Giving birth abroad was never in any life plan of mine. If I’m entirely honest, the idea of giving birth never really came into my having babies plan. At the forefront of my mind were cute socks, adorable outfits, and of course, those leisure strolls with a delicious baby in their hot-off-the-press, newest and grooviest stroller. I sure had a lot to learn.

I met my husband in Germany. We were both civilian employees with the British Forces. When we got married, I was 29 and my husband was 35, so the pressure to start our family was on. Nine months after getting married, I found myself pregnant and miles away from home, in Dusseldorf, Germany.

My antenatal care with my first pregnancy was complex because we were with the British Forces. British midwives supported pregnant women in the British Forces and at regular intervals, a German gynecologist would also monitor the pregnancy. Our babies were born at a local German hospital. As soon as I got pregnant, my close friend in the garrison who was in charge of the midwives assigned me to a midwife. Of course, she chose the coolest and kindest midwife to support me, but unfortunately for her, I wasn’t the easiest of customers.

Navigating language barriers and culture shock

Early pregnancy complications such as hyperemesis gravidarum took over my body and my capacity to keep anything down. Close monitoring by my midwife landed me in the German hospital. While the medical staff was very efficient, I couldn’t understand anything said and had to wait for the military personnel to help translate. I felt anxious and out of control, something which I’m not good at. The language barrier was one issue, but Germany’s different healthcare approach was like a culture shock.

Daily bed strips at some ungodly hour, the main meal at lunchtime consisted of some bizarre food, and an extended stay took a toll on my anxiety levels in the early stages of the pregnancy. I was under 2 separate systems: an English system when our midwives would take care of us at the community level and a German system when dealing with our specialists, getting admitted, or giving birth at the hospital level. Essentially each service wasn’t well coordinated with the other, and my wonderful midwife could only do so much to support me. She’d have to wait until the medical notes were handed to her.

With hyperemesis gravidarum subsiding, we excitedly went for our 1st appointment with the German gynecologist whose English was much better than my German. The findings from a nuchal translucency scan were far from perfect, while the need for a 2nd appointment got lost in translation. All I heard was “problem,” so I turned to my lovely midwife, Karen, for further translation.

Communicating birthing needs

Discussions with Karen around my birth plan went in circles. I was frightened and couldn’t cope with the concept of having to deliver a baby in the hospital with nobody I was familiar with nor communicate with. I knew that my husband felt just as anxious, so I wasn’t confident in his capacity to communicate my needs in a birthing situation effectively. Recognizing my anxiety, my midwife organized an appointment with the chief gynecologist at the hospital who agreed to perform a Cesarean section. We were relieved.

This pregnancy didn’t fall short of complications or issues. This time, the anesthetist couldn’t administer an epidural, so I had to go under general anesthesia (GA). All gowned up, ready to come in and watch his firstborn’s birth, my husband suddenly found himself outside the birthing suite overlooking bloodied placentas, bloody babies, bloodied sheets hauled all over the place, accompanied with the noises of birthing women. Not the finest hour for him, I dare say.

The perks and perils of health insurance

Three years later, in Munich, we went through the whole process again, except this time, the military didn’t cover our medical expenses. My husband’s very generous private health insurance Vanbreda did. Like most expat communities, a handful of specialists are on rotation because good word travels fast. I saw my gynecologist as often as I saw my regular GP. While we were trying for our 2nd baby, she would conduct monthly ultrasound scans. As a result, I have images of an unfertilized ovum and got instructions to “have sex tonight” if I wanted a girl. We followed instructions and got our daughter.

Having top of the range health insurance not only ensured high-quality medical care but exaggerated my hospital bills too. I recall my horror on realizing they were charging ME to MAKE an appointment to see the doctor. That said, I adored my gynecologist. I loved visits to her room where I could read English, Australian, and American magazines, nibble on fancy chocolates, and spray myself with the latest perfumes in the bathroom.

You can then imagine my disappointment when she informed us that she didn’t perform births and handed us over to her preferred obstetrician and gynecologist for the delivery. I was devastated. Worse, her specialists were not stationed in my hospital of choice, where all my expat friends had told stories of marvelous afternoon teas (Kaffee and Kuchen) served on the lawn. I wanted a piece of that!

My determination to go to the private hospital was successful, and my birth plan was simple. Put me to sleep, wake me up, and give me my baby. And given that we had spectacular health insurance, my wishes were granted. If I was outraged at paying to MAKE an appointment to see a specialist, you could only imagine my response when I saw that the gynecologist charged for every time he popped his head by the door, which was often! My daughter was delivered with no drama, and my husband reports being handed a beautiful baby girl about an hour after she entered the world – all cleaned up and dressed.

Attachment theories can wait

If there was one thing I loved about having my babies in Germany, it’s the fact that they took them to the nursery at night. Many parents were horrified by that and spoke of the need to bond. I was so grateful for the time to rest and recover in the full knowledge that I had many years, months, hours, and minutes to bond with my baby or perform interactive bottle-feeding or dress her up in adorable little outfits.

I’m always mindful of my cesarean birth stories because many women get mortified when they hear I was under GA for both of them. I don’t know what labor pain or what water breaking feels like. I neither regret this, nor do I think I missed out. I didn’t breastfeed by choice, and my decision was fully supported. Still, I don’t feel I missed out. Neither do I feel embarrassed or ashamed of the choices we made around the birth of our children.

Tips for expats giving birth abroad/oversees

It was tough giving birth in a foreign country where everything was so very different. If I were to give any advice to anybody giving birth in a foreign country;

• Empower your birth. The process leading up to the delivery of your baby is personal and unique. So learn your rights, know your obstetric care team, and don’t be afraid to ask them questions.
• Advocate strongly. Advocate for yourself or have someone who can be more assertive in obtaining your birthing needs and proper treatment.
• Embrace wholly. Like your time abroad, a foreign birth is another way to experience your host country’s gifts. It’s an experience you won’t forget.