No, I am not, thank gosh, pregnant again, but one year ago this week my beautiful baby boy was born, and I've never shared my experinece of my FS OB med-evac.
Although it is State policy to recommend that all women return to the US to give birth, many FS women give birth abroad and have good experiences. Manila has excellent medical care and I loved my Filipino OB, Dr. H. However, this being my first birth experience, I wanted to be with my family in my own country, and also wanted to use a hospital-based midwife (which I highly recommend). Plus, I didn't want to deny my baby the ability to run for President. God help him if he takes that task on.
First, the facts. If you choose to return home or give birth in your region's med evac point (EAP's is Singapore), you will receive housing and meals per diem for 12 weeks: 6 weeks before birth and 6 weeks after. In general, MED is pretty strict about this timing, so if you want to depart earlier or return to post later, you will be paying out of pocket for the extra days. My boss, the CLO, was very generous and accommodated me taking 16 weeks of maternity leave. State does not offer paid maternity or paternity leave, so once you have used up your annual and sick leave you go on LWOP status.
Your per diem allowance varies based on where you go. In Florida my allowance was only $88/night, which is absurdly low for the area, amd so I stayed with my parents for the duration of my med evac. If you return to DC, your allowance is appropriate for housing costs in the area. If your due date falls during home leave or a DC assignment, you are not on a med evac and are on your own.
The pros to returning home are obvious: familiar medical care setting with providers who speak English--can you imagine being in labor and trying to speak a newly acquired language, if you even had language training?--easier access for family members to meet the baby, and the convenience benefits of being in the US. Drawbacks: if your per diem is insufficient and you can't afford to get an extended stay hotel room, crashing with your folks for 4 months with a new baby is a lot to ask of one's family, unless they live in a very large house and have a cook and a maid. My parents were wonderful and extremely generous, but they do not have the aforementioned house and helpers.
In addition, if your embassy is short-staffed or very small, it may be more difficult for Dad to be present for the birth AND the first few weeks of newborn care, which is hard on both parents. If you have the baby at post, Dad has more flexibility, and Mom likely has a domestic helper at home.
I am glad I returned home for Kyle's birth, and if i have another baby my choice to med evac or not will depend on the situation. In Albania, having the baby in country is not an option due to lack of sufficient medical care. Other than freaking out, I'm not sure what MED would do if one hired a local midwife and insisted on a home birth. Probably revoke your medical clearance.
If you have any questions about being in the FS while pregnant, please don't hesitate to ask.