America is the land of the free, the home of the brave, and the domicile of broke parents. With or without insurance, the U.S. is the most expensive place to give birth in the world. At the same time, America has one of the highest rates of infant and maternal death among developed nations. Maybe it's time to consider how a few other countries approach childbirth.
1. The Netherlands
Except in high-risk cases, women in the Netherlands turn to midwives, not obstetricians, during their pregnancies. Couples have the option of a hospital birth, but most choose to stay home. In that case, the Kraampakket comes in handy. It sounds like something you might buy at IKEA, but it's actually a home delivery kit sent to every mother-to-be in Holland. (Watch this American expatriate open hers.)
The Dutch healthcare system includes universal coverage with the option of additional private plans. Once a baby's born, insurance pays for at least a week of home care visits called kraamhulp. A nurse will visit the new mom each day to take care of everything, from caring for mom and baby to cooking and cleaning.
Pamela Druckerman's 2012 book Bringing Up Bébé made thousands of moms want to relocate. Who could blame them? The American expatriate author observed that French parents are happier, more relaxed, and better-balanced overall than parents in the U.S. (However, Druckerman didn't say that pregnant French women won't get fat.) It could have something to do with a national healthcare system that covers approximately 70 percent of health costs and is supplemented with additional care plans. Housecalls are a big perk. Nurses at the Maternal and Infant Protection Service visit moms during and after pregnancy to teach childcare skills, provide care, and make sure parents aren't negligent. But if you want your laundry done, you're going to have to ask someone else.
Midwives call the shots in Deutschland. They're legally required at every birth. Doctors aren't.
But here's something that'll really make you cry—with joy or outrage, depending on where you live. This infographic from the International Labour Organization illustrates paid parental (not just maternal) leave in other countries. You'll notice that German women get at least 98 days of fully-paid maternity leave. U.S. employers aren't required to provide any.
It's not uncommon for pregnancy to be treated as a career liability, even in countries that outlaw such discrimination. Not so for German women. They legally can't be fired after announcing their pregnancy. (The same goes for women in the U.K.). Full-time workers can take up to three years of unpaid leave and will still have a job if and when they return to work.
Most of the other countries you've read about so far emphasize midwifery, comprehensive maternity care, and natural birth over C-sections. Japanese women usually deliver in modern hospitals with doctors, but many still consider unmedicated birth a rite of passage. Fathers are allowed in the delivery room if they've taken prenatal classes. Otherwise, they stay in the waiting room. But the biggest difference is one you might have to hear—or not hear—to believe. Japanese women are discouraged from screaming in pain during childbirth. Instead, they keep calm and push on.
Japanese women recover in the hospital for at least five days, even after a perfectly healthy delivery. Once released, the new mother begins a 21-day bed rest, usually at the mother's parents' house. Mom and baby bond during this time, and friends come to visit the new bundle of joy.
Women in China have an even stricter time-out period after birth. When new moms "sit the month," they spend 30 days bundled up in warm pajamas and slippers. They aren't allowed to bathe themselves, eat fruits and vegetables, or cuddle their babies too much. The goal is to restore their health with Chinese medicine and breastmilk-stimulating foods while also learning how to care for their infants. (Because of China's one-child policy, many men and women don't have experience with babies.) Traditionally, women "sit the month" at home. Now well-to-do families send new moms to luxury confinement centers, where they have 24-hour nurse supervision. Giving birth might be the easiest part of the process!