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Saturday, October 24, 2009
Portabebés a la venta en Costa Rica!
Como cada vez que salgo a la calle con un portabebé alguien me pregunta si podría conseguir aquí en Costa Rica... ahora sí! Portabebés hecha y a la venta en Costa Rica:
Saturday, September 19, 2009
Making Gabriel a Gringo
Here's my special archive for the the whole process that I went through to get US Citizenship conferred on my Tico-born baby Gabriel... in order to travel to the States we needed to go through this (or we could have applied for a visa and had him travel on his Tico passport, but that would have been a useless expense since he qualifies for US citizenship anyway). In the end, we were able to obtain Gabriel's equivalent of a US birth certificate (called a Consular Report of Birth Abroad) and his U.S. Passport in a process that lasted a little more than one and a half months.
First of all, plan to spend two whole days at the U.S. Embassy in Pavas; you'll probably get out before noon on the first day but it's better not to have anything else you need to do those days.
Here are things I did before turning in my paperwork:
1) Filled out a DS-2029 form (printed from http://www.state.gov/m/a/dir/forms/)\
2) Provided an "official record of the child’s foreign birth" a Costa Rican birth certificate from the Registro Nacional de Costa Rica (there's one in Heredia city)
3) Provided "evidence of the parent(s)’ U.S. citizenship" with my own certified birth certificate, my current US Passport. However, since I was told incorrectly by phone that I needed to prove 5 years of physical presence in the U.S. (which I would have had to do if I were married) I also submitted high school transcripts and college transcripts. Another option would have been to get "proof of employment" letter or payment stubs from a long-term job in the States.
4) Since Julio and I are not married I did not have to provide "evidence of the parents’ marriage", but this might be pertinent to other friends who might be going through this same process soon! :-)
5) Provided "affidavits of parent's residence and physical presence in the United States" - I thought I had done this by including this info on the DS-2029 form, but it turned out I needed to do more (see below)!
I had the above documents and a few more on the day I turned in the paperwork at the US Embassy. They only accept documents through their Walk-In Service: Monday - Friday 8:00 am - 11:30 am but do not recommend coming in on Mondays as that's a high-traffic day. They went through them and strongly suggested I bring more supporting documents to the interview. The interview was scheduled for several weeks later in the early afternoon.
So here's a list of additional supporting documents brought to the interview (which Julio, Gabriel and I had to attend together):
**Since I am an "Unwed US Citizen Mother" it turned out that I only needed to prove 1 year of physical presence in the U.S. and that can be done using my passport (mine proves only 1 full year staying within the US borders since it was issued in 2003, but that's enough!)
**In item number 12 on the application form it requires you to: "List periods of physical presence in the U.S. Prior to the child's birth in exact detail... Vacation trips abroad, schooling in foreign countries, and any other brief absences cannot be counted as periods of physical presence in the U.S." So I had done that at home while Gabriel was asleep and I could type it out simply enough. Now here's the fun part: when I got to the embassy they required me to create an affadavit including me writing out all of my physical presence OUTSIDE the U.S. prior to Gabriel's birth!!!! I had to write that all out longhand with Gabriel fussing in one arm (took me about 40 minutes!) because he had been waiting a long time and was no longer patient or willing to be in the baby carrier. And because I was in the U.S. Citizen Services section (and not in the other waiting area where the Ticos wait for their visa appointments), no one offered to help me with my baby.
** Gabriel's Costa Rican passport
** Julio's Costa Rican ID card (cédula)
** Julio's Costa Rican passport
** They wanted to see any other proof that I was pregnant with this baby and that he is really mine... so I also provided photocopies of:
-The "Expediente de Parto" document from my midwife Rebecca
-The official letter from my midwife Rebecca stating that she had seen me throughout my pregnancy and attended the birth.
- Ultrasound photos and corresponding health records from the 2 visits we had with Dr. Adam Paer during pregnancy (even carried a copy of the CD with photos)
- Snapshots of me throughout my pregnancy, one during labor, and a couple of the first photos of me and Julio with Gabriel on his birth day.
- Copies of blood and urine tests I had taken during pregnancy (which if a medical official were to review them would indicate I was pregnant)
- My Carné Perinatal and Tarjeta de Citas from my 3 visits to the ebais (health clinic) before Gabriel was born and the 2 visits I made after he was born. (After that I told them we were seeing a private pediatrician so they didn't need to schedule further appointments for us.)
Some related online resources:
http://travel.state.gov/law/info/overseas/overseas_703.html
Acquiring Birth Cerificate Abroad (CRBA)
http://sanjose.usembassy.gov/conscitizen.html
http://travel.state.gov/law/family_issues/birth/birth_593.html
VIP treatment!
One thing I love(d) about being pregnant and now a mother in Costa Rica is the VIP treatment! Not only do we get to go in the "preferential" line at the bank and other offices, but EVERYONE is so considerate and helpful. There is a true respect for the hard work that is carrying and raising a baby. If I am alone I get even more help. For example, the parking lot guard at the farmer's market will help me load my bags in the car, people will give up a seat to us on the bus, or attend to me first at the meat counter at the grocery store.
The very best VIP experience I had was back in June on a Saturday when we needed to withdraw money from one bank and deposit to another. The only banks that are open on Saturdays are in the mall, so that's where we went. We were frustrated when we saw that there was a line of over 50 people at the first bank - not only were people packed inside, they were waiting out the door and down the hall. However, there were no babies and no small children outside, so I went to the guard and asked to go in. There were no babies or small children inside either; I was called up to the cashier immediately... and (shockingly, amazingly to my gringa mind) no one groaned or complained at all - rather they smiled at Gabriel and continued to wait patiently. I repeated this experience in the other bank.
The second best VIP experience I had was at Immigration... more on that later!
Saturday, July 4, 2009
La Comunicación de Eliminación de Noche // Nighttime EC/pottying
Like I've mentioned before we started daytime Elimination Communication (EC) at about 1 month. For several months we just changed him at night if he fussed. At that point we were using some work-at-home-mom produced all-in-one (AIO) dipers similar to BumGenius brand. Since they have fleece against the baby's skin they don't feel wet even when the "soaker" inside is wet.
Starting at about 4 months those AIOs stopped fitting so well and I wanted to keep him drier at night, so we went to using Motherease AIOs (a terrycloth cloth diaper that closes with snaps) without their covers. I feel like this gives a quick release for pottying or changing if they do get wet. Our little guy rarely has a bowel movement at night, so that's not too much of a concern.
Gabriel is now nearly 6 months and every night is different - sometimes I'm just so tired all I can when he rouses is plug him on the breast and we both fall back asleep. However, if I'm in a lighter sleep stage I'll usually wake up and try nursing him over the Baby Bjorn Little Potty (BBLP) and see if he'll pee. Seems like he squirms and kicks lightly when he needs to pee then moans and kicks when he's wet, so if I'm fast asleep it's hard to catch early.
Once it gets light out it's a bit more delicate - if I sit him on the potty he'll really wake up and be ready for the day versus just changing him and we all sleep longer. This week we have had a couple completely dry nights and then a couple nights/mornings with 6 wet diapers! First thing in the morning is also when he's likely to have a BM, so I do keep an ear tuned for his warning signs (little farts!)
I think that with babies in general and especially with practicing EC there are always going to be occasional puddles. So for protecting the mattress - I find it is useful to have something other than just sheets & mattress cover. We currently have a "Blue Max" waterproof bed pad but I would not buy it again as it doesn't breathe and overheats us... I have my eye on changing it for the Wool Puddle Pad from http://continuum-family.com instead!!!
The bottom line is that everything changes all the time with the individual baby... if you are thinking of ECing your baby at night you'll need to see what works for him or her this week - or even just tonight!
Starting at about 4 months those AIOs stopped fitting so well and I wanted to keep him drier at night, so we went to using Motherease AIOs (a terrycloth cloth diaper that closes with snaps) without their covers. I feel like this gives a quick release for pottying or changing if they do get wet. Our little guy rarely has a bowel movement at night, so that's not too much of a concern.
Gabriel is now nearly 6 months and every night is different - sometimes I'm just so tired all I can when he rouses is plug him on the breast and we both fall back asleep. However, if I'm in a lighter sleep stage I'll usually wake up and try nursing him over the Baby Bjorn Little Potty (BBLP) and see if he'll pee. Seems like he squirms and kicks lightly when he needs to pee then moans and kicks when he's wet, so if I'm fast asleep it's hard to catch early.
Once it gets light out it's a bit more delicate - if I sit him on the potty he'll really wake up and be ready for the day versus just changing him and we all sleep longer. This week we have had a couple completely dry nights and then a couple nights/mornings with 6 wet diapers! First thing in the morning is also when he's likely to have a BM, so I do keep an ear tuned for his warning signs (little farts!)
I think that with babies in general and especially with practicing EC there are always going to be occasional puddles. So for protecting the mattress - I find it is useful to have something other than just sheets & mattress cover. We currently have a "Blue Max" waterproof bed pad but I would not buy it again as it doesn't breathe and overheats us... I have my eye on changing it for the Wool Puddle Pad from http://continuum-family.com instead!!!
The bottom line is that everything changes all the time with the individual baby... if you are thinking of ECing your baby at night you'll need to see what works for him or her this week - or even just tonight!
Saturday, May 23, 2009
blessingway and baby shower
13 December 2009
I was very blessed to have a low-key baby shower last weekend with all of DP's family and many friends. It was great food, great company, and not stressful... it really just felt like a regular family bar-b-que (instead of a traditional baby shower with parlor games). The only "game" we played was to have everyone share their advice for Julio & I and their wishes for our baby Gabriel. Then Julio and I read them out loud for everyone to hear.
Instead of getting lots of baby things we don't want or won't use, we asked for anonymous contributions towards a custom-made padded rocking chair for nursing. It's awesome - we did receive contributions for all but $14 of it!!!! It's already completed and pretty darn comfortable. Of course a few miscellaneous gifts showed up too, but I'm amazed that our plan worked out so well!
Today I had my Blessingway at my house which turned out wonderfully. I was a bit more nervous about it because I was planning it with one of my friends helping to facilitate. It's hard to ask other people to honor you! Being a (sometimes lonely) ex-pat I have definitely learned to bring people I love together. Five of my friends and one of my midwives (also a friend!) were able to share in person today. It worked out wonderfully and I anticipate many more get-togethers between women who had not met previous to today! We did a belly cast of my amazing belly - oh, it turned out sooooo cool! I highly recommend it!!!! (I got mine online at www.proudbody.com/html/PBCKdetails.html)
I am blessed to have been able to read my own birth story from my own brave mother in 1977 (that she just wrote out for me)! She had a natural birth in a birth center and there are amazing pictures of my head just emerging, my first bath, and our first breastfeeding bonding time. That has always been "normal" birth for me and I know it has influenced me in my own choices to study as a doula and now to choose natural birth.
The blessings and good thoughts my friends shared were so touching. It was also great to share some of the quotes and excerpts of emails from my friends and family back in the States who had contributed via email. I feel so loved and supported and I am very happy that I was able to have the Blessingway turn out just how it did!
Elimination Communication at 7 weeks - starting out
3 March 2009 - Gabriel at 7 weeks
EC'ing since: flirted with EC since his birth (cueing when he peed during BFing or when he pooped), starting in earnest just before 2 months (using timing, cueing, and lots of nakey time)
Diapers (use 'em? what sort? how often?): CDs when out of the house - usually prefolds in Bummis SWWs or Kushies AIOs. At home we are using Motherease OSs (aside from nakey time) because I can leave the covers off for more immediate awareness/action. He is used to a dry diaper, so fusses right away when he pees.
Favorite 'potty': I've been using prefolds when I am nursing and we are also starting to use the Baby Bjorn Little Potty. His first "caught" poop in the potty was when I first posted this (3/3/09)!
Other info: My best friend Liziee from elementary school started ECing when her daughter (now 7 years old) was born and I was fascinated to hear about it - she inspired me to read Diaper Free! and be prepared for ECing my own baby.
I am a perfectionist so this is hard for me... I am trying not to obsess over ECing, but still focus on it. Hard balance! My other friend who has successfully EC'ed tells me that I'm doing just fine and the best thing is just to relax and enjoy the process. I guess it's good to remember that there's no deadline and that he'll most certainly be diaper free before anyone else his age!
Our current stage: I generally hold him over a prefold while I'm nursing and make our cueing noise ("pssst") when he pees. But he does spend most of his days and all of his nights in cloth diapers - I'm leery of putting him in the sling without a diaper cover. Not sure why since he's dry I'd say 90% of the time when I get him out! Most of his poops we've caught; they've either been while he was nursing over a prefold or he waited until we were already changing his diaper to let loose!
sharing about Gabriel's birth
20 January 2009
I had a beautiful birth! Gabriel was born at home on 10 January, 2009 at 3:50am. I expected him to come a week or so after the due date, so this was a bit of a surprise! I honestly think that the 6.2 earthquake in Costa Rica on Thursday got my labor jump started!
I feel blessed to have been able to have a wonderful natural labor (9 hours) at home utilizing a lot of walking in the (nearly) full moon light outside our house, a birth pool and DP Julio being wonderfully supportive!!! Gabriel is so perfect and healthy, for which we are very thankful!!! He weighed 8lb, 12 oz. and was 50 cm long. His Apgar score was a 10 out of 10!!!
My midwife is awesome and things worked out very well - although we were all tired, because I was laboring at night she was able to arrive much much faster than expected. Which was good because he was born less than 3 hours later!
I had a not-so-beautiful afterbirth - a partially detached placenta - and lost a lot of blood. I was on IVs during the day and then have been taking iron supplements, iron-rich food, and drinking lots of water. My midwife is surprised and pleased at how well I'm bouncing back!
I'm working on writing out his birth story...
Gabriel at nearly 2 months
5 March 2009
Gabriel is cooing and laughing all the time now, which is just hilarious!
He's an angel baby and is sleeping wonderfully well at night - pretty much from 8-11pm, then wakes up for some giggles (and often some time on the webcam with Grandma & Grandpa), then nurses and goes to sleep until 7am. That does include one or two diaper changes & nursing sessions for which I don't really have to wake up fully.
I never expected such a mellow baby. Julio says he did - I guess his personality is shining through our little one! Thank goodness; I was not an easy baby myself! He only cries when he had a need to be met, and really is so sweet with us.
He adores his bath - smiling and splashing or just blissing out looking like he's meditating. He doesn't cry even when he gets sprinkled with water or water in his eyes, only when he's actually being taken out and dried off! He loves his bath so
much that I've taken to giving him half of his bath, leaving him in his little tub while I shower (with an eye on him every second, of course!) and then finishing his bath after I've gotten dressed. (He does have a little terry hammock thing that sits him in his tub securely.)
During the day he spends a lot of time in the sling - just observing and sleeping a lot. He also spends some time in the little bouncer seat when the sling gets to be too much for me - he's generally happy to let us eat our meals while talking to him there!
We are very much in love and enjoying being his parents!
Gabriel is cooing and laughing all the time now, which is just hilarious!
He's an angel baby and is sleeping wonderfully well at night - pretty much from 8-11pm, then wakes up for some giggles (and often some time on the webcam with Grandma & Grandpa), then nurses and goes to sleep until 7am. That does include one or two diaper changes & nursing sessions for which I don't really have to wake up fully.
I never expected such a mellow baby. Julio says he did - I guess his personality is shining through our little one! Thank goodness; I was not an easy baby myself! He only cries when he had a need to be met, and really is so sweet with us.
He adores his bath - smiling and splashing or just blissing out looking like he's meditating. He doesn't cry even when he gets sprinkled with water or water in his eyes, only when he's actually being taken out and dried off! He loves his bath so
much that I've taken to giving him half of his bath, leaving him in his little tub while I shower (with an eye on him every second, of course!) and then finishing his bath after I've gotten dressed. (He does have a little terry hammock thing that sits him in his tub securely.)During the day he spends a lot of time in the sling - just observing and sleeping a lot. He also spends some time in the little bouncer seat when the sling gets to be too much for me - he's generally happy to let us eat our meals while talking to him there!
We are very much in love and enjoying being his parents!
3 month update
13 April 2009
Here are my answers to some questions another mom asked on a Mothering.com forum
How's baby?
Amazing! Gabriel is a happy, mellow baby who loves interacting with people and has been trying to stand up and even bounce since about 1 month old. Now that he's actually able to he is so pleased with himself. Julio and I are loving watching him learn about his world. He's just starting to reach out to toys and sometimes grasping them to bring them to him, very exciting! We live in Costa Rica where baby wearing
isn't too common (though breast-feeding is, thank goodness!) and so we get tons of comments when he's in the sling - everyone thinks he's so cute, asks "is he comfortable in there?", or comments "oh, must be just like when he was in your belly!" I thought I would hate that kind of thing, but it turns out that both of us love the attention! 
How's nursing working?
Wonderfully! My LO is a good eater - latched on at 3 minutes old and we both continue to enjoy nursing. I am soooo thankful that we figured out the side-lying position early on since I really love being able to get him latched on and then fall back asleep. Neither of us really wake up for it!
Are you working?
I am so blessed to be completely available to my baby for right now. DP and I agreed that I would have the first 3 months just to be a mommy. That doesn't mean I haven't done anything work-related, but I've just been working behind the scenes (such as the urgent work email I finished and sent after I'd been in labor for 3.5 hours?!??! Or the nights under a deadline working 8-11:30pm while the baby sleeps?! Ugh... we are trying to figure out something better.) Since we have our own business, we have control over and flexibility about how I can integrate back into the daily running of it. I feel kind of bad because this is our high season (we do custom eco and adventure travel in Costa Rica!) and DP is shouldering nearly all the burden of emails, calls, and creating itineraries. I've been thinking about advertising for either a babysitter or personal assistant so I could get 3-4 hours of work done a day.
Are you tired?
My LO sleeps wonderfully well - for his whole 3rd month he pretty much feel asleep on his internal clock at 8pm, and slept until 11:30pm (give or take), woke up to nurse and to play for a short time, then slept again from about 12:30 to 7am. So... I haven't been feeling sleep deprived unless I stay up super late of my own volition - there have been a couple nights of cooking until 2am so I can do it uninterrupted!
Are you having any troubles?
I had mastitis twice and a plugged duct once - all of which were hell for a short time! Other than that I feel very lucky and blessed; I have an easy baby, motherhood comes naturally and I am content with my life situation.
I am especially happy that my friends (the ones who live locally) adore and dote on Gabriel and can't get enough of him... so we have potlucks and dinners out and he is more than invited along. I think that being able to have a social life post-baby was a worry for me and it is no longer.
Here are my answers to some questions another mom asked on a Mothering.com forum
How's baby?
Amazing! Gabriel is a happy, mellow baby who loves interacting with people and has been trying to stand up and even bounce since about 1 month old. Now that he's actually able to he is so pleased with himself. Julio and I are loving watching him learn about his world. He's just starting to reach out to toys and sometimes grasping them to bring them to him, very exciting! We live in Costa Rica where baby wearing
isn't too common (though breast-feeding is, thank goodness!) and so we get tons of comments when he's in the sling - everyone thinks he's so cute, asks "is he comfortable in there?", or comments "oh, must be just like when he was in your belly!" I thought I would hate that kind of thing, but it turns out that both of us love the attention! How's nursing working?
Wonderfully! My LO is a good eater - latched on at 3 minutes old and we both continue to enjoy nursing. I am soooo thankful that we figured out the side-lying position early on since I really love being able to get him latched on and then fall back asleep. Neither of us really wake up for it!
Are you working?
I am so blessed to be completely available to my baby for right now. DP and I agreed that I would have the first 3 months just to be a mommy. That doesn't mean I haven't done anything work-related, but I've just been working behind the scenes (such as the urgent work email I finished and sent after I'd been in labor for 3.5 hours?!??! Or the nights under a deadline working 8-11:30pm while the baby sleeps?! Ugh... we are trying to figure out something better.) Since we have our own business, we have control over and flexibility about how I can integrate back into the daily running of it. I feel kind of bad because this is our high season (we do custom eco and adventure travel in Costa Rica!) and DP is shouldering nearly all the burden of emails, calls, and creating itineraries. I've been thinking about advertising for either a babysitter or personal assistant so I could get 3-4 hours of work done a day.
Are you tired?
My LO sleeps wonderfully well - for his whole 3rd month he pretty much feel asleep on his internal clock at 8pm, and slept until 11:30pm (give or take), woke up to nurse and to play for a short time, then slept again from about 12:30 to 7am. So... I haven't been feeling sleep deprived unless I stay up super late of my own volition - there have been a couple nights of cooking until 2am so I can do it uninterrupted!
Are you having any troubles?
I had mastitis twice and a plugged duct once - all of which were hell for a short time! Other than that I feel very lucky and blessed; I have an easy baby, motherhood comes naturally and I am content with my life situation.
I am especially happy that my friends (the ones who live locally) adore and dote on Gabriel and can't get enough of him... so we have potlucks and dinners out and he is more than invited along. I think that being able to have a social life post-baby was a worry for me and it is no longer.
natural birth in Costa Rica
21 April 2009
I was recently asked if I knew anything about natural birth in Costa Rica and here's what I answered:
A little about my experience:
Our amazing baby Gabriel was born at home in San Juan de Santa Barbara de Heredia in Costa Rica on 10 January, 2009 at 3:50am. My DP Julio and my midwife Rebecca were there helping me bring Gabriel into the world. I feel blessed to have been able to have a wonderful natural labor (9 hours) utilizing a lot of walking in the full moon light outside our house and a birth pool.
My midwife Rebecca is awesome and things worked out very well - although we were all tired since I labored through the night. However, because of this she was able to arrive much much faster than expected. Which was good because my baby was born less than 3 hours later!
I had a not-so-beautiful afterbirth - a partially detached placenta - and lost a lot of blood. I was on IVs during the day and then took iron supplements, ate iron-rich food, and drank lots of water. Because Rebecca lives farther away from my house they tag-teamed and Marie checked in on me several times on Gabriel's birth day and especially that first week. I felt so supported and cared for by both Rebecca and Marie!
In short I was very pleased with my prenatal, labor & delivery and post-partum attention from Rebecca and Marie. Their business is called Mamasol http://mamasol.com/. I clicked really well with Rebecca from long before we'd even conceived our baby - we had talked at length on the phone and I already knew that I wanted her to be my midwife. Therefore Rebecca was my primary midwife - she lives in Turrialba, Cartago. Marie was my secondary midwife; she lives in Belen, Heredia. Marie was not able to attend the actual birth, but as I mentioned she helped a lot with my post-partum visits.
Here's an article from last July that came out in the national newspaper in Costa Rica about homebirth: http://www.nacion.com/ln_ee/2008/jul...ea1596996.html
I believe that overall the health system in Costa Rica is excellent - both public and private. However, for labor and delivery, my opinion is that the protocols call for measures that are antiquated and over-medicated.
This is what I've learned about standard labor and delivery in Costa Rica:
The public health system was created in the 40s and modernized throughout the 40s, 50s, and 60s. http://www.ccss.sa.cr/html/organizac.../c_org_06.html With those changes the government did put a lot of scare tactics out there and effectively killed off the profession of traditional midwifery. The general public in Costa Rica now believes it is much safer to birth in a hospital than at home. There is no certification for midwives here, just certification for Obstetric Nurses. Therefore, the only midwives practicing are foreigners who have been certified in other countries. They are not technically allowed to practice here, which is why I said that they operate "under the radar" and often with the back-up of Dr. Adam Paer (more on him below).
On a positive note, Midwifery Today had their 2007 conference in Costa Rica and did the first doula training with 30+ women participating. It should be fairly easy to contract a doula - any of the practitioner links I'm providing will be able to help connect you with one. I took my doula training in 2004 in Portland, Oregon, but haven't yet practiced; I would be happy to help anyone who lives in the Central Valley who is interested.
If you had national insurance with the Caja (the national health service) everything would be free but you would need to have your baby in a hospital and be subject to those protocols. You can get national health insurance as a tourist/visitor and I know it's very cheap - I heard it was less than $50 a month a few years ago. As a pregnant woman in Costa Rica you are entitled to public health care without paying anything at all, same goes for babies. This widespread availability of healthcare is one reason that the entire population is so healthy as opposed to other Latin American countries. At the public hospitals the norm is to give pitocin to speed up labor, but of course it just makes the contractions faster and more intense and more painful - they don't offer pain relief meds, birth pools, or allow you to walk around. You labor in a large room with about 20 other women until transition, then you are transferred to a more private room where you'll get a table with stirrups. Julio's sister had a hellish experience with what sounds like an overdose of Pitocin at the Hospital de Alajuela - over 100 45 second contractions with 15 seconds to recover between contractions... but a friend just said she had a positive experience birthing in the Hospital Mexico and DP's sister-in-law just had a positive experience birthing at the Hospital de la Mujer (Carid). I wouldn't judge those public hospitals on one experience each, but that's something to start with.
If you opted for private medical attention there are at least half a dozen private hospitals in the Central Valley (and others in cities around the country) - the doctors there will all do what they can to follow a woman's birth plan... though there are varying levels of belief in natural birth, just like in the US. Sadly, most of the time a woman goes in for a natural birth she ends up with a c-section in the private hospitals, simply because it's more convenient and they make more money.
Doctor Adam Paer is about as natural as you can get for a doctor and a hospital birth - he believes strongly in the midwifery model and waterbirth. He did our 4-D ultrasounds (2 of them) and if I had needed to transfer to a hospital would have been the lead of my birth team. Here's his profile: http://www.obgyncr.com/online/modules/i/index.php?id=1 My friend Mary did have a scheduled C-section with him and was very pleased with her whole private hospital experience at La Cima.
So as you can see for private homebirths attended by a midwife it's a bit harder to get in touch with the right people, but a great place to start is with Rebecca or Marie at MamaSol. I've also heard great things about Nati and Ansu of Mamas Al Nacimiento http://www.mamasalnacimiento.com/
I was recently asked if I knew anything about natural birth in Costa Rica and here's what I answered:
A little about my experience:
Our amazing baby Gabriel was born at home in San Juan de Santa Barbara de Heredia in Costa Rica on 10 January, 2009 at 3:50am. My DP Julio and my midwife Rebecca were there helping me bring Gabriel into the world. I feel blessed to have been able to have a wonderful natural labor (9 hours) utilizing a lot of walking in the full moon light outside our house and a birth pool.
My midwife Rebecca is awesome and things worked out very well - although we were all tired since I labored through the night. However, because of this she was able to arrive much much faster than expected. Which was good because my baby was born less than 3 hours later!
I had a not-so-beautiful afterbirth - a partially detached placenta - and lost a lot of blood. I was on IVs during the day and then took iron supplements, ate iron-rich food, and drank lots of water. Because Rebecca lives farther away from my house they tag-teamed and Marie checked in on me several times on Gabriel's birth day and especially that first week. I felt so supported and cared for by both Rebecca and Marie!
In short I was very pleased with my prenatal, labor & delivery and post-partum attention from Rebecca and Marie. Their business is called Mamasol http://mamasol.com/. I clicked really well with Rebecca from long before we'd even conceived our baby - we had talked at length on the phone and I already knew that I wanted her to be my midwife. Therefore Rebecca was my primary midwife - she lives in Turrialba, Cartago. Marie was my secondary midwife; she lives in Belen, Heredia. Marie was not able to attend the actual birth, but as I mentioned she helped a lot with my post-partum visits.
Here's an article from last July that came out in the national newspaper in Costa Rica about homebirth: http://www.nacion.com/ln_ee/2008/jul...ea1596996.html
I believe that overall the health system in Costa Rica is excellent - both public and private. However, for labor and delivery, my opinion is that the protocols call for measures that are antiquated and over-medicated.
This is what I've learned about standard labor and delivery in Costa Rica:
The public health system was created in the 40s and modernized throughout the 40s, 50s, and 60s. http://www.ccss.sa.cr/html/organizac.../c_org_06.html With those changes the government did put a lot of scare tactics out there and effectively killed off the profession of traditional midwifery. The general public in Costa Rica now believes it is much safer to birth in a hospital than at home. There is no certification for midwives here, just certification for Obstetric Nurses. Therefore, the only midwives practicing are foreigners who have been certified in other countries. They are not technically allowed to practice here, which is why I said that they operate "under the radar" and often with the back-up of Dr. Adam Paer (more on him below).
On a positive note, Midwifery Today had their 2007 conference in Costa Rica and did the first doula training with 30+ women participating. It should be fairly easy to contract a doula - any of the practitioner links I'm providing will be able to help connect you with one. I took my doula training in 2004 in Portland, Oregon, but haven't yet practiced; I would be happy to help anyone who lives in the Central Valley who is interested.
If you had national insurance with the Caja (the national health service) everything would be free but you would need to have your baby in a hospital and be subject to those protocols. You can get national health insurance as a tourist/visitor and I know it's very cheap - I heard it was less than $50 a month a few years ago. As a pregnant woman in Costa Rica you are entitled to public health care without paying anything at all, same goes for babies. This widespread availability of healthcare is one reason that the entire population is so healthy as opposed to other Latin American countries. At the public hospitals the norm is to give pitocin to speed up labor, but of course it just makes the contractions faster and more intense and more painful - they don't offer pain relief meds, birth pools, or allow you to walk around. You labor in a large room with about 20 other women until transition, then you are transferred to a more private room where you'll get a table with stirrups. Julio's sister had a hellish experience with what sounds like an overdose of Pitocin at the Hospital de Alajuela - over 100 45 second contractions with 15 seconds to recover between contractions... but a friend just said she had a positive experience birthing in the Hospital Mexico and DP's sister-in-law just had a positive experience birthing at the Hospital de la Mujer (Carid). I wouldn't judge those public hospitals on one experience each, but that's something to start with.
If you opted for private medical attention there are at least half a dozen private hospitals in the Central Valley (and others in cities around the country) - the doctors there will all do what they can to follow a woman's birth plan... though there are varying levels of belief in natural birth, just like in the US. Sadly, most of the time a woman goes in for a natural birth she ends up with a c-section in the private hospitals, simply because it's more convenient and they make more money.
Doctor Adam Paer is about as natural as you can get for a doctor and a hospital birth - he believes strongly in the midwifery model and waterbirth. He did our 4-D ultrasounds (2 of them) and if I had needed to transfer to a hospital would have been the lead of my birth team. Here's his profile: http://www.obgyncr.com/online/modules/i/index.php?id=1 My friend Mary did have a scheduled C-section with him and was very pleased with her whole private hospital experience at La Cima.
So as you can see for private homebirths attended by a midwife it's a bit harder to get in touch with the right people, but a great place to start is with Rebecca or Marie at MamaSol. I've also heard great things about Nati and Ansu of Mamas Al Nacimiento http://www.mamasalnacimiento.com/
my personal plastics report!
Gabriel is now 4 months, 1 week old!
Plastic for my Babe:
I have been teased by DP's family about only allowing 100% organic things touch my baby's lips, but in reality I'm not so good. His (rarely used) pacifier is silicone which I understand to be safe. His teether is a plastic made from corn resin (definitely BPA free, etc.) from www.greensproutsbaby.com so I don't have to worry about that (although I would hate to lose it!!!) I do worry about the rest, though. He has a few stuffed toys that are polyester and/or have velcro, which he loves to suck on. Plus he's been sucking on the toys on the hand-me-down Tiny Love playmat and Fisher Price bouncy seat, which both pre-date awareness of PBA free plastics... I've been debating - should I take them away from him even though he seems to adore them?!?!?!
I do have hand-knit, sewn and crocheted toys, plus a wooden rattle but he has not yet taken an interest in any of those. He does love his quilt that his grandma made for him. Oh, and of course books - but I've noticed that a lot of books seem to be printed in China these days... should I be extra concerned about the ink being toxic?!?
Plastic in the Kitchen:
I've been teased by Julio about being a freak regarding minimizing plastic use in the kitchen.
I cook on the stovetop exclusively in stainless steel and cast iron, microwave only in glass or ceramic. The only Teflon thing I have left is the rice cooker and I've debated getting rid of it, but hard to do when rice is a staple in my Tico (Costa Rican) family and we only have two burners on the stove anyway!
For storage I've been trying to switch over to glass Pyrex and Ball jars as much as possible, but I still use plastics for storage (in fridge & freezer & dry goods) when food is already fully cooled.
For drinking water I religiously use a Kleen Kanteen or Sigg bottle. I'm just starting to figure out pumping for those times when I'm away from my babe. For breast milk I bought glass baby bottles, but find that they are enormous and not very realistic, at least right now. The storage bottles that go with my Lansignoh breast pump are BPA free, so I'm going with those. Silicone nipples only.
Elimination Communication at 3 months old - we are really getting the hang of this!!!
21 April 2009
Just wanted to share our rousing success: over the past week I've lost track of how many pees we've caught per day - it's been anywhere from 5 to 10+ each day!! Plus, just a few days ago Julio cued Gabriel to pee and he went immediately, which has made him even more of a believer in ECing. It was so validating to hear Julio and my friend (who wants to get pregnant soon) talking enthusiastically today - my friend had just observed two successive cued pees and said "I'm completely sold on the idea now!" The thing I love most is that our baby considers this form of peeing and pooping completely normal as opposed to doing it in a diaper.
Tricks I've been finding especially useful:
*Using a cloth diaper without a cover at home during the day so that if he fusses I can immediately tell by touching the outside whether he needs to pee or if we've had a miss.
*Offering the opportunity in the mornings upon awakening and after every nap
*Offering the opportunity after nursing; my little one seems to have stopped automatically peeing during nursing (which he did for the first couple of months)
*Offering the opportunity whenever he gets squirmy or fussy
*Having my little one naked for several hours a day when it's nice weather
*Keeping the BBLP (Baby Bjorn Little Potty) by the bed at night and by my nursing rocker during the day
*Giving my little one the opportunity to pee outside whenever possible
In his second and third month we were pretty darn good about catching the poops, but recently he's only been having bowel movements when he's super relaxed - like in the bath (ew!!!) or asleep. I had a particularly frustrating time last week when I knew he had to poop so I offered the potty (not interested), then he had the bowel movement in the bath less than 30 min later.
Tricks I've been finding especially useful:
*Using a cloth diaper without a cover at home during the day so that if he fusses I can immediately tell by touching the outside whether he needs to pee or if we've had a miss.
*Offering the opportunity in the mornings upon awakening and after every nap
*Offering the opportunity after nursing; my little one seems to have stopped automatically peeing during nursing (which he did for the first couple of months)
*Offering the opportunity whenever he gets squirmy or fussy
*Having my little one naked for several hours a day when it's nice weather
*Keeping the BBLP (Baby Bjorn Little Potty) by the bed at night and by my nursing rocker during the day
*Giving my little one the opportunity to pee outside whenever possible
In his second and third month we were pretty darn good about catching the poops, but recently he's only been having bowel movements when he's super relaxed - like in the bath (ew!!!) or asleep. I had a particularly frustrating time last week when I knew he had to poop so I offered the potty (not interested), then he had the bowel movement in the bath less than 30 min later.
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