Bearing the Fruits of My Two Labors: Birthing in Oaxaca Part I

14 Jun

In 2014, a waiter in a restaurant in Louisville, Kentucky, kindly advised my dad that I should not give birth in the town where I live in Oaxaca, Mexico.* The waiter and my dad and stepmom had been chatting, and it turned out the waiter was from Oaxaca. One thing led to another in the conversation and suddenly the waiter knew my entire life story and my unborn child’s due date (yep, this talkative business runs in my family). So the waiter asks, “When is she coming here to have the baby?” My dad says that I’m not, and the waiter is taken aback. He tells my dad to convince me to go home and have the baby. He tells him that Oaxaca is not a good or safe place to give birth. He doesn’t go into details, but he’s very firm on the idea that it’s not going to be good for me and the baby.

Thanks to that helpful waiter, I spent weeks reassuring my protective father that no, really, I was going to be fine. The baby was going to be fine. Yes, the baby really will have dual citizenship, too. No, I don’t know where I’m going to give birth yet, but I will pick a great doctor. No, I’m really not coming home. Everything will be as fine as it can possibly be; I promise. Conan promises, too.

Fast forward to the present. I’ve now given birth twice- once in the U.S. and once in the poorest state in Mexico. They were outrageously different births, but probably not in the ways that that nice waiter imagined.

My Home Birth …. Err, My Hospital Birth in My Hometown

In my first pregnancy, in Kentucky, Conan and I took classes together about healthy pregnancy and drug-free, vaginal childbirth. We wanted to hire a midwife but went the (free, insurance-covered) hospital route instead, mostly because I found a gynecologist that I felt really comfortable with. We hired a doula, a (non-medical) labor assistant, to accompany us in the wild process of bringing new life into the world. We toured the hospital. We decorated the baby room. We agreed on all the big decisions- and if this happens, then x, and if the situations looks like this, then y, and be ready for this other thing. I felt grateful to be having a baby in my home country, where I thought I could best prepare for all the possibilities, where I was sure I would at the very least be safe and respected.

My labor and delivery in Kentucky was amazing, because, to some extent, having a baby is an awe-inspiring, life-altering event one way or the other. But almost everything that I didn’t want to happen did happen, and that wasn’t especially thrilling. Some of it was circumstantial, or due to things that I can blame on the baby (that’s right, kid- might as well start taking some responsibility around here). For example, I was stuck in purgatory (aka early stage labor) for over 24 hours. I was in labor altogether for about 48 hours. Once at the hospital, I was rewarded with an IV full of Pitocin (the drug that makes your contractions horrendously fast and strong because your body’s not giving you a hard enough time). Alas, labor is unpredictable. I knew it wouldn’t be how I’d dreamt it.

Some things, though, could have been different in a different setting. For example, it would have been nice to not be meeting new doctors while I’m starting to push a baby out. “Oh, hi, nice to meet you,” wasn’t really in my repertoire at the time. The absolute worst part, though, the way I remember it, was those Marquis de Sade-style strappy belt things they use for fetal monitoring. Making laboring women (gasp) sit still is truly cruel punishment. I realize that I was lucky it only happened once an hour (twice when it didn’t work during the first contraction) instead of constantly. Still, though, when swaying and gyrating in time with your gut-wrenching cramps is your salvation, imposed stillness is pretty rough. Thanks to Conan, to our doula, to only intermittent monitoring, and to generally being even more stubborn than my now four-year-old when she wants the triangle shaped sandwich, I did not get the make-the-pain-go-away-drugs- aka epidural. (What is the reward in this, you ask? Getting up by myself to go pee right afterwards? I must be out of my mind. But I’m entitled to be out of my mind on this!)

Not having an epidural and not having a Cesarean were pretty much the only things that coincided with my hopes and plans. When the time FINALLY came to get this creature out of me, as I might have screamed at one point, two male doctors who I’d never seen before attended to me instead of the fabulous lady gynecologist that I’d carefully selected for this purpose. These two random dudes (okay, I guess they were doctors, but how do I know?) used pretty much every intervention possible except for cutting my belly open. They made me lie down when I wanted to squat, perhaps just to make sure I knew this was going to go by their terms and conditions. I won’t go into all the gory details here of the way-too-eventful trip down the vaginal canal, but suffice it to say that neither of us two main characters were unharmed. When the baby was born, they put her under a warmer instead of on my chest. They cut the umbilical cord immediately. They let me hold her for a minute before they whisked her off for testing, even though all of these things were expressly against our wishes except in case of an emergency, and a true emergency it was not.

I’d like to say that at the end of the day, it didn’t matter, because I had a healthy baby and I was healthy, too. Except it did and does matter. I’m not complaining, and I wouldn’t even say I had an awful birthing experience. In fact, I felt like such a such a raging warrior / shaman-back-from-the-mountain that when Conan asked me a couple hours later if I wanted to do it again, I said, honestly and sincerely, “Hell, yes.” But the way that you treat people does matter, always.

My ReBirth…. Errr, Second Time’s the Charm, Abroad

The second child, of course, is not really comparable, because #1 has already paved the way, so to speak.** But my birthing experience here in Oaxaca could hardly have been more different. This time, I made my doctor sign a pact with the blood of his first-born that he would be the one to actually deliver my baby. (Okay, maybe it wasn’t real blood.) My wonderful, simpatico (all-around nice), knowledgeable, son-and-grandson-of-midwives, modern gynecologist committed to be there. So I called his cell phone a little bit after my labor started. “Okay,” he said, calm and cool as usual, “Let me know when you want to come in.”

I went in about 3 hours in to my labor. The clinic is like a mini private hospital, with big airy rooms in a lovely tree-covered yard/corridor just a little ways from the beach. My doctor checked out me and the baby and promptly sent Conan and me off to go walk on the beach while things progressed. He monitored the baby with a regular old Doppler instead of that horrendous belt thing (although that, along with all the other medical equipment in a U.S. hospital, was available). The sheer lack of the sadistic strap-down belt instantly made for a more peaceful, happier bringing-forth, compared to my hospital birth in Kentucky.

In general, he and the staff let me do my thing. I was extremely privileged to be accompanied by Conan and by a terrific doula, which is a nearly non-existent position in my neck of the woods. This birthing experience was essentially everything I’d hoped for with the first. I wouldn’t call it easy, because, you know, your little internal alien is forcing your body open, and even if you get to walk on the beach meanwhile it is not a regular walk on the beach. But I felt like I was taken into account. I felt like an active, respected participant in the birth of my baby the whole time.

Because of all these wonderfully calm and conducive circumstances, because luck was also on my side, and because it was my second kid, everything was over and done about 8 hours after my first contraction this time. In fact, the only real negative was that it went a bit faster than the doctor predicted at the end, and he almost wasn’t there for the birth. But he made it in time and guided us through the last bit beautifully and smoothly. The baby was placed right on my chest and Conan got to cut the umbilical cord several minutes later. My now beloved doctor told me I could go home that evening, but that he’d prefer that we stayed till morning just to be on the safe side. We did, since having a toddler to go take care of right after giving birth doesn’t make going home quite as enticing as it might be otherwise.

Other Differences in My Experience

What you receive, and the level of attentiveness, afterwards was very different between my two births. In Kentucky the hospital provided all my meals and all my drinks after birth, in addition to diapers, onesies, a hat, a blanket, and everything else necessary to care for me and the baby for two days. I even had a choice of items for my meals. Sure, I needed some more flavorful food shipped in, but if I hadn’t had family there I would have survived just fine. I’m sure they charge the insurance company for every last cup of ice they give me, but since I didn’t have to pay for it, it was all incredibly helpful.

For my birth here in Oaxaca, on the other hand, even at my fairly expensive private clinic, they don’t provide me with much of anything. They gave me some fruit and some juice and tea, and something for breakfast the next day, I think, but that was about it. I knew this was the norm going in, and I thought I was all prepared, but in the moment I ended up having to send people out to get things quite a bit. The baby dirtied up half of his first outfit immediately out of the womb, for example, so I needed another hat and blanket for him for after his bath. I even had to buy soap for his first bath. There was hand soap in the clinic for everyone’s hand washing needs, thank goodness- not like the typical lack of soap in public clinics and hospitals. And the room was clean and free of mosquitos, which is, of course, a big deal. That was the extent of the hospitality, but my bill was a whole lot smaller than it would have been in the U.S., too, and luckily I did have people to make sure we had everything we needed.

All in all, my supposedly scary/ dangerous/ substandard birthing experience in Mexico was far, far superior to my birthing experience in the U.S., where we have this idea that everything is the cleanest, safest, most modern standard on earth. This is absolutely not the case. The U.S. is really low on the list in the “developed” world in terms of using best practices- doing the most researched, highest recommended things in medical practice. The U.S., among other “developed” nations, has some of the highest rates of maternal and infant mortality.*** Being a rich nation does not make it a better environment for giving birth. Being a poor nation does not indicate that health care is always substandard (geez, look at Cuba if you need another example).

It’s important to note, also, that while I was able to have my “perfect” birthing experience in Mexico, money, and several other factors, played a big role in my access to that experience. My experience is not typical. For this reason, this is the first post in a series I’ll be doing on giving birth in Oaxaca. I have talked to a lot of people about their birth stories (which will only be shared anonymously and with permission). I’ve read a lot of research. I’ve talked to doctors, I’ve been through the insurance company saga. And I am all fired up to start changing the system! But every time I sit down to hammer it all out, I get overwhelmed. I cry again, and again, tears of outrage and solidarity for everyone who hasn’t had- and those who probably won’t have- a birthing experience like mine- where they felt respected, where they were treated like a valid, participating member in the event. Which is most of what it takes to have a truly “perfect” birth, and which should be a human right for all. And I won’t shut up until it is.

*Seriously! Why does everyone- and their mom- have such excessive amounts of unsolicited advice for pregnant women?? Resist the urge to say everything you think, people. Please.

**If you are the oldest in a family, you know this is true. Your siblings who come after you have it so much easier in every respect because you’ve been busily training parents in how to parent since you were born, on top of all your other difficult jobs, like throwing tantrums in the grocery store.

*** source

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