- My partner and I have been in four countries during our fertility and pregnancy journey.
- Italy offered free care, but I opted for private insurance that allowed me to see a doctor near me.
- The US healthcare system was the most expensive and confusing.
The first trimester was in Italy, the second was in the United States, and now I'm in Canada, where I plan to give birth. And if you count where we started our fertility journey, then it's four countries. My husband and I lived in London when we decided to have my IUD removed.
Living the global life that we've been fortunate enough to live, we needed to choose where to have our child, so I went about my pregnancy with that decision top of mind.
The first trimester was in Italy
I first encountered Italy's medical system a few months after moving to a small town in southern Italy. While I certainly appreciated that all citizens and residents receive free healthcare, I was disappointed to learn that the hospital in our city — population 55,000 — didn't have an obstetrician on staff, so I had to take a train to the next town over and walk to its hospital, which took about an hour in total.
That inconvenience was partly why, for subsequent appointments, I ended up going the privatized route. Although the care I got at that hospital was competent, the building was old, and the care was transactional at best.
I was much happier with the private gynecologist a five-minute walk from my apartment who smiled at me and took his time to communicate — extra important when speaking a second language.
As an Italian dual citizen, I applauded this accessibility to healthcare on both sides of the spectrum. Plus, I'd soon learn that paying for a private obstetrician in Italy was downright cost-effective compared to paying for basic prenatal care in the US.
The second trimester was in the US
For my second trimester, we were in the US — where both my partner and I were raised. We bought health insurance that was 10 times as expensive per month as a single prenatal visit with a private doctor in Italy, and that's not even counting the copays for visits.
If I was grateful to have the means to afford to see a nearby private doctor in southern Italy, for both convenience and bedside manner, then I quickly realized that luxury wouldn't even have been able to cover half a month of prenatal care in the US.
It was not only more costly but also more complicated. My husband and I — both smart people, we like to think — were confused by the complexity of choosing an insurance provider and the best premium for our situation, and then, in the end, I was restricted by in-network options.
The third trimester was in Canada
By the time my third trimester rolled around, my husband and I packed our bags for Toronto. Our visas had come through for the job offer that relocated us, although we weren't yet signed up with the Canadian health system.
At my first appointment, I was told that I would retroactively be taken care of. The medical system in Canada is centralized, universal, and publicly funded. By the time I received my health card, it was added to my file, and that was that. There has been no exchange of money for the excellent care I've received — standard prenatal checkups and additional ultrasounds — although I'm sure it will be felt when we pay our taxes.
There's a lot of talk among my friends regarding maternity leave and how dismal it is in the US compared to other countries. While that's absolutely true, as a self-employed professional who hasn't lived in this country long enough to pay taxes before the baby comes, I won't get the benefit of that income supplement in the months after my child's birth.
But I'll take what I can get, and I'm happy with where we've landed to bring this life into the world.