Choosing to give birth in a developing country


“I don’t ask you for much, but I’m asking you for this.”

The words my sister had written were blurring together on the page. She wasn’t asking for money, or one of my kidneys…but something that she had deemed just as important. It didn’t matter though, because I had made up my mind. I was six months pregnant and had decided to give birth to my baby on the other side of the world, on a small island in the Indian Ocean – Sri Lanka.

Suffice it to say, my family and my partner’s family were extremely vocal in their discontent. “You live in Canada,” they said. “The healthcare is amazing here.” It’s true that the Canadian healthcare system is widely regarded as one of the best in the world. Loosely based on a socialist view, healthcare is free and accessible to all regardless of status, class or creed. In fact I don’t think I would be sitting here writing this if I hadn’t had access to free healthcare throughout my life.

So when we thought about having the baby and how we would fit it in to our busy, world-traveling lives, the choice seemed easy. Stay in Canada. First, I called a midwife. I’m a big proponent of natural childbirth and had always assumed that I would deliver my child in a birthing centre. The first midwife collective I called was booked up. So I called another. And another, and another. In fact, I called every midwife collective in the downtown Toronto area and was put on eight waiting lists. After asking around, I discovered that the general rule of thumb is pee on the stick, call a midwife. Meaning that if you don’t call right away, you won’t get one. It has been 7 months now, and I have still not received a call back.

Okay, I thought, I’ll just find a progressive, holistic-minded doctor. Easy-breezy, in a liberal town like Toronto. Hmmm. Couldn’t seem to get an appointment. So I sucked it up and decided to try to locate a doctor out of the city. I found a woman who seemed very sweet, at first. But when I mentioned that I wanted a natural birth, she visibly shuddered. I’m not kidding, she turned her back to me and I saw her shoulders shake.

After more research I discovered that even if I had found a fantastic doctor and spent nine months developing a relationship with her, there would be no guarantee that she would be the one to deliver my child. It really comes down to whoever is on call on that specific day. This made no sense. Did I really want a stranger to guide me through the most important day of my life?

I decided to meet with a doula, to ease my woes. She shared even more shocking news. There are no birthing centres in Toronto. None. Also, water births are not allowed in hospitals. Another fact? Ontario has the highest incidence of C-sections and epidural deliveries in Canada. I was told that when I go into labour it would be important to wait until the last minute to go to the hospital, otherwise they are likely to induce the birth. The doula told me that she once heard a nurse say to a labouring mother, “You’re here to give birth, not to labour.”

Lastly, I spoke to a friend who is an ER doctor. Many things were divulged, but there was one important fact that could not escape my attention. Ontario doctors do not get paid unless they are present at the time of the delivery. So if you come into the hospital and labour for 13 hours, right through one shift and into another, only the doctor who attends the actual birth will be the one who gets paid. The more research I did, the more I realized that having a baby in Canada has become about money and time.

We were astounded. My partner had a home in California, but I was not insured. It would have cost us upwards of $40,000 US to deliver there, and that’s as long as everything went smoothly.

So we went to Sri Lanka on a work/leisure trip, intending to do similar research over there. We entered the private health care system and found that a birth would cost us about $3000 CDN. Each visit to the doctor cost us $10 CDN. So far, so good. After asking around we found a doctor who had helped several friends through difficult births and also happened to be the head of the Obstetrics and Gynecology department at the University. We made an appointment that week to see him.

Sri Lanka has many large fully-functioning hospitals and several small nursing homes which serve as a type of birthing centre for mothers and moms-to-be. The one we arrived at was simple and sweet with beautiful gardens surrounding it. The doctor was incredibly affable and direct. He believed in what he called a non-violent birth, with full communication. Music to my ears. In 17 years he had only sent four women to the neighbouring hospital with birth related complications.

I was in love and completely placated. Not only were we able to spend time in an island paradise, but we had found a doctor and a hospital that put the labouring mother’s needs above all else. My partner and I are were thrilled with our decision. Our families of course, took time to come around.

It’s hard in Canada to see past our reputation. I love this country and am proud to be a Canadian. But I think it’s important to see the faults in our system. All these little idiosyncrasies about the obstetrical practice are overlooked and therefore come as a shock to many expectant mothers. While delivering our child in a small, impoverished country may seem like a radical choice, it was actually an informed one.

Like any mom-to-be I still have anxiety about going into labour. It is the great unknown, the uncontrollable. But every time I have a doctor’s appointment now, I leave feeling calm, informed and ready – a big step towards the kind of birth experience that I believe every mother should have access to.

Maya Bastian is a dreamer by nature, a wanderer at heart, and an artist when the inspiration strikes. She writes for online magazines such as and HoneyColony. After a decade working as an award-winning filmmaker and video artist, Maya left Toronto and started traveling the world in search of further insight and enlightenment. Currently she is developing her first feature film and raising her four-year old daughter to be tough, beautiful and proud.