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.
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.
Finding 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.”
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.
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.
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.
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.
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.
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.
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.
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.
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.
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!
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