Where in the world should we have a kid?
March 14, 2015 1:09 PM   Subscribe

What are the best countries to consider in terms of prenatal care/maternity leave/childcare for American expats?

My husband and I (female) are both American citizens who live in a large metropolitan area in the US. We are thinking about the possibility of making an international move to experience life in another country for a few years. We have also been planning to start a family within a year.

If we decided to make this kind of move, it would ideally involve moving to a country that meets at least the majority of the criteria below:

- English-speaking or with a high proportion of English speakers (I speak decent French, so French-speaking countries are fine)
- High-quality prenatal care (that I would have access to as an expat)
- Reasonable maternity leave (it seems like almost anywhere is better than the US)
- High-quality, affordable childcare (again, that we would have access to as expats)
- Relatively politically liberal and secular

A few other bits of information:

- Whether or not our future child can get automatic citizenship in this different country is not really a consideration
- We most likely would not stay in the new country for more than a few years (though anything is possible)
- Assume that we will both aim to be employed in this new country (we are both white-collar professionals)

So what countries should be on our list and why? I would love any advice about places to consider or other resources to check out. We’ve started doing some initial research, but it would be helpful to hear from Americans who have lived abroad about their experiences having children in other countries. (And if there are other things we should consider when it comes to having an American child abroad, please feel free to share those too.) Thanks in advance!
posted by Synesthesia to Travel & Transportation (26 answers total) 11 users marked this as a favorite
The Netherlands might be an option for you. As white-collar professionals, you might be able to get jobs and residence permits under the highly-skilled migrants program. The plus side is that if one of you gets a job offer via the program, the other automatically gets a normal work permit (though there might be a short waiting period).

About 90% of Dutch people speak English, and receiving medical care in English is definitely not a problem if you live in a major city such as Amsterdam, Rotterdam, or The Hague. It's a little bit harder in smaller towns, but not impossible.

You're allowed 16 weeks of paid maternity leave by law, and you can choose how many weeks to take before and after your due date. You're also allowed to take unpaid maternity leave after the birth if you've been with your employer for over a year. There are also laws protecting mothers who return to work while breastfeeding.

There are tons and tons of resources online about prenatal care in the Netherlands; Googling will lead you to lots of info from expat mothers.

I think the downside of the Netherlands for you would be affordable child care. Cost of living is high here, and child care is accordingly expensive. That's a big complaint among the expat moms I've worked with.
posted by neushoorn at 1:38 PM on March 14, 2015 [2 favorites]

Looks like you want to leave America while living American.

Australia and Britain come to mind, for the language at least.
posted by Kwadeng at 1:41 PM on March 14, 2015 [3 favorites]

I was just doing some research on parental leave and I found the International Network on Leave Policies. They have country reports which break down what's available in each country. I can vouch for the accuracy of their information on New Zealand, at least.

Bear in mind that a more relevant question might be whether you can actually get a work visa for a given country. For instance, there is massive political pressure in the UK to cut immigration, and because they can't stop EU citizens from entering the UK, they have made it harder for workers from other countries to immigrate - you'll probably only get a visa if you have a job offer. The Australians have a Visa Finder that shows you what visas you are eligible for, that could be worth looking at.
posted by Pink Frost at 2:19 PM on March 14, 2015 [1 favorite]

I just had my daughter in Sydney. Totally happy with my experience. I was eligible for Medicare, but a British friend wasn't and still had her baby at the same hospital with the same doctors and midwives and same good experience using her very cost-effective insurance.

If you do move somewhere like this, note that most private insurance schemes have a 12 month waiting period for maternity cover. Plan accordingly.
posted by olinerd at 2:35 PM on March 14, 2015

FYI, American pre-natal care isn't that brilliant and the US ranks behind almost every country in Europe in terms of infant mortality. It's #57 in world rankings; statistically, you'll be better off in any other English speaking nation in the world.

Also note that most civilized nations gives parents some form of child benefit, which is cash in hand you can put towards child care. It's about £100 a month in the UK and €135 per month in Ireland.

You've said nothing about visas, and as mentioned, that is a very significant hurdle. The world is not your oyster.
posted by DarlingBri at 2:41 PM on March 14, 2015 [11 favorites]

May I gently point out that the services you are seeking (high quality pre-natal care, parental leave, and affordable childcare) are extremely expensive and an economic burden to the entire country you plan to visit. You will not be contributing anywhere near that amount in taxes. In effect, you are planning on free-loading on other people's taxes. I would feel differently if you planned to remain in that country and contribute a fair amount for the next generation to also enjoy those benefits instead of planning on moving back to America when you no longer require state support. I imagine most countries have done a cost-benefit analysis and are not overly interested in subsiding an American's expensive prenatal/infant care for a temporary stay. Regardless, I do think there are moral aspects you should be considering. Canada meets many of your conditions and accepts a huge number of New Canadians but it is still usually a years-long expensive process in getting a visa. I know a number of people that have not had visa's renewed suddenly, and had to leave Canada, so the life you are proposing may not have a lot of stability within your control.

Also, you wouldn't be an expat (a word that whites use only to refer to other whites living outside of their birth country) but an immigrant. A lot of people object to the tone-deafness of "expat" nowadays, and you might not want to use it outside of America.
posted by saucysault at 3:11 PM on March 14, 2015 [31 favorites]

Costa Rica
posted by Jacqueline at 3:26 PM on March 14, 2015

Hong Kong fits all of your requirements assuming you live somewhere reasonably inexpensive (surprisingly not difficult if you look beyond the traditional expat areas). Some people here hire foreign domestic helpers to make things easier when they have a first child; however, FDHs earn far less than the minimum wage and are live-in, which causes some ethical and space issues. The air pollution compared to Europe or America is absolutely shocking, though.
posted by mdonley at 3:47 PM on March 14, 2015 [1 favorite]

Though was Saucysault says above has merit, I would not consider two white collar people who are going to at least try to find meaningful work (which also by definition means providing a needed service in that country) as a burden on the system. Many of the best countries for affordable childcare/maternity leave etc have a huge amount of free-loaders many of which come from other countries specifically to leach off government funds without even attempting to look for work. You are not in that same category at all in my book.

The Netherlands meet all your requirements. I think possibly Australia as well. Iceland probably might, (If I remember correctly I think many companies offer free daycare for their workers) but it's still incredibly expensive to live there overall.
posted by rancher at 4:55 PM on March 14, 2015

I'm a u.s. citizen living in Canada as a permanent resident. I applied for permanent residency based on family status. I have friends who came here on a work visa and then went through the permanent residency process. I think it took them about two years from when they applied and the fees come out to about $1000.

Maternity/parental leave differs by province. In Ontario you have to work 600 employment insurance eligible hours in the 12 months before giving birth. You can get up to something like 47 weeks of combined maternity/parental leave. I think the formula is 40% of your salary up to $47,000. Some employers top up to partial salary. It's all taxed.

I get $100 a month for my son. Low income families get more.

Quebec has $7 a day daycare, which is great if you can get a space. Taxes are higher in Quebec but it's usually worth it if you use daycare.

Children born in Canada to u.s. citizens are dual citizens of both countries.

Canada is better than the U.S. but I'm not sure I'd move here specifically for mat leave.
posted by betsybetsy at 7:32 PM on March 14, 2015

Denmark has generous policies in all these areas. You can read about them here. And here is a list of the different ways you can get a visa/residency based on employment or skills. I thought Denmark's benefits were top of the line, though, until a friend who lives there started complaining about how much better things are in Sweden...

One study found that Danes have the best English-language speaking ability for any non-English speaking country. Anecdotally, though, I've heard it is hard to find employment without already speaking Danish or having very in demand skills and making a commitment to your employer to immediately start learning Danish.
posted by whitewall at 7:50 PM on March 14, 2015

As an Australian, I don't have a problem with you going over there and free-loading on my taxes. I live in the US at the moment, and I wouldn't want to give birth here either. I don't plan on having kids anyway, so as long as you guys can secure a work visa there (easier said than done), feel free to take my hospital bed. Go nuts.

(I do agree with others that getting a work visa for most first-world countries might be a bigger hurdle than your post would suggest, depending on what kind of "white-collar professionals" you are. As in the US, you often need to have a job offer in hand to get one, and it will mean extra work, money, and risk on the part of the employer. So I think your plan does hinge on how in-demand your skills and/or speciality [or your partner's skills or speciality] are. Tech or finance? Good. Publishing or media? Probably not so good.)
posted by retrograde at 8:39 PM on March 14, 2015 [1 favorite]

I think what saucysault said was highly inappropriate, as you are not moving to another country solely to give birth, rather you are planning to move to another country for the experience and may or may not have a child while living there (you say you are planning to start a family, but nobody knows how long that will take - for some people it's easy, for others it takes years or never happens). That said, one thing to consider, is that in many European countries, finding a job as a woman of childbearing age is very, very difficult because companies do not want to pay for that year of leave.
posted by echo0720 at 9:02 PM on March 14, 2015 [2 favorites]

I'd say not Costa Rica. From my short time there any welfare system seemed seriously inadequate, the streets are lined with people with all kinds of disabilities forced to beg. Also if you are fair haired and female getting your ass actually grabbed in the street is the commonplace. I will never go back.
posted by tanktop at 1:42 AM on March 15, 2015

You might want to look at Belgium. State support for parents is miles ahead of the US (this is true for all of Europe ), and French is spoken in Brussels and south.

Your problem is going to be finding a job. I'm not aware of any discrimination against women due to their potential motherhood. Actually, maternal leave is mostly paid by the state. There is, however, a huge recession that is not getting better. That said, there are tons of international companies with large offices in Brussels, and if you are able to work out your employment before you go, your visa worries will be minimal.
posted by Steakfrites at 1:59 AM on March 15, 2015

You might want to read this series about parenting in various countries by Joanne Goddard if you haven't already. From there you can do some more investigation.

One thing I'd suggest keeping in mind is that if you are going to move to a country where English is not the main language is that you should brush up on your medical language. I know a lot of people who speak English very well but who get lost with medical terms and other science-y terms.
posted by Ms. Moonlight at 2:42 AM on March 15, 2015 [1 favorite]

That said, one thing to consider, is that in many European countries, finding a job as a woman of childbearing age is very, very difficult because companies do not want to pay for that year of leave.

Just to clarify, companies positively do not pay for maternity leave, the state does. Women are paying themselves forward a benefit which they will repay in taxes later in life. And there is nothing like the kind of discrimination which makes it "very, very difficult" for women of childbearing age to find a job.
posted by Thing at 6:55 AM on March 15, 2015 [2 favorites]

Thing - perhaps I am wrong about who pays the benefit, but I have several highly qualified friends who had a very difficult time finding jobs and were consistently passed over less qualified men in Germany and France. One of them was told "offline" by a potential employer that this is why she wasn't hired. That's why I wrote my comment.
posted by echo0720 at 10:04 AM on March 15, 2015 [1 favorite]

. Also, you wouldn't be an expat (a word that whites use only to refer to other whites living outside of their birth country) but an immigrant.

I've never heard someone living temporarily in another country referred to as an immigrant and this usage is sometimes codified in immigrant (permanent) vs non-immigrant (temporary) visas. I would go ahead and use the term expat for yourself as it is much more appropriate for your plans.
posted by the agents of KAOS at 10:40 AM on March 15, 2015

Seeing as you want to live somewhere politically liberal and secular, you may be interested in a secular and liberal perspective expressed in this this recent article from The Guardian.

I am European and found your question to be so imbued with entitlement to be actually offensive, to the point where I have thought about it several times since you posted it. This reaction isn't really relevant to answering your question though, except under the category of "other things we should consider when it comes to having an American child abroad".
posted by bimbam at 11:20 AM on March 15, 2015 [5 favorites]

As a US citizen who lives in Europe ( Ireland ) for much of the year I think a number of excellent points have been raised. Currently Europe,has fairly high unemployment, is struggling with "medical tourism" from both within and outside the EU and is increasingly scrupulous regarding the granting of visas and temporary/permanent residency. As a practical matter I would encourage you to consider the following: 1) having difficulty securing an appropriate visa without an employment commitment, 2) unless you are very highly skilled (or in demand--nurse, physician etc) having difficulty finding employment, 3) you should plan on buying private insurance at least one and possibly two years prior to needing it or paying cash, (4) You will need to have proof of sufficient funds and/or insurance to cover all medical expenses. My experience is that primary care services are generally very good throughout Europe--however--the quality of specialty medical services varies dramatically from country to country and with in a country. I admire your interest but I also agree that "coming to live for a couple of years" is much more complicated, costly and potentially burdensome on your host country than one might imagine. Continue doing your planning and saving your money.
posted by rmhsinc at 11:59 AM on March 15, 2015

BTW--I have no idea what you might call yourself. I would think if you are successful in this venture you could refer to yourself as an 'ex pat" when talking with fellow US citizens and as a temporary resident in your host country--you would not be an immigrant. I am not sure where this 'white" thing came from nor do I understand the "tone deafness" of the word ex pat. You are only an ex pat from your country of citizenship and when referring to your status as a US Citizen. I think of myself as a guest in my host country and am there as a temporary resident.
posted by rmhsinc at 12:17 PM on March 15, 2015

OK so just taking your questions in turn:

- English-speaking or with a high proportion of English speakers: Ireland. We speak English and Irish. You can send your child to an Irish-speaking school. He or she will become bi-lingual, which will be wonderful for later language learning and harm his or her English not at all.

- High-quality prenatal care: I covered this briefly above but as soon as you have a visa ("leave to remain") you qualify for a Personal Public Aervice (PPS) number and have full access to public healthcare. If you wish to give birth in a hospital, the maximum cost will be €750.

- Reasonable maternity leave: 26 weeks paid, and an additional 16 weeks unpaid if you would like them.

- High-quality, affordable childcare: I can't really speak to this issue except to say that au pairs are plentiful because of the European Union.

- Relatively politically liberal and secular: I get that this is often a new concept for Americans, but almost every Western nation's conservatives are more liberal and more secular than the US liberals. Like, the spectrum is thus:

[LIBERAL] Mainstream European Parties > US Democrats - US Republicans [CONSERVATIVE]

There are exceptions to this with the occasional whacky pockets of National Front representation in France, for example, but it can pretty much be assumed as the defacto political setting over here.

In Ireland we are in the midst of sorting ourselves out over abortion, but the country is in fact very progressive and we're about to pass same sex marriage.

Note: if liberal politics are important to you, I would stay out of Australia because Tony Abbott is somewhere between a Republican and a Tea Partier and doesn't believe in global warming or you know, science.
posted by DarlingBri at 1:09 PM on March 15, 2015 [2 favorites]

Thanks, all, for these very helpful responses (including those who brought up the moral and ethical issues of such a move, which will certainly be considered). Lots to think about. Please note that we’re not trying to go abroad to “free-load” on others’ taxes; rather, this window of opportunity in our respective careers is coinciding with an understanding that if we want to start a family, it needs to be relatively soon, and if we’re going to take the leap of living elsewhere, we’d prefer it be somewhere our future child could get a strong start. Believe me, I would happily pay higher taxes in the US for a more supportive infrastructure for new parents and a stronger social safety net.

In terms of questions about visas, I decided to leave out identifying information about our jobs, but rest assured we understand that getting a work visa is not a walk in the park.

saucysalt and others, please know that I meant no offense by the term “expat” (there are over 200 other questions in the archives tagged this way). I will reconsider whether to use this language in the future and have added tags for “temporary resident,” “immigrant,” and “immigration."
posted by Synesthesia at 6:19 PM on March 15, 2015

Speaking as an American raising two young kids under age 3 abroad, I don't think you really want to be doing this. How's your extended family going to fit into this? It's when you're struggling with the constant crying/messiness/sleepless nights that you really need a mother-in-law or sister to come by with some homecooking or new toys and to look after the kids for a few hours so you can partially try to recover some sanity. How can you do that if they're in, say, SF and you're in Denmark or Hong Kong?

Do you really want to be dealing with visa hassles when you're trying to nurse a two-month old? It's hard enough trying to navigate a new country or a new company culture when you're young and childless. But add in all the stress of trying to take care of an infant?

I'll be blunt. There are certain advantages to living in some typical "expat" cities like Dubai or Hong Kong. With the extreme income inequality, you can get a live-in nanny or once a week maid cleanings for crazy cheap.

If you're really that pressed for time biological clock-wise (you don't specify how old you are), I think you've got to make a hard decision and choose one or the other.
posted by alidarbac at 12:05 AM on March 16, 2015 [1 favorite]

I'm a Canadian who's immigrated to the UK. We had our first child in Canada, and the second will be born this summer in the UK. Both countries are fairly comparable in terms of ante(pre)-natal care, social programs, and leave. Hopefully some of the following is helpful:

1. Immigration is a massive hassle in and of itself. My husband is a dual citizen, so our son and I came over to the UK on a spousal/dependent visa. He still had to prove he had sufficient assets to support us (at least £15,000 in savings per spouse/dependent). When we landed, until we received our "Indefinite Leave to Remain," we had the condition of 'no recourse to public funds.' This means while we could use the NHS for our healthcare, we were ineligible for other National Insurance funded benefits, such as unemployment if I had a job loss, and I think that may cover statutory maternity benefits as well. Because of recent rule changes, there is a long wait (5 years) to be eligible to apply for ILR. I do not know what kind of access to funds/benefits you'd get on a limited length visa.

2. Paid leave in both countries is reasonably comparable, though it's not all sunshine and roses. In each country your job is protected for about a year if you wish to take your full leave period (most people do). Except that leave may as well be unpaid. You do not get your salary for that year, you get a percentage of it, up to a paltry maximum. In terms of 'white-collar professionals' you can probably easily conceive of spending your week's "maternity pay" on a single pre-baby night out. In Canada it's about $180/wk. In the UK it's about £130/wk. Some employers will top that up, but it's rare. And again, if you're not a permanent resident/ILR holder, you may not be eligible for either.

3. The UK has a very nice set of workplace laws that make being a parent a lot easier than I found it in Canada. Part-time work is much more common here (though not always easy to get), and every employee has a right to request flexible work arrangements, such as working from home or compressed hours, etc. Officially your employer has to prove it'll cause material harm to the business to say no, but in practice, this really depends on what kind of job you have, and how valuable you are to your employer. As a white collar professional, you probably have a pretty good shot. Every parent of a child under 5 may also take up to 18 weeks off unpaid (max 4 weeks in a given year) to spend time with their kids, without losing their job or suffering a penalty.

All that said, I find European countries in general (of which the UK is the least European) to be much more pleasant places to have young children than I did in Canada (and from what I hear, in certain US cities). I've experienced much less 'side-eye' and 'us-vs-them' in terms of parents vs. non-parents.

And I currently live in a university city, with a very transient population of non-citizens. There are loads of support groups/networks available for parents, and a range of private services for those who don't qualify for public systems. If you aim yourselves similarly, you'll probably find that, even if you need to pay for it, the logistics of having a kid abroad aren't too bad.
posted by jennyweed at 10:25 AM on March 16, 2015 [1 favorite]

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