The pregnant expat

Pregnancy and childbirth in the US

“You’ve been trying for four months already? I think you should see a fertility doctor!”

We heard these words from my OB/GYN in Portland, Oregon after we had been trying to get pregnant with our first child for about four months. She also added that at our age (at that point I was 31 and my husband was 36), most people wouldn’t wait long and see a specialist right away.

This was the starting point of our journey to become first-time parents abroad and we could already see some cultural differences. In Germany and Austria, where my husband and I are originally from, no one would send a healthy, average-aged couple to a fertility specialist after trying for just four months.

I probably don’t have to mention that we switched to a different doctor.

Cultural differences and hearsay

She was more relaxed (and originally from Canada, by the way) and I got pregnant soon after. We were extremely happy but at the same time I was also nervous about giving birth that far away from home. I knew several women (some expats, some not) who already had given birth in the US and had heard mixed stories from them. Many mentioned the lack of midwives, which they perceived as negative, and the high C-section rates. Other foreigners, not expats though, had mentioned the exorbitant costs of giving birth in the US. I also had heard of the fewer number of ultrasounds, which made some women very uncomfortable.

Some of these statements felt true to me, others not so much. The C-section rates in the US, for example, are at a level of around 30%, and thus not much higher than in my home country Austria, where they rank at around 27%. Some doctors in the US, however, will have higher rates, so the key is to find a doctor who shares the same opinion on C-sections as you. But I guess this is true for any country.

Yes, it can be very costly to give birth in the US, but only if you don’t have good health insurance. Expats usually don’t encounter this problem, since they normally have excellent health insurance. And yes, you won’t find the classic midwife that you would find in Austria or Germany, but I honestly did not feel that having one would have provided that much more value to my personal birth experience.

While you will get an ultrasound with almost every visit in Austria, you definitely won’t be getting them in the US. I was not considered a high-risk patient and thus had, in each of my pregnancies, only three ultrasounds, which were “medically necessary”, as stated by my doctor. To tell you the truth, I was curious and impatient to see my baby at times, but it didn’t really bother me nor made me feel unsafe.

Pregnancy and birth overseas

I guess, whether you will experience your pregnancy and childbirth abroad, possibly thousands of miles away from family, friends and familiar surroundings, as positive or negative, will depend a lot on your personality and mind-set, but maybe also a little bit on luck.

As with anything in life there are pros and cons.

I have perceived both of my pregnancies and births in the US as very positive. The medical care was excellent and I was lucky to find a doctor whom I could totally trust. She not only cared for me throughout both pregnancies, but was also there when I gave birth. Also, pregnant women are treated with a lot of respect in the US and I received more help in daily life than I could ever have asked for. I also like the fact that our kids have dual citizenship.

Of course, there are also disadvantages. You live, as I have already mentioned, thousands of miles away from family and friends. This meant, that my family and friends were only able to see my pregnancies via Skype and a photo diary that I kept online.

The biggest drawback for me personally, however was, and still is, the fact that you have to live without a family support system. Grandparents and other close relatives are simply too far away to help you in everyday life. A struggle on some days, but I still feel that the pros outbalance the cons for us.

By Yasemin Polikar

Yasemin Polikar grew up between two cultures: her mother is Austrian and her father Turkish. Her expat life started in early 2008, when she moved with her German husband to the United States. Their two daughters were born in Portland, Oregon in 2011 and 2013. The family currently lives in Birmingham, Alabama. Yasemin writes about her life as an expat partner, mother and hobby photographer on her blog YPs World.

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  1. How true! I gave birth to my first in Stockholm and am about to give birth for the second time in Monza, Italy. Everything completely different from my home country (Mexico) but honestly for the better. I’ve loved the mid-wife led maternity care and the more relaxed attitude towards pregnancy and birth in general.

  2. I gave birth to my third daughter while living as an expat in Poland. Originally from the US, I found that the prenatal care, after a few unfortunate experiences early in the pregnancy, was good. After giving birth in a semi private hospital I was most surprised by my post natal care. Happy to say, my baby girl was born healthy and is turning 3 next week.

  3. So interesting to get the reverse perspective of what I am going through as an American preparing to give birth in Germany. As a lot of my reading has been of American sites, it is funny to note the same differences mentioned, but the opposite way.

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