Motherhood around the world: Pregnancy and birth

A birthing center in England c/o themindfulbirthgroup.com

Motherhood is a universal experience, but it's also deeply shaped by culture, tradition, and place. Since becoming a mother myself, I’ve been fascinated by how different cultures approach the challenges, joys, and expectations of raising a family—especially while simultaneously navigating having a career. This curiosity has grown into a desire to explore how mothers from around the world navigate their unique realities.

This is the first in a four-part series on motherhood around the world—future articles will focus on parental leave, child care, and larger work/family culture. The women featured all subscribe to this newsletter and grew up in the US and now live abroad (in the case of one interviewee, she lived abroad for several years before returning to the States). Ex-pat mothers have the benefit of comparison, and their dual perspectives allow them to observe both cultures with a critical lens.

It’s important to note that these articles are meant to represent individual experiences, and no woman interviewed presumed to speak for her country as a whole. I’ve changed their names and some identifying details, but otherwise what you read comes straight from my transcribed interviews with them.

I hope you enjoy reading this as much as I enjoyed speaking with each of these women. If you live abroad, please feel free to share your experiences in the comments!

Prenatal care and birth

Evelyn, geologist, Denmark: In Denmark, there's this fundamental belief that childbirth is a very natural human process. It is not something that requires extreme medical intervention unless something goes not as planned. So you don't meet with an OB/GYN, you meet with a midwife for all of your prenatal care.

The birthing process itself was fairly hands-off. The midwife made [the lights] a little bit darker. She turned on some calm music. She drew a bath, and then she just sat there quietly while my husband and I worked through the labor. Every now and then she would come and check my vitals. If I seemed to be having trouble, she would offer a suggestion. She would either talk to my husband, “why don't you try holding her hand here? Why don't you try rubbing her back here?” Or she would talk to me, “why don't you try rolling over this way and see if that help?”

After the baby was born, the midwife checked vitals, did the post birth checks on me, and I was handed the baby on my chest with a blanket. Nobody said anything. Once they were finished cleaning me up, they rolled in a little tray with cakes and a little bit of juice and left. And we were there resting and meeting our new baby and figuring this out quietly for about two hours before they came in, made sure I could pee, and then sent us to the postnatal ward, and then we were there for two days.

The funniest thing that happened was they left us alone so much that we felt like we were waiting for instructions on what to do and nobody was bringing it to us. And eventually we went and found somebody and asked, “how do we change her diaper?” We were like, “oh, here”. And at one point we asked, “do we need to bathe her? When does she get a bath?” And they're like, “unless it’s important for you culturally that she’s bathed, that stuff just absorbs right into her skin. She's fine”. It was amazingly hands off.

Natalie, graphic designer, gave birth in the Netherlands and now lives in Sweden: Honestly, the maternity care was kind of amazing! In most of Europe, pregnancy is seen as a very natural process, not a medical problem. You're seen by a midwife the whole time, and most people give birth in a birthing center. There was some concern about baby’s size, so I gave birth in a hospital, but still it was much less medicalized than many of my friends in the US.

Denise, self-employed editor and author, the Netherlands: One thing that I really liked about pregnancy here was that they do not look at it as an “illness”. You don't see your GP, you don't see a OB/GYN either, unless you have a medical reason to. So they take away the medical feeling from it, and it's just like another phase of your life. So here everyone goes to midwives.

When I got pregnant with my first child, I was obviously unfamiliar with prenatal care in the city, so I took my GP’s recommendation for a midwife practice in a very gentrified part of the city. I just took her word, and that was a mistake because when I got there, instantly you could tell that there was a difference between how I was treated and everybody else that was going there was treated—most of their patients were Dutch. It definitely felt like I was the only person of color that I ever saw the whole nine months that I went. If I'd go in, you'd see future parents sitting in the office just staring, kind of gawking at me.

And most of the midwives were just kind of hands off with me. I think they thought I came in with too much “Americanness” because I was already quite knowledgable about pregnancy. So I would come in, and I would ask questions. I think I was asking too many questions to their liking. Personally, I feel that within Dutch culture, there is this idea that the professional—whatever that setting is—knows all and you must come to them in total ignorance. So when you present knowledge, it's almost like an affront to what they're trying to provide. It's almost like you're asking too much of them. And I bumped into that a lot.

Daphne, marketing and design consultant, England: Because all hospitals are part of the National Health Service [NHS], I was able to do my research and choose the hospital I liked best—there was no worrying about whether I was “in network”. The interesting thing in the NHS is that, as long as everything is going to plan, you never see a obstetrician, a midwife provides all the care.

In terms of giving birth, it’s normal to go into the birthing center, where they encourage much more natural delivery methods. So they will have hanging ropes that you hold onto, they will have special chairs, they have the balls, they will have the pools, they'll encourage you to walk around and they do not have any provision for an epidural there. If you go into the birth center and then you choose to have an epidural afterwards, they will move you from the birth center over to the ward. So it's actually quite a fundamental philosophical decision you need to make early on about what type of labor you want to have.

Affording care

Denise, self-employed editor and author, the Netherlands: For starters, when you move to the Netherlands, it's required by law that everyone residing here have health insurance, which is a big difference. Regardless of whether you have a job or not, you will always be covered here. So your health insurance covers all your prenatal care—even if you select the most basic tier plan, prenatal care and birth are always covered. So, I paid zero euros for both of my births.

Evelyn, geologist, gave birth to first child in Denmark and second child in the US: To have a child in Denmark cost $0—except that my husband did have to pay for his meals during our two day stay in the hospital. In contrast, I don't have a specific number for how much money I spent to give birth to my son in the United States. I'm confident it was well over $4,000, even with a very generous healthcare package through our former employers. But a big reason that I don't have the specific number is that bills trickled in slowly for nine months after he was born. And we never had a clear understanding of what each bill was, why we were being charged it, why it wasn't included in a former bill. And so in addition to just the sheer cost of it, there was quite a bit of emotional cost in having to pay another very large expense in a year when we were on a single salary and not knowing if this would be the last one, and not knowing if we were being properly charged or if there was a mistake because we couldn't even understand what the charges were.

Isabella, market researcher, Singapore: The Singapore healthcare system is very different whether you are Singaporean or whether you are an ex-pat. So if you're Singaporean, then you have access to subsidies and you have access to a forced health savings account called Medisafe, and you are encouraged to use that plus your subsidies to cover the cost of your maternity costs.

But unlike the US, your typical corporate insurance does not cover maternity care at all. So the expectation is that Singaporeans will rely on the public system and if they want to go private, then they would get private insurance. Foreigners or ex-pats are expected to get their own private insurance, as well. I had to go ahead and get maternity insurance and I had to have a 10 month waiting period before those benefits came into place. So, it requires a lot of planning! It’s also important to note that the benefits are limited, but you get it in case there are complications or a NICU stay. But a lot of people just kind of go out of pocket because the birth itself is not super expensive compared to the US.

Kate, hospital administration, Canada: In Canada, all of my prenatal care was covered through our provincial healthcare system. So I didn't have any out of pocket expenses, nor did I have to face any concern about whether insurance would cover certain expenses. They send you home faster than in the States, because they're not getting a bunch of extra money for it. You usually go home within 24 hours if it's been a medically normal birth. Oh, and in Canada, you’re literally expected to BYO everything you’re going to use in the hospital, including your own plates! I hear friends in the States talking about how you need to grab all these samples and stuff when you’re in the hospital. There’s none of that here.

Postpartum care

Daphne, England, senior marketing and design manager: When the baby's born, you get something called a “red book”. Your red book is basically all of the records of your child's health. So height and weight assessments, vaccination, etc. The NHS also does a two year check to screen for any early signs of autism or developmental delay. And since my kids were both in full-time nursery care, those checks were done at the daycare.

Also, within the first 24 hours of you being discharged from hospital, you get an unannounced visit from a “health visitor”. This person is there to make sure both baby and mom are ok. For example, she made sure my stitches weren't ripped open or infected or anything like that. Then you get a few other visits as the baby gets older to check height and weight.

As baby gets older, you’re assigned a National Childbirth Trust (NCT) team for ongoing support. Personally, I felt that some of the workers were a bit dismissive and condescending. But the side benefit of the NCT program is that you are put in a small group of moms with a similar delivery date. So I had a prebuilt, a mini sorority of eight women who are having babies at the same time.

Natalie, graphic designer, gave birth to child in the Netherlands, now lives in Sweden: For the whole first week after birth [in the Netherlands], you’re entitled to something called kraamzorg, which means that someone comes to your house for up to eight hours a day. We paid a very small amount of money for this, but it's heavily subsidized by the government and is the post-birth default.

And this person’s whole job is dealing with babies in their first week of life. So she helped us figure out the cloth diapers, helped us give the first bath, brought me bowls of fruit while I was breastfeeding, kept an eye on the baby while I took a nap. And they also check on you. They check your temperature, they check your stitches. They're obsessed with temperature. They're always taking your temperature and the baby's temperature, and they also have this hot water bottle that you're supposed to get to put in the cradle to prewarm it. But yeah, that was amazing. It made us so much more confident in our ability to be parents. I'm so grateful to that woman. She was the best.

Evelyn, geologist, Denmark: We were assigned a midwife for all postnatal care. And all midwife visits were house calls unless there was some complication where we needed to go to a doctor's office or a hospital. I think her first visit was when my daughter was four days old. Every single well visit until my daughter was a year old, was a house call from a midwife. The midwife would always check on me, too. Every visit, I would be screened for postpartum depression.

I remember for my daughter’s four month well visit, she brought us a complimentary cookbook with recipes for baby food and a little template for how to introduce foods and when to do it. They're very much proponents of baby led weaning, so they go over how to make sure you're cutting things that are safe for them to try chewing without choking.

The other amazing thing they did was, since everything is registered with the national health network, they know where all the new moms are. And so I got a letter when my daughter was three weeks old, that requested me to join a mom's group. They organized mother's groups for people that lived close to each other and all had a new baby. And so I was in a group with five other first-time moms who all lived within five blocks of each other. And we met monthly for the entire time that I lived in Denmark. So two and a half years. And it was amazing.

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