Baby Abroad: First Steps

IMG_2874Photo by Mollie Pritchett I'm sure most of you have noticed that the blog has been a little quiet the past few months. It's mostly because the weather has been unbearable and thus we aren't out to take lots of photos. It's also because we're really enjoying these low key months before our new addition arrives (tentatively scheduled for September :-)

However, I have put off for far too long writing a post about everything we needed to do during the first few months of the pregnancy. I think it's valuable information to share for current and future expats that find themselves pregnant in Italia. Having a baby in Italy as an expat is definitely a unique experience. A few disclaimers before we get started...

  • It's important to note that healthcare -- like most social services -- is incredibly regionalized here in Italy. That means the information that I share below is, to my knowledge, how things operate in Tuscany. I cannot speak for any other regions, so be sure to check with your local ASL/USL if you're a pregnant expat!
  • This is based entirely on my experience. People with more Italian fluency or knowledge of the "system" might be able to chime in on shortcuts or other benefits that I don't even know about.
  • Just stating the obvious: I am on the national health system here in Italy. I don't know what services are or are not available if you find yourself pregnant here and not in the system.

Step One: Confirm Your Pregnancy

In order to get your libretto di gravidanza (which I'll explain in a minute) and on to the pregnany lady healthcare track you need to formally confirm your pregnancy. This can be done in a few ways. First, easiest and cheapest, is that you can get a "prescription" for a urine or blood test from your primary doctor, go to the ASL, get your test results and use that as your confirmation. It just so happened that the lab at the ASL near us was closed during the week we wanted/needed the confirmation. We probably could have gone to a different ASL, but this was during the crrrrazy cold snap we had earlier in the year and the thought of venturing that far from home was not an option. As such, we went to a private OB-GYN, he did an ultrasound, and was able to confirm that I was indeed pregnant. Even though it cost money, it wasn't such a bad thing because we got to hear her little heatbeat! Long story short: you can't walk into the ASL/USL (see below) with an at-home pregnancy test...we tried.

Step Two: Get Your Libretto di Gravidanza (aka Pregnancy Booklet)

For first-time parents like Rob and I, nothing was more amazing than getting the libretto di gravidanza. It is a little booklet with "coupons," for lack of a better word, for all of the standard tests and appointments that you should have. During the course of your pregnancy, a test or appointment may lead to additional things not listed in the booklet -- but, the booklet sets the standard course for the 40 weeks. Aside from one extra test we did very early on, we've stuck strictly to the libretto.

The libretto is great because it gives you week ranges for all of your tests. You know exactly when do go in for tests and/or when to make appointments. Because treatment is standardized it gives you a sense of comfort that you are doing things "right," and you don't worry like you might in the US when you hear that someone has had X number of ultrasounds or blood tests and you haven't.

One very particular piece of advice for fellow expats pregnant in Florence: make all of your ultrasound/ecografie appointments right away. The super nice woman that issued our libretto did it for us that day, so we didn't have any trouble. I've heard that if you don't book your 1st, 2nd and 3rd trimester ultrasounds right away, there won't be any space left. Yikes!

Step Three: Take All Tests and Go to Your Appointments

It feels like I live in the local health center, but once a month I go for lab tests and once a trimester I go for my ultrasounds. At least at the health center I go to, pregnant women are able to skip the line -- anyone with experience in an Italian government office can explain how amazing this is! The lab test results come back fast and I share them with my doctor.

I found out later from a pregnant friend that you can be assigned an OB-GYN to review your results with you once a month. I didn't know this, but I'm very happy with what we've been doing instead. Since everything associated with the pregnancy is free (yes, free! Ok, ok, I pay taxes here so it's not really free), we splurge and go to a private doctor every 6-8 weeks. He speaks English, so it allows us to get clarification when needed. If something is even slightly off with a test result we can ask him about it.


So, there you have it...the first steps to take when pregnant abroad in Italy. I'll do another post about selecting a delivery hospital, preparing for the birth and having the baby, well...once we've checked that final item off the list!

Before I go, I want to share a few random observations about pregnancy here in Italy:

  • Doctors are very strict about weight. Don't gain too little and don't gain too much. Americans used to politically correct doctors (aka, that wouldn't call a pregnant woman fat) might find this a little jarring. My doctor asked me if I planned to gain weight like an Italian woman or an American woman. It was important for him to know, but funny for me to hear. Thankfully, I've gained like an Italian woman -- I thank my baby daily for this.
  • In Tuscany, it's free to have a baby. For some of our non-American expat friends, this doesn't have the same novelty. For us, it's amazing not to argue about copays and fork over money at every visit. The only test we had to pay for was the one that wasn't included in the libretto and it was only 30euro.
  • Milk the bump for all it's worth. People here love and appreciate pregnancy in a way I can't explain. I get skipped to the front of the line, priority at places I never thought possible and offered seats on the bus by people that overlook the 90-year old nonna holding on for dear life nearby. It's awesome, I can't lie.