True story from my pregnancy in Ukraine:

My pre-natal doctor: “So, have you decided where you’re going to have the baby?”

Me, very matter-of-factly: “Here, in L’viv.”

Doc, after recovering from her look of shock: “Have you been to the hospital where you’ll deliver?”

Me, slightly amused: “Yes, I’ve actually been a patient there before.”

Doc, again, after a slight pause and with an incredulous look: “And you liked it?”

Me: “Well, it was fine. It seems like the best option for our family.”

Doc, visibly collecting herself: “Well, I hope they’ll be nice to you.”

Pregnancy and Childbirth on the Mission Field

Our son, Titus, is one year old today. This tender, sweet hearted little boy was the answer to many tearful prayers, and today, on his birthday, we’re thankful beyond words for the little miracle that he is.

As I’m sure every mama does, I’ve been reminiscing a lot the past week about Titus’ pregnancy and birth. For any of you reading who might be squeamish about the messy, disgusting, amazing process that is childbirth, let me put your mind at ease – so am I. This post will NOT be a detailed recounting of every moment of the rather disturbingly beautiful birth of our son.

Instead, I’ll be sharing about the many cultural idiosyncrasies that I discovered as an American being pregnant and giving birth in Ukraine. I’ve talked with enough women here, both American and Ukrainian, to know that experiences vary from city to city and even hospital to hospital. So, I’ll be sharing my story, Titus’ story.

“Just One More Test”…Prenatal Care in Ukraine

Pretty sure that from the moment the doctor pointed to the ultrasound screen and said, “Yep, you’re pregnant!”, I spent more time in the following ten months at her office than my own home! Ukrainian pre-natal care is BIG on blood tests, and urine tests, and check-ups, and ultrasounds. I wish now that I would have counted the number of times I went to the lab or the doctor’s office, but it was at least bi-weekly, even from the beginning.

I quickly realized that healthcare providers here respond to pregnancy complications with a much grimmer approach than in the States. Granted, with Titus I did have major complications early on, and that surely played a role in the concerns throughout pregnancy. Nevertheless, I can’t tell you how many times I left my pre-natal appointment choking back tears, terrified for Titus’ life, only for Josh to later tell me, “Nicole, you had the same thing with Nora, and she was fine.”

One of the challenges for me during pregnancy was deciding which medical orders to follow and which to opt out of. I’m a Type A, mark every item off my checklist kind of person, so my natural reaction to any doctor’s recommendation is, “Well, I better do exactly what she said.”  I also struggle with fear and anxiety, so I often worried that if I didn’t do something they recommended, I might be putting Titus in danger. In the meantime, I had both Ukrainian and American friends here telling me that they didn’t follow a lot of the orders during their pregnancies, because it seemed overkill.

In preparing for delivery at a Ukrainian hospital, the prenatal care team has to fill out (by hand) a booklet, containing all of your medical records throughout the pregnancy – test results, ultrasound findings, doctor’s appointment notes…Mama is expected to have that book, complete and ready, when she shows up at the hospital to give birth. Some of the appointments in the booklet are for consultations with a dentist, an ENT, and other specialists that you definitely do not see as a regular part of prenatal care in the States.

We fumbled through decisions and appointments and made it to about nine months. At that point of pregnancy in the States, your doctor typically wants to see you more frequently, keeping an eye on your progress as you get close to delivery. Imagine my shock and surprise when my doctor here not only did not ask me to come more often, but basically said, “Well, if you haven’t had him by your due date, come back and see me.” What?!

Another interesting tid bit about pregnancy in Ukraine: one doctor handles all of your prenatal care, but they do not deliver babies. You only start seeing the delivery doctor at about nine months, and usually only once or twice, if everything is going well.

Childbirth in the back of a van?! Well, almost…

The day Titus was born, I was home alone with our two year old. Laying next to her at nap time, I felt the first contraction and knew, “This is it.” After about half an hour, I called my doctor to let her know I was coming.

We didn’t have a car. Josh was working in town. I was alone with Nora. I called Josh and told him to meet me at the hospital – no way he’d make it home in time. Called my mom and brother (who are also missionaries); my brother would stay with Nora, and Mom was coming to the hospital, in case Josh needed translation and I wasn’t able to do it. She called my dad, who would drive me.

I gathered my pre-packed bags. Cultural moment here – in Ukraine, you don’t just pack baby clothes and PJs and diapers for the hospital. No, you also bring the bed sheets (two sets – one for delivery and one for post-delivery stay), gloves for the doctors, syringes, gauze, umbilical cord clamp, toilet paper, and oh, so much more!

Bag of hospital supplies and half the list of items I was responsible to bring.

I gave Nora a quick kiss and hug, and we were out the door, all the while, contractions getting closer and closer. I texted Josh – “Better get there fast!” He was having trouble getting a bus or a cab, so he literally ran about 1.5 kilometers to the hospital!

We got stuck in traffic. At one point, I asked my mom, “Do you remember how close contractions are at the end?”

“About a minute or two.”

“Okay…um, we might want to hurry, ‘cuz that one was about two minutes!” I was still calm, but starting to imagine delivering in the back of that van!

We made to the hospital (as did a worn out Josh), and they took me to triage. I let them know the contractions were close, but maybe I didn’t seem panicky enough. The nurse was working through paperwork with me when my doctor arrived to check my progress. After a single glance, she said, “She needs to be in the birthing hall NOW! Baby is already coming!”

We were rushed into the birthing hall, which was clean and tidy, but reminded me of a hospital room from a ’50s TV show. They quickly made up the bed (using the sheets I had brought), told me to pee in a bed pan at the end of the bed (embarrassing!), and I spent a grand total of fifteen or twenty minutes on the bed in labor. Just over two and a half hours from my first contraction, Titus made his appearance!

Hospital Stay with New Baby

In Ukraine, the typical length of a hospital stay after giving birth is four days. My recovery room was for six women. That means six women, six newborns and usually six caregivers (husbands, moms, friends), plus any visitors who came to see the new babies. The room was connected to a second recovery room (no door between them), which was also for six women, their babies, and their caregivers. As you can imagine, we didn’t sleep much! The day I went home from the hospital, I was so exhausted that I literally felt like I was outside my body, watching everyone around me!

We did not have a toilet in our room. There was one bathroom for the whole department (for patients and visitors) – it had three toilets in it. We did have our own sink, but only cold water. Each woman brought her own hand soap for herself, her guests, and her doctors to use. There was a shower head and a drain on the floor in the public bathroom (which was uni-sex, mind you). Three days after giving birth, I decided I had to at least wash my hair and sponge bathe. The water was so cold that I had a headache by the time I was done!

The pediatrician and my doctor were both amazing. They came by frequently to check on both Titus and me, and they took great care of us. Another cultural moment – I learned very quickly that nursing moms are under MAJOR dietary restrictions here, compared to the States. I felt like every time the pediatrician walked into the recovery room, I was being scolded for something I was eating or some food item that was on my bedside stand. They were very concerned about allergies and possible negative effects on Titus, whereas in the States, I had been accustomed to an “eat it and if you notice a reaction, don’t eat it again” approach.

Another obvious difference (although not a new revelation for me) was that newborns are treated with extreme caution. Our room was probably about 75 or 80 degrees Fahrenheit (no AC), but the babies were still bundled in thick, wool blankets and hats. Titus was definitely the odd man out in terms of dress code! Also, I’m used to the fact that Josh plays pretty actively with our kids, but it’s not as normal here culturally (although that is changing). Every other parent in our room held their swaddled baby close and watched in amazement as Josh propped Titus up on his legs and made him try out dance moves!

The hardest difference for me was that children are not allowed to visit in the recovery ward. We arranged for my parents to bring Nora to the hospital one day, and I met her outside for a walk, leaving Titus with Josh in the room. While I was loving the one-on-one time I had with our new son, it was killing me to be apart from our two year old for so long. Thankfully, Nora was as happy as ever, just anxiously waiting for us to bring her new brother home.

Bringing Baby Home – A Cultural Event

I feel like Ukraine has America beat in the area of “bringing new baby home from the hospital.” It’s a big deal in the States, and your close family and friends are usually a part of it, but here, bringing baby home is a beautiful, cultural event.

The day we took Titus home, there was a mass exodus of moms and babies. Every mama got dressed up in her “Sunday best”, did her hair up right, and put on her makeup. Women I’d been with for days, who had worn pajamas and bath robes and not put on a stitch of makeup, looked completely different – fresh and excited. Every baby was dressed in something fancy and then wrapped in a beautiful, carefully selected blanket.

Husbands, fathers, grandparents, friends…they all arrived, bringing lavish bouquets of flowers and wearing big, beaming smiles. The nurses came into the rooms to make sure each baby was properly attired, and then, one by one, they carried Baby to the door, escorting Mom and Dad all the way. Outside the hospital, for every baby, there was a group of eager loved ones, anxiously waiting for their new arrival to make his or her first appearance into the outside world.

When our turn came, we experienced one of the sweetest parenting moments of our lives so far – Nora ran toward us as we walked through the door, holding out her chubby little toddler arms and begging to hold her new baby brother.

Culture Shock, Comfort Zone and Learning to Adapt

And now here we are, one year later. I remember saying when I was pregnant that I’d never felt like such a foreigner as I did being pregnant in Ukraine. I experienced more culture shock than I had in years, having moved here when I was only twelve. Every day now, I’m realizing that parenting cross-culturally involves just as much culture shock.

Culture shock is that feeling of bewilderment you get when you realize that behaviors, expectations, ideals, communication (the list goes on)…they’re all different than what you consider to be your norm. It’s that awkward, “out-of-place-ness” when you truly know that you’re not in your comfort zone.

A huge part of our lives as missionaries is adapting. I don’t love adapting. I like being comfortable and familiar. Change is hard for a lot of us, isn’t it? Whether it’s changes in family, work, the place where you live…change has a way of ripping us from our comfort zone and forcing us to make a choice: dig your heels into the past and hold on or embrace some new facet of life and be made stronger.

Sometimes I dig in my heels for a while, but in the end, it always makes more sense to accept what God has allowed to come my way. I may not like the changes initially – actually, sometimes, I don’t like them period! But in adapting to change, there is a richness to be gained.

In our lives as missionaries, that richness is found in incorporating a “new” culture into our family. It’s a beautiful thing to draw from the good in both American and Ukrainian cultures, whether it’s in pregnancy, childbirth, parenting, or other areas. Yes, we face culture shock and are forced to adapt sometimes when we’d rather not, but in the end, we see that God is using it to grow us, challenge us, enrich our lives, and hopefully impact the hearts of people around us.