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.

Adventures in Eating: The Other Kind of Sushi in Tokyo

“I serve raw meat,” said the chef, as I approached an empty seat at the counter.

“Did you hear me?,” he said. “Raw. Meat.”

He said it as if he were trying to scare me away, a verbal tone akin to “inadvertently” lifting up his shirt above his waste to reveal a handgun tucked into his pants. I nodded and sat down. After all, I didn’t just happen upon this restaurant by accident. I was in Tokyo and had read on a food message board about a small place in the back alleys of the Ebisu neighborhood that served the raw meat from your favorite farm animals as sushi.

Meat sushi, particularly of the horse variety, isn’t the most uncommon menu item in Japan. The Japanese began consuming “basashi,” as they call it, due to necessity. Mid-19th-century Japan was not the foodie paradise it is today; the people were undernourished and needed protein. So when the hungry people of pre-Meiji Japan looked around, they saw a galloping dinner with four legs and a tail and began sharpening their knives. Still, I gathered from the chef’s hesitation at my presence, raw horse meat is not something a lot of non-Japanese seek out when they’re in town.

Besides, the place was hard enough to find, so I wasn’t going to turn back now. I only had a vague idea of its whereabouts and wandered the narrow streets, popping into restaurants to ask if they served meat sushi. When I’d get a blank stare in return, I’d say, “Sushi: neeeigh,” doing my best equine imitation. Everyone I had asked shrugged. Except for one guy, a chef in an izakaya, who took me by the arm and led me here, to a narrow, covered alleyway flanked with countertop eateries. This place, I later learned, was called Wakadaisho (1-7-4 Ebisu Yokochowai, Tokyo, 03-3444-7005).

The chef plopped a piece of purple, veiny meat in front of me, stretched out on a thumb-sized bunch of rice and said, “Horse.”

The meat was all texture, like masticating on a chewy piece of Play-Doh. The thirty-something couple next to me, slid over a bowl of edamame and gestured for me to indulge. Either I was now part of the horse-eating club or they were taking pity on me. As the chef would plate sushi, I’d ask him to identify each piece: horse neck, cow lungs, chicken breast. It was a virtual farm of raw meat at this tiny 12-seat eatery. The chef, whose name was Hiraoki Toda, said he had only been a meat sushi chef for three months. He had previously been a bartender, but his love of raw meat was so strong it inspired a career change. And from the look of it, he was doing well: the restaurant was full with young people munching their way to raw meat Valhalla.

Next up: a gooey, chunky, pale concoction wrapped in seaweed. I was afraid to ask. But before I could, Toda nodded at me and said: “Raw pork guts.”

I know what you’re saying: yum! For many people, this entire meal probably goes against all things that are good and civilized in the world. And this finale-raw pork-seems as counter-intuitive as eating road kill. After all, how many times did our mothers tell us never to eat raw pork, as if some day we might be stupid enough to actually do it. I guess I am: I commenced chewing, my taste buds absorbing the chewy texture and the porky flavor. When I was done, the couple next to me, slid over a bowl of raw chicken skin. Then raised their pints of beer to me and I followed. “Kompai,” we said, clinking glasses. I came for the raw meat, but I stayed for the new friends I made while I was there.

Traveling with Co-Workers: An Obsession with Steak Tartare

Steak TartarThere are co-workers that are close friends and then there are co-workers that are strictly co-workers and will never be anything more. Occasionally the lucky pair that consider themselves pals on and off the clock will be given the opportunity to travel on the company’s dime and have a ball. The other set which may be just as fortunate to head out beyond the office space together will painfully smile through it all and nit-pick the other behind closed quarters to all their friends and family.

Tonight, I consider you (the readers) my friends and family for I am trapped in situation number two. Sometime last month I believe I made note that I would be touring the north east corner of the country on a mobile marketing gig. Fantastic for me considering how I’ve never been to Vermont and Maine and can’t wait for next year when I finally get to check them out. On the road sharing this experience with me is my co-worker and strictly co-worker, who will remain unnamed for now until things totally escalate out of control. With our situation we basically have to spend every waking moment of the day with each other and to sum my feelings on that up, let me just say it’s um, alright. Yes, she is a nice sweet person and in spending so much time together I’ve come to learn several interesting things about her, but nothing more interesting than her obsession with steak tartare. (Yes, the freshest of raw red ground beef served with onions, capers and seasonings.) It is her mission in every big or slightly decent sized city to sample the dish even if she’s had it the previous night, because you can never have enough fresh raw red meat.

Well last night I almost reached that limit where a person can stand no more with their co-worker and their annoying bicker-babble on gross food topics. We had just pulled into the Best Western in the lovely and historic Gettysburg, PA (a very all-American sort of place) and while checking in at the front desk she inquires not about the local flavor, but whether any Frenchies have assumed the position in a cozy little bistro or cafe where they are serving steak tartare. The bar-tender who had just walked up and a man on business along with the front desk lady all pause for a moment before laughing. This is where I make my exit and start backing away slowly, for I did not want to be mistaken for a raw meat-eating carnivore and wished to engage no more in this conversation. I hear them say, “This is Gettysburg. You think there is some place to get steak tartare?” I’m dying on the inside. My stomach turns and I run to the elevator. I say a silent prayer so that I don’t have to deal with hearing about this or her other unique tastes until my contract ends in April 07′.

But please – as much as many of you probably agree with me out there (because you always take the Gadling blogger’s side) I must be sure that you do not paint me to be an angel free of annoying co-worker bicker-babble. I’m sure my daily marathon training talk is enough to make her hurl up the last serving of steak tartare. The two just don’t mesh well. So I’m asking you for tips on how you deal with co-workers that you just don’t click with while traveling for work. I want to hear stories. I’m sure some of you have been in my shoes or perhaps you have some positive feedback to offer. Yes… perhaps there is some constructive criticism to be provided here. I’ve searched Google, but found nothing of great help except this Q&A article on not discussing your mental illness with your co-workers.

The day she tells me she has a mental illness – I’m out of here.