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So You Are Having a Baby...
on International Assignment
Part Two
Mary D. Werner, RN, BS, CCM, PAHM,
Senior Nurse Clinician
CIGNA International Expatriate Benefits
When an expectant mother follows guidelines for a healthy pregnancy, and she and her partner are educated about the conditions that will surround the birth of their baby, even in another country, there's likely to be a positive birth experience – and a healthy baby.
In this article, part two of a two-part series, you will find information regarding common birthing practices, as well as how best to prepare for labor and delivery – in another country. As you'll soon learn, practices vary widely worldwide, and may be very different from what you're used to. (See sidebar for some country norms).
Labor and Delivery
Perhaps the most important decision to make is where you will deliver the baby. In locations where medical care is advanced, this usually amounts to selecting a local obstetrician and hospital. However, because your preferences for international standards of medical quality and accessibility may not yet be available in your assignment location, you may want to consider returning to your home country or traveling to a city or country known for medical excellence for the last month of pregnancy to ensure the safest circumstances for delivery.
CIGNA International recommends investigating in advance what responsibilities you will have as a patient. In some cultures, it's uncommon to have a husband or partner present during labor. Women may rely instead on a birthing coach. In some locations birthing coaches, called "doulas," are popular with the expatriate community. Doulas should be certified and licensed and should also be familiar with the local medical setting and able to act as a liaison between you and the medical staf.
Language Barrier
Communication with your obstetrical provider in your assignment country will help to avoid confusion and frustration relating to cultural differences. If you don't speak the native language, we recommend having a translator present during all office and hospital visits, especially for the birth.
Single or Dual Nationality
Deciding whether you would like your baby to have single or dual nationality is an important decision that can have long-term benefits and repercussions for you and your baby. Before you leave your home country, contemplate this decision carefully and know the requirements for your baby's passpor.
Complications
The single most important thing you can do to assure a positive birth outcome is to see a trained provider for prenatal care regularly. Also, become familiar with the birthing practices in your new country (see sidebar).
Cultural Differences: Circumcision and Breastfeeding
In some countries circumcision is performed for specific medical conditions or as part of religious ceremonies. If considering circumcision for your baby boy, do advanced research on how –or if – this procedure is performed in your assignment country, so that you are prepared.
Breastfeeding offers several health and nutritional advantages to your infant, in addition to its emotional benefits. In developing countries, it's becoming increasingly fashionable to bottle feed babies. The World Health Organization is working to make breast feeding the norm worldwide; however, you may experience some resistance in your efforts to nurse your baby. It's always best to consider local breastfeeding customs and attitudes as they may not be what you anticipate. You'll want to be sensitive to the local feelings within your assignment country.
Though most women report breastfeeding as a very rewarding and easy experience; it can be difficult to start and is usually exhausting in the first few weeks. You may want to talk with a lactation consultant for some tips.
Helpful Websites
Information about Lamaze childbirth classes worldwide, as well as pregnancy and birth resources, tips for healthy pregnancy, and an inspiring birth video.
Educational resources, including links to online childbirth classes and videos such as prenatal yoga.
Find mother-to-mother support, encouragement, and education on breastfeeding your baby.
These international websites have information to locate doulas.
CIGNA International has assembled information on standard practices in a number of countries:
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In Brazil, 80 percent of births are cesarean sections. Although there are special maternity hospitals in metropolitan areas, midwives are not part of the delivery system. |
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In the Netherlands, about 70 percent of deliveries are by midwives and around 30 percent occur at home– more than in any other country. Even women who deliver in a hospital typically go home in 6-8 hours unless there are unusual risks or complications. The culture strongly encourages natural childbirth. |
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In Germany, hospital births are standard. A doctor is only present in complicated or high-risk deliveries. Otherwise, midwives are in attendance. |
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In Britain, home births are rare, accounting for only two percent of the total. Doctors choose the delivery hospital. |
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In Japan, the vast majority of births take place in a hospital, and new mothers are usually in hospital for seven days. A few mother-centered maternity centers have opened in major metropolitan areas. |
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In Singapore, all deliveries occur in a hospital, but some now allow doulas, who have become popular among expatriates, especially those seeking to have a natural delivery. |
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