All things expat pregnancy related
The long awaited post on all things expat pregnancy related… I have had a few people reach out to me, asking if I was going to cover off my pregnancy journey, so here it is! Since I am a South African expat living in Ireland – there are a few things that may be different to what it would be like for me to be pregnant back in South Africa, compared to what it is like to be pregnant here in Ireland. However the truth is, this is my first pregnancy, so I can’t really compare (and that may or may not be a bad thing actually!) I think if I had had my first baby in South Africa, and then came over and found that things were different here – I think the OCD planner in me would be thrown off a little. I like to prep and plan the shit out of things, and what I am slowly learning about pregnancy (and now motherhood) – is you can’t plan this shit the way you want it… you are kinda left to just wing it, and do the best you can day to day.
I will say that I have a load of friends back home who have given birth in South Africa (and multiple times). When I spoke to them about being pregnant back home versus my own experiences of being pregnant here in Ireland, the most striking differences with pregnancies back in SA is that:
- Most of my friends have private health care, so its difficult to compare their level of service with what I had in Ireland (which was public); however costs to visit the gynae/doctor throughout your pregnancy is ridiculously expensive – OMG. It makes me super grateful to know that I was able to have free check ups throughout my pregnancy here in Ireland. I honestly am not sure if we would have been able to afford having a baby in South Africa. Yes, we would have had medical aid back In South Africa, but that probably would have covered only a portion of the costs. We still would have had to make upfront payments and claimed back.
- Back in SA, there seems to be more regular scans and tests done – like for example testing if the baby has any chromosomal or genetic abnormalities is a standard test offered to pregnant women in SA – this is not something that is checked in Ireland (unless you pay for it).
- There also seems to be a heavy support from midwives in Ireland, whereas most of my friends in SA regularly met with a gynae or doctor (however I do have had friends who opted for home births, and doulas in SA – so those are options you can most certainly choose).
Before you get pregnant:
Right let’s cover off some red tape, expat related, baby admin… because we were not great at this planning stage (I blame Mauritian Rum Cocktails, too much sun and sea, and perhaps being around my niece and nephew who got me all broody).
Here are the top questions to cover off BEFORE you get pregnant (if you are an expat living in Ireland):
1. Can baby get an Irish passport?
This has honestly been the biggest assumption, most people automatically think that if you have a baby in Ireland that the baby is entitled to an Irish Passport, and that would be the wrong information. The laws on this changed a few years ago, and maybe they will change again, but as it currently stands:
- if one parent has an Irish passport, the child can get an Irish passport
- if one parent has a EU passport, you must have live in Ireland three of the four years before the child’s birth, and will need to sign a declaration form as well as show proof of residency.
- if both parents have a non-EU passport, you must have live in Ireland three of the four years before the child’s birth. It will also depend on the type of residency you have held.
Your child may not qualify for an Irish passport if your residency was granted for:
- Having an application for refugee status determined
- Study or training purpose or
- Where your child’s parent had diplomatic immunity at the time of the birth
So for us, we won’t be able to apply for an Irish passport for baby since we haven’t been living in Ireland for 3 years yet. What does that mean for us? Well it means that now we have to go through the process of getting a South African passport for our child. This can be done at the South African embassy in Dublin (however processing times are currently taking 8 months to process… more on this process in another post!).
2. Are you entitled to a maternity benefit?
This is worth checking out before you get pregnant – and it mainly relates to if you have been working in Ireland – you will be entitled to the maternity benefit which is a payment that is covered by social insurance when you are on maternity leave. If you have been working in Ireland for 2 years then you will most definitely be covered and should be entitled to the maternity benefit payment scheme but it is a good idea to check your employers maternity leave policy. A good resource is on Citizen Information, click here.
3. Maternity Leave in Ireland
Maternity leave in Ireland is much better than back in South Africa! You are entitled to 26 weeks of maternity leave (which has to start 2 weeks before your due date), and a further 16 weeks of unpaid maternity leave. Whether you will get paid maternity leave is entirely up to your employer, so it is a good idea is to check your company’s policy on maternity leave (which is different to the maternity benefit) before you get pregnant. For example, with regards to my company, in order to get a paid maternity leave, I had to be working at the company for a minimum of 2 years.
Congrats, you are preggers, what now?
Right, as soon as you find out you are pregnant, what are the next steps as a now pregnant expat living in Ireland?
Firstly you need to book an appointment with your GP.
Your GP will confirm with a urine sample that you are pregnant. I went as soon as I found out (at 5 weeks!) But that is kinda because I had no idea what I was supposed to do. My GP said most women wait till 8 weeks before going to the doctor… if you are anything like me, good luck with waiting 3 more weeks! I honestly feel so much better that I went straight away. At your first GP visit, your GP will cover off things like a basic urine test to confirm the pregnancy, check your blood pressure, advise on your current medication/vitamins/diet you should follow when pregnant, along with the choice of hospital and service you want to follow for this pregnancy.
It was a good time for me to ask a load of personal questions with my GP – and in my opinion now is the time to ask all the questions you might have, especially if this is your first pregnancy. It can feel very overwhelming and as an expat, you can feel very isolated if you are far away from home and pregnant in a foreign country – so ask all the questions, even if they seem silly, your GP is there to help you.
Choosing a hospital:
At your first GP visit, you will need to decide what hospital you want to give birth in. In Dublin there are 3 maternity hospitals namely; Rotunda, Hollis and Coombe. My GP said that she has patients who have gone to all three, there really isn’t much difference in the level of service in any of these hospitals, according to her. Rob and I debated between Hollis (which would be close to his work) and Coombe (closer to my work, and also closer to home). In the end we chose Coombe. I can’t really say if we made the right choice, but I have been very happy with the level of service, attention to detail and support that I have received as a first time mum going to the Coombe.
After you have chosen a hospital, your GP will send off your forms to that hospital. And like all good things in Ireland, you will wait to receive all your confirmation details and first appointment and scan at the hospital… via the post. Another good thing about choosing a hospital and submitting forms early on, means you get into the system quickly and it gives you time to book and prep for things like antenatal classes etc that are available at all maternity hospitals. Like most things, it depends on the time of year, but there is usually a waiting list for these additional (and free) services, so best you get on the list quickly to avoid missing out.
Select the kind of service you would like: public, semi private, private.
My GP and a few of my friends explained that there is not much difference between the three. For semi-private and private, you will need to pay in for these services (usually your medical aid covers this). The big difference is that for these options you are entitled to a semi private or private room and they endeavour to arrange that you meet the same consultant at all your antenatal appointments. When I spoke to a few friends who gone down one of these two routes, they often said its not always possible to meet with the same consultant at every appointment, and the private hospital room is based on first come first serve – so you might find on the day you deliver, that there are no private recovery rooms available. It is important to note that the private rooms are related to recovery (after you give birth) – if you opt for public, then you will share a room with other moms. However regardless of public, semi-private or private – you will have a private labour room (Rob thought I would be giving birth in the same room as other moms – thankfully this is not the case!)
Note: You need to have been a resident in Ireland for more than a year to be able to make use of public health care services.
I chose to go public, in hindsight, if I wanted to have an elective c section, perhaps private would have been a better option. With public, as long as your pregnancy is deemed low risk, they will try to encourage you give birth vaginally (with several pain management options). When I asked at one of my first antenatal appointments, I was told c sections are not really an option, and they are only offered in high risk pregnancies, or in emergencies. I am not sure if I had pushed the subject further if having an elective c section would have been an option, but it seemed like it wasnt from the conversations I had with the midwives.
It is also important to note that once you have decided between public, semi private and private in the beginning, you cannot switch. So ya, have a think about it carefully before you make the decision.
First trimester: Weeks 1 – 12
- As soon as you find out you are pregnant, start taking folic acid daily (Your GP will advise you to do this at your first appointment too, and you will need to take this up to 13 weeks)
- It is advised that pregnant women get the flu vaccine – I got this done at my first GP visit.
- Your first antenatal appointment at the hospital is usually around 8-10 weeks, depending on availability. This is when you will need to prove that you have been a resident in Ireland for more than a year to be able to make use of public health care services (you will need to supply relevant documentation to support this at this appointment like: GNIB, Proof of Employment/P60, Proof of Address, Medical Aid, Photographic ID etc). At your first antenatal appointment, the midwives will check your blood pressure, weigh you, check your height, ask for your medical history, basic check up. You will also need to have some blood drawn for further tests. What I can say about being an expat with a bit of a complicated medical history, is be 100% honest with your history, list all your medications, give as much information at this appointment as possible – because from this appointment, the midwives are able to set up the care you and your baby will need throughout your pregnancy. I have to say the Coombe were incredibly thorough, and very cautious with me in the beginning of my pregnancy. Given my medical history there were a few extra check ups and appointments scheduled and only when they were completely satisfied with the results did I go back to a regular appointment schedule. If you are deemed a low risk pregnancy then you will follow the standard appointment schedule (alternating between GP and Hospital visits), here is where I say that you need to trust the doctors – over 200 babies are born every day in Ireland. They know what they are doing, but they can only work on the information you provide them.
- Decide if you want additional scan and tests. A big issue for us with the antenatal care here in Ireland is that they do not routinely check for chromosomal or genetic abnormalities (for example down syndrome) These are not screened for in the early stages of pregnancy, unless you specifically ask for these tests, and pay for them (around €400). This probably goes back to the catholic culture, and pre-2019 when abortion was still illegal. Regardless of what your opinion is, I really do think knowing is better than waiting and seeing. Also, I am a bit older, and so the chance of my baby having one of these defects was a bit greater. I wanted to know so that I could better prepare and decide what I wanted to do before it was too late. At 9/10 weeks you can do a non invasive prenatal test (NIPT) which is called panoramic or harmony test. You will need to do this privately or check as some hospitals do offer this at additional cost to you. I went to a private clinic, and we did the panoramic test which we were able to do at 9 weeks. It basically involves a blood test and a scan – it takes 10 days to get the results. You can also find out the gender if you would like, we opted to keep it a surprise. I have to say it was really nice to see the baby so early in the pregnancy, it made it a bit more real. And I was happy to pay the money for the comfort in knowing that my baby was healthy.
- Your first scan at the hospital is usually around 12 weeks, this is to confirm that baby is well and happy in there. It doesn’t offer any in-depth tests or screenings but it’s a great appointment to bring your partner and you get to take home a picture of your baby. Hearing baby’s heartbeat and seeing the little body on the scan was honestly a surreal moment for us. (*note in Ireland you get two free scans; one at 12 weeks and one at 20 weeks – you are able to pay for additional ones if you would like, but usually they only conduct additional scans if your pregnancy is deemed as high risk, and they want to check on the baby more regularly).
- Book your antenatal classes; hospital tour etc – It is really important to book them early, like basically as soon as you have the first 8 week check up with the hospital. Fill in the forms and get sorted for antenatal classes (which usually happen around 28 weeks). You can also go do a hospital tour so you can see where you will be giving birth and what to expect when you arrive at the hospital. This tour booked up fast and I wasn’t able to book this before my due date.
Second Trimester: Week 13 – 26
- If you are lucky, the second trimester is usually when you start getting your energy back, and hopefully the morning sickness subsides. It is also when you can start exercising again (note: check with your GP or midwife first). At 13 weeks, I was able to join a pregnancy yoga class, and honestly I highly recommend it, it’s a great way to stay active, but also to meet other pregnant women and share your pregnancy experiences. My yoga instructor was also great at showing us all exercises for certain aches and pains you may get while you are pregnant. It is really important to go to pregnancy yoga class that is reputable, as some of the poses needed to be done carefully when you are pregnant. Another good tip for second trimester is to invest in a yoga ball for at home. I started sitting on the yoga ball instead of the couch, as I just found it much more comfortable position to sit on the ball – plus there are some great exercises you can do with a yoga ball at home, along with the beginning of your labour and contractions.
- From 16 weeks, it is advised that you get the whooping cough vaccine – its best to check when you should get this with your GP.
- At 20 weeks you will go for an anatomy scan at the hospital. This is absolutely incredible! It really is amazing how much detail they can see and check at this scan. You can also opt to find out the gender of your baby at this scan – we decided to keep it a surprise, so we were team green right till the end (much to the disappointment of my sister in law!).
- After 24 weeks, it is a good idea to start filling out your maternity benefit forms. You will need some info from HR, so best to get that ball rolling ahead of time. You can access the forms you will need to submit here. Fill them in and post them off. I posted them, and got a response in the mail a few weeks later.
- Between 26 – 28 weeks your will need to have a glucose tolerance test – this is to check for gestational diabetes. The test is fairly straightforward, but it’s a long morning. You will need to fast before the test (no water, medication or food for 12 hours before). When you arrive at the hospital on the day of your test, they will draw some blood first. Then they will make you drink a glucose drink (tastes a bit like lucozade). Then they will make you wait one hour, before drawing more blood. Then another hour, and they will draw more blood. So it will take at least 3 hours to do the full test. They will then check to see how your body processes the glucose drink, and will only call you if you fail the test. Thankfully I passed this test, I have had friends who failed it and then went onto a controlled diet and regular check ups for the remainder of their pregnancy.
- Other things to consider in your second trimester are: planning a babymoon (especially if you are planning on taking a flight, you might want to check with your GP before you book flights for late in your pregnancy); now is also the time to consider booking a maternity shoot (usually advised to book around 30 – 34 weeks but photographers can book up quickly, so book in advance to avoid disappointment).
Third Trimester: Week 27 – 40*
- Usually around 28 weeks your hospital should offer antenatal classes that you can attend. At the Coombe there were various options; eg one full day; or night time/ day time class over 4 weeks (one a week). We opted for the evening class once a week for 4 weeks. Again, I found these classes to be very good, especially as a first time mum. Topics range from stages of labour, pain management in birth, giving birth, breast feeding and the first few weeks after the baby is born. The Coombe also asked us to fill in additional questionnaire if we intended on breastfeeding – and if you ticked yes to a few of the symptoms they presented, then an additional breastfeeding class was provided, as well as on-on-one time with a lactation consultant. I found these additional resources to be so beneficial!
- It is recommended that if you would like to do a maternity shoot then between 30 – 34 weeks is a good time to do this, its usually when your bump is prominent, but also you still feel good and not yet uncomfortable ( I was very lucky in my pregnancy, and honestly put it down to yoga and yoga ball – I was dancing right up to 41 weeks+5 days!)
- The third trimester is also a good time to have a baby shower – again, that’s if you want one. Baby showers are only recently becoming popular in Ireland, which was another difference to back in SA where they are held more regularly. I was really lucky that my Irish friends planned one for me, and although I was nervous it was going to be awkward (I don’t know a lot of girls here, and without any family over here it felt random) – but it turned out to be the best day ever! My friends went OTT on all the snacks and the decor (it was a jungle/animal theme to represent my African roots). I felt so loved and really blessed to have such great friends. The day ended with my girl friends and their hubby’s having a bit of a braai at our place – which was so lovely!
- From 34 weeks, you start going for antenatal appointments more frequently – usually every 2 weeks, alternating between hospital and your GP.
- From 36 weeks, your antenatal appointments become weekly (between GP and hospital). It is a good idea to pack your hospital bag at around 36 weeks. Although I only really had mine packed from 38 weeks – you never really know when baby could arrive. I had friends who went early, and then others who went over (like me)
- At 38 weeks, you will need to finish up work and start maternity leave. I was told by someone that some women lie about their due date to start maternity leave later (which gives them more time with baby). For me, even though I felt good right up until I delivered the baby (over 41 weeks + 5 days pregnant), I still struggled to sit in the office and work full days… so I was thankful to go off from 38 weeks, use the time to rest and relax and really just enjoy those few peaceful moments before baby arrives. Its a good way to get your head mentally prepared for this new adventure that awaits you.
- From 40 weeks (i.e if your go over your due date) then your antenatal appointments stay at the hospital weekly. The Coombe will wait for baby to come naturally up to 41 weeks + 5 days, thereafter they will induce you. This is because from 42 weeks, things can start becoming high risk – and the induction process can be lengthy, so they do it a few days before you hit 42 weeks. But more on the induction process and giving birth as an expat in Ireland in a follow up post!
I hope the above info is interesting, or informational – I tried to stick to just the facts in terms of what to expect if you are pregnant in Ireland. Obviously this is related to my own personal experience, and does not account for any medical advice – please seek out medical advice that is specific to your needs with your GP and/or maternity hospital of your choosing. I am not a medical professional, and this information is purely based on my own experience.
AS AN EXPAT, WOULD YOU HAVE YOUR BABY IN A FOREIGN COUNTRY, OR WOULD YOU OPT TO GOING HOME TO HAVE THE BABY?
Live Simply & Travel Slow,
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