What to Expect When You’re Expatriating

The Internet is a horror story playbook when you’re trying to put together your expat birth plan. It’s not even a birth plan really; you just want to know what to expect when the contractions start, when you’re wheeled or walked or whisked into the maternity ward by people who speak a language other than your own. You’ve heard rumors that hospital patients in Italy have to bring their own toilet paper, their own bandages, even their own night nurses. Your obstetrician only tells you that you’ll need to bring “tamponi,” which means exactly what you think it does… but could also translate as any kind of absorbent swab or pad. Even an inkpad. You’re overwhelmed by the unknowing. It feels like you’ve been cast to star in a play but haven’t been given the script, and Opening Day is ticking closer and closer and closer.

So you do what any 21^st century deer-in-the-headlights would do: You turn to Dr. Google.

The problem with public forums, however, is that people don’t generally use them to share their Kodak Moments. According to the Internet of 2007, no American or British expat has ever had a birth in Italy go well. An image grows in your mind of doctors with sauce-stained mustachios operating on you with pizza cutters in the hallway of a former Fascist bunker. You pack your hospital bag with gowns and eating utensils and towels and diapers and Tylenol and your best guess at “tamponi” and so much worry that your whole heart goes numb from it. How are you going to get through this?

/ / /

Your baby is too large. The 38-week ultrasound shows her to weigh nearly 4½ kg. (over 10 lbs.), and at your 39-week checkup, the doctor determines that based on the baby’s head size and your internal structure, you will be unable to deliver naturally. This explains why the contractions you’ve been having for weeks now haven’t gotten you anywhere. You don’t know exactly how to feel about this, but you’ve already had one C-section; at least tomorrow’s delivery will be familiar territory.

You return to the hospital that evening to settle in so you’ll be ready to go first thing in the morning. The nurse who checks you in is annoyed that you don’t speak the language well, that you don’t know your weight in kilograms or your height in centimeters or the words for all the health conditions she chants off her clipboard. You want to explain that you’ve been in the country less than three months, but you’re afraid of planting yourself deeper in the immigrant stereotype in her mind. You feel like an unprepared student on test day. You’re sorry to be a bother.

That night, you don’t sleep. Your hospital roommate has just had a C-section herself, and her moans coupled with the whimpers of her newborn boy mark the hours like a pair of restless chimes. You wouldn’t be getting much rest anyway; your contractions have amped up, making a clenched fist of your belly every few minutes, squeezing the air out of your lungs and shooting electricity down through your hips. You get out the final Harry Potter book, the treat you’ve been saving for just this occasion, but it’s small comfort. You’re terrified of the next day, of surgery in a foreign context, of the potential complications of birth, of not knowing how to love your new baby. (After all, how could you have any mamalove left to give when the whole sum is already curled up in a toddler bed back at home?)

/ / /

You’re prepped for surgery at 9:00 in the morning, but then every pregnant woman in the city seems to need an emergency C-section. You lie on a gurney with an IV for the next 4½ hours waiting for your turn and wondering if you’re now in the thick of your own forum-worthy horror story. The anesthesiologist has had to eyeball your height and weight because you still don’t know them in the damn metric system, and what if he gets the dosage wrong? What if your doctor is worn out from the gauntlet of unscheduled surgeries? What if you don’t understand what the obstetrics team is telling you to do? Your husband isn’t allowed in the operating room, and Dr. Google’s is the loudest voice you can hear as you’re finally escorted in to lie beneath a cluster of jewel-toned lights.

To your intense relief, the anesthesia takes. The medical team is upbeat and kind. They chat lightheartedly while you try not to think about the zipper-like tugs coming from your abdomen or the little spirals of smoke drifting up into view. Despite how disconcerting surgery can be to experience, everything is actually going okay. You are okay. The forum threads begin to fade from view as the present comes ever into focus. The tugs on your lower body grow more insistent. A sense of collective breath-holding takes over the room.

And then…

She’s born. You feel her weight leave your body just as the obstetrician cheers, “Eccola! Here she is!” Mother instinct floods your mind so quickly that it knocks common sense straight out; all you can think of is her, and you spring forward on the operating table, oblivious to the gaping incision across your abdomen. “NO!” ten doctors yell in unison pulling you back down. You laugh, partly from embarrassment but mostly from delight. Your daughter is here.

Someone brings your tiny-huge baby over for you to kiss, and your heart swells, filling the space she so recently vacated. Mamalove is a multiplication table, you realize. This new babe has your whole heart as surely as her older sister does. The details you’ve been worrying about up until now no longer matter. Not significantly, at any rate. Not enough to overshadow the big picture that is filling in with color and dimension at every breath.

She’s the star of the show. She was always going to be. If you could have written the script for her birth, it would have looked much different; you don’t mean to discount yours or any other mother’s longing for a familiar setting or a peaceful natural delivery. You’re baby’s out safely though, and all your earlier fears are eclipsed by the warmth of her cheek against your lips, the grip of her little fingers on yours, the sweet murmuring noises she makes as she gets used to the taste of air. She’s the outcome of all expectations, and in this moment, Kodak’s got nothing on you.

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Happy seventh birthday, Sophie Ruth! I’m so very, very glad you were born.

(Photo by Dan)