I live in a foreign country (in the middle of a 5 year contract) and we are unexpectedly pregnant with #3
The only options available in my city are a hospital delivery with an OB. In general, healthcare in this country is not good and there are only 1 or 2 hospitals where most expats who stay in country deliver (a lot of expats go home). The best hospital here has a 40% c section rate (expats often have money and insurance so are good candidates for c sections), constant fetal monitoring, and absolutely no visitors under age 12 (which aside from the fact that I hate the idea of being away from my older 2 for 2-3 days, because we are away from family and community I don't know what I do with the kids - my DH would have to be at home with them which means I'd be in the hospital by myself).
I had a natural hospital birth with DD and a birth center waterbirth with DS. I don't think I'd be so conflicted if my birth with DS wasn't so much better than my hospital birth. I know many laboring women don't care about modesty but I hated feeling so exposed in the hospital, and I loved how in the birthing tub I could wear a bathing suit top and feel "covered" - it felt so much more dignified to me (not to mention the pain was so much more bearable in the water) and when I visited the hospital here and imagined delivering on the table exposed under bright lights as a very conspicuous foreigner it made me want to cry.
I could convince my organization to send me to a neighboring country where I could deliver in a birth center waterbirth, or possibly even to the US, but that would mean 2-3 months minimum away from home, pulling my older two out of school, being away from our current community, not being with DH the whole time (he wouldn't be able to get enough leave to be with us for the whole 2-3 months), etc. So I'm trying to decide if the 24-48 hours of a better labor and delivery is worth the extra hassle of being away from home for so long (I'm the kind of person who enjoys traveling to a degree but I don't like staying away from home for a long time)
There are no midwives I can find here who will do a home delivery because electricity is not consistent (though we have battery inverters so wouldn't be an issue in our house), and there is no good emergency back up. Traffic is terrible and people don't always make way for ambulances so the trip to the hospital could take a while (any where from 10 mins to an hour plus), and if I arrive at the hospital on a Sunday or in the middle of the night they may not have full staffing and may not be able to attend to me immediately.
I do know of a midwife from a neighboring country who is open to the idea of coming to do a home water delivery but not sure how I feel about a homebirth in this context. (we know the midwife well and we really trust her skills). I don't think I would be able to tell my family I am planning a homebirth because they are already so worried about me delivering here and would be worried about me having a homebirth even in the US. I don't like the idea of hiding this fact from my family until after the baby is born but I don't think I would ever be able to convince them it's a good choice and will cause my mother especially so much anxiety.
Feeling discouraged about my options is putting a dark cloud over this whole pregnancy. I'm 20 weeks and having trouble feeling excited because I am just stressed about how this baby will enter the world. My expat friends who have delivered in the hospital here think I'm making too big a deal of it and the hospital here is just fine, but I felt so unsettled when I visited last week and I left the hospital visit in tears.