Twenty weeks: this baby’s half-baked. And kicking like crazy. So, on Monday, Steve and I will attend our first prenatal appointment here in Mexico. We are excited. We are eager to find out whether we are having a boy (probable, given Steve’s family’s generations of boys) or a girl (wouldn’t that be wild?!). And we have been so busy moving out and moving in and moving everything in between that this pregnancy has been something we almost forget about until it gets in the way of moving furniture or luggage, or because there is nothing available to eat that doesn’t have cold cuts or soft cheese on it. It’s time we turn our attention back to this brewing baby that will really explode into our lives in a few months.
Of course, not thinking about something is nice too. Not thinking comes with a bonus: not worrying.
I am sure that there are generic worries that I’m supposed to harp upon as I anticipate having my baby in Mexico. Sanitation, maybe? Poorly educated doctors who sell snake oils and moonlight as shamans? It’s true that Mexico, or at least the country’s reputation, is still reeling from last year’s swine flu epidemic, but the days of women dying in childbirth because their attendant hadn’t washed his hands are long over for all but perhaps the very most dire slums of this world. Compared to the U.S., Mexico is poor, but on a global scale, Mexico is a middle-income country with a large middle class, particularly in the cities. Looking specifically at a key health measure (one that happens to be pertinent to my own situation), Mexico is ranked 112 out of 221 countries for infant mortality. This doesn’t make it Singapore (where a scant 2.3 babies are lost each year), but doesn’t make it Angola either (where a whopping 180 babies die during their first year of life). But it’s also not all that far off the United States, whose paltry position behind 44 other countries including Cuba, Israel, and South Korea is nothing to brag about.
But I don’t choose my doctors in the U.S. based on their statistics. I choose them for their humanity, or their convenience, or because they had an open appointment when I needed one. And, frankly, whatever the statistics, the status of Mexico’s health system doesn’t frighten me any more than the realities of pregnancy and childbirth. Before I left the U.S., I had a pedicure with a group of mom-friends to mourn the stillbirth that arrived at the end of our friend’s healthy, full-term pregnancy. The tips of my toenails remain red to remind me: things can and do go wrong. Anywhere.
And I do worry. I worry about being vulnerable not to Mexico, but to medicine.
As I see it, there are two ways to look at childbirth:
- 1. A woman gives birth. Or, in Spanish, ella da luz. She gives light.
- 2. A doctor (in stork white) delivers a baby.
Having already experienced the giving of light with my firstborn, I have even less interest in the postage stamp-and-stork model. Barring the unforeseeable, of course. If it weren’t for the risks, I might labor alone and in secret darkness like a lioness, like my own ancient mothers. But I’m not craving incense, aromatherapy pools, and mystic music here; I’m hoping for a balance between autonomy, a body doing what a body does, and community, which helps when the individual is no longer sufficient to the task. I don’t want a lifeguard jumping in to save me when I am splashing in ankle-deep water, and I’m not afraid of a little rough surf either, but I want that lifeguard there in case of strong currents, riptides.
In the U.S., the women’s movement has spent more than a generation wresting control of the delivery room, as an extension of the woman’s body, from what Michel Foucault called the “medico-sexual regime” of the scientific medical world (which had wrested control of childbirth from midwives—whom they outlawed from using any surgical equipment—back in the 1700s). The revolution in childbirth practices in the U.S. during the 1970s was fast and really radical. My mother-in-law had three children over the course of that decade. For the first, she was given general anesthesia and woke up magically a mother. For the second (my baby’s father), she was given an epidural (yes, he turned out fine). And for the third son, she was assisted by a nurse-midwife, her husband was brought into the delivery room for the first time, and she gave birth without chemical assistance. My own mother, had less choice in the matter after I’d begun my entrance into the world with my arm outstretched: she had her three children by Cesarean-section. Presumably, in another era, she might not have survived my unconventional entrance into the world.
Mexico has had a women’s movement of its own, and one of the outcomes of that movement is the rising number of professional women evident in the parks and plazas around Morelia in the form of older mothers with only one or two children. But science and technology, capacity and know-how, and more importantly who possesses them and who doesn’t, are not really up for questioning.
Or, rather, this is what I worry is the case.
In truth, I hardly know anything about Mexican obstetrics. I know that midwives, “parteras,” are rare. I know that homebirths are unheard of (except the old-school, by necessity sort in remote, traditional areas). I know that Mexico has one of the highest rates of birth-by-Cesarean of anywhere in the world, 70% of births in private hospitals and 40% in public hospitals, according to the Mexican newspaper El Universal.*
Surfing the net, I read that Mexican midwives use avocado leaves and temascal, or ritual vapor baths, for correcting a baby’s position, then, once the baby is born and slapped sensible, they sprinkle the newborn’s head with oil. Articles like these don’t seem to deter pregnant women, though, who plaster water birth articles with pleas for information on where or with whom they too might have a water birth.
In Guadalajara, there is a natural birth center inside one of the hospitals (my dream scenario, frankly). And in San Miguel de Allende there is CASA, a government-accredited midwifery school. But each of these cities is over three hours from where I live in Morelia.
I know I’m supposed to be afraid of pain. And I am no martyr. But tubes and stirrups and those blue surgical masks terrify me.
In 2008, I labored at home with my first child, alone in the beginning, while I let my husband sleep, then in my bathtub, and then, when the contractions came whenever I moved, we went to the hospital where nurse-midwives were awaiting us. Avery was born four hours and a single dose of local anesthetic later, just as the sun rose over Albuquerque’s Sandia Mountains. I held his blue body (high altitude babies are normally smurfy) against bare skin over my heart. We have hardly been apart since.
I want a similar story for my second child, although I know better (under any circumstances) than to set my heart too strongly on what I can’t control. I will be happy when I hold my healthy child. The road that gets us there is negotiable. But I do hope that I get to negotiate.
On the other side—or maybe on the same side, from a different angle—I know that I don’t want to stomp into some doctor’s office here in Mexico and announce, “this is how we do things in the U.S., mister!”
I don’t want to be the bully any more than I want to be bullied. But how, with different languages and cultures and worldviews getting between us, will a doctor and I find some middle ground?
So this is why I’ve put off thinking very hard about this pregnancy in favor of more mindless questions of suitcases and decorating. But soon enough—perhaps on Monday, or perhaps not until January—I will have answers.
And, above all, I will know if this kicking, flipping body is a second boy, or a girl who will inevitably cringe at the stories of her birth—so old-fashioned!—as she contemplates having her own children in ways that will be at once unlike and identical to all the births that led to her own.