Knocked up abroad: prenatal care and pregnancy advice in a foreign country

pregnancy foreign country See part 1 of Knocked up abroad: getting pregnant in a foreign country here.

One of the best parts of my experience so far with pregnancy in a foreign country has been the excellent medical care I have in Istanbul. Like many other expats before me, as soon as I took a positive pregnancy test, I called up the American Hospital for an appointment. The hospital treats many foreigners each year, is renowned for infertility treatment as well as other quality medical care, and is popular as part of Turkey’s growing medical tourism (the cow pictured at right is in the hospital lobby; you can tell how serious he is because of the glasses).

My first prenatal appointment was scheduled for Thanksgiving Day, and while many Americans were getting up to stuff the turkey, I confirmed I was six weeks’ pregnant (you’re welcome for sparing the “bun in the oven” puns). My very charming and English-speaking Turkish doctor gave me the usual pregnancy advice/warnings*, all peppered with only-in-Turkey bits:

  • Eat lots of dairy like ayran (yogurt drink Westerners often hate because it’s not sweet), yogurt, and cheese. While pregnant women should avoid unpasteurized milk and soft cheeses, you won’t find many of either in Turkey (or in the U.S.) unless you are looking for them.
  • No undercooked or raw meat like çiğ köfte, a popular raw meat and bulger-wheat snack served all over Istanbul (I first tried it outside a trannie bar here). I’ve discovered that the primary concern with sushi is an elevated risk for food poisoning; there is no additional or specific risk to the fetus. Sushi fish is often flash-frozen when caught, therefore it contains lower levels of bacteria. Use your judgment when ordering raw sushi, or stick to California rolls.
  • It would “be a crime to not eat fish in Turkey,” according to my doctor, but stay away from the big ones like shark which have high mercury levels. 1-2 servings of salmon or tuna per week is fine.
  • Sadly, especially in a country with excellent produce, eating unpeeled vegetables or salads in restaurants is a no-no, due to the hepatitis risk. While most restaurants are very clean in Turkey, when you are in a country with some traditional “natural-position” (aka squat) toilets still in use, you run the risk of some food contamination that’s riskier for expectant women than the general public.
  • Like many Europeans, I was told that 1 or 2 alcoholic drinks a week is okay, such as a glass of wine with dinner. Moderation and common sense are key, and it’s always best to err on the side of caution.
  • Caffeine is also fine in moderation: 1-2 cups of coffee, tea, or sodas are allowed per day, though I’m not convinced that a piping hot, two-sugars-no-milk glass of Turkish çay isn’t higher in caffeine than your average cup of tea.
  • Light exercise like yoga, pilates, and swimming are fine, but no “jumping exercises.”

My other concern was, of course, travel, but that was given the green light as long as I have no complications. Most airlines allow travel up to 28 weeks without a doctor’s note and up to 35 weeks with medical clearance. Whether your flight is short or long-haul, it’s advised to get up and move around every hour or so (good advice even for non-preggos) and choose the aisle seat. As I get bigger, I find puffing out my stomach as much as possible helps to get baggage assistance, and seats on the subway is good too.

The costs of prenatal care in Turkey are low: each of my appointments to a top-end private hospital cost just over $100 USD even with NO insurance (my U.S. insurance treats all international care as out-of-network and thus, out-of-pocket), even with ultrasounds at every visit–most American women get only a few over the course of the pregnancy. I’ll pay less for childbirth with a private room and catered meals for the family than I would for a shared room in a New York hospital. I rarely wait more than a few minutes to see the doctor, and the facilities and equipment are new and clean.

So far, Turkey has proved fairly easy to navigate as a pregnant person. I’ve never had a doctor who I could easily email with problems (such as which cold medicines were okay to take when I was sick in Russia), and everyone I meet is helpful with my concerns and questions. Istanbul is built on hills, so walking to the store can mean a fairly strenuous hike, but modern Turkey accommodates with online food and grocery delivery. Organic food is cheaper than at home, and nearly all of my cravings have been satisfied so far (though I could go for some American mac-and-cheese). I’m not yet halfway through the pregnancy but wouldn’t hesitate to reassure another expat that Turkey is a fine place to have a baby.

*Note: none of this is intended to be taken as medical advice, but rather my personal experience and anecdotal evidence. Talk to your own doctor about warnings and concerns before traveling to a foreign country, pregnant or otherwise.

Stay tuned for more on pregnancy travel, including Turkish superstitions and customs, where to travel in each trimester, what to eat when pregnant abroad, where to do pre-baby shopping, and more on having a baby in a foreign country. Check here for further updates.