Made In Brazil
My Husband and I are both Americans and had lived in Brazil for two years when we got pregnant with our first child. We’d lived there through the Zika scare and the concerns from family that we would get pregnant and bitten by a zika mosquito at the same time; leading to horrific deformities in the development of the baby’s brain. Despite this, there was never a thought of returning to America for the birth. Dual-citizenship was a gift we wanted to give our baby. This is the journey of our international unmedicated birth story.
The Land of Cesareans
Brazil has the highest cesarean rate in the world- upwards of 80% in private hospitals and 55% in public hospitals according to the Public Health Ministry. Vaginal birth simply isn’t common and finding a doctor who would actually advocate for a natural birth felt like an uphill battle, yet we were determined to do it!
Additional Resources: Prepare for Birth: A Guide For First Time Moms
Throughout my pregnancy I stumbled clumsily through the medical process from one doctor to the next never quite confident that I was in the safe hands of someone who would advocate for my natural birth. The language barrier was a huge challenge, my Portuguese on the street was great, but technical medical language was a whole new sphere of vocabulary and I struggled to fully comprehend. Because of this, I often had to awkwardly take translators with us to all our appointments. Early in the pregnancy, I got a bad yeast infection. Embarrasingly, “candida” was lost in translation as the doctor diagnosed me with chlamydia! Imagine having a semi-acquaintance with you at your doctors’ appointment helping you describe the color and texture of your discharge; my propensity for privacy flew out the window!
Finding a Doula
At 7 months I finally found my doula who saved the day! Within five minutes of meeting her I burst into tears because I immediately knew I had an advocate. She promised to fight with me for a natural birth in the cesarean-factory of Brazilian hospitals. She had the experience and confidence that my husband and I needed to believe we could do this.
Additional Resources: If you’re interested in hiring a doula or finding out more about their services, check out DONA International.
The Unexpected: Preeclampsia
My pregnancy progressed normally and other than a boiling-hot January in a nation without central air conditioning, I was feeling great! But at 37 weeks things turned and my blood pressure shot-up to levels dangerously close to pre-eclampsia. My doctor at the time was telling me she’d give me a natural birth but the more I talked to my doula, who’d been in the area doing natural births for 10 years, the more suspicion I had that this doctor would opt for a cesarean and quickly, especially given my blood pressure.
I began bed-rest on my left side and a regimen of checking my pressure every few hours. At 38 weeks it continued to climb and entered the range of pre-eclampsia. My doctor told me to come to the emergency room. Sensing I might choose a different hospital and go with the doctor on-call, she offered me a “major discount” on her cesarean services (as if that would entice me to come closer to her knife). I opted out and in that 11th hour followed my doulas’ advice to go to a private hospital and hope for the best with whoever was the doctor on-call.
You Can’t Go Home, But You Can Try To Birth Naturally
We checked in on a Sunday night at about 10-o-clock. They admitted me and began meds to stabilize my blood pressure. During the first 12-hours I saw three different doctors as each started their shift. Each one spoke English and was incredibly kind and reassuring. One of my greatest fears had been that I would not understand what was happening because of the language barrier. Although I’d wanted a steady stream of care with a primary doctor, this last minute change-of-plans was working out. Mid-day on Wednesday the doctor on-call came in and told me I was stable. I couldn’t go home and wait until 40 weeks (because of the pre-eclampsia), but he was willing to let me try a natural birth. He would begin the process of ripening my cervix and monitor how my body would respond.
Although not an ideal situation, we were giddy at the thought that our son would soon be here. We danced around the room filming videos for our family across the world.
Birth is an incredibly humbling experience. As much as you prepare and arm yourself with knowledge of what you’re walking into, you ultimately have to let go, trust your intuition, and surrender to the process. In all my preparation I hadn’t foreseen this scenario: pre-eclampsia at 38 weeks, about to be induced. I felt like my body had let me down, yet at the same time I had a doctor who believed in me and was willing to let me try for a natural birth.
Beginning the Induction
Early Monday evening we began ripening my cervix. Every six hours they would put a tablet into my vagina which thinned-out the lining of my cervix. Contractions began in the middle of the night, more discomfort than real pain at first, like strong period cramps. I was able to sleep until about 5am when they began to get stronger. I woke up and began to work through them letting my husband sleep as I sat in the quiet— breathing and preparing myself for the hours ahead.
At about 7am the nurse came in and put another tablet in my vagina. After doing this, I was supposed to lay down for 30 minutes to allow the tablet to fully dissolved. Laying down for those thirty minutes was almost unbearable as the contractions intensified. At 8 a.m. a fifth doctor came in an introduced himself as the newest on-call doctor. He spoke English and as he checked my cervix, he told me I was dilated at 1 centimeter.
We’ve Got All Day
Side-note: This hospital was a small maternity hospital with about 10 rooms. I was only in the beginning of the long induction process, so they’d put me on the other side of the hospital in a wing where people recover from plastic surgery operations. The birth-side of the hospital was full with delivering moms, so I’d been put in this side area.
After the doctor left, I got on the birthing ball as contractions intensified. My husband was up and moving around now. He is a coffee snob and had his full pour-over coffee kit with him. The smell of freshly ground coffee beans filled the room. My best friend came to see us and brought my husband breakfast around 8:30. At this point I was on the ball, my husband in-front of me and my hands around his waist. I had buried my face in his stomach as I moaned through the contractions that felt relentless. My husband was hungry and my best friend began passing him bites of food over my head as I groaned. I remember vaguely the crumbs falling over my head and my husband giggling apologies for the mess.
Transition
My doula arrived at 9:30a.m., about the time that I’d begun asking for drugs to ease the pain. We’d planned to have an unmedicated birth as we strongly wanted to avoid the cascade of interventions, especially in a climate that was so prone to cesarean. My husband would later tell me that he was doubting that I could do the birth unmedicated, I’d been only one centimeter just an hour an a half before and already begging for an epidural. He kept trying to calm me, helping me to breath, and reminding me we had a long day ahead, to pace myself and work through each contraction one at a time.
My doula’s arrival was right at the moment I needed her and she calmly began to reassure me. She massaged my lower back as she accessed where I was in the labor. She suggested I get in the shower and the hot water felt amazing mixed with her massage on my lower back. After being in the small shower for about 20 minutes I began to panic and feel trapped in the small enclosure. I stepped out of the shower with her help and sat on the toilet while she dried me off. Two contractions on the toilet that had me feeling like I was being split in two. Bracing myself against the walls, I remember screaming “what is happening” as my son shifted inside me.
1-10 cm in Less Than Three Hours
When I came out of the bathroom the atmosphere in the room had changed. My husband had dimmed the lights and turned on the diffuser, he’d hung my birth affirmation signs around the room. Words like “I can do hard things” and “each wave brings my baby closer to me” were hung around the room to encourage me for the hours ahead. The doctor was there to check me; it was now 10am. At 8am I had been only one centimeter. The doctor put his hand between my legs and surprising exclaimed that he had touched the head, lucca was here. It was time! I’d gone from 1 to 10 centimeters in less than two-and-a-half hours.
Time to Push
They moved me onto the bed (but remember I was in a side wing of the hospital in a recovery room), and the doctor asked me to wait to push saying they needed to move me into a birthing room. At the same time, my doula was whispering in my ear to stay calm, just breath, listen to my body and If I needed to push it was ok… I felt the overwhelming urge to push and asked to be on my hands and knees, this was always how I’d visualized my birth. I pushed three times in this position but didn’t feel comfortable.
The room had became a flurry of people moving all around as they scrambled to bring the necessary equipment into the small room for the birth. Someone brought in a birthing stool and I sat on it and leaned back into my husbands’ arms. My doctor laid on the floor below me like an auto-mechanic under the hood of a car and I pushed three times over about 7 minutes. I remember yelling “Vem Lucca”, Portuguese for “come, Lucca” and on the last push, he emerged in one fluid movement! It was 10:17am and I was immediately flooded with relief that it was over, the pain that had felt so consuming was over, I wasn’t trapped in it any longer. I was on the other side with this beautiful boy in my arms.
My Little Brazilian
The tiny room was filled with nurses cleaning up the mess of fluids, weighing the baby, and taking care of my needs. My husband can remember in detail the amount of fluid on the floor and the feeling of his flip-flops being stuck to the floor in the sticky blood. I was taken to the operating room in a wheelchair to stitch up a small tear. My doula came with me and brought my son and I was able to breastfeed him for the first time I was being sewn-up. The elation I felt was unparalleled, the relief overwhelming, the joy as I looked at my son, pure love-inducing. He was here and he was mine, my little Brazilian.
