All I want for my birthday…

…is an email response from the US Embassy in Mexico about our daughter’s paperwork. Ugh. It’s been MIA for 8 weeks. We spent two hours on the phone today trying to get through.

In the meantime I’m working on a version of Amecameca for Christine. She picked the colors and I love their high contrast.
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Things are kind of winding down in Mexico and we’re both feeling antsy about returning home. It IS peak mango season right now, which is helping, but even cheap and abundant mangoes cannot compete with my desire to pet Samson again.

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Giving birth in Mexico

This post is not an hour-by-hour birth story with all the gory details (I figure most of you just breathed a sigh of relief). If you ask my mom what it was like to birth two kids sans drugs she’ll say, “Oh I don’t remember it being so bad.” Hmm. Apparently there is some really healthy forgetting that happens afterwards, because as Leela was entering the world I remember thinking, “Women have done THIS for all of human history??!”  If she’s ever to have a sibling it’s probably best I not immortalize all the memories in writing. I’ll leave those out while still reviewing what it was like to do this in another country.

In summary, we did not regret choosing to do this in Mexico. It was an overall positive experience and we felt comfortable, listened to, and well taken care of. However it did require some flexibility on our part, particularly with regard to delivery and post-delivery protocols.

Birth Plan
My good friend is an anesthesiologist in San Francisco and has been present at a lot of births, so I asked for her thoughts about prepping for this one. She said ridiculous birth plans are becoming commonplace at her hospital…like 15-page novellas complete with long lists of words no one within earshot of the mother is allowed to utter. “And in the end, hardly any birth follows such a rigid play-by-play, nor can people predict how they’ll feel during labor. My advice? Know what’s important to you, but stay flexible.”

I’m not too keen on making detailed plans ahead of time anyway. For anything. So talking through what was important to us felt like a much worthier use of time, and out of that conversation came this very simple plan:
– pick a hospital where they’d let me move around during labor
– try labor without an epidural
– avoid an unnecessary c-section (more on that in an earlier post)

Due Date
At just over 30 weeks pregnant I flew home to see Samson and family. I was uninsured in the states, so if the baby came early it was going to bankrupt us, and every day I’d repeat don’tgointolabordon’tgointolabor. Fast forward two months and it had changed to pleasegointolaborpleasegointolabor.  My doctor told me he would induce at 41 weeks (one week earlier than most U.S. doctors) and I’d read that induction more often leads to c-sections.

P1130633At 39 weeks I tried hiking to the top of this butte in Atlixco in hopes it would spur labor…it did not. It did, however, yield some beautiful shots of Mt. Popo at sunset.
Atlixco, MexicoAt 41 weeks my doctor refused to wait longer on the induction, but I did some self-advocating around starting the induction as slowly as possible, and at home. By the time we met him at the hospital some mild contractions had started, so we didn’t end up using petocin. We just checked into the labor room and waited.

Labor
We had an entire room to ourselves, including my own bathroom and shower. We checked in at 11am, and throughout the afternoon and evening it was pretty much just the two of us with occasional check-ins from the doctor and nurses. My doctor stayed in the hospital the entire time, which we really appreciated.

I tried negotiating my way out of the IV since walking around with the stand was awkward, but it was pretty much mandatory. Oh well. Stay flexible Katie.

P1130724At some point in the afternoon my water broke which started the clock ticking. If more than 12ish hours passed without delivering, my doctor was moving to a c-section. From what friends have told me this is similar to policies in the U.S., the exception being some midwifery practices.

I turned down the epidural because I heard it typically slows labor. But then my labor turned to back labor, and it was….rough. I endured the worst of it for 6 hours with hardly any progression. “At this rate, you only have 18 more hours of labor left,” R. cheerfully joked. I think my response was something like, “Come here. I want to punch you in the face.”

If it was all heading to a midnight c-section anyway I figured the pain was pointless, so we called for the epidural. The ironic thing was that after the epidural, everything sped way up. Maybe because my muscles weren’t so clenched? Regardless, I’m so glad we stayed open to different ideas. Just after midnight my doctor said we were getting close to delivery.

Delivery
There was hardly anyone in our labor room all day, but for some reason there were something like 11 people in the delivery room. To this day I have no idea who half of them were or why they were there. That might be more about our hospital – it’s affiliated with a university and I think there were a lot of doctors-in-training around.

Probably the saddest I got during this whole process was when I saw that they were going to make me go all old-school for the delivery. Like flat on my back, legs restrained. Ugh. But getting worked up over it wouldn’t have changed anything, so I just rolled with it. My sense is that this kind of set-up is more common in Mexico, even in the modern private hospitals.
P1130739Post-Delivery
They let us hold Leela for a few minutes. After that she was taken to the nursery, where she was put in an incubator (even though her Apgar score was a 9…I think it’s just more about the Mexicans’ obsession with warmth) and given a bottle. None of this was our preference but it was already 3am and they promised to bring her into our room in the morning.

I was put in a “recovery room” for an hour, which was really just a dark corner of the hospital where I was hooked to an annoying beeping machine. It seemed weird but eh…it was only an hour. R. was not allowed to sit with me, but he was allowed to go with Leela to the nursery while they measured and weighed her.

If I remember correctly, the only vaccination that was non-negotiable at birth was Hepatitis B. For the others we just went with the CDC’s recommendations.

The next morning they wheeled Leela in and we had some nice family time. Around noon our doctor called and said he felt I was ready to go home if I wanted, so that’s what we prepared to do.
P1130737Claiming they needed to do a couple more measurements, the nurses took Leela back to the nursery. We found out that this is more about putting the baby in lockdown until you pay your bill. Verrrry clever! R traipsed all over the hospital paying portions of the bill and gathering receipts and approval stamps (they love multi-step payment processes in Mexico). Only after presenting it all at the nursery door were we handed our baby.

Here we are leaving the hospital less than 12 hours after her birth. I don’t think they would’ve made us leave that soon if we didn’t want to – recovering at home just seemed more appealing to me.
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Before leaving the hospital we provided information for the Acta de Nacimiento (record of birth). Rebel Heart’s blog contains a detailed post on this process, which turned out to be very helpful, particularly the note about how the mother needs to write her MAIDEN name on the form…not her married name. Even after reading this we messed up the form and had to ask for our doctor’s help in officially amending it.

The Acta de Nacimiento is then taken to Civil Registry, where you apply for a Mexican birth certificate. After going through the process of obtaining visas we were well-versed in the nightmare that is Mexican bureaucracy, so when our doctor suggested we hire a lawyer to handle the process for us, I think our exact response was, “You can DO that?! YES PLEASE.” We gave her our records and then met her at the hospital a week later to receive Leela’s birth certificates (we paid to get extra copies, thinking that would be much easier than trying to request some years later). It cost approximately $50, and honestly, we probably would’ve paid three times that for all the trouble it saved us.

After you have the birth certificate, you set up an appointment with the U.S. Consulate at the nearest embassy to apply for the Consular’s Report of Birth Abroad (essentially the equivalent of a U.S. birth certificate). Their website contains detailed instructions on all of the paperwork that needs to be assembled. Our appointment there was very straightforward and now we’re just waiting for her CRBA and U.S. Passport to arrive in the mail.

Ear-piercingP1150620Last week Leela made an appearance at the English class where I volunteered before she was born (the teenage students wanted to throw her a “baby shower”, which was super adorable and sweet). They were varying degrees of shocked and horrified to learn that we didn’t pierce Leela’s ears. All little girls here get it done, which I suppose explains why the public assumes our baby is a boy. “It’s less painful if you do it when they’re a baby,” is everyone’s reason. Call me crazy, but after seeing the cutest little gold hoops on a baby last week I’m half-tempted. In the meantime we just get to hear a lot of “hermoso” and “precioso”.

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Other posts in the “Moving to Mexico” series:
At home in Cholula
Transporting a pet to another country
What to pack for a year abroad
Animals in the murals and on the sidewalks
Preparing to have a baby abroad

Four reasons baby knits are the best

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1. They finish quickly. Even when the gauge is tiny.
2. Compared to adults there’s not the same angst over fit and sizing. A baby body is shaped like a sack of sugar with four sausages coming out of it, which everyone loves and the baby is not trying to disguise, so why fuss over a slimming neckline or the exact placement of waist darts?
3. Little knits are great stash-busters, especially for partial skeins (bring on the stripes!).
4.  A baby is too small to have an opinion about a garment or, let’s be honest, look anything but cute in it.

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baby!

Tomorrow our little dual-citizen will be two weeks old. Defying overwhelmingly skewed prediction odds from friends, family, and strangers throughout Mexico, we had a little girl. We named her Leela. I’ll write more later about her birth, but all in all it was a very positive experience.

P1130817It took less than a week before we were admonished for not wrapping her in enough blankets. I knew it was coming. Mexicans are SERIOUS about infants and piles of fleece – it’s rare that you glimpse any part of a baby being carried down the sidewalk. No face, no hands, nothing. Everything’s swaddled into a super thick cartoon fleece baby burrito.

The woman who approached us in the park had an agenda, but she tried disguising it amongst friendly baby chatter:

Woman: Oh what a cute baby. How old is she?
Me: One week.
Woman: So pretty. But you need another blanket on her. It’s very cold out.
(it was sunny and 75 degrees)
Me: We are from the United States and it’s not very cold for us. It’s warm.
Woman: Did you have the baby here in Mexico?
Me: Yes, in Puebla. My husband is studying here for the year.
Woman: So she is a Mexican baby! How great. You should put another blanket on her though.

……and so it continued. Social niceties interspersed with PUT A BLANKET ON YOUR BABY BEFORE SHE FREEZES!! Exasperated with our lack of shared urgency over the situation, she eventually left.

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In general, Mexicans seem more excited about babies than Americans. Or at least the average random person here is much more likely to want to see the baby, ask questions, and gush over him/her. That part is fun. I just have to also expect that they might voice concern over her dying of exposure.

In between baby care I’m working on some little sweaters for her, and together R and I are moving forward on all of the paperwork for the Mexican and American birth certificates.
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Other posts in the “Moving to Mexico” series:
At home in Cholula
Transporting a pet to another country
What to pack for a year abroad
Animals in the murals and on the sidewalks
Preparing to have a baby abroad

Villa Illuminada

Last weekend we walked through Atlixco’s “Villa Illuminada” – which was described to me as “a street of Christmas Lights that goes up around the holidays”.
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Talk about an understatement. We walked for over an hour through tunnels of lights and past Christmas character displays. My personal favorite was this giant shepherd and his flock of…chickens.

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Also, a boy and his Santa dog who looked like they’d had enough of this light-display-stuff.
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Pregnancy in Mexico: Preparing to have a baby abroad

Atlixco, Mexico
My parents have always supported my brother and me in making very independent choices, even when the choices made them nervous. Still, it made me really happy when after visiting in October, my mom announced that she “felt just as good” about me having the baby here as at home. “Maybe even better…your doctor was soooo nice.” And remember, this is with no car, no nearby family, and (at least for me) little knowledge of local language. It has been a good experience thus far – one I’ve never regretted, even during the few times I’ve felt maybe a little lonely or isolated. Really, the worst of my anxieties took place while I was still in Boston, struggling to make plans and answer people’s questions. Finding just a couple of blogs where women spoke first-hand about pregnancy/birth in Mexico helped immensely, so with this post I’ll add what I can.

Health Insurance
This one caused the most stress. It was the hardest to google. There was insuring the baby as well as insuring me once I left work (halfway through a pregnancy). Healthcare costs a lot less in Mexico, but what if the baby needed NICU time? Or what if on a visit to the states this year I got in a car accident? One uninsured surgery at home is enough to wipe out a savings account and then some.

We’re in Mexico because R. has a Fulbright from the US government, and while they provide him with health insurance, that coverage does not extend to spouses. While I could have stayed on my job’s health insurance (or bought COBRA), neither works abroad. It would have cost thousands to add me to his university insurance, and it wasn’t clear to us even then how it would translate to Mexico. So I tried contacting companies that specialize in coverage for expats and travelers. The first broker replied, “Katie, no insurance company will cover you if you are pregnant. I’m sorry.” Right around here I think I cried.

After some more emailing, I did find an expat insurance company – CIGNA – that was willing to sell what’s essentially global disaster insurance with an exclusion for all prenatal/maternity costs. It took about a month to process my application and finalize the policy details. We also found out that adding the baby to R’s university insurance was possible, and although pricey, would work both abroad and in the states.

Once the insurance was selected I knew I was locked into having the baby abroad no matter what. I’m uninsured for the birth, and we can only afford to do this out of pocket if we’re in Mexico and not the states.

P1130567Finding a doctor and hospital
Before arriving we made a list of area hospitals that also have neo-natal intensive care units, and first on the list was UPAEP Christus Muguerza. We walked up to the info desk one day, asked if any of the OB-GYNs spoke English, and were invited upstairs to meet a doctor.

The doctor was kind and patient, and the fact that he gave us so much of his time without us having an appointment felt good. R. and I agreed that we could keep looking, but we liked the hospital and we liked the doctor, so we stayed put. I had monthly appointments until week 32 and then I moved to weekly. A few days before each appointment I do a lab test, the results of which I can check online that same day. During each appointment the doctor talks with me, records my weight and blood pressure, and does an ultrasound.

It’s common here to be given your doctor’s email address. And the best part is they ACTUALLY WRITE BACK. I know…I tried it once. Our doctor also gave his cellphone number and said I should call if I have concerns. Any family members who were still feeling weird about me having a baby in Mexico (ahem…Gramma) found this to be very reassuring. In fact, I think her exact words were, “Well shoot – I’ve never been able to call my doctor on the phone.”

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From my conversations with Pueblans I think we picked a fancy hospital. Their eyebrows go up and they kind of whistle when I name it. BUT. BUT. Here’s the thing. If you want to get called a liar, if you want to watch jaws drop, tell someone in Mexico how much it costs out of pocket to have a baby in the US. Seriously. My prenatal appointments, including ultrasound, are $45. My lab tests are $6. It will cost us about $2,200 to have the baby here and pay out of pocket…slightly more if it’s a C-section.

The C-section thing
Okay, I’m going to give this its own heading because the topic kept coming up in all of my pre-trip research. And that is that the C-section rate in Mexico is high. Really high, even by U.S. standards. The World Health Organization puts it at just under 38%. This article says between 50-70% depending on the hospital. The reasons given vary, but top among them are scheduling convenience (for mom and doctor), economics (larger insurance payouts for C-sections), and cultural attitudes about labor pain.

This has definitely been on my mind as we’ve navigated prenatal care and birth prep, and based on my conversations with women here, it should be. Of the handful of mothers I’ve met, not one has had a natural birth. One said her doctor told her the baby was “too big” in week 38, another said she wanted to give birth when her husband wasn’t traveling for work so she scheduled a C-section, and so on. If I have to get one so be it, but I’d rather it be a last resort.

Honestly, it remains to be seen how things will pan out with my doctor in this regard. From the start I’ve said that I want to avoid a C-section if possible, that I want to breastfeed and not have the baby spend all its time in the hospital nursery, that I want to move around during labor… and he’s indicated that he’s on board with all of it. Everything. But then at my last appointment he said something about measuring my pelvis to see if it’s big enough for birth. And I was like, “UHOH. This is how it starts.” Because I think the only way to truly tell if your pelvis is big enough is to go into labor and see what happens. So I might have to fight him a little. Or a lot? Sigh. Wish me luck.

If I had a do-over I would have sought out prenatal yoga sooner. I did so many online searches – in English and Spanish- for things like doulas, orgs that support natural birth, recommendations for Pueblan doctors who support natural birth, and I couldn’t find anything to go on. Or at least anyone who would respond to my inquiries (sidebar: google searches don’t function as well here. Existing businesses don’t show up, addresses are incorrect – the system just isn’t as omniscient). Anyhow, when I started yoga classes down the street and got to talking with classmates? Pshhh those women had the inside scoop on ALL of this stuff. I just got to them too late to make changes to my setup. So my advice is to hang around a local yoga center, fancy bike shop, health food store – wherever the alternative hippie ladies congregate – and make friends.

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Documents for citizenship
A baby born here has dual-citizenship. First you complete paperwork for its Mexican birth certificate and then go the U.S. Consulate for the Consular’s Report of Birth Abroad (CRBA) and Passport. At the end of this post I’ll provide a link from someone who’s been through this process start to finish.

For now just be aware that you need to have two originals of each of your birth certificates plus two originals of your marriage license (assuming you’re married). We didn’t figure this out until later and so had to arrange for the documents to be mailed to a family member who’s scheduled to visit soon.

The Consulate will want to make sure that this baby is really who you say it is, so as part of their long list of documents they ask for proof you were pregnant. Like actual photos. And doctor receipts, hospital receipts, etc. As you go along just be sure to keep everything.

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Day to day life
I think the biggest differences have more to do with our nomadic-researcher circumstances than what country we’re living in. Without a car we walk a LOT. Just going to the grocery is about a 2 mile loop. All this walking at 7,000 feet elevation is a blessing; it’s kept me more in shape than if I were working at a desk all day in Boston. But I won’t lie…one of my favorite daydreams is that I get to walk outside, hop into my little black Mazda, and run some errands. Oooo. I never thought that phrase would sound so luxurious.

If we’re not walking we’re taking crowded public buses or collectivos (shared vans), which are sort of their own kind of exercise as you brace for sudden stops and frequent speed humps. I stood on buses through month 7, when a mysterious Mexican switch flipped and suddenly I was always offered someone’s seat on the bus.

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We were already a couple that got a lot of stares (R. is tall, very blond, with ice-blue eyes), especially in small towns. The belly just ratchets up the attention a little. Usually I don’t mind at all, but there have occasionally been times where we’re on crowded sidewalks for an hour and the cumulative effect of so many pointed lingering stares from adults is draining. What’s weird is that the worst of the starers are usually young men – I don’t know what that’s about. Older women are more likely to look then share a kind smile, which feels much friendlier.

Aside from the staring, people are otherwise pretty shy. The one thing they like to ask is whether it’s a girl or a boy, and when I say “es una sorpresa”, they cast a confident vote with an accompanying explanation. My favorite was a taxi driver who said his accuracy rating on this type of thing is “90%”, and that I was most assuredly having a boy because if it were a girl my stomach would look higher, “como una piña” (like a pineapple) ??? Okay!

Stuff – what’s available, what’s hard to find
After four months of scoping out the selection I can say that while you’ll save on food and healthcare in Mexico, the United States is truly the land of cheap and abundant consumer goods. Clothing, housewares, furniture, appliances, technology…I was surprised that for the most part, these are cheaper in the US.

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At any Mexican Walmart or mall (above is Angelopolis mall in Puebla…super fancy) you can find baby clothes, blankets, strollers, car seats, etc., and the town markets carry essentials. But outfitting a nursery doesn’t yield the same sort of money-saving-joy as buying a kilo of mandarin oranges in the market for 40 cents. Sometimes just the opposite, in fact. For her first baby my yoga friend and her Mexican husband drove to Texas just to shop. Given gas prices for a 15-hour drive I don’t think they really worked out the final costs on that one, but she’s not the only person I’ve heard mention visiting the states to fill suitcases.

Obviously it doesn’t make sense for the average person to import everything; prices and selection here aren’t universally worse. However, there are certain items that have been either impossible to find, or significantly different and/or more expensive. Here’s what I can share (know that we are not creating any kind of fancy nursery-scape, and that our prime objective is to have as little stuff as possible to deal with come June when we move back with 4 suitcases):

Baby clothes – You can find familiar brands in the malls or Costco and the prices are similar to the US. Cheaper baby clothes ($2 onesies, $6 sleepers) are available in downtown markets as long as you’re okay with 50-100% polyester. I chose to fill my suitcase from a baby thriftstore at home because it was the best combination I found of quality and price. My mom and I bought two bags of infant clothes, many of them with the tags still on, for something like $33. I plan to wait for the baby to arrive to see if we’re short on anything and then fill in the gaps with local stuff.

Baby furniture
We’re going to try and get away with just a pack-n-play here in Mexico. New ones are about $100 ($20-30 more than their counterparts in the states). I searched two craigslist-like Mexican sites – Vivanuncios & Segundamano – and saw a lot of nice used baby things, including a Graco pack-n-play with a bassinet and changing insert for $50. Funnily enough, the guy bought it in the US on what sounded like the same sort of baby shopping trip my yoga friend took. I convinced R. to join me on the long walk to pick it up, and after seeing the prices for new pack-n-plays at Walmart the next week he recognized what a deal we got. And yes, that’s the cat napping in there.

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Nice bras –
Mexico gets a pass on this one since the average store in the US doesn’t sell a huge range of bra sizes either. But I was surprised that the underwear shops downtown don’t even sell D-cup (nothing above a C in fact). And they’re kind of expensive even then. This is currently my favorite bra. The price is really reasonable, which is great since in the beginning I was going up a cup size way more often than seemed necessary. I brought 4 or 5 with me in various sizes. I mailed to my mom two nice nursing bras, including this one which I bought off ebay for $7.

Unscented anything
If the selection at stores says anything about consumer preferences, Mexicans love perfumed products. Dishsoap, body soap, maxi pads, diapers…we’re talking THICK combinations of scents. The worst of it is the laundry soap. Even baby laundry soap. We went down the aisle opening and sniffing bottles until we found the least offensive scent (some kind of waterfall from Arm & Hammer). I’m fine with it and hopefully the baby is too, I just mention it in case you’re super sensitive to perfumes and dyes.

Yarn
Ehh…yarn selection outside of Mexico City seems poor. There’s a ravelry thread specifically to share store locations, but I’ve been to some of the recommended ones in Puebla and they’re 99% acrylic, with lots of bobbles and sparkles. Also, nobody seems to sell circular needles. I’ve been mailing yarn to my mother and mother-in-law, who are tasked with bringing it when they visit.
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Alright…that’s what information seemed most relevant to share. I’m happy to answer questions if I can – just email me at foxflat (at) gmail (dot) com. One more week until my due date. I think it’s hard for us to really feel just how close that is!

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Other posts in the “Moving to Mexico” series:
At home in Cholula
Transporting a pet to another country
What to pack for a year abroad
Animals in the murals and on the sidewalks

Additional blog posts about pregnancy and birth in Mexico:
Rebel Heart – this is like the holy-grail. She’s compiled so much worthwhile information, including links to other womens’ blogs
Southern Living – natural birth resources in Mexico City

Christmas Lights

Christmas Lights in downtown Puebla
Went in to Puebla recently for an evening doctor’s appointment and afterwards we walked around downtown Puebla. The lights are up. LOTS of lights. Also an alpine slide, a small ice rink, and a village of gingerbread houses filled with vendors. Which all matches what we’ve come to know as the Mexican decorative philosophy, “More is never a bad thing.”

Christmas Lights in downtown Puebla
Christmas Lights in downtown Puebla