With just 5 weeks of my pregnancy to go, my big belly is getting me alot of attention. People ask me on the street “Dat gonna be a Jamaican baby?” and then beam at me when I say I’m having it here. Lots of expats go home to their native countries to give birth, but I have chosen to stay; a decision that has it’s pros and cons!
On the plus side, I get to be with H (my husband). If I was having the baby in Ireland or the UK, I’d have to fly home by 36 weeks (about now), so would be away from him for a month before the birth. At this stage of pregnancy having to sit on a flight for ten hours would be pretty uncomfortable. Then, H would have had to try and fly over to make the birth, which considering only 5% of babies come on their due date, would have been a been a bit too hit and miss for me. So I decided to have my baby here; at Andrew’s Memorial Clinic (I’d post a link to their site – but it’s been down for 3 months, not a reassuring sign about their technological abilities!) It’s a 7th Day Adventist Hospital, and the staff are very friendly. I’ve been for a look at the maternity ward, and had to forcibly stop myself from stealing a cute Jamaican newborn from an incubator. The ward seems lovely, fresh and clean and light, and I have been reassured by the positive experiences some of ladies I’ve met who have had their babies there.
But there are downsides. Some of you will think I’m mad, but I had been planning a home-birth back in Ireland. My interests in this had started through conversations with my Auntie, who is an independent mid-wife in the UK, who’s inspired me over the years with stories about women birthing peacefully and naturally at home. I had got onto the Dominio Scheme, a comnmunity midwife led service that can help women with normal, healthy pregnancies (only available in South Dublin and Wicklow) to birth at home. Only 52 women in the whole of Ireland had homebirths last year in Ireland, and not all of those intentionally, so it is still a very unusual choice. Much more so than the UK, where more people are choosing homebirths. I really wanted the familiarity and privacy of being in my home, the possibility of labouring in a birthing pool, being able to play music, turn down lights, cook, move around etc, all away from the unrelaxed, stress-inducing, medicalised atmosphere of the hospital.
In terms of pain management, I have been practising hypnobirthing techniques. I attended two sessions at the Kerrigan Clinic, have done lots of reading and been listening to the excellent MP3s available to download at the Hypnoclinic. I firmly believe that deep relaxation can help women avoid severe pain in childbirth, but I’m also sure that reaching that state takes practice! The theory goes that fear and anxiety in labour creates stress hormones which blocks the body’s natural highs which should be flooding the brain during birth; endorphins and oxytocin. Culturally, we are taught, through TV images of women screaming their way through childbirth, and by telling each other negative birth stories, that contractions will be agony, therefore our fear levels and expectations mean that is how we experience birth. I’m hoping that through deep relaxation, and being able to work with my body’s surges, to give birth calmly and gently. That is the hope anyway, and I’ll let you know how it goes!
But then, everything changed. Suddenly we were moving to Jamaica! Before we left Ireland, I had been recommended a doctor here in Kingston. When I rang his secretary and gingerly told her that I had been planning a homebirth in Ireland and if this was possible in Jamaica, she laughed at me with a big booming Jamaican laugh and said, ‘No man! We don’t do homebirths any more!! In Jamaica, we got HOSPITALS!’ So that seemed to be that. Plus from the research I did, there is no midwife association here, at least not one that answers emails or phonecalls, and the only natural birth centre has been shut down due to health risks. And, while I’m sure plenty of women do have homebirths here, it’s because of poverty not choice. When I think of it like that, I know I extremely fortunate to be able to be in the hospital in case of any emergency arising. In Ireland, I was 5 mins away from the National Maternity Hospital, and could have been transfered in a flash, but here you need to be fully booked in to hospital or, if something happens, you’d be rushed in with no notes, no doctor and possibly no bed to go to!
Now that I’m here and ‘dat baby soon come’, my project is to keep the birth as natural, gentle and calm as I had dreamed. I started by writing a birth plan, and taking it into my doctor. A lovely, gentle man, he still, rather charmingly, seems to see the magic in it all. His face lights up everytime he hears the baby’s heart on his monitior or feels it kick. His office is covered with hundreds of baby pictures all whom he delivered, some of which I’ve met at the baby group I’ve been going to. He read my birth plan, smiling, and said that there was no problem for him with any of it, BUT I’d have to go through it with the mid-wives at the hospital. Labour was their domain, he’d only be there or the actual delivery. This is one of the lovely things about having a private doctor here, you actually know that he will be attending the birth. (Luckily for me, this all covered by H’s health insurance, a nice perk of his job!) But for the rest of labour I’ll be in competent, if slightly intimidating, hands of the midwives.
When I went to register at the maternity ward and was looking around the facillities, I asked one of the midwives if the hospitals had any birthing pools or if they could be rented, she laughed and said, “You wanna take a shower? Sure!” which wasn’t quite what I meant! I don’t think she’d ever heard of a waterbirth, and my heart rather fell at that. Also, when I asked about the availability of gas and air (also known as Entonox, or ‘laughing gas’; a mix of oxygen and nitrous oxide) she said it wasn’t available in Jamaica, but a women had once bought in her own kit! I researched all this on the web, and while Entonox is widely available and used in the UK and Ireland during childbirth as a gentle anaesthesia gas, it is indeed illegal here, across Europe and the US. This seems bonkers to me. It’s a mild and effective pain reliever that can’t cross the placenta and affect the baby, much safer than pethidine (a synthetic version of morphine) or having an epidural which are the only options they offer here. I have had a look to see can I import Entonox; it seems my doctor could rom the British Oxygen Company, but would need a special letter from the Ministry of Health. With only 5 weeks to go, that just isn’t going to happen, considering the speed with which paperwork happens in Jamaica. Oh well, those hypnobirthing techniques had BETTER work…
With all of this in mind, I wrote my birth plan, and took it back into the hospital, hoping to discuss it with one of the mid-wives. After I waited for half an hour, a young nurse appeared and told me they were too busy to see me, but to bring it with me on the delivery day. That hardly seems like a time to start haggling over preferences, particularly as my intention is to stay at home as long as possible, so feeling a bit glum I asked her to add it to my file and wandered off.
It’s not that I want anything difficult or unusual, or at least I don’t think so. The freedom to move around, wear my own clothes, turn the lights down, not have continuous monitoring unless completely necessary. To be able to take my, and the baby’s, own sweet time in peace and quiet, and not feel rushed or under any pressure, or being yelled at when to “PUSH!” like I’m in some kind of rugby match. The most important, and controversial issue, is that I don’t want to give birth lying down or propped up in a C shape, which judging from their delievery room where the bed has raised feet pads, looks like the only options! Anyway, seems like we are going to have to leave all that till the day itself. And if I insist on giving birth in a different position, what can they really do? Tie me to the bed? Judging from that authoratitive air of the mid-wife I met, probably…
Yesterday, I saw the doctor again. He seems to be open to my ideas on birthing positions, although my suggestions seem to be completely new to him. It’s hard to for me to be confident in my ideas against his many years of experience, but from our chat yesterday, it seems he’ll let me have the baby the way I want, and hopefully not just out of scientific curiosity to see if this crazy expat’s theory make any sense! So, I’m feeling fairly calm and confident about the birth. At the end of the day, when push literally comes to shove, it’s me that will be getting this baby out, hopefully in a calm and relaxed atmosphere that if I can’t have in the room, I will have to create in my head! And, as I’m sure my obstetrician knows, Obstetrics, comes from the Latin obstare, “to stand by”…