Giving birth abroad: home or hospital?

More and more expatriate mothers-to-be are asking themselves whether they should opt for a home birth or a hospital birth when having their baby abroad. Depending on your country of residence, practices, costs and medical care vary drastically.

Choosing where to give birth is a crucial decision, and one that requires you to anticipate local legislation, medical protocols and, above all, your insurance cover. Let’s take a look at these essential differences before the big day.

Home birth abroad: where is it common practice?

Home birth appeals to women who want to experience birth in an intimate, less medicalized environment, focused on their well-being and autonomy.

Acceptance varies widely from country to country:

While planned home birth is a marginal option in countries such as France and the United States (often hampered by strict protocols and insurance difficulties for midwives), it is very much established in other regions:

• Netherlands: Historically, this is one of the countries where AAD is most common. Around 13% of births take place at home, supervised by highly qualified midwives recognized by the health system.
• United Kingdom and New Zealand: Health authorities regard DAA as a safe option for low-risk pregnancies, with clear integration into the public health care pathway (via the NHS in the UK).
• Parents’ motivations: Home comfort, autonomy, reduced rate of systematic medical interventions (inductions, epidurals, etc.) and confidence in the continuity of midwifery support.

Giving birth in a hospital abroad: safety and supervision

Hospitals remain the preferred option for the majority of births worldwide, guaranteeing maximum safety in the event of unforeseen circumstances or complications.

Why choose a hospital?

• Immediate access to emergency care: Crucial in the event of complications for mother or baby (emergency caesarean section, haemorrhage, neonatal unit for premature babies, etc.).
• Specialized equipment: monitoring, anesthesia (epidural), and full technical support.
• Multidisciplinary team: obstetrician-gynecologists, anesthetists, pediatricians and midwives are available 24 hours a day.

However, the hospital experience is highly dependent on the local medical culture. Childbirth can be highly medicalized (as in the USA or Japan) or adopt more natural, respectful approaches (often the case in Scandinavian countries or Canada).

Cost of giving birth abroad: home vs. hospital

The costs of giving birth abroad can be the biggest source of financial stress for expatriates, varying enormously from country to country and depending on the choice of venue (home or hospital, public or private).

To remember: Home birth is often less expensive than hospital care, but beware: if it is not officially regulated or recognized, reimbursement is far from guaranteed.

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Reimbursements and international health and maternity insurance

Reimbursement for your delivery depends both on the type of place you choose and on the legislation in your country. In some countries, home birth is recognized and partially reimbursed by the local health system or your insurance, as in the Netherlands and the United Kingdom. On the other hand, in countries where this practice is a minority or is not regulated, such as the United States or the United Arab Emirates, the costs are often borne by the parents, unless your international health insurance contract explicitly provides maternity coverage for A.D.A.

Determinants of reimbursement :

1. The status of AAD in the country: If home birth is recognized (as in the Netherlands or the UK), chances are it will be covered, at least in part, by the local health system or your insurance. If it’s illegal, you’ll have to pay the full cost.
2. Your international health insurance policy: Most health insurance policies for expatriates (such as those offered by Santexpat.fr) include essential maternity cover.

Santexpat tip: always check your international maternity contract before you leave, making sure that :

• expenses related to childbirth (AAD or hospital) are covered,
• prenatal and postnatal consultations,
• emergency transfers and complications are covered.

What does good international maternity insurance cover?

The right insurance covers you for the birth, whether at home or in hospital, and prevents unpleasant surprises, particularly in the event of very high costs. It generally covers :

• The cost ofhome delivery by a certified midwife.
• Prenatal and postnatal consultations, examinations and ultrasounds.
• Hospitalization and surgical fees.
• The vital cost of complications or emergency transfer to hospital.
• Newborn care from birth (including in cases of prematurity or congenital malformation, which are often very costly).

Tip: Maternity is subject to a waiting period (often 10 to 12 months) in all policies. To be covered, you must have taken out your insurance well before conception. Check your policy’s maternity reimbursement limits carefully.

Preparing for childbirth abroad

Whether you choose the safety of a hospital or the intimacy of a home birth, safety and serenity must remain your top priorities.

Practices differ from country to country, and costs can be astronomical. The best way to prepare for the birth of your child abroad is to :

1. Find out about local legislation on home birth.
2. Choose a certified practitioner and an emergency plan (for AAL).
3. Take out international health insurance with appropriate maternity cover, right from the start of your pregnancy.

With the right cover, you can live through this major stage of your expatriation with confidence, wherever you are in the world.

Allow you to choose your delivery, without worrying about reimbursements

At Santexpat.fr, we believe that every woman should be able to choose the place and method of childbirth that suits her – without financial or administrative considerations weighing on that decision.

In many countries today, complications and caesarean sections are only reimbursed if the birth takes place in a hospital. This inequality often forces women to forego a home birth, which is safe and supervised when performed by qualified midwives. In addition, medical practices are sometimes geared towards scheduled caesarean sections, which are more costly and therefore more profitable for hospitals.

Our ambition is to make these models evolve by proposing, in time, fairer and more balanced international maternity contracts, where the level of reimbursement will not depend on the place or mode of delivery, but on the actual need for care.

Because birth should never be a question of cost, but a moment of freedom, security and confidence – wherever you are in the world.

Planning a birth abroad?

Discover Santexpat.fr’s offers, including international maternity options, to choose the coverage best suited to your situation and anticipate costs and reimbursements with peace of mind.