While becoming a mother for the first time is wonderful, it’s also a period of major upheaval and exhaustion – something which can be compounded for emigrants.
For Louisiana-based Co Dublin woman Heather Langran, not only had she to navigate the major differences in the United States health, maternity leave and childcare systems, but she was also grieving her father.
Her Dad died exactly a month before she gave birth, last November. She had decided not to travel home to see him late in pregnancy. “I knew deep down, and my Dad was adamant I needed to stay.” Langran watched his funeral online. “It was like observing from the sidelines. It was a very strange experience.”
The trained dental nurse is married to a US citizen and has been living in the US for five years, based in a small city in Louisiana close to the border with Mississippi.
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While some American friends had told her about differences in how things are done there, she readily admits, “I didn’t know tons”.
For her, seeing the final itemised hospital bill related to giving birth, at €30,000, was a shock. “You assume everywhere is like Ireland. It surprised me when I realised how expensive things are. I know going to the doctor in Ireland isn’t always cheap, but when I saw the itemised bill, I thought – that is crazy.”
Luckily for Langran she had health insurance from her employer, which brought what she had to pay out of pocket to a few thousand dollars. The average cost of pregnancy, delivery and post-partum care in the US averaged $20,000 (€17,500) in 2023, rising to $28,000 for C-section delivery, according to a Peterson KFF Health System Tracker. The average amount paid out of pocket is $2,800. In 2021, about half of women in the US giving birth had private health insurance and about 40 per cent had public health insurance Medicaid, according to the CDC National Center for Health Statistics.
The Donabate woman’s care from doctors and the hospital was, she says, “really good”. There were also some unusual differences: “They gave us a birthday cake the night Kilian was born – we got a menu to choose from, and two cakes going home. It was kind of bizarre. I was so exhausted and spaced out.”
When it came to maternity leave Langran was lucky getting 12 weeks, six weeks paid and six weeks unpaid (short-term disability cover). But Langran explains each state is like a different country when it comes to leave, and her cover depended on what her employer was willing to offer.
“I was lucky I was working for a really nice company. They were really good to me. They gave me time off to go to my appointments.”
‘I always tell people, you need to go to Ireland to experience the Irish. What they do when you need them is wonderful. From people you don’t know to people you know really well’
There is no national entitlement for paid maternity leave in the US. In Louisiana, a pregnant employee is entitled to six weeks of unpaid leave and up to four months where they are disabled because of pregnancy-related issues. Many employees are eligible for 12 weeks of job-protected unpaid leave under federal law. There is no entitlement to paid antenatal appointments. This is in sharp contrast to Ireland, where women are entitled to a minimum 26 weeks of statutory paid maternity leave, 16 weeks of unpaid leave and all hospital appointment time covered.
Langran’s postnatal recovery was “difficult”. “I ended up having three epidurals and found it hard to walk. The first six weeks were a fog,” she says. This period compounded the grief she experienced over her father. “The sleep deprivation made me miss Dad more – for much of the day the only person I had to talk to was non-verbal.”
Returning to the office just a few weeks after giving birth can be “really hard mentally” for some mothers, says Langran. Other mothers “really leaned on family, which helped them go back to work”.
“When I got to the end of six weeks, I couldn’t imagine going back [to work]. I was only coming to normality. Luckily around that time my Mum arrived.
“Once my Mum arrived I knew I could fall apart, now that she can pick up the pieces. If you aren’t from Ireland you won’t get the value of an Irish mammy. They are a breed all of their own, the greatest gift.”
Having her mother helped her recovery, with assistance on practical things such as meal prep and emotional support. “We were able to grieve together and it gave me confidence to keep going. So by the end of 12 weeks I was back to normal.”
With her leave entitlements up, Langran went back to work for “a little bit” when Cillian was a few months old. She struggled to find childcare, however. “Some places won’t take them so young. A lot of places were full or very expensive.” Langran couldn’t find an option close enough to home. “So I took a break from working to be home with Cillian and I’d like to go back to work when he’s a little older.”
The existence of “childcare deserts” (areas of the US experiencing a critical shortage of licensed childcare) is a major issue, particularly in rural parts and majority black/Hispanic areas. An average of 46 per cent of US children under 6 live in a childcare desert, the Center for American Progress says.
Living away from home after having a baby, Langran says she missed the Irish sense of community. While there are some church groups in her area, she’s not in a big city, and a lot of mothers work, so there are fewer mother-network opportunities.
“I always tell people, you need to go to Ireland to experience the Irish. What they do when you need them is wonderful. From people you don’t know to people you know really well. I missed that sense of community and where they rally around.”
But she sees the timing of her son’s birth as a “gift” and in a strange way “perfect timing”. “It was something for my Mum to invest time in... it just lifted eveyone’s hearts when he was born.
“Grief is a strange thing. It catches you off guard,” she says. While they celebrate every little milestone of baby Cillian’s development, they are “a reminder of another month without Dad”.
Langran is looking forward bringing Cillian home for the first time this summer. “He has every bit the personality of my Dad – so happy and cheerful. Sometimes I look at him I just see my Dad, even though the two never met.”
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