US vs NZ: Pregnancy and Birth
First off, no this is not any sort of announcement. I am not pregnant nor have I given birth in New Zealand. However, I’ve noticed that there are quite a few Americans who come over to New Zealand and end up having babies here. I remember how crazy it was to have a baby in the US, and I can’t even imagine how stressed out I would feel if I found myself pregnant in a foreign country with a different way of doing things.
So I decided to ask two American friends who have gone through pregnancies and deliveries both in the US and New Zealand to answer the same set of questions and give some insight on their experiences. Mama 1 was already onshore when she got pregnant with baby #3 and had a c-section. Mama 2 arrived in New Zealand pregnant and had a vaginal birth. It’s fascinating to hear their different stories, and I hope this helps other mamas go through the experience of being pregnant in a new country.
1. How did you go about selecting a medical professional for your pregnancy and childbirth? What options did you have in New Zealand and what did you find different than your options in the US?
Mama 1: When I first found out I was pregnant I had no idea where to go or what to do. I was told by my GP that I had to find a midwife and get registered that way. I had no experience with midwives so I searched online and found a local midwifery clinic, called them up and was assigned to someone available at the time. To be honest I was quite sceptical about having a midwife instead of a doctor.
Mama 2: I knew based on information provided by the Ministry of Health that a midwife would be completely covered cost wise, unless it was a complicated pregnancy and my primary doc would recommend that I see an OB. So I joined a few mom groups on Facebook (ex: Moms in Auckland) and just asked for some recommendations. Greenbay Midwives was recommended (for my area) by a few so I reached out to them via email and got registered and ready to meet with them the week after we arrived!
2. Were your doctor/midwife visits similar to what you experienced in the US? Was the schedule the same or different? What was the length of each visit here versus America?
Mama 1: The appointments with the midwife were very different from what I was used to in the US, but surprisingly better! It was less stressful since my checkups were not in a medical facility. It was more relaxed and she focused more on how I was feeling or questions I had regarding my current month of pregnancy. Less blood tests, less blood pressure checks. I don’t recall anyone monitoring my weight gain very often.
Mama 2: The meetings here were significantly less formal and shorter. The timetable for visits was similar to home, however I arrived and had my first visit at nearly 31ish weeks so I can only speak to the last 10 weeks. With both my OB and my midwife each appointment included a weight check and urine test. The urnine test back home however involved me urinating into a cup and it being anazlyed by a lab. Here, I just peed on a stick and if it turned a certain color (indicating high protien) I was just supposed to let her know. My OB always checked how dialated I was, however the midwife only checked once I reached my due date.
3. Did the healthcare professionals in New Zealand ever give you advice that was different than what you received in the US?
Mama 1: No answer
Mama 2: I worked with 2 different midwives within the practice and both often discussed the option of delivering naturally and at the birth center vs a hospital. It’s not that my OB didn’t offer me options back home, but I knew that I wanted an epidural and hosipital birth and she didn’t try to change my mind. Otherwise it was the same regarding prenatals vitamins, eating well, staying active, etc.
4. What was your labor and delivery experience like? How was it different than in the US?
Mama 1: It was required that I have a c-section with this birth due to a possible placenta issue I had previously. What made me so nervous was that, although I met a doctor at the hospital a few weeks before delivery, I was told I would not know who was delivering the baby till the day of. That scared me, but the midwife was able to be in the delivery room with me and although I didn’t know the doctor as well they did an amazing job and the baby was delivered healthy with no placenta issues. In the US, it was repeated at every appointment that I was “high-risk”. It didn’t seem to be as much of an issue in NZ or at least they didn’t bring it up as often. It felt more like a routine pregnancy and on most occasions I felt as though I was more nervous about it than they were.
Mama 2: In the US I was admitted at 5 cm and received my epidural as soon as I asked for it. It was painless and then suddenly below my wait was painless and that was glorious! It allowed me to sit calmly in bed eating popsicles and chatting with my sisters until I felt the pressure of needing to push. I kicked everyone out except my spouse, pushed for 30 minutes and was all done! I was then brought up to my private room where my spouse had a place to sleep as well. Someone came in every few hours to make sure I had my pain medication, helped me go to the bathroom, shower, etc. A lactation consultant visited and made sure he was latching okay and my OB visited a few days later to check on my nether regions to make sure I was healing and all was well. He was taken away to have his circumcision with the Glomco clamp, which was quick and healed perfectly. I stayed 3 nights in the hospital before heading home. In New Zealand, there is incentive to birth at the birth center (which means no epidural). If you birth at the birth center you have access to a private room after and your spouse can stay with you. However, if you birth elsewhere, you are then moved to the birth center within 24 hours after birth and you have to share a room with another mother and baby and your spouse can not stay. I opted for delivering in a hospital, but naturally. I was in the tub nearly all night long until finally we decided I’d been fully dilated long enough and to break my water and get the show on the road. So we did and it did! Luckily enough I only pushed 30 minutes this time around as well, however because I didn’t have an epidural I was able to move around and push in different positions. I ended up on my knees, allowing me to catch my baby as he came out. It was such a beautiful experience and was totally worth all of the pain. I’m glad I got to experience both ways and I’m thankful to my midwife for supporting me in doing so. The hospital asked us to leave 1.5 hours after delivery and move to the birth center. I have to say, that was difficult. I had mentally prepared to do so, my midwife had informed me the hospital kicks you out the same day, but I was hoping for a little bit more time that that. The birth center was nice, clean and decent food. I was lucky enough to be in a shared room but the other mom didn’t arrive until my second day so I had my first night to myself. I had to call out for pain medication and monitor my own intake (they kept track as well but didn’t just show up with medication, the just approved your request for them when you asked if it was an appropriate time to take them) while also monitoring my newborn, all while not sleeping. It was extremely difficult to not have my spouse at night as I was feeding constantly and was finding that I kept falling asleep feeding the baby. When I told the nurse her only response was, “you can’t sleep with the baby!” I ended up checking out a day early to go home and get some help but my other child was home with a fever so we were quarantined to the bedroom (which was fine by me). We decided to circumcise, which is not as commonly done here so there are fewer options. You have make an appointment for the week after birth. This was traumatising for the both of us. They use the Plastibell Technique which is a dated method and often had complications. And that was the case for us. I wish I had never done it. Because this was my second child I was comfortable on how to care for the baby, how to get the baby latched, etc. but I would have really struggled if this was my first experience. In the end the bill was $0 so I guess I can’t complain.
5. What type of aftercare did you receive? If you didn't birth at home, when did you go home?
Mama 1: I went to an amazing “mom and baby hotel” which was funded by the government I believe. It was sort of like a bed and breakfast. I was able to have my husband and kids visit during the day and in the evening I was able to relax alone with the new baby in a quiet environment. To have that support after a c-section was fantastic. I believe I stayed at the Birthing Centre for 4 days. There was a full-time kitchen staff who made the most delicious food. Home cooking! Roast chicken, potatoes, gravy. I’d go back just for the food!
Mama 2: I went home after 2 nights in Birth Care. The after care was wonderful! The midwife came once a week for the first 5 weeks. She checked the baby’s weight, height and listened to how we were doing. It wasn’t until week 3 though I asked one of them to check my stitches, because I could feel something wasn’t right. She was happy to do so, but you have to ask for what you need. It was so nice to not have to take a newborn into the doctor’s office!
6. What kind of follow up care did you receive in the weeks and months after delivery?
Mama 1: Through Plunket, I was able to have a home nurse visit my house to check on my c-section scar and the baby. This was amazing...I did not have to drive anywhere while in pain or find someone to drive me and the baby in for the checkup. The Plunket nurse brought a scale to weigh the baby and also was able to make sure I was healing properly. This was so useful.
Mama 2: Plunket started coming not long after the midwives ended their service. They mostly just ticked their boxes and offered ideas on how to interact with the baby or groups we could access in the community. It was nice to know someone was coming if you were feeling overwhelmed by something. I don’t remember exactly how many times they came, I want to say 2-3 times in the first few months, then they switch you to office visits.
7. If you were to have another child, would you prefer to be pregnant and deliver in the US or New Zealand? Why?
Mama 1: I had two babies in the US and one baby in New Zealand. I would definitely choose New Zealand as it was less stressful, less medical, and absolutely more affordable.
Mama 2: I would say New Zealand, the aftercare is crucial. Although next time I’d be using that epidural and then going straight back to my house!
8. What advice would you give anyone who is going to have a child in New Zealand for the first time?
Mama 1: Don’t stress over the difference. I was worried throughout my pregnancy due to my inexperience with midwives. They are skilled, knowledgeable and caring people.
Mama 2: Make sure you advocate for yourself, ask for something if you think it’s necessary. Have a good plan for after care as well. Make sure you feel comfortable caring for the baby overnight alone if you don’t deliver at birth center and end up sharing a room. Be honest with the midwives in the follow up appointments as well, they are very experienced, knowledgeable and concerned for a mothers mental wellbeing as well as the baby. Access as many of the resources in the community as you can (SPACE, community coffee clubs, La Leche League, etc.), they really are worthwhile!
