Honduras Pandemic Birth - Kristin's Story
Kristin lives in Honduras and can be found on Instagram (@add_to_the_beauty_kristen) and she has really kindly allowed me to share her birth story which she features on her blog.
It has been a bit overwhelming trying to find a way to start writing out this story. Childbirth, especially for the first time mom, is literally an unprecedented experience no matter where it happens or in what kind of global crisis or time of peace it takes place. My story just happens to take place in Honduras, Central America (a country considered third world), far from family, and in the middle of a global pandemic.
I will try to use respectful language in describing my childbirth experience in this foreign country as to not cast a negative light on customs or medical practices performed here. Much is similar to the care I would receive in the states but there is also a great deal that is very different. I do want to stay true to my story and personal experience, though, including the expectations and worries I had in comparing U.S. medical care to Honduran medical care. So, with caution and respect for medical professionals in Honduras I describe here some of those differences that affected me.
The morning we arrived at the birthing center: Friday, August 28.
In a way, as someone once said to me, having your first baby in Honduras is probably better than having your second. There is room for fewer expectations and no previous experience with which to compare. I have to begin by saying that the idea of birthing a child in general used to scare me to death. There were moments in my adult life when I wondered if it was even something I wanted to (or could) do. Then upon seeing the positive pregnancy test on January 1st of this year, all at once I was elated and convinced that I was meant to be a mommy. An instant change occurred in me and it propelled me on a journey of education and empowerment as I learned about how my body would house and nourish a little life for nine months and then bring him into the world.
I studied everything pregnancy and childbirth as if I were getting a degree in obstetrics/gynecology. The two most beneficial books I read during this process were Ina May’s Guide to Childbirth (although I’ve never been interested in natural birth) and Pregnancy, Childbirth, and The Newborn: The Complete Guide. I have had countless fellow moms reach out to me offering support and answering all my questions. The camaraderie and connection I have felt during this time of quarantine and isolation was an ironic and unexpected surprise. Thank you, mommy friends!
When we found out I was expecting, we had not fully decided if I would give birth in the states or in Honduras, where I reside and work as a full time missionary. I preferred 100% to have my regular obgyn back home deliver my baby, with his English speaking staff, in my home country, near my family, and take advantage of the comfortable (luxurious even) hospital amenities and resources. COVID was a factor in deciding to give birth in Honduras but it mainly caused a chain reaction of other factors like: international borders closed, my Honduran husband not being able to reapply for a US visa in order to be with me, the possibility that my child, not having Honduran residency, wouldn’t be allowed entry into Honduras for an indefinite amount of time, etc. So we ended up making the best decision to keep our little family together which was having baby Kairo in Honduras.
Coming to accept this decision was not easy. It was not part of my original plan (the theme of this entire year, am I right?). I still hung on to the hope that 1. I would be able to visit home at some point during my pregnancy and that 2. my mom would be able to travel to Honduras in time for the birth. Neither ended up happening and I mourned it over and over in various stages.
We found an obgyn and private clinic in our town by word of mouth and I started my prenatal checkups. I will forever be grateful that my husband and I could share those special moments together seeing our son grow in my belly via ultrasounds. (Which otherwise wouldn’t have been possible had I continued my prenatal care in the states) We planned to shop around for a doctor because I had been forewarned by other missionary moms here of certain things that weren’t customary or even allowed, the biggest of which being whether the father is allowed to be present in the labor and delivery room. That was my first question to Dra. K on my first appointment with her and she assured me that Natán would be able to stay by my side through the entire process. (She later approved that our doula friend, Kellie, be present as well. We were sold and decided to stick with her.)
In preparation for the birth I wrote up a type of birth plan – I called it “birth preferences.” This is rarely done here. I realized it was a very uptight gringa thing to do but it gave me peace of mind in the middle of so many unknowns. I created this “plan” based on my research, friends’ previous birth experiences, and questions/conversations with my doctor here. I presented it to her and her staff (with much apologizing and excusing away this possible cultural taboo) and explained that it was not to tell them how to do their jobs but was a way to keep everyone on the same page and to help me feel organized and prepared. After all, I am a low context culture individual living in a high context culture – I like things explained explicitly and I’ve learned that too often too much is left to assumption here. In the end, not a lot went according to my birth preferences but I had prepared myself emotionally for that anyway. If any part of my personality has been challenged since moving to Honduras it is my control-freak nature so I’ve already been on this lifelong journey of learning to “let go and let God” for a little while now. Why would a Honduran birth be any different?
Some things that did not go as planned:
I requested to tour the birthing center months in advance to get a visual idea of what labor and delivery would be like. What I missed in conversations with our doctor was that they were planning to completely move from one location to another. The weekend that I completed 38 weeks gestation they moved their practice to a building in the downtown area of our little city. I found this out days before we ended up scheduling my induction and it threw me for a loop.
I wanted to go into labor naturally but at my 39 week checkup my amniotic fluid was low so we scheduled an induction for two days before my due date (Sat. 8/29.)
I was determined to receive an epidural even though it is not commonly offered for vaginal births here. I was assured from the beginning that since I requested it an anesthesiologist would be available to administer the epidural. (The anesthesiologist would be traveling a bit of a distance to get to the birthing center so before scheduling the induction I understood that the possibility existed that he just wouldn’t be able to arrive in time. We tried to convince a mutual friend of ours & the clinic’s, a nurse anesthetist, to be on standby as backup but she wasn’t completely comfortable with it. At about 30 weeks gestation I was notified that there was an epidural catheter shortage in the country and that it might not be a possibility after all. I started searching for epidural kits (in country and to be sent from the states) and started to prepare myself for the possibility of a natural birth. We eventually got our hands on a kit here and had a backup sent from the states.
While researching U.S. prenatal standards I realized that a Group B Strep test is required around 36 weeks. I expected it to be the same here in Honduras but it is not. In fact, there are many countries (not just in Latin America) that do not require this test. Due to risk of infection of the newborn it is considered protocol in many places like the U.S. to administer penicillin during labor for any mother who didn’t get tested or whose test came back positive. It was uncomfortable to insist on getting tested and request antibiotics as a backup but I had to make the decision that I felt most at peace with. This whole decision process emphasized the tension of living between two countries and cultures and I was very emotional over it. I consulted medical professionals in both countries and each had strong opinions on what was acceptable. I ended up getting tested (swab had to be sent to a lab a couple cities away) in my 39th week and it came back negative within days of going into labor.
We were told on a Monday that I would be induced the following Saturday. Thursday night we received a phone call that my induction would need to be rescheduled for Friday, the following morning, because of the anesthesiologist’s availability. I was nervous but excited to have the date moved up a day and rushed to finish up all last minute preparations for baby. (Although my hospital bag had been packed for a month – bag including EVERYTHING needed for newborn and postpartum care. It is rare that clinics/hospitals here provide much more than acetaminophen.) Oh, and that anesthesiologist never did actually show up…
I halfway prepared to play some selected music during labor and delivery until it became obvious once inside the clinic that I would not even be able to hear my own music over the construction noises and reggeaton music from the neighboring gym. I listened to these things for the majority of my labor.
Induction Day – Friday, August 28
We arrived at the clinic by 9:00 am. The induction process got officially started around 10:30 or after.* They were concerned that for several hours my contractions were increasing but I was not dilating enough. I walked and used the birthing ball for most of this process. Our doula friend Kellie helped me move and relax as contractions increased.
My water broke at 5 cm after having increasingly stronger and frequent contractions for several hours. I wanted to shower and since we couldn’t get the hot water to work I took a cold shower.
When it came time for an epidural it took a while to finally get our nurse anesthetist friend (our plan B) to come to the birthing center because, for a reason we never heard, the anesthesiologist was in fact not available. By the time the IV and epidural process was started I was experiencing very strong contractions and was already at least 7 cm dilated. In the middle of administering the epidural the ENTIRE BUILDING’S POWER WENT OUT. Apparently an electrical fire had broken out in a business a couple blocks away. I finished receiving my epidural in the dark illuminated only by cell phone flashlights. In one moment of peak pain and frustration I screamed at the top of my lungs OH MY GOD and thought this is so like 2020.* Once the meds kicked in I did tell our nurse anesthetist friend that she was my favorite person! And I MEANT IT.
After the epidural I labored in my room a few more minutes and started pushing. I got to 9 cm and baby’s head was visible. I was then transferred from the bed to a wheelchair, wheeled into labor and delivery, and was helped to step up into the stirrup delivery chair.* Within half an hour of pushing, Kairo was born! The epidural had greatly alleviated the pain but I felt everything that was going on. It was extremely difficult but I found it AMAZING to be able to feel his little body slide out. From that moment I was giddy and on such a high. He latched on to start feeding on his first try, within 20 minutes of being born.
I am still so in awe of the miracle of birth and also at how natural and normal it felt. There were several moments during labor and delivery that I truly felt like I wouldn’t be able to go on; I just didn’t think I could do it. It was one of the hardest and most glorious things I’ve ever done. There is a photo (thanks to Kellie and Valentina for capturing such special moments) right before the very last push when I’m leaning back on Natan and feeling completely depleted. That is my last photo before becoming a mother and when I look at it now I wonder who that person even was. I’m sure I will spend the rest of my life discovering all the ways motherhood has and is changing me.