Mom Talk: Giving Birth In a Foreign Country

9:00 am
07/14/17

PHOTOGRAPHY COURTESY OF Evelien Docherty

We’re back with another round of  “Mom Talk”, where we invite some incredible mothers, from all walks of life to share their personal experiences and journeys through motherhood, whether it be struggles, triumphs, or anything in-between—nothing’s off limits when it comes to topics. This week, Evelien Docherty talks about being Dutch and giving birth in a completely foreign country—The States. -JKM

My Clear Blue test read pregnant, not “zwanger”. Not that surprising since I was living in New York now, rather than Amsterdam. Three months before, my husband and I had started our adventure in the greatest city on earth. We’d already commenced Project Baby just prior to moving countries, and I couldn’t wait for him to come home from work to give him the best present ever—the test I just took, wrapped up in Star Wars-themed paper.

I come from the flattest country on this planet, where windmills spin and midwives hold sway—the Netherlands. Had I peed on a stick in a bathroom back home, my next step would have been to register at Het Geboortecentrum around the corner from our apartment, a midwife practice highly recommended by my sister-in-law. A gynecologist only comes into the Dutch pregnancy and birth equation when you’re facing complications. Here, I found myself without any personal recommendations, and I wasn’t even sure if midwives existed in this country. When I discovered that they do, but not all of them are trained to the academic standards we know in Europe, I decided to follow in the footsteps of 90 percent of my fellow American preggos, and go with an OB/GYN. Hello, Integration.

My choice for an OB/GYN meant entering an unfamiliar world of extreme monitoring, scores of fetus shots for baby’s first photo album, and loads of medical claims. Back home, I would have remained in the dark about the 500 genetic diseases I now know I don’t have, cherished one sonogram instead of 26, and been looking at claims only one percent (yes, I did the math) the amount of what we (or more importantly our insurance company) ended up with here. It is fair to say I was going all in on an American pregnancy.

So, I’d embraced the OB/GYN, but I was still clinging to the hope of a typical Dutch scenario—an un-medicated, natural birth. Eighty percent of women there deliver without any pain meds, and caesarian rates are only half what they are in The States. A midwife in the Netherlands would have helped me master several breathing techniques and labor positions to enhance the odds of this happening. My clinical OB here supported me in pursuing my birth preferences, but I was on my own in figuring out how. So, as New Yorkers do, my husband and I threw money at “the problem” and spent $397 on hypnobirthing classes. We might just as well have thrown it into the Hudson River. We picked the wrong teacher. Breathe in, breathe out was mostly useful in helping us tolerate the judgmental nonsense that came out of her mouth. But, despite the absence of a Dutch breathing coach and a wasted birthing class, I felt prepared for the big day and was extremely confident I could have my Dutch birth. I could not have been more wrong. I was induced, took an epidural, and ended up with a C-Section. Hello again, Integration. The first few weeks after my son was born, I noticed I was suffering from an unhelpful thought process that made me wonder if I was a bit pregnancy homesick.

Chances are, I would not have been induced in the Netherlands, since they induce less quickly than here. Not having an induction might have saved me from the non-stop killer contractions that tend to accompany it. So, perhaps I would have been able to pull the whole shebang off without any pain medication. But could I have had my unmedicated, natural birth in Holland? No. Because a caesarean was inevitable. My son’s head was simply too big and delivering in a different part of the world would not have made it any smaller. I wondered whether things could have worked out differently, and then felt ashamed of thinking like that because all that should have mattered is my son was here safe and sound, right? But, looking back on it, I realize I wasn’t homesick, I was just coming to turns with a traumatic delivery. My emergency C-Section was no picnic.

Giving birth in America put me in a situation that made me feel far away from home for a number of reasons: a different approach to pregnancy and labor, my baby kicking inside me without my family and friends being able to feel it, sharing my delivery story with my loved ones on FaceTime and Skype without feeling their comforting hugs. There is an indispensable element that softened my heartache though—the amazing team of doctors who only had the health of me and my son at heart, and some of the wonderfully supportive new friends I had made here. I wish women all over the world the same. Because, in the end, it doesn’t matter where you give birth, or what your personal preferences are, as long as you have good support by your side. Thanks to mine, I can now marvel at my son Owen’s beautiful (and big) head and feel completely at home wherever we go.

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8 comments

Clare

Oo, yeah, this. Pregnancy and birth was my first go at really navigating US healthcare. I have doctor friends back home, and used to run all the things that were happening (or not) past them, just to see the difference.

The biggest surprise for me was no gas and air in the USA! I chose my hospital because it’s one of the like, 19 hospitals in the entire country that offer gas and air!

The bigger struggle for me has been the different attitudes to taking time off from work when you have a child.

    Kelly Rae

    I still can’t believe they don’t do gas and air here. My first was birthed in the us with medical transfer from a midwife center to hospital. I got all the bells and whistles minus a c section. This was only because the doctor didn’t mind waiting. Thanks doctor lady.

    My second I had in Scotland. So much better. The care was great and I could birth at home as part of the NHS. The midwife was exceptional and I had gas and air at the end in my home. Amazing!!! They basically bring everything to your home and come out to see you. The best part ever is that they check on the baby and your latch by coming to you. I’m in awe of the quality of care I had here compared to the states.

    Sandra

    Evelien, the start of this could’ve been a page out of my own book. I had my 1st in Amsterdam with a midwife from the Geboortecentrum, such an amazing all natural experience at home. So much so that I was determined to replicate when we moved to NY when I was 7 months pregnant with my 2nd. I’m happy to say I lived in Carroll Gardens and was able to find an amazing local midwife, she was Korean American and had the no-bullsit attitude I love from my fellow Dutchies. Water birth in our brownstone, it all worked out. But like you said, I was prepared to do anything (and birth anywhere) as long as it was in the best interest of my baby. I was initially scared of the generalizations (as a half Dutchie) you hear about the American medical system and was a little dubious about laboring in a hospital – scared I would be forced to do all sorts of unnecessary things that I didn’t feel were right for us. But having lived in The States for 3 years (now in San Francisco a couple streets down from Katie!)), I have to say my experience with Dr.’s have been nothing but positive and has helped to break down a few of those stereotypes I had. I’m so glad that, despite the “what if” emotions you had following your labor, it all went well. It’s so true, whether NL or NY, they had the best interests of your sweet kleintje at heart. Geniet er van! – sandra ajanaku

Chelsea

This was a fascinating read, as I did the exact opposite — moved from California to Amsterdam and promptly got pregnant with our second child (less than two weeks after touching down at Schipohl). Having been through birth in the US, it was a tiny bit less daunting to navigate the Dutch system, knowing what pregnancy and birth were like generally, but the maternity care is vastly different between the two countries. My first daughter (US birth) was induction/pitocin/epidural/5 day hospital stay. My second daughter (born in Amsterdam) was a completely natural water birth (no drugs, no nothing) with a total of 5 hours spent at the hospital (we were sent on our way when our daughter was 2.5 hours old!)I LOVED my Dutch birth experience (and now tell any expat I meet here that is thinking about conceiving to do so ASAP so they can reap the benefits of the Dutch system) and now wonder how I would ever go back to the US model if we have another child.

Thank you for sharing your experience, Evelien! So interesting to read about other people’s birth experiences.

Abba

Unfortunately, this experience is all too common in the United States. Induction that leads to more and more interventions that eventually results in a C section. (Why are so many women induced when they are a few days “late”? A due date is simply an estimation with nearly a month long window of safe full-term delivery [38-42 weeks]). I’m sensitive to the author’s story, but I think the “head is too big” scenario is generally an untruth perpetuated by too many hospitals and OB/GYNs to justify interventions and surgery to speed up the hospital process (as well the “my hips are too small” myth). If you look at the success rates of places that approach birth differently (letting labor begin on its own, teaching natural birthing techniques, and the main thing: GIVING WOMEN TIME), there is almost none of that. Ina May Gaskin has said that nearly less than 1% of women have this issue. I think the main problem is rushing birth and rushing the body, then performing a major surgery and blaming the baby or the body for the impossibility of the task of vaginal birth. It’s such a shame. Given enough time and resources, nearly all women can get their babies out vaginally. Sometimes labor is very long and very difficult. But medical intervention, though obviously a women’s choice, has a lot of consequences. Obviously there are cases where c sections are warranted (statistically much less than they are performed in the US) or times and thank goodness for that option. But providers encouraging inductions that often lead to more problems, and perpetuates the lie that you “needed” a c section should really be curbed. Thank goodness more birthing centers and midwives and holistic approaches to birth are on the rise.

Of course, in regards to this woman’s story, she successfully got her baby out, who is healthy, and has much to be thankful for. But overall, our approach to birth and women’s healthcare in the US would greatly benefit from reevaluating the current hospital model and looking for options that approach birth and women’s bodies more naturally, gently, and holistically.

Sarah

I gave birth to my son last year in Amsterdam and ended up having to be induced and have a C-Section! It can happen in either country. X

Kristina

I’m an American who gave birth to my twins in Switzerland last year. I had a lovely experience there with midwives and doctors, despite a traumatic premature birth and long NICU stay. I had zero hospital or maternity bills and felt so taken care of during the entire experience!

Ali

This was a great read! But, I am also sorry that you found yourself in this “typical American model.” Although, in the end it may have been a good thing having had a c-section. I will soon be delivering my 3rd baby with a midwife attending to the birth. I go to an OBGYN’s office, but unless there is a complication, you only see the three midwives on staff, one of whom will be there for your labor. There is a sonogram at the beginning and an optional one at the end of the pregnancy. They fully support an un-medicated birth, but I agree that you are on your own in figuring out how to accomplish this. I chose this practice because I hated the idea of having a nurse attending to my birth at the hospital that I had never met before and then my doctor (or another one that was available) swooping in at the last moment for the delivery. They also allowed me to go 11 days beyond my due date and 7 days beyond my due date to avoid induction. There are definitely alternate models here, but you really have to seek them out. All the nurse/midwives at my practice are also ARNPs. But, their may be regional differences as well and it is likely different in NYC than it is in the South.

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