For expatriates who have planned their pregnancy, many have likely already carefully weighed the pros and cons. They've probably made a well-informed decision based on their aspirations for the future, financial and professional situations, quality of life, and healthcare and support available in the country during pregnancy and postpartum. Some may already feel deeply rooted in the country and have no intention of leaving, especially if their partner is from there. In such cases, the question of whether to stay or leave may not even arise. On the contrary, for others, the pregnancy may mark the end of their expatriate experience, prompting them to return home.
But what about others? Naturally, this question is more complex. Consider a couple who has recently relocated to a new country, with plans to stay for a few months or years for professional or personal reasons, and hadn't anticipated starting a family at this stage. However, now that they're expecting, returning to their home country may seem more viable.
The best and worst countries for pregnant women
Maternity care, coverage, costs, compulsory maternity and paternity leave, health risks, and habits vary enormously from country to country.
For instance, Iceland stands out as one of the world's most family-friendly countries, offering a 12-month maternity leave and covering 100% of maternity and childbirth expenses. According to a 2021 ranking of countries with the best maternity conditions, Japan, Estonia, Finland, Norway, and Denmark are other desirable destinations for expats. Canada is noteworthy for its 12-month maternity leave policy as well. However, in the USA, maternity leave is almost non-existent. While up to 12 months of leave can be requested, it's typically unpaid in most states (with some exceptions like Rhode Island, New Jersey, and California offering 50% paid leave).
For those who prefer giving birth at home rather than in a hospital, the Netherlands is the ideal destination. It's the only European country where home births are not only permitted but also encouraged. In the Netherlands, assuming everything goes smoothly, both the mother and baby can leave the maternity hospital just four hours after delivery. However, in some cases and countries, such as Italy, Caesarean sections may be mandatory for twin pregnancies.
Finally, according to a ranking published a few years ago by the NGO Save the Children, the worst countries for pregnancy (and therefore where the decision to return would not be a bad idea) are Somalia, the Democratic Republic of Congo, the Central African Republic, Mali, Niger, Gambia, Ivory Coast, Chad, Guinea-Bissau, Sierra Leone, and Haiti.
Culture and traditions
Culture plays a significant role in deciding whether to stay abroad and adapt or return to one's home country. Some might feel more at ease raising a child in their home country, where they are familiar with the healthcare system, language, and cultural practices. In Ethiopia, pregnancy is celebrated with lively ceremonies, rituals, and blessings, similar to traditions in India, Japan, and Hawaii. This can be unsettling for those who are not used to it. In contrast, in Scandinavian countries like Sweden and Norway, pregnancy is viewed as a time for relaxation, with pregnant women receiving ample maternity leave and fathers being equally involved—a concept still relatively uncommon worldwide. Moreover, these countries offer high-quality healthcare and a holistic approach to motherhood, incorporating psychosocial aspects.
In Italy, family holds significant importance, and attitudes toward motherhood can often lean towards the traditional, depending on the region. Fathers typically have less involvement, often only receiving a few days off when the baby is born. Conversely, grandparents frequently play a crucial role, with some parents relying on them for childcare while they work instead of sending their children to daycare.
In Latin America, especially in Mexico, pregnancy is often surrounded by religious rituals, such as prenatal blessings and feasts dedicated to the Virgin Mary, illustrating the profound influence of faith and family values in this region.
In Japan, everything remains private in the first trimester, resulting in a more discreet approach to motherhood. Other countries do the same and don't officially disclose the pregnancy immediately, notably in Europe. But this doesn't prevent indiscreet questions.
Some cultures have specific norms or expectations that might seem perplexing or overly restrictive to some people. These cultural factors can also influence the decision of whether to stay or leave. In Saudi Arabia, strict laws influenced by a conservative interpretation of Islam can impose limitations on a pregnant woman's mobility and enforce strict social expectations regarding her behavior. For example, it might be frowned upon for a pregnant woman to travel alone, which may require the approval of a male family member for certain activities. Similarly, in certain regions of India, a country deeply entrenched in tradition, pregnancy may be subject to rigid social expectations, with pressure to have a male child leading to discriminatory practices.
Considerations to bear in mind
First of all, it's important to assess the quality of healthcare available in your host country, including medical facilities and practitioners for prenatal care, delivery, and postpartum support. Additionally, inquire about access to social security and available health insurance options for pregnancy-related expenses. Consider the flexibility of both your and your partner's professional situations, as well as the availability and terms of maternity leave. While some countries provide maternity benefits, the specifics can differ significantly.
Do you have enough financial stability to support yourself and your newborn? Consider whether you'll receive more assistance in your host or home country. It's crucial to evaluate your current financial resources, which should ideally cover expenses related to pregnancy and childbirth, including medical and other maternity-related costs.
Overall safety also needs to be considered. Ensure that you feel secure and that environmental conditions pose no risks, and compare them to those in your home country.
Returning to your host country after giving birth
Another option, if you wish to give birth in your home country with family and friends, is to return home for the whole of the maternity period, then go back to your host country when you, your partner, and your child are ready. This way, if you're not ready to give up your expat life, you'll be able to start this new life more serenely.
Indeed, making such a decision requires some planning. For example, if you're employed abroad, inquire with your company about options like remote work from another country or extended maternity and paternity leave. Consider the legal aspects in your expatriate country—will you be covered by social security, and if so, what are the conditions? In short, there are numerous factors to consider, but addressing them will ultimately contribute to a smoother transition into parenthood before embarking on new adventures.
Deciding whether to stay in your host country or return home during your pregnancy is deeply personal. Some expats may choose to remain, others to return home, and some might opt to return temporarily before resuming their expat life. Cultural differences, healthcare conditions, and personal circumstances significantly influence this decision. Consider the pros and cons carefully, and make the choice that you believe is best for both yourself and your child.
