If you know me, you’ve probably heard by now that I gave birth to my second child in May. And if you don’t know me, well now you have! Today, our baby girl is 12 weeks old, happy and growing at an almost alarming speed. We’re endlessly fascinated with and totally in love with her.
I’ve received a lot of questions about my experience of being pregnant and giving birth in Lithuania. Let me just say that it was never something I had on my bucket list any more than, say, starting a business in Uruguay or retiring on the Moon. But here we are, almost a year and one super random story later. This is that story.
But before I get into it, a little disclaimer: These are obviously my own opinions based on my subjective experiences. I had my first kid in a Finnish public hospital three years ago. For our second we chose the Baltic-American Clinic, the go-to private clinic for many an expat here in Vilnius. We also used the services of a private breastfeeding consultant, who discussed the Lithuanian culture around childbirth and breastfeeding at length with us. I’ll share a few of her insights here as I feel they provide useful context for my own experiences.
Second disclaimer: I hesitated naming my clinic at first because my experience with them wasn’t 100% positive. However, I’ve come to understand that the issues we faced are more or less common across the Lithuanian health care sector and not unique to any one care provider. I hope that by sharing my experience I can help other expectant expats (say that three times in a row) prepare for their journey better, regardless of what hospital or clinic they choose.
Step 1: Pregnancy
The first question non-Lithuanians sometimes ask me if giving birth in Lithuania is even safe. To that I can only say yes, yes it is. The quality of physical health care in Lithuania is generally on par with Western Europe. Not all clinics have a perfectly polished appearance, and there can certainly be a language barrier to overcome, but don’t let that throw you off: this is a good country to have a kid in.
Maybe you noticed me saying “physical health care” there. I’ll explain why.
During my pregnancy I saw my doctor, a gynecologist, every few weeks. She performed an ultrasound almost every time. The appointments were pretty short and focused on the physical health of me and the little life growing inside of me. The other parent is allowed to be present at the appointments, but they’re not really given any particular role in the process. Pregnancy is, in my experience, treated as a physical condition of the pregnant parent’s body. Its psychological, social, practical and other aspects are not part of the care package.
This is one area where expat families might want to enlist additional help. Having a kid is a complete life overhaul in itself; having one abroad is only going to bring an extra set of challenges. You might want to talk about your thoughts, expectations and fears with a health care professional. Or maybe you’re curious about practical matters like parent-baby interaction, family sleeping arrangements and available services in your area. Your gynecologist probably won’t be able to help you with any of that.
I can’t say for sure if the Lithuanian public sector provides more holistic care than its private counterpart, but in either case one option, if you can afford it, would be to go rogue and hire a doula. A doula obviously cannot replace a doctor or nurse, but they can be a great support person and help you navigate the experience of pregnancy and prepare for labor. The latter could prove to be an especially valuable service as there are, to my knowledge, no English-speaking birthing classes organized in Vilnius.
However, be aware that private clinics generally do not allow non-affiliated entrepreneurs to practice their profession on their premises. Your doula will probably not be able to be there for your actual labor and hospital stay (unless you can pass them off as your Lithuanian cousin or something, I guess).
Personally, I didn’t end up hiring a doula even though I was considering it in the beginning. I do come from a country with holistic maternity care: our legendary neuvola (literally “place for advice”) system is designed to guide families through the whole experience of having children from pregnancy until the child goes to school. I knew from the get-go to not expect the same kind of experience this time around, but I do admit that the strictly physical nature of my doctor’s appointments still felt a little… alienating. Perhaps having a doula to talk to through it all would have been the right choice after all.
Step 2: Delivery
As mentioned, I gave birth via a planned C-section. My doctor gave me a choice between that and trying to push the baby out. The latter was oddly referred to as “natural birth”, which has a much more specific meaning where I come from. I chose the option that was considered safer given that I’d already had one C-section before.
I’m under the impression that Lithuania has an average rate of C-sections and they’re not super socially stigmatized, but I could be mistaken. My doctor had explained the facts and given her recommendation while ensuring that I didn’t feel pressured to choose one way or another. I appreciated this.
The operation was a short one, as C-sections are. We arrived at the clinic three hours before showtime, were shown to our family room and changed into our scrubs. They took a bunch of tests and wheeled me into the operating room. I was given an epidural and some 10 minutes later the team of five or six started operating on me. The whole thing felt as surreal as it did the first time around, but that’s just the nature of the procedure. My husband was at my side through the whole thing.
A few minutes later we heard that first primal cry of a newborn babe and met our daughter for the first time. After they’d pieced me back together, I was wheeled back into our room, high on morphine and with an adorable little cherub in my arms.
Step 3: Clinic stay
We ended up staying at the clinic for five days, which in hindsight was a little too long. This was not due to any shortcoming on behalf of the facilities: it was like staying in a nice hotel. Our room was large and had a soothing forest view. The downstairs restaurant had a rotating menu of healthy yet luxurious options, including vegetarian (and ice cream if you knew to ask for it). We were the only couple in for most of our stay and pretty much had the entire floor to ourselves. We also had round-the-clock help from a couple of nurses.
I should also say that the entire staff was always very friendly and welcoming, even when we disagreed on certain things. If you’ve lived in Lithuania for any period of time, you know even paying €€€ for a service doesn’t always guarantee that. And when you’re dealing with something as major as pregnancy and childbirth, it’s non-negotiable.
However, language definitely was an issue when communicating with the staff, despite what the clinic advertises. One of our two nurses spoke basic English while the other didn’t speak any. The doctors spoke reasonable English. This was enough when we only needed something straightforward like painkillers pour moi, but became quite inconvenient as soon as the conversation turned to something more complex. In one case we didn’t get the critical nursing equipment we asked for because the only person on night shift misunderstood us and refused it. Or at least I think she misunderstood us, because anything else would be just weird.
We also noticed a few things — cultural differences, maybe — about the staff’s approach to infant care that kinda surprised us. First, my husband felt that he had to insist to get to take care of his own baby. All guidance was addressed to me as the mother. The nurses were also a little too eager to tend to our baby when I was bedridden. I know they meant well, but my husband was understandably quite taken aback by it, being one of those crazy modern guys who actually want to spend time with their children.
Second, our nurses and pediatrician encouraged us to always keep our baby swaddled up to her head in a thick felt blanket and to add an extra loose blanket on top. The breastfeeding consultant we met with later did mention that Lithuanians, in her opinion, tend to overdress their babies for warm temperatures. Whether or not this is true, we chose not to follow the swaddling advice because of the risk of suffocation and SIDS by night and no chance of skin-to-skin contact during the day. Plus, it was very hot in our room.
Third — and this is the part that led us to look for outside help in the first place — we found breastfeeding support at the clinic extremely lacking. This came to me a complete surprise as I’d discussed my intention to nurse my baby prior to her birth. I was assured that help will be available should any problems arise. Which, of course, they did. Our girl basically slept through those first few days and couldn’t quite get a hang of that whole eating thing. It became a major struggle to feed her every 2 to 3 hours.
To their credit, the staff did try to help, but it just didn’t seem like they were trained in either the mechanics or the psychology of breastfeeding. I’m saying that as somebody who has received qualified breastfeeding support before and has an idea of what to expect from these sessions. I felt that I had to do all the re-positioning and troubleshooting myself; the staff seemed content to just keep doing one thing for hours on end. Also, not all of them had received the memo that you’re supposed to ask for the patient’s consent before touching them — not good. Our sessions quickly became very stressful for both me and my baby.
What made the situation worse was that the staff never acknowledged the limits of their expertise. Instead they attributed my failure to nurse alternately to my own confusion (insisting that it was working when it clearly wasn’t) or my own body (telling me my anatomy was at fault). After a few days of this back and forth, they settled on the opinion that I was physically unable to do it and recommended that I just stop trying.
Now, I’m aware of all the great alternatives for breastfeeding from expressed milk to formula and had obviously used these to keep my baby fed while she refused to nurse. However, breastfeeding was the most desirable and sustainable solution to us and I wasn’t going to give it up without even giving it a proper try. I didn’t feel like the staff really understood this. I felt that their only priority was ensuring that our baby was getting her calories in one way or another. To me, this just reveals a dangerously simplistic and kinda sexist understanding of breastfeeding.
Step 4: Reflections
Ultimately, I think the above issues come down to the strictly physical nature of the care I received. Psychological, practical and other matters didn’t really factor into it, even when they intersected with physical ones (like in the case of our nursing issues). I can appreciate that this might be the case in many countries around the world, and perhaps it’s all some other families are expecting from their maternity care provider. In that case, more power to you! We were lucky to find the help we needed elsewhere.
Today we’re successfully breastfeeding and have been almost since the day we left the clinic. This is all thanks to our amazing IBCLC-certified (International Board of Lactation Consultant Examiners) consultant whom we contacted through the Lithuanian Lactation and Breastfeeding Consultants Association and invited over as soon as we were back home. She did her thing, which involved creating a relaxed atmosphere, trying a few different nursing positions and letting our baby find her way instead of trying to force her to nurse.
And get this: within 15 minutes it started working. After some further troubleshooting the next day we were in the clear and, almost as importantly, our moods had greatly improved. I was simply stunned by how quickly my little one went from never having nursed to nursing at a 99% success rate. Our consultant’s holistic understanding of the process helped our baby finally “get” what we had been trying to achieve for the past several days.
And that right there is the takeaway: you can’t do what you’re not trained to do. Our consultant mentioned that very few local hospitals and clinics in Lithuania are equipped to deal with breastfeeding issues at a level required from so-called baby-friendly hospitals — no, one nurse who took one course 15 years ago doesn’t count. Moreover, breastfeeding remains understudied and underinvested at the national level, so change happens very slowly. Parents, generally women, are basically left to figure it out for themselves.
So it’s not that I would not recommend BAC to expectant expat families. I have only good things to say about the physical care I received there and, let’s face it, it’s not like they have many viable competitors out there if you don’t happen to speak Lithuanian. All I’m saying is that you would do well to remain open to the possibility of enlisting additional help, be it from a breastfeeding consultant, doula, baby sleep coach or even another clinic. Maybe you’ll get lucky and not need it, but just having a few extra folks on speed dial can make a world of difference when push comes to shove.
Trust me, you’ve earned all the help you can get — not least because your next quest will be to get local authorities to issue a birth certificate for your newborn and that is a whole can of worms I’m not even going to open right now. Suffice to say that we’re still at it. Godspeed and feel free to check back in another three months just in case I have an update for you!