Tag Archives: birth

Routine and Obscene: Birthing in Oaxaca Part II

12 Apr

Life is messy, and birth is super messy. No matter how you birth, C-section or vaginal, in a pool while listening to jazz or screaming like a banshee at that dumb-ass doctor, it is full of messy body fluids and messy emotions. There is no sterile birth. The whole messy shebang- pregnancy, birth, and the never-ending afterwards is a wild medley of joy and misery for most people. Your body is totally hijacked by this creature and just about everything in life therefore becomes about this creature, which is maddening some of the time even if you had to work hard to get that creature in there. But here’s the thing: it’s still your body, and everybody, every body, every baby, and every body carrying a baby, deserves respect. Period. You deserve respect. You deserve information and you deserve care. No ifs, ands, or buts.

So this is about to be messy, y’all. This is approximately my 18th attempt to finish and publish a blog post about this topic, but I am over-the-top-determined, fired-up and mad and impassioned all over again. So brace yourselves. I am bringing the mess.

Now, let me be clear. I’m about to get very detailed and slightly rabid over doctors, nurses, education, and health care in the state of Oaxaca, Mexico (especially the coast, since that’s where I live.) But that does not mean that this does not apply to you, too, my darling USA. Do not- I repeat, Do Not- go around patting yourself on the back that you’re doing better than Mexico, or that you don’t need to worry about it because you’re safe up there in the North. Do not fool yourself. Mexico learned a lot of these tactics from the US in the first place. The problem is, Mexico ends up scoring higher on the charts at all the wrong things. Soda consumption? Mexico wins! Type 2 Diabetes? Another goal for Mexico. Cesarean births? Mexico is kicking the US’s butt again!

So there are the fews stats I have: “…(T)he maternal mortality rate in Oaxaca is approximately 62 maternal deaths per 100,000 live births, double the national rate,” according to Child Family Health International. The US has about a third of its births via C-section, when the World Health Organization suggests that a C-section is medically necessary about 10-15% of the time. Around here in Oaxaca, it’s hard to get solid statistics*, but it’s estimated that 50% of births terminate in a Cesarean, and that the rate of C-sections is even higher in private clinics, with some estimates at high as 80%. Such a high C-section rate brings much higher risks and worse birth outcomes for both mother and child. And that’s only part of the story of what’s wrong with birthing in Oaxaca.

References: WHO C-Section Statement, mortality rate, in Spanish, more information about the state of giving birth in Mexico, more info in Spanish, more info on estimated rates  (I am not very familiar with the publisher of the information in Spanish, so I can’t vouch for how definite it is, but it is just about the only information I can find.)

Now, I studied sociology and everything in me is against relying on anecdotal evidence as fact, but in the absence of well-researched statistics, I think anecdotal evidence is worth a mention. This is a big part of what has had me crying and wringing my hands and pumping my fists alternately in these nearly 5 years of living down here- the birth stories that I hear. This is what is going to be my long-term mission to join with others in the community to change, if I end up living here forever: humanizing pregnancy and birth.

It’s ugly in the public sector and it’s ugly in the private sector, but your treatment is drastically worse the poorer you are. In the news there are loads of stories about women who were forced to give birth in the parking lot, on the lawn, in the bathroom, in the waiting room, etc., because there wasn’t enough space for them in the hospital/clinic when they came in. The women that this happens to are always indigenous, but luckily there is no racism here (yes, this is sarcasm). I suppose that’s the worst end of the spectrum, although I’m not sure the care that people receive when you’re admitted qualifies as desirable, either. Yes, it is better than giving birth outside with nothing, but is that really what we’re willing to accept?

What always strikes me as the worst acceptable, routine thing, is that women are giving birth alone. Labor and delivery is one of the hardest and most beautiful and wildest and messiest things you can do in life, and that’s cool if you choose to do it alone. Anytime you give birth in the public sector, though, you have to be alone. All by yourself, with just a bunch of other women around who are also in labor, with not enough doctors and nurses or even, sometimes, enough beds. ALONE! With no one to advocate for you, for your health and wellbeing, for the baby’s health and wellbeing. With no one to hold your hand, to rub your back, to get that hair out of your face, to tell you that you’re doing great and it’ll all be over eventually. Alone! For your entire labor and delivery. Already that, in and of itself, is completely and utterly inhumane to me. I can. not. fathom. it. And it pisses me off extra here in Oaxaca because if you go to the hospital for ANY other reason, they force someone to accompany you. If you have to be recovering from something in the hospital for 3 months, you have to have someone there, just about 24 hours a day, because there aren’t enough resources for the hospital to take good care of you. So why the hell would you send people in to give birth totally on their own?! Heartless bastards! I suspect it’s partially because they don’t want anyone there to defend you and help take care of you.
Let me tell you what kinds of things happen there, while you’re there, contracting and alone. You don’t get any water. I know, many places in the US like to do this too, which is equally senseless and unnecessary, but it’s even more cruel here, where it’s 85 degrees and more humid than Hades. One friend told me that they STILL wouldn’t give her water or food for hours after her birth. Finally she begged a doctor for water and he told her it was at her own risk- as if water was going to do her harm after giving birth!

Furthermore, more than one person has told me that nurses berated them for making too much noise. You’re often in a big room with a ton of beds filled with other laboring women, receiving little attention. One woman just told me that during her birth, they decided that she wasn’t progressing fast enough (normal), but there were no gynecologists in at the time. Therefore she had to wait another 12 hours for the gynecologist to come on call, and then they could only give her a C-section because they decided it was too late to try to speed up her labor any other way (which is a pretty common story in the public sector, due to lack of gynecologists).

Then there are all the excuses they give you to have an unnecessary C-section, especially in the private sector. The cord is wrapped around the baby’s neck. The baby is too big. You’re a couple days past forty weeks. Your hips are too small. You already had one C-section. Ad infinitum.

All of this is similar to stuff they might tell you in the US, but the difference here is that there is no such thing as pregnancy and birth education. There are no child birthing classes. There is no education about what to expect while pregnant even. If you have a doctor like the one I had at the insurance company, they don’t even tell you basic information like when to suspect there is a problem. Culturally, there is no questioning authority. So if the doctor says your baby is too big for you to give birth to, you don’t ask how he or she knows that. You either accept it and get the C-section like they want or you reject the system entirely and go to a midwife, which could or could not be a good option. (More about midwives in another post, I promise- it’s too broad a subject to broach). Many people don’t have the option of midwives, or of anything beyond the very limited bit their health insurance provides.

If you do have the money or borrow the money to give birth elsewhere, it ends up being a similar scenario. The private sector thrives on your ignorance and the total lack of available options, on the fact that almost all the doctors are out to screw you over equally. For example, one prominent gynecologist here told me beforehand that if I didn’t want an automatic episiotomy, that I would have to sign a bunch of consent forms beforehand, and that, you know, it was all at my own risk, because that made it very dangerous! It felt to me like they just make stuff up to sell you more services you desperately “need”- and if it turns out you need a C-section, (which you probably will), then even better, because it’s more convenient and way more money for them. (Multiple people have sworn to me that doctor friends have even admitted this is how they operate.)

On top of treating women like animals in labor, often doctors take the opportunity to abuse their power and your reproductive health and rights while you’re there. The straw that broke the camel’s back in forcing me to finally publish this messy, disorganized blog post about this was hearing ANOTHER story of forced birth control. This story came directly from a doctor who had no reason to make it up. We were talking about IUDs, and how sometimes the strings hang down too short, and he was telling me that he just had a case where a woman had been trying to get pregnant with her second child for years, She had had all kinds of testing done and everything, and they couldn’t figure out what was wrong. Finally, it turned out that she had an IUD in place, that had been put there when she had her first child via C-section, without her consent or knowledge. Apparently this is a common thing- giving women an IUD, either without their knowledge at all, or forcibly without their consent. Another second hand story came to me about a woman getting a forced IUD and the doctor telling her, “I don’t want to see you in here pregnant again for the next few years!” Which I can totally imagine, because that is how doctors talk to people here, especially to women.

Of course they do the same thing with sterilizing women. They pressure you into it if they decide you have enough children. Just this weekend I was chatting about this with someone who experienced it. They tried to force her to get a tubal ligation when she gave birth to her fourth child. “How many children do you have? Don’t you think four is enough?” The doctor tried to shame her. This woman is a total heroin, though- she is the same woman my nurse friend told me about who REFUSED to let the doctor put his hand in her uterus to “clean her out” after birth (another routine, unnecessary, and very painful procedure). She was like, “I came to deliver my baby, not to get surgery, thank you.” She said the doctor wouldn’t leave her alone about it until another doctor who is her neighbor came in and defended her right to decide. Your rights mean nothing. She got to decide because a man in power intervened on her behalf.

I could rattle on and on about more abhorrent stories and accounts, more abuse and lack of rights, but here’s the end game for me: We need more education in the community, AND a total shift in the system. Let’s stop reading about another indigenous woman giving birth on the lawn of IMSS and acting like it doesn’t affect us. Let’s stop listening to each others’ horror stories. It does affect us. It means that we are accepting this as the care that we deserve.  Giving birth is messy but it shouldn’t be dehumanizing. Being routine does not make something acceptable.

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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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The Exile Continues with a New Mexican-Gringuito Addition!

22 Mar

I  haven’t actually dropped off the face of the planet, as one might assume by the silence emanating from me these past few weeks. Many things have happened to conspire against me posting a blog piece, starting with pregnancy-induced utter despair and rage.

That first week that I skipped out on writing I did you all a giant favor. I was almost 41 weeks along, huge and swollen and over it. All of the space in my brain was consumed with imagining this baby´s birth. My blog would have been about 5 pages of something like “This is so unfair. I already had one baby at 42 weeks. The second one is supposed to come early. Why didn’t my baby get the memo? Why do all of my children torture me like this? (all being all two of them) I’m never doing this stupid pregnancy thing again! Unless the baby agrees to come out at 38 weeks! But spontaneously! I don´t want a C-section or an induction! This is so unfair!” Etc., etc., etc. So you can thank me later for sparing you from that.

Worst of all that first week I didn´t write, the next day I was going to have to go back to the insurance company to negotiate with burocratic maniac doctors to get my prenatal maternity leave extended. If you read the súper-saga about my dealings with the insurance company  https://exiletomexico.wordpress.com/2015/02/01/me-versus-the-insurance-company-doctors-a-saga/, you can imagine how much I was looking forward to the experience. Right up until I walked through the doors at 6.30 AM I had held out hope that contractions would start and save me from having to deal with the evil insurance company. But alas, this child is just as thankless as the first, and did not come out in time to rescue me.

I set baby a deadline after that. Induction was happening Friday morning, ready or not. It would put me at not quite 42 weeks, but I decided it was close enough, especially since my dates weren’t chipped in concrete. Conan and I planned an alone day for Thursday, hoping to naturally induce the baby. So the grandparent schedule for taking care of Lucia was already in place when I woke up with contractions that Thursday morning. Finally! Apparently it takes impending induction dates to make my babies come out. So be it. It finally happened!

I won’t trouble you with all the gory and glorious details (this might be a little too public for me), but it was a pretty fantastic birth. It was about 18 thousand times faster than Lucia’s birth. My doctor was awesome and there were zero interventions of any kind, exactly like I wanted. Conan and I walked along the beach during part of my labor. It was all very laid-back and peaceful, and best of all, “the baby came out of your belly!” as Lucia says. Ta-da! We have a little boy named Khalil Michael. “Now you have a Mexican child and a gringo child,” people tell us, thinking that where you’re born is the only determinante to citizenship. Really they’re both dual citizens. “Now we can have one kid who can be the president of Mexico and one who can be the president of the US,” Conan corrects them. (I’m praying our children won’t be politicians, period, but, you know….)

my two tiny dual citizens

my two tiny dual citizens

So that week I had a newborn baby! Thus I excused myself from blogging again. Plus my mom, Dee, and my mother-in-law were all still in town so it seemed excessive to make myself work. My mom and Dee were leaving on Monday, so I promised myself I´d get some writing in then.

The next week I got started on two separate posts, but I failed to finish anything by noon on Sunday when my Dad and Karen, my stepmom, arrived. It was definitely not happening then. So this week I continued to work on my two posts, and I started writing down Khalil´s birth story to boot. I was being seriously virtuous about this writing thing. And then my computer went out.

But this is it anyway! No more excuses. (Well, I’m excused from not having more photos because of the computer situation.) I’m posting this little update at the very least. Just so you, dear, lovely reader, don’t think I’ve ceased to exist. This merry-go-round exile in Mexico continues, with a bigger and better family.

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Living on Prayer (of all shapes and sizes and not just Bon Jovi)

8 Feb

Prayers made to the Virgin of Juquila remind me a bit of a third grader negotiating with Mom, trying to barter action figure cards for more time playing the video game. Does Mom really want your action figure cards? Does she just want you to sacrifice something? It doesn’t make much sense to me, but who am I to judge? 

I’m honestly not even trying to be snarky about the situation. The thing is, people go to the Virgin when they need a miracle. It’s a shameful sign of how bad the socio-economic situation is in Oaxaca and our neighboring states when most people’s miracles are things like buying a car, building a house, graduating from school, good health for their child- things that I fervently wish did not need miracle status to be acquired by people.

What I might think is a little weird, though, is the kind of deal that people make for their miracles. They make a promise to the Virgin in exchange for Her help in whatever it is they’re asking for. For instance, that three-day, giant, public, Christmas celebration I mentioned a few weeks ago. My friend’s family hosted that because of her mom’s promise in exchange for her health. One of Conan’s cousins promised to visit the Virgin every year in exchange for his truck that he uses to work. There are long braids at the shrine from women who obviously promised their hair away. There are folks who have promised to go walking on their knees from the entrance to town all the way to the church. Whole families make trips with a hired band, and dance in front of the church. All in exchange for something.

I guess, though, I just don’t get what it is the Virgin wants with someone’s braid. I don’t really understand why it would please Her to see someone get bloody knees. I can’t really imagine how it benefits anyone except the folks of Juquila selling stuff to the pilgrims if people come every year, or hire a band, or make a big fireworks display, or whatever. Wouldn’t it be better if they, I don’t know, promised to do some kind of good deed for someone else every year? Or even promised to improve themselves in some way- give up some vice or do regular exercise or something. I don’t know. I’m digressing from my point horrendously now.

My point is, there are all kinds of prayers, and I suspect they all work equally well as long as you put your energy into it and believe enough. I was raised Catholic, although the only remnants of that aspect of my life are my frequent prayers to my two favorite saints. One of them has been disclaimed from the Church, though- go figure- but that’s not stopping my loyalty. St. Christopher is (and always will be, for me) not only the patron saint of travelers, but also of Barga, the small town my grandmother is from. I’m convinced St. Chris is the only reason I’m still alive, after all the outrageous risks I’ve taken time and time again on all kinds of trips. Furthermore, I’m pretty sure I can attribute some of my smashing success as a traveler to his help (beyond not dying, also acquiring good stories, meeting amazing people, seeing cool stuff, everything flowing just like it should with little effort on my part). That said, do I think there’s a guy up there in heaven or outer space or I don’t know where just waiting to hear my prayer and throwing out a helping hand? Not exactly. I picture the situation a bit more like the Mayans and their corn god- something/someone specific to focus your energy on when you’re want to invoke forces from beyond yourself.

My other saint/minor god is Saint Anthony, the patron saint of lost things (not to be confused with Saint Jude, who’s got it covered on lost causes). In Mexico, somehow, partly due to an old pop song, he’s become associated with helping girls find a boyfriend. Personally I’ve never asked him for this, but do regularly need help finding keys, notebooks, misfiled important documents, and much more. He pretty much always comes through for me, so who am I to doubt? 

I am a believer in the power of prayer. I think that when you focus your energy, send your energy up and out to whomever or whatever you call this energy beyond you- God, Allah, the Universe, a saint, whatever- then powerful things can happen. It’s no guarantee. But it doesn’t hurt, either.

As a teenager, I discovered paganism, with all it’s lovely rituals to help you focus your energy. I’ve long since stopped practicing any kind of religion, but I have kept on with my beliefs about the spiritual universe. So I pray, in my way. I don’t fall to my knees, I don’t cast a circle, but I do concentrate, focus my thoughts, try to be very clear about my intentions and my desires, try to get beyond the daily banality for just a moment.

Back in December, just two months shy of the estimated arrival time of this new baby, we still had no idea where we were going to give birth. I was getting some prenatal care with my insurance company, but I was adamant that I’d rather give birth in the middle of the street than leave responsibility for my body and my baby in their hands. That said, I knew no other doctor, had investigated zero other options. I was getting nervous.

I was also bummed out because we really wanted to have a doula like we did with Lucia’s birth. A doula is a non-medical birth assistant- basically someone who is there to support mama and (if present) papa. Our doula in Lucia’s birth had been fabulous times a thousand, surely one of the reasons that I did not end up with a C-section, and definitely a big help in keeping Conan and I on-track and relatively sane. Down here I’d only heard a vague rumor of one existing doula, and couldn’t find her contact information. I didn’t want any of our friends or family down here to accompany us in the birth, either, because we couldn’t think of anyone who could remain calm and collected, be emotionally helpful and get super intimate with us in that space.

Before I even tried any silent prayers to the universe, I did a little social prayer; I started talking to everyone and their mother about birth options, putting my energy out there, letting my intentions and hopes be known by all. This is the only real way to acquire information down here; Google ain’t got nothing on word of mouth. 

Sure enough, I started reeling in bits and pieces of useful information. I got the name of the doula. I made an appointment with a gynecologist at a clinic with a reputation for quality care. I got contact info for a German expat who had three home births here. The lovely German lady (who I’m still waiting to meet in person- it’s hard to coordinate busy mom schedules!)gave me even more information about possible doctors, and I made more appointments.

At the very end of December we found our ideal doctor. He’s a gynecologist, but he’s also the grandson of a midwife. He was the only doctor we met who wasn’t pretentious, who didn’t act like whatever procedures he routinely does for birth are definitely the best thing for us and if I want anything different it’s “at my own risk.” He really listened to us and didn’t think our ideas were unreasonable. He expressed his ideas about C-sections in exactly the way that I think of them- as a wonderful option that can save the lives of mothers and babies when they’re necessary, but that aren’t necessary very often and are risky when they’re not called for. (And in a country that now has the highest C-section rate in the world- yes, more than the U.S.!- having a doctor who’s not anxious to cut me open was of great importance.) The clinic where we’ll be for labor and delivery is comfortable and relaxing, much more like a birthing center than a clinic or a hospital. I’m thrilled that we’ve found what seems like an ideal set up to welcome this new creature into the world.

But then there was still the doula issue. Conan is an excellent birth partner, and I’d never have made it through Lucia’s birth without him. But it’s an awful lot of pressure on him if he’s the only one supporting me. So I enlisted my mama, an ex-Catholic who is an expert in prayer She’s had a whole lifetime of practicing prayer and trying out different communication styles with God and/or the Universe. “Don’t pray for a doula, though,” I told her. “It’s really unlikely I’ll find an official doula down here. Just ask for somebody who can accompany us in the way that we need.” 

I kept up my social prayer and I’m sure my mom did her part. I found an email for the doula, who was pregnant with her third and had almost the same due date as I do. She had just moved back to Canada after six years here. But she gave me some suggestions for places to look for accompaniment. And she said there was another lady who should be in town who’s done this sort of thing before. The doula said she’d contact the other woman and see if she could talk to me. 

She did agree to talk to us. When we met her, she was a bit hesitant in the matter. “I had no intention of working as a doula down here,” she explained. She and her husband spend the winter down here every year with their daughter and grandkids. “For one, my Spanish isn’t good enough,” she said. And yet somehow two other women had been put in her path just before me- a woman from Mexico City who speaks excellent English, and a French-Canadian woman who does linguistic services in French, Spanish, and English. They were looking for information and help, and so she agreed to teach a birth class, even though she said she’d never even attended a birth class before. She does have training and experience from the U.S. as a doula, plus some experience attending births here in Puerto. We had a nice chat and it seemed like she could potentially provide exactly the kind of support we were looking for. She did not really want to commit, though. Perhaps she was feeling a bit overwhelmed at this sudden surge of need for her help when it wasn’t something she’d been looking for. “I’ll pray about it,” she told us. “And you guys pray about it, and we’ll see.”

Forces aligned correctly in the universe, prayers were prayed, and a week later she was giving us paperwork to fill out so she could be our doula. So here we are, in February, me 38 weeks pregnant and now with an ideal birth team lined up to help bring this new life out of me.

Of course there are no guarantees on anything. Our doula could get called to the U.S. for her very elderly mother-in-law. Or the woman from Mexico City with almost the same due date could go into labor at the same time as me (which would be really bad because we have the same doctor as well!). All kinds of things could go wrong with the baby. But at the end of the day, part of the strength and wonder of prayer, in whatever form it takes, is the power of letting it go. When you believe in a power or a force beyond yourself, you can bundle your worries and doubts into a prayer, and ship it right out so you’re not hanging on to your fear, so you’re not taking responsibility for things which you don’t have much (if any) control over. So I guess even if you have to walk a long way on your knees or cut off your hair or make some other deal, if it can help you travel down your path and give you a little piece of mind as well, then it’s probably all worth it, and about as much as any of us can hope for.

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