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If you’ve followed our international adoption story, you may already know pieces of this adventure. But today, I’m sharing the full journey, including the most unexpected twist of all: discovering I was pregnant while waiting to bring home our daughter from South Africa and ultimately giving birth abroad during our adoption travel.

Yes, you read that right… I gave birth in South Africa while finalizing our daughter's adoption. It wasn’t part of the plan, but looking back now, I wouldn’t change a thing.

Starting Our South Africa Adoption Journey

When we signed our adoption paperwork back in May 2019, we acknowledged one important clause: getting pregnant could delay or disrupt the adoption process. At the time, it didn’t seem relevant. We were focused solely on adopting a child and welcoming them into our home.

After years of waiting, we were finally matched with a beautiful two-year-old girl named Lowina. We spent months preparing, from baby showers to packed suitcases, eagerly awaiting the call to travel to South Africa.

A Surprise Positive Pregnancy Test

In September 2021, after a few days of feeling off, I took a pregnancy test... then another... and another. All positive. I was shocked.

I called John to come home. This is typically an incredibly exciting time for most future parents, but all I could think about was Lowina and the form that we signed years ago when we started the adoption process.

The first call wasn’t to my OB. It was to our adoption agency, because we had no idea how this surprise pregnancy would affect our adoption. The agency told us they needed time to review the situation and reminded us once again that pregnancy could derail the entire process.

Those initial 48 hours of waiting turned into weeks of uncertainty and stress. But finally, after writing letters of commitment and waiting for approvals from both our U.S. and South African agencies, we were told we could move forward, now with two children on the way.

Planning to Give Birth Abroad

We were told to expect to spend 6–8 weeks in South Africa to finalize the adoption, but just one week before our departure, our agency informed us that the stay would now be at least three months due to policy changes.

With a mid-May due date, we had two options:

Postpone travel and meet Lowina after giving birth in the U.S.
Travel immediately and give birth in South Africa.

My heart was set. We were going to South Africa and would figure the rest out along the way.

Finding Prenatal Care in South Africa

Giving birth abroad wasn’t in my original plan, but I quickly dove into research. We learned that private hospitals in South Africa are the preferred choice for higher-quality maternity care, and we also discovered a third option: birth centers.

That’s when we found Blissful Births, a mother-daughter midwife and doula team operating a private birth center in Johannesburg. One WhatsApp call later, we were sold. Their warmth, professionalism, and flexibility made us feel completely supported from across the globe. One of the best decisions we made!

Healthcare & Insurance Abroad

One challenge we faced: our U.S. health insurance didn’t cover international care, and John’s plan didn’t allow me to join mid-year. We looked into private health coverage in South Africa, but it wasn’t cost-effective for such a short stay.

Instead, we paid out-of-pocket, and shockingly, the entire birth experience, including prenatal care, birth, postpartum support, and even placenta encapsulation, cost less than $2,500. That’s a fraction of what we would’ve paid in the US with our high-deductible plan.

From Adoption to Antenatal Appointments

We arrived in Johannesburg in February 2022, exactly one year after our adoption shower, and soon after, we finally met our daughter Lowina for the first time. A few weeks later, we shared the news with her that she would soon become a big sister!

Our first antenatal appointment in South Africa included exercise classes, birth prep, and meeting our entire care team. Blissful Births became our support system, our home away from home.

Babymoon in Cape Town & Final Preparations

At 34 weeks, we took a quick babymoon to Cape Town, our last trip as a family of three. Blissful Births had to rush over a doctor's note just minutes before our flight gate closed so I could travel.

As my third trimester progressed, we shifted into full-on prep mode. We attended weekly checkups, practiced birth affirmations, drank raspberry leaf tea, and prepared for a natural birth in South Africa.

When John had to fly back to the U.S. briefly for work, I had my first solo OB appointment, and thankfully, I survived my first experience as a single mama plus Ellie stayed cozy until he returned.

South African Birth Plan: Natural Birth at Blissful Births

We were 100% ready: backup hospital, private gynecologist, birth supplies (including our own U.S. infant car seat), and even childcare arranged for Lowina during the delivery.

On Mother’s Day, I soaked up the special time with Lowina, our last as a mom of one.

Then, days after my due date, the real contractions started…

Labor & Delivery in South Africa

We arrived at the birth center early in the morning after a night of growing contractions. After confirming I was in active labor, John took Lowina just a few steps away, in our doula’s home where she stayed with their nanny and kids.

Labor was intense and emotional. After hours of little progress and intense nausea, I suddenly jumped from 4 to 9 cm. I moved into the birthing tub and, after 20 minutes of pushing, Elizabeth Grace was born at 4:39pm.

The experience was painful, empowering, and beautiful all at once.

Postpartum in a Foreign Country

We cuddled in the tub, cried tears of joy, and transitioned into a cozy recovery room that night. Lowina came in to meet her new baby sister, now officially “Sissy.” Watching her hold Ellie for the first time remains one of my most cherished memories.

The team brought us dinner (butter chicken and champagne… yes, you read that right!) and ensured we had everything we needed for the night as a family of four abroad.

What I Learned Giving Birth Abroad

Looking back, I brought way too many supplies from the US, but I’m still glad I had my Frida peri bottle and US car seat with chest clip (which aren’t commonly used in South Africa).

The entire process from prenatal care to the birth itself felt like a deeply personalized, community-driven experience. I wasn’t just a number in a hospital system. I was cared for, seen, and supported by women who walked alongside me every step of the way.

And the best part? We brought home two daughters, both forever tied to their birth country of South Africa.

Would I Do It Again?

Sheesh… loaded question… Absolutely. And in some ways, we’re doing a portion of it again with a second adoption in process (however, we won’t be pregnant this time!).

Giving birth in South Africa wasn’t the plan, but it was the story we were meant to live. And now we get to tell Ellie that her birth was part of a much bigger journey, one filled with love, courage, chaos, and connection.

From a surprise pregnancy during adoption to giving birth in another country, this was our greatest adventure yet.

Have questions about giving birth abroad or traveling for international adoption? I'm always happy to chat and share what helped us navigate the wildest season of our lives.

Our Surprise Birth Abroad: Giving Birth in South Africa During Our International Adoption Journey