When you find out you are expecting most couples will run
the gamut of emotions from ecstasy (if planned) to terror. Your mind then turns to ‘what next?’. In your home country it is fairly simple –
you know how processes tend to work so will go to your doctor and be guided by
them. You will probably have family –
parents, in laws, aunts, cousins and friends who have been through the system
and can give advice if you want it.
When you are abroad things get a little more complicated –
expectations are different and sometimes the language can be a hurdle. I had our first two children in the UK – I
had lived there for some years and was quite accultured but no one in my family
had been through the system there before.
My mother and I were shocked when we found out how unmedicalised it was
and it made us both feel very
uncomfortable. Being au fait with the
language and cultural expectations, however, meant that I could advocate for
what I wanted. Interestingly a friend
has just had this experience in reverse – she is from UK and currently
expecting in Australia – she finds the process there far too medicalised for
her taste.
We were still in Kazakhstan (but due to move to Malaysia in
the third trimester) when we found out about our third child and I had to
negotiate a complex web of Kazakh hospitals, general clinic, insurance and the
potential contacts in Malaysia as well as speaking to my lovely UK OB and arranging
for her to speak to and send my operative notes on to my new consultant in
Malaysia.
Because I was not going to complete the
pregnancy in Kazakhstan it was decided not to book me in to the Kazakh system
but to have ad hoc appointments every few weeks. My general clinic would attend appointments
with me to translate for the sonographers and OB. This was a great idea until it transpired
that the representative had no knowledge of obstetrics in either Russian or
English – I ended up doing most of the translation/speaking myself including making
sure we understood the results of the anomaly scans. Because I refused an amniocentesis I was not permitted to have any maternal blood risk checks in Kazakhstan although this had been permitted in the UK. It was not until we arrived in Malaysia that
I was able to understand with 100% certainty what my OB was saying to me. He had to rely on my translations of the Kazakh notes for background and ended up doing a from scratch work up.
Advice and expectations differ greatly from country to
country as well. In the UK dietary
advice for expectant mothers is very strict and extremely restrictive. Both Kazakhstan and Malaysia seem to be far more
easy going, at least as far as food is concerned. My Kazakhstani friends were, however,
horrified that I would wear high heels when expecting as it was ‘dangerous’. I was seen as cavalier for lifting and moving
a dining chair and one told me, in all seriousness, her husband had been warned
not to drink beer while she was expecting as it might harm the baby! In the UK I was allowed to take paracetamol
for a cold or headache and antibiotics for tonsillitis. In Kazakhstan I was told I could not have
antibiotics or painkillers at all (though I managed to sneak some paracetamol from
a pharmacy saying they were for my husband) Conversely it is not unusual to see
expectant mothers in saunas and jacuzzis in Kazakhstan – something completely
beyond the pale in the UK.
In the UK you are given a firm estimated day of delivery – (our
first child is the only one we know who actually arrived on that day) and
everything is calculated in the number of weeks and days. In Kazakhstan I asked when this date would be
and was told – ‘some point in September – when the baby feels like coming’. In Malaysia the system is similar to the UK
and the doctor and I spent some time working out when we could safely schedule
the operation. In the UK women are rarely weighed but sugar and bloods are
checked assiduously – in Kazakhstan and Malaysia I was weighed at every appointment
– I did not, however, have as many blood or sugar checks.
UK visitors to hospital tend to be restricted in
number and time. Even fathers are thrown out at the end of visiting time to
allow mothers and babies to ‘rest’ a
strange rationale as I know I would have rested more had my husband been able
to help look after the babies. I recall
my parents and sister being barred from coming in (with our breakfasts) to meet
our first baby, it took us a long time to convince the nurses to let them
in. Here in Miri I was told I could have
the whole family to stay over and sleep in my room if I want (for a small
surcharge). They were most apologetic
that our children would not be allowed in the operating theatre! The mind boggles as to the requests they must
have for that pre-emptive statement to be made with apology!
My babies have all been operative deliveries. In the UK, as long as a local anaesthetic is being used the
baby (if healthy) is given to the father and stays with the parents in the
Operating Theatre. Here in Malaysia I
was allowed a quick sight of the baby before she was whisked away to the
Nursery my Husband rushing behind to get out of scrubs and back into his
clothes so he could keep her in view the whole time. I spent another hour and a bit rather bored
and wishing I had a book to read as the operation was concluded, with recovery checks
etc it was about two hours before I got to meet the baby properly. The nurses kept trying to take the baby back
to the nursery for her checks and to ‘give me a break’. As soon as I was allowed to walk I followed
them everywhere – they were quite surprised that I did not want to be away from
her and concerned that the walk (all of 200m) and standing around might be too
much.
Top tips
- Find out how things work in your host
country and see how it differs from your expectations.
- Speak with friends and family at home to
find out what their experiences were.
- Decide with your husband/partner where you
want to have the baby – is your host country safe or should you go home? This will depend on the host country and
whether you have any complications, be aware that a text book pregnancy does
not guarantee a text book, problem free birth.
- Try and find a health care professional who
will support you in your wishes for care and delivery. Be prepared to research options and advocate
for what you want.
- Be realistic about care – in some countries
you will not be allowed whale music, dim lights and a water birth. In others this will be encouraged, if you
have your heart set on a particular type of birth you may need to arrange for a doctor
who agrees with your ideas or (at the extreme) move to a country that will allow it.
- Take ‘advice’ with a pinch of salt – it
varies from country to country, try to find out the reasons for the advice and
weigh your own risks.
- Be aware that cultural expectations can be
very different – in some countries your baby will stay with you at all times –
in others it will be removed. If you do
not want this speak to the hospital staff and explain why. We found staff happy to accommodate our ‘strange’
requests and allowed us into the nursery when our daughter was brought down.
- Remember that the doctors are professionals and, at the end of the day, want only the best outcome for you and your baby.
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