Having a baby is pretty daunting - especially if you’re in a foreign country.
Thankfully, for all our Mums-to-be (or those considering it),
fellow MWN member Chiara can clarify what having a baby in Milan actually means.
She explains our options, the kinds of experts to consider, and gives us important questions to ask, so that we can create the best experience possible.
And you never know, maybe the option you never considered is what could support your perfect birth experience here in Milan.
Written by: Chiara Lops (birth & postpartum doula)
Finding out you’ll soon be welcoming a new addition to your family while living far from home can be super exciting, and, at the same time, can easily make you wonder "What now?"
“How do I know?” you may ask.
Let me share a bit of my story: my name is Chiara, and I’m Italian, born and raised in a small town just outside of Milan. I've always had a passion for travel and adventure, which led me to many places around the world. In 2011, my journey took me to China, where I welcomed my son Alessandro in the city of Hangzhou, just an hour from Shanghai.
I've been just “slightly east” of where some of you may be today, I could say. I experienced the joy, excitement, and bewilderment of becoming a mother in a foreign land. I was fortunate to have a wonderful birth team and a positive birth experience, but I also faced crippling postpartum depression.
Years later, life led me to yet another adventure: in 2020 I decided to become a birth and postpartum doula.
Today, my goal is to help expat women have the smoothest and most memorable birth and early motherhood experiences possible, while living in my beautiful home city.
I know it’s possible, and I love witnessing it.
So, if you’re expecting a child in Milan (or nearby) and have been entertaining questions like:
- “Can I achieve the birth I’ve always envisioned?”
- “How will I navigate the notoriously complex Servizio Sanitario Nazionale?”
- “Will I find a healthcare provider I can communicate with?”
- “Is homebirth even an option in Milan?” then this post is for you.
You may also even be wondering about what happens postpartum, especially if your family and closest friends can’t be here with you.
If any of this resonates with you, grab your favorite tisana, sit back and relax while I give you an overview of the possibilities available to expat moms-to-be living in our vibrant city.
While covering every potential path for your motherhood journey in Milan in one post is impossible,
I’d like to provide you with a general understanding of what the city offers regarding pregnancy and birth care.
This way, you can make informed decisions that best fit you and your family.
Hopefully, after reading this, you’ll feel confident and empowered on your journey ahead.
Step 1: Set Your Goals for Your Dream Birthing Experience
Think back to a significant achievement in your life, whether at school, work, or personally.
How did it start?
Likely with a clear vision of what you wanted to achieve.
Getting your desired birth outcome or experiencing the best possible postpartum in Milan starts in the same way - with clarity about what you want, and how you want to feel throughout the process.
Think of your pregnancy and birth as a journey. You need to know your destination to map out the steps to get there, like choosing transportation, booking accommodation, deciding on travel companions, and setting a budget.
Many of us believe that birth will just happen naturally, without our input.
But that’s only partially correct.
Yes, birth will happen - you won’t be pregnant forever. However, your preparation and intention significantly influence how your pregnancy, birth, and postpartum will unfold.
My wish for you is to get clear on what you want to experience,
and then excited about working towards it.
Step 2: Navigating Your Options with Servizio Sanitario Nazionale and Beyond
The Italian National Healthcare System (Servizio Sanitario Nazionale, SSN) offers free care for all pregnant women residing in Italy, and we pretty much all know that.
You could go through your entire pregnancy, birth, and postpartum almost entirely for free with the assistance of a public hospital, your local consultorio, and GP.
A consultorio is a public clinic providing basic services related to pregnancy, birth, and postpartum, including birth prep courses, breastfeeding support, pelvic floor health, and mental health care.
Services vary, so you’ll need to find out what’s available in your area. Following this path, you’ll receive necessary checks, ultrasounds, and visits as required by Regione Lombardia’s pathway to birth.
Sounds straightforward, right? Well, not exactly.
The language barrier can be an issue since many practitioners in the public system do not speak English fluently.
Additionally, the SSN offers standardised care, which may not always consider individual circumstances. While you can receive competent care in our top-tier public hospitals, having someone to help you navigate the public system is crucial to avoid feeling like “just a number.”
Most Italian women don’t choose the free pathway, partly due to the misconception that private gynecologists provide better care, or due to cutting down waiting times.
Consequently, finding someone who has navigated the free pathway from start to finish can be challenging.
If you’ve shared your news with Italian friends and asked for suggestions, they’ve probably recommended their private ginecologo (gynecologist).
A ginecologo is a physician primarily trained in identifying pathology rather than focusing on health signs; however, pregnancy and birth are natural physiological events, and choosing a ginecologo may lead to extensive testing and checks, which might be excessive for most situations, even though necessary for some. Nonetheless, most women in Italy still resort to their ginecologo for pregnancy care.
So, maybe you’re wondering if there are other options.
And, absolutely, there are!
Let me share my favourite with you.
Italy has a long tradition of midwifery. Midwives (ostetriche) are integral to our culture.
Both my parents were born at home in the 1950s with the help of a levatrice, a woman responsible for the reproductive wellness of women in their community.
Today, midwives are university-trained professionals present in hospitals for all uncomplicated labours and births.
If your pregnancy is considered low-risk, you can meet midwives alongside doctors during your periodic checks through the SSN pathway or at your local consultorio. However, their role in the public system is somewhat limited, if you ask me.
That’s why some midwives work independently and have private practices.
If you want to increase your chances of a healthy pregnancy and physiological birth, I strongly suggest hiring one: in Italian they are called an ostetrica libera professionista.
They provide personalised, in-depth care and are experts in women’s reproductive health, from the first period to menopause. They are particularly skilled in promoting health and wellness during pregnancy, birth, and postpartum.
Some specialise in specific areas such as home births (legal in Italy but not reimbursed in Regione Lombardia), pelvic floor health, and postpartum care.
Independent midwives are your best choice if you plan on having a physiological pregnancy and vaginal birth, and want to work actively towards it; even if you choose or end up giving birth at a hospital.
Thanks to the internet and social media, many are easily accessible, and some speak English well enough to work with expat mothers.
Remember, it’s not necessarily one or the other. If you hire an independent midwife, you can still access the SSN for all your checks and for birth itself.
Finally, you can also consider completely private hospital care, available at some public facilities and private clinics. One major perk of this path is having the privacy of your own room and the chance to have your partner, family, and other support people with you at all times.
Many expat families have private insurance that covers the cost of private care and other services, such as midwifery care or doulas. However, private doesn’t always mean better or “closer to my needs and desires.”
Step 3: How to Choose Your Birth Team Wisely
Whichever way they choose to go, I always encourage my clients to visit different facilities, speak to staff, and ask all their questions to find the place and people that will be their perfect match.
If you hire an independent midwife and/or a doula, this should be no different.
Your options in Milan are truly plentiful, so take some time to set clear goals, do some research and sit down for interviews.In order to help you get started, I’ve put together a list of preliminary questions.
Please consider these as just a starting point - you’re welcome to revise and expand them according to your wants and desires.
Questions for a potential midwife:
How long have you been in practice?
How many births have you attended?
Do you work or have privileges in any specific hospital?
Do you deal with home births? Do you work in a team with other midwives?
How many other clients will you work with around my due date?
How often will we meet during pregnancy and approaching my due date? What will we typically do during appointments?
What typically happens during the early and later stages of labour? When will you join me?
Are you trained in dealing with emergencies during labour and birth?
Questions for hospital and their staff:
What is your policy regarding labour inductions and/or cesarean births?
How many days past the due date do you typically begin inductions?
How do I give or decline my informed consent in this hospital?
Will I be able to get in-depth information about (insert your concern)?
Can I bring my doula/private midwife?
Do you have English-speaking staff? Can I choose to have a particular midwife/doctor on call?
What are the main differences between public and private care at this facility?
Questions for a potential doula:
How do you envision birth? What do you believe to be true about birth?
How many births have you taken care of?
Do you offer pregnancy and postpartum support too? If not, can you recommend a colleague who does?
I am considering (i.e. pain medication/a home birth/bottle feeding, etc ): will you support me and my choices?
Is it possible to speak to one (or more) of your past clients?
Do you already have any other commitments around my due date? Do you work with a back-up doula and is it possible to meet them?
I promise that navigating birth and postpartum abroad isn’t as daunting,
once you find your support team.
Living in or around Milan puts you in the very lucky position of having a potential network of highly valuable pregnancy, birth and postpartum professionals at a stone’s throw.
My heartfelt wish is that you find the perfect people to guide you and be by your side on this larger than life journey - and if you need a little extra help, you can find me here:
IG: @chiaralops.doula
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