Pregnant Paulistana

Many people have asked me about what it’s like to be pregnant in Brazil, how the medical care is and about our decision to have the baby here versus returning home for the birth. So, lemme tell ya’bout it.

I’d like to start by saying that being pregnant here is awesome. People are SO nice to pregnant women in Brazil. I can basically go to the front of any line anywhere — whether it’s checking in or going through customs at the airport, buying groceries, waiting at the bank or getting into a bar that has a line. It’s just their policy to give “priority status” to pregnant women and this policy infiltrates people’s mindsets so that everyone is generally just very thoughtful and kind towards pregnant women. So that’s great!

Also, health care here is fabulous. In Brazil, there is public health-care that is free and available to all which is not very good, and then there is private health-care which is pricey but luxurious. We are blessed to have an amazing insurance plan that has thus far covered 100% of all of our medical expenses, so we love that. We would definitely be paying more in the US and receiving a much lower level of attention.

That being said, there are certain things relating to health-care that are pretty different in Brazil, and labor and delivery practices are at the top of that list.

First of all, your OB is the person who delivers your baby. Although you give birth in a hospital, you call your doctor and he or she comes and meets you there and brings his or her own team (of nurses, assistants, anesthesiologists, etc.) to perform the delivery. I think this is a huge bonus as it allows you to deliver with a doctor who already knows you and your whole situation from the very beginning. When you deliver at a hospital in the US, you never know who will be delivering the baby, and you typically have a stream of nurses – whoever is working that shift – in and out throughout your labor and then you periodically see whichever doctor is there at that time.

Secondly, and the biggest difference here, is that Brazil has a very high rate of elected, scheduled c-sections. Culturally here, c-sections are viewed as the high-class, educated thing to do. For example, other than my maid (who delivered all 3 of her babies at her home because she lived too far from a hospital), I have yet to meet a Brazilian woman who has had a “normal” delivery. I’m not sure what the actual numbers are, but I asked my doctor what the ratio for her is and she said that on average, she will do about 95 births/year and maybe only 4 of those will not be c-sections. Michael and I saw more proof of this on our hospital visit where the labor & delivery rooms are simply called operating rooms! This in turn feeds into a whole host of other differences…

For example, because birth is typically a scheduled, planned event, it becomes just that – a big, planned event! Parents know that they will be staying at the hospital for a few days (due to recovery-time from the surgery) so they all bring elaborate decorations to decorate their “apartment” (the room where you stay after giving birth) door and “lembracinhas” (or party-favor type gifts) for visitors and nurses. I’m sorry but I feel like the BABY that I just produced will just have to be lembracinha enough for everyone! It’s also customary for new parents to receive LOTS of visitors to the hospital including family, friends and coworkers. Not quite sure how I will feel about that one yet…

Anyway, I could go on and on but suffice it to say that there are lots of cultural differences with regards to pregnancy and birth here. Luckily, I was fortunate enough to find a great OBGYN who speaks pretty good English and is located just a couple of blocks from our apartment. Although she doesn’t normally perform “regular” deliveries, she has said from the beginning that if it’s what I want and everything seems safe, she is totally supportive, and until last week, I hadn’t had any issues. THEN I showed her my birth-plan. I don’t think she had ever even heard of a birth-plan before and wasn’t really used to the idea of a patient making so many requests or having so many preferences. Since most people have c-sections, it’s just not really a thing. Anyway…there were a few points where we disagreed and she literally told me she “doesn’t do deliveries” the way that I was hoping to do mine. I think we both took each other off-guard by the whole thing and I ended up leaving her office feeling totally defeated and confused. I wanted to have a doctor who would be totally supportive of my wishes (down to the details!) but I do really like her and the thought of trying to find a new doctor who is covered by our insurance, speaks English, is accessible for me to get to and will be supportive of my whole plan seemed really overwhelming and potentially impossible at this point. Plus, labor and delivery is so unpredictable that it’s likely I could go through all that trouble to find a new doctor and in the end still have to throw my birth-plan out the window anyway. The points of disagreement were actually just a few details, but it still took me off-guard and knocked the wind out of my sails. It was one of those times where I felt like I was really far from home…

After the appointment, I went home and started doing more and more research on the points of disagreement to try to determine if they were actually a big deal or not, but the internet is only so helpful so thankfully I was able to grab some Facetime with my mama-bestie, Bess, and it was truly the best medicine. She had such a great perspective on what those little details were like in the context of actually giving birth versus when you are sitting at home on the couch, typing up your birth-plan. She was full of other wisdom and encouragement and by the end of our conversation I felt 100 times better. Thank you Bess!!!

Then, over the weekend our dear friends Trent and Paige had their baby girl! We got to visit with them at the hospital (same as where we will be having our little guy) and hear all about their experience. Although Paige has a different doctor and was much more ambitious than I think I’ll be (the girl gave birth without ANY pain meds!!), it was still encouraging to hear their story and even more, seeing their beautiful baby girl was a huge reminder that the real priority is healthy baby, healthy mama. The rest are just details.

Just to be sure we were making the right decision though, Michael suggested that we call one of our OBGYN friends in the US and get his opinion on it as well. So, we did something I never thought we would do, and scheduled a call with Vinay. Now, Vinay is totally amazing and at the top of his field. I just know him more as…the guy getting kicked off the microphone at weddings as he tries to lead the party in “Shout.” However, Vinay really was a life-saver and it was so comforting to get his expert opinion and some reassurance.

All that being said, I am now truly feeling better and more confident than ever about having this baby and having him here, with my doctor. Now let’s just hope it stays that way.  🙂

9 thoughts on “Pregnant Paulistana

  1. Loving this post, thanks for the shout out! You are gonna do great Ash! I seriously cannot wait to hear your birth story when it happens!!!!!

  2. Ashley, first off, congrats! You and Harper are going to be such amazing parents! Also, I didn’t think it was possible for you to be any prettier, but every time I see your next blog post, you are more and more radiant!

    This was a really fascinating post! I had no idea there were so many cultural differences for labor and delivery between the US and Brazil. I have to admit that I laughed out loud when you mentioned Vinay. I remember him as the guy who showed up at BC to visit Harper wearing a French fry costume! Seriously! He’s now an OBGYN? That’s awesome.

    Congrats again to you guys! Exciting times!
    xo
    Julia Ralston

    • Julia! You are so sweet to write this!
      And THANK YOU for relating on the Vinay front. 🙂 Although he is a very talented OBGYN, I can’t help but think of him the way that you do. He was great and very professional when we talked “business” with him, although he did still use words like va-j-j. 🙂 ha
      I hope you are doing well!! XO

  3. Pingback: Culhane’s Birth Story | Jeans & A T-Shirt

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