Every year around this time my family and several of the families I grew up with take a long trek and cross the Canadian border for a ski vacation together in Canada. We cherish being able to spend time together, and it’s become a family tradition for over a decade.
Because of that, I thought that I was pretty familiar with the border crossing process. However, this is the first year that I have crossed the border being visibly pregnant, and since I always like to be prepared for the “just in case” scenario, I made sure to throw in an extra car seat and a few essentials in case of this baby coming early. I called our insurance to make sure we were covered in case of premature labor and birth in a foreign country, and I even called the American Embassy in Vancouver to make sure I had all my ducks in a row in case the baby was born early. So I was really surprised when we were asked to come inside the office at the border crossing and even accused by a rather rude border patrol agent of attempting “birth tourism”. When we left the border and returned to the USA I was fuming. I was upset because even after all the research I did I had no idea of just how much documentation the border control agent could and would request, and I was angry that they assumed that because I am in my third trimester and wearing maternity clothes that they said “the baby could come any day now” and described me as “really pregnant”.
Thankfully for me my husband is just as stubborn as I am but much more patient. We stayed the night in a hotel about an hour from the border and in the morning he called the supervisor at the crossing we had been to the night before. The supervisor was great, he gave us time to explain what happened, ask questions, and ask what would be required of us if we were to try to cross the border again. We felt encouraged by his help and started to get together all the possible documentation that we thought could be requested by border patrol.
When we came back to the border we had to be directed back to the office since we left without entering the last time. We worked with a different agent who was much more professional and reasonable. He felt that the question of whether or not our insurance would cover the cost of a premature labor and delivery was not clearly enough defined in the documentation we provided, so he let us talk on the phone with our insurance and eventually we ended up putting them on speaker phone so that we could all better understand what was needed. As always, getting a direct answer from an insurance company was nearly impossible without being put on hold, transferred to a different department, etc. Eventually though (4.5 hours AFTER we started), we were able to provide sufficient documentation to support the fact that we were indeed covered in the case of a birth, and we were able to enter the country.
It has taken me a few days to calm down from the stress of the situation, but now that I have I think it is a great opportunity to provide you with a few tips on traveling internationally while pregnant so that YOU hopefully will not encounter the same situation that I did.
1) Talking to the US Embassy in a country may not be enough to be prepared. If you speak the language of the country you want to enter, try to contact a representative of their border patrol/customs/immigration to get a better picture of what type of information you might be asked for when crossing.
2) Make SURE your insurance covers birth in a foreign country. This is the MOST important! Many western countries such as the US and Canada have travelers who enter the country specifically to have birth in their hospitals and then leave the taxpayers to foot the bill when their insurance won’t cover the cost. Because of this, just having verbal confirmation from your insurance may not be enough to enter the country, so make sure you have it explicitly spelled out in writing. This type of documentation may take weeks or more to process, so make sure to start working on this early on.
3) Have a signed doctor’s note approving you for travel. This note should have a number for the doctor to be reached at, and should also include your estimated due date and the doctors recommendations for when you should cease to travel.
4) Be prepared to show that you CAN pay in case of a preterm birth. At one point during our first encounter with border patrol, the agent mistakenly thought that our insurance would not cover a preterm birth and so we were told that we should not reattempt to enter the country without a bank statement proving that we had at least $50,000 in cash to pay for a birth without insurance. When we were able to prove the next day that we were covered, we still had to provide documentation that explained at which point our insurance would step up to pay. Their main concern is to make sure that the country’s taxpayers will not be liable for ANY of the medical bills.
5) American insurance is confusing, and the agent may not understand terms like “deductible” and “out of pocket maximum”. Make sure that your documentation clearly explains this.
6) Be prepared to prove ties to the US. While we thought this was a strange request (shouldn’t US Passports suffice?) we were asked to provide something else, such as proof of home ownership or statements for electric bills.
7) Be ready to show proof of reservations in that country. We clearly explained that we were headed to a family ski vacation, but because they suspected we might be crossing the border for other reasons we needed to provide proof of reservations.
8) Not everyone is knowledgable about pregnancy and birth. You’ve probably learned this already, but there are many people who will treat you like a ticking time bomb when they find out you are pregnant. Some people consider pregnancy to be a huge risk, and will treat you differently because of it. Be prepared for the common misconceptions ( like “Pregnancy is 9 months”). This can be extremely frustrating, but keep in mind that losing your head and arguing is NOT going to help the situation.
9) Protecting citizens and tax payer interest is the main objective of a border patrol agent. While a good agent also can work reasonably to encourage and support commerce, do not expect that just because you have or will be spending lots of money in that country that it in any way will change their decision when it comes to admittance.
10) Every agent you encounter has their own agenda. Some may be “nice” or “mean”, others can be cooperative and reasonable. Some may be trying to prove themselves. You never know who you are going to get, so it is important to be as prepared as possible. If you feel like you are being mistreated or that the agent is acting in poor conduct, you can always ask for a supervisor to be present.
I sincerely hope that my experience can help provide some clarity and information to others. I am very grateful to all of those at border patrol who were so kind, patient, and helpful during the time that we were there, and especially to the agent who gave my toddler a sticker while we tried our best to entertain her in the office. I really appreciate what they do, and I promise that next time I cross the border I will be much better prepared!