The decision to give birth to my first child in Tanzania was a surprisingly easy one.

My husband and I had been working in the country for about 12 months and had just signed on for a second year, and it seemed every other week someone we knew was giving birth to a healthy, happy baby.

In my more arrogant moments (often after speaking to another Australian about my decision and seeing in their eyes what I liked to think of as wonderment, but very well could have been horror at my naivety), I thought having a baby in Africa made me seem brave and adventurous.

“Our baby will be born in Tanzania,” my husband and I would say to each other. “That’ll be a cool story.”

Then the reality set in.

Wake-up call number one: When I discussed my decision with my colleagues, they told me I was crazy. They said it was not unusual for two or three labouring mothers to share the one bed during childbirth. This was my first dose of reality. And it scared me.

I grew up on the carefree shores of the Sunshine Coast in Queensland, and wasn’t convinced I would have the same fortitude that so many women in Tanzania carry on their proud shoulders. Was I built for this?

Luckily, I had health insurance (something the vast majority of people in Tanzania do not have) and found a good hospital where I could have a bed to myself; something I will never take for granted again.

Wake-up call number two: Even good hospitals in Tanzania have serious limitations.

While I hadn’t planned to rely on medications, including an epidural, knowing they could be available was comforting … until I found out they wouldn’t be.

The hospitals in Arusha, a small city near the border with Kenya, have a very limited supply of painkillers. To get the same medication available in Australia, I would have to drive 10 hours to the coastal city of Dar es Salaam, or travel to Nairobi, a six-hour drive away in Kenya.

Australian doctors in Tanzania warned me obstetricians in Tanzania were often quick to resort to caesarean sections, something I also wanted to avoid if possible.

A caesarean section can often save the life of a mother, her baby or both of them, but being told the doctors were a “little caesarean happy” was not what a first-time mother wanted to hear about the hospital where she would be giving birth.