What are the Unique Challenges of Infertility, Miscarriage, and Stillbirth Overseas?

Apr 25, 2024 | 2 comments

Today, we conclude this four-part series on birth overseas by Chandler Gilow of The Global Birth CoachWe know that infertility, miscarriage, and stillbirth are hard anywhere in the world, but there are unique challenges to them overseas. Chandler ends our series today by educating us all on this disappointing reality. Here’s a summary of the series:

Having a Baby Overseas: A Chat with Chandler Gilow (Read here)

How Do you Prepare for Birth Overseas? (Read here)

What does Dad Need to Know about Birth Overseas? (Read here)

What are the Unique Challenges of Infertility, Miscarriage, and Stillbirth Overseas? (Read below)

If I’m being honest, I did not think much, if at all, about infertility and pregnancy loss when I started The Global Birth Coach because I had not had any personal experience with it. Within the first year, though, I met many mothers who shared their stories of loss and loneliness with me, and I realized how uniquely painful it is to go through these situations while overseas. 

LaDonna Cunsolo is one of the mothers who allowed me to ask questions and lovingly corrected me along the way. She has partnered with me as a coauthor in this article as I continue to learn and grow. I am thankful for her openness and desire to support other families. Infertility, miscarriage, and stillbirth are devastating, potentially isolating incidents no matter where a family is located. 

However, living in a host culture can add additional and different layers of grief to each situation. While I still have a lot to learn, I want to share the knowledge I’ve gained so far, to help others who, like me, may be unaware of the invisible suffering of those around them. Each family’s journey is different, but as we learn to understand the specifics of each situation, we can use that understanding to love and support those around us.

The families involved in each scenario listed below share the experience of grieving and possibly grieving away from their strongest support system–those who have known them for the longest time and understand how to provide the best support. It can be difficult to open up to new people while grieving, yet in many cases, being vulnerable to strangers is the only option to receive in-person support and comfort. Another challenge of grieving outside your passport country is that you may receive comfort and support from the community differently than you are used to. You may also be unfamiliar with the local customs and protocols surrounding grief and pregnancy loss. Many cultures still have outdated misconceptions about fertility and pregnancy, which can lead to unintentionally hurtful comments or questions. 

Each situation has its own nuances, so a basic understanding of both the terminology and common struggles can broaden our perspective and help us better reach out to those experiencing grief.


Infertility can be a complex issue to define. Some couples arrive on the field already aware of the potential fertility challenges they may face. Others may discover after arriving on the field that conceiving a child will not be as straightforward as anticipated. Still others encounter secondary infertility after quickly conceiving before. In any of these situations, I recommend that couples share their feelings honestly with their local support team. 

The desire for and lack of a child is a profound and enduring sadness that both parents carry, and it can affect their relationships with others. A support team who knows about the situation can offer comfort, support, and prayers. To the support team of this couple, it is crucial to understand that infertility will have an impact on every aspect of their lives and will remain a constant presence, just like any other form of grief, even if they don’t express it. Try to create a safe space for them, be willing to learn from them, and seek ways to serve them.

Unique nuances of infertility: 

—A couple serving in certain areas may have limited access to infertility testing or medical support.

—In a socialized medical system, access to services may only be granted after meeting specific requirements, such as a particular time period or a certain number of miscarriages. This can be frustrating and painful. 

—Host cultures may handle infertility differently than a couple is used to, with outsiders making assumptions, intrusive remarks, or asking prying questions. (This may relate to a woman’s value as a wife or her standing before God)

Pregnancy Loss

A pregnancy loss, no matter how far along, is the loss of a child who was often deeply loved and wanted. Miscarriage is typically a loss that a couple suffers through, unannounced and unnoticed. For many couples, keeping private wounds private is preferred. However, for those serving in a foreign culture and away from family, I encourage them to share their experience with their teammates and lean on them for support. Physical bodies need time to heal, and hearts and minds need time to process and grieve. The support and understanding of the community physically present to the couple is crucial to the healing process.

Miscarriage is a loss that occurs before the 20th week of pregnancy.

Unique nuances of miscarriage: 

—Accessing medical care is always stressful, but it can be even more overwhelming when a child’s life and a mother’s health are at risk.

—Some cultures do not value the lives of the unborn, resulting in dismissive comments from medical professionals and national friends.

—In some socialized medical systems, families may struggle to get appointments if they do not meet certain criteria, which can lead to difficulties accessing care.

—If there is a language barrier, communication can become difficult and may lead to increased fear or harsh information delivery.

Stillbirth is a loss that occurs during or after the 20th week of pregnancy.

Unique nuances of stillbirth: 

—Family not being able to hold your baby.

—Family missing the funeral or celebration of life. 

—Cultural stigmas in your host country regarding stillbirth. 

—Your child may be buried in a country you not always live in or have access to. 

—Lack of access to adequate postpartum support or skilled lactation services to guide you through the healing of your body. 

—Lack of in-person counseling options. 

—Many countries are not set up to deal with infant death, so the process of figuring out what to do can be extremely vague and complicated to figure out. While coping with the shock and trauma of your baby’s death, you may not have the mental energy to deal with figuring it out alone. 

If someone on your team or in your expat community is experiencing one of these situations, you may feel unprepared for how to help them, but don’t let that become a barrier to reaching out. You can acknowledge your lack of knowledge regarding their specific situation while also expressing a sincere desire to love and serve them through this time.

It’s important not to wait for them to ask for help but to ask them frequent, intentional questions about what they need. If you have served in a culture for a more extended period and have insight into how the host culture expresses grief or what expectations they have on grieving parents, offer that knowledge to parents to help them prepare for anticipated comments or responses.

People who have experienced pregnancy loss need their teammates to recognize the depth of their loss and honor their roles as mothers and fathers. When a family has a newborn, a meal train is created to support them. Similarly, allowing a couple time to grieve can be achieved by relieving meal preparation stress, especially if they already have other children. When a family has a newborn, we go and sit with them, listen intently to the details of the birth, and ooh and aah over the baby. 

The best way to support a couple who has suffered pregnancy loss is to be present with them. Sit with them and listen to their story. Share in their pain and offer sympathy. Don’t be afraid of silence–sometimes, just being there is enough. Use the name of their child when you speak to them. Keep checking in on them regularly. 

When we prepare to move cross-culturally, we usually expect and prepare ourselves for the ministry we’ll be doing with the people of our host country. However, sometimes it’s our coworkers or teammates who can present the biggest challenge we encounter. 2 Corinthians 1:4 reminds us that God comforts us in all our affliction, so that we can comfort others who are going through any kind of affliction by sharing the comfort that we ourselves have received from Him (ESV, emphasis added). 

You may feel unprepared or ill-equipped to support someone who is experiencing the unique challenges and nuances of infertility, miscarriage, or stillbirth while overseas, but the Lord promises to equip you to share His comfort with those who are going through any kind of affliction.

What questions can I (we) help you with? What do you wonder about when it comes to infertility, miscarriage, and still birth?

Coauthor LaDonna Cunsolo: Wife. Mom. Friend. Lifelong Expat.

Chandler and LaDonna, thank you for the time, effort, and love you’ve put into this series!

Photo by Elyas Pasban on Unsplash

Chandler Gilow

Wife, Mom of two little girls, Registered Nurse, Lactation Specialist. Founder of The Global Birth Coach. Based out of sub-Saharan Africa. 




  1. Stephanie Rice

    Great job ladies! Thank you for sharing about this difficult topic so that we can help and minister to our friends and teammates who have experienced these kinds of struggles and losses. Thankful that the Lord is near to the brokenhearted and comforts those who mourn.

    • Chandler Gilow

      Thank you and amen! We serve a gentle and merciful God. Thank you for taking the time to read.


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