheeling and whirling inside of you. Let him in by communicating that you need him to be around and aware.

Some more advice for making it through this transition from my own personal experience:

Get references for doctors and hospitals from other people. If you don’t know anyone in your immediate circle, reach out through your social networks to find an indirect connection. Better than landing in a new place and relying on a google searcher yellow pages.

Try to settle into your permanent accommodation as soon as possible. Moves often include temporary housing which will leave you feeling unsettled. The sooner you plant some roots the more you will feel like you are bringing your baby into a home rather than an impermanent space and this will become important to you as the nesting hormones kick in towards the end of your pregnancy.

Make the effort to get out and make some friends. As much as I didn’t have the energy for socialization and new friends I am glad i reached cut to a few people especially when they threw me a baby shower and visited me in hospital after the baby.

Seek professional help if you are feeling overwhelmed or depressed. You are going through a LOT of transition and you deserve all the support you can get. Further, it will help to cement a relationship with a professional if you need help post-baby as well.