Hi ladies! I've been lurking here a tiny bit, but not really posting much this pregnancy on preg.org at all--I haven't felt like I had a lot to say! (Plus we only have electricity every other day, and I just haven't had as much time as I'd like to be online.) As my due date approaches, I've been really needing to express the fears and concerns I'm having about birthing in Africa, and the ladies on this board have always been wonderful, so I thought I'd better make the computer time and come on back! I'm hoping I can get on at least a couple times a week, and get to know some of the new ladies/reconnect with old friends.
By way of introduction for those who don't know me, I'm Rachel and this makes baby #4 in the course of 5 years. We are from the US, but spent one year in France and now live in Central Africa for at least the next couple of years.
You'd think that in Africa there would be a lot of freedom for birthing choices, right? I'm finding that I'm pretty hemmed in. Local public hospitals are not recommended (you're likely to get a bed with sheets covered in someone else's blood, for example). I've checked out the various private clinic options in town, and the one where a colleague had two of her babies seems to be the best one. I have no way of finding a qualified home birth attendant--no resources, no social network since we're new arrivals. There are some confusing government regulations but it sounds like it's illegal to have an unattended home birth (or maybe, illegal to have a home birth at all?). Apparently the mother/infant mortality rate was too high, so as I understand it, it's a measure intended to keep men from forcing their wives to stay home to give birth so they can save on hospital costs. I'm not sure what's involved besides a fine, but I prefer not to get into trouble with the government in a foreign country if I can help it!
So I've been going to the private clinic for prenatal appointments, and right now the plan is for me to birth there. But I'm having a lot of misgivings. Even though it's a private clinic, it feels very "hospital." The midwife barely talks to me, and just goes ahead with her routine as usual. She's been a midwife for 30+ years and she kind of has her own set way of doing things. I get the impression that maternity care here is decades behind the US--I heard from another lady who gave birth at this clinic a few years ago that they still use "on your back with your feet in stirrups" positioning for the birth, and the colleague who had her baby there just a few months ago said they were debating giving her an episiotomy (and I don't think they were including her in the discussion). They also routinely give enemas at the beginning of labor. None of those things are *too* huge in and of themselves, but the whole feel of the thing is very scary for me. What else do they do that I haven't heard about? Will they allow me to decline/alter some of their routines?
My last birth, in the US, was an intervention-free waterbirth at a freestanding birthing center with an amazing midwife. I just keep comparing that wonderful experience with the battle I'm sure I have ahead of me to get even a few of my wishes followed at this upcoming birth (especially with the language and culture barrier--DH and I do both speak good French, but I'm not sure how to express some things, and I don't think they care quite as much here about the parents' wishes and rights). It makes me want to buck the system and just have an unattended homebirth--and pretend I couldn't get to the clinic in time. But I also don't want to get in trouble with the government, have any major issues getting the birth certificate and other documents so we can get the baby's passport taken care of, etc etc.
If I had my way, I'd be on a plane back to the US right now and have this baby with the same midwife I had with DS2...before I get far enough along that the airlines won't let me fly! But we really, really don't have the money (a *cheap* ticket home would be $2-3,000 just for me, not to mention DH or the kids), so there's no way for me to justify a move like that...and we've worked long and hard to get to Africa, so I don't want to jeopardize our work here.
Thanks for reading and letting me ramble! I'm thinking I'm really going to need my lodge this time around, just for getting my thoughts out and processing. There isn't anyone IRL here I can talk to about these things--DH is probably the closest thing, and he really is very sensitive and caring, but I don't know that he really "gets" it either.