Once we had gotten moved into our new place in the DC area, we dedicated ourselves full-time to getting ready for our new son, Paulo. I must admit I wasn't a very big contributor in this; my wife Caro was much more proactive. If it weren't for her, the baby might have been born on the stairs one day going up to our apartment, with no clothes or bedding or anything ready for him.
I wasn't totally useless; I made lists. First we had to find our apartment and get moved in, then find a preschool for our son Sam, then straighten out our new health insurance, and finally set up a birth center for Paulo to be born at. And actually, I helped with a lot of the phone calls and logistical preparations for these things, but both Caro and I were so well-organized that it didn't seem like we did much work. Each day we would take care of one element that needed resolving, and before long we had a preschool, a birth center, and a health insurance policy to cover us. In retrospect though, a week or two after Paulo was born, we realized we'd spent the last two or three months without a moment's pause, without much free time. Any free moment was taken up with making phone calls, searching for apartments, packing, unpacking.
We looked at a few preschools in our area for Sam. All were decent, and seemed like good places for kids to play and learn. We noticed that most preschools these days belong to corporate chains with multiple sites. We visited two such places, and beyond my instinctive distaste for the idea of entrusting my child to a corporation, they probably would have been fine for Sam. Sam loved each of them when we visited, and wanted to stay there playing. Both corporate preschools had a focus on early learning, with lots of art and science activities. We didn't like how glossy and perfect they were though. They were immaculate, the toys were all intact. In short, they didn't look like places where kids were playing. We didn't see a plethora of books, either, and both places had as a selling point that the meals came from a high-end catering service (snack time was packaged tortilla chips and salsa when we were visiting one place). Neither of these traits were attractive to us. Also, both corporate chain preschools were located on the ground floor of tall, massive office buildings, so their inside spaces didn't have much natural light, and their outside spaces were totally manmade.
The place we ended up choosing for Sam's preschool was a home daycare that had at some point in the recent past become a more formalized institution (but still based in what had originally been a residential house). It wasn't as flashy, lots of the toys and books were worn, and they didn't have the frenetic pedagogic program of the other schools. This place was mainly kids playing, singing, reading, and drawing with the all Latino female staff. Basically it felt like Sam's preschool in our small town in Colombia (where Caro had also gone in her childhood)--few pretensions, but good for the learning and development of our son. It is explicitly bilingual, in that I believe they speak only in Spanish in the morning and English in the afternoon. I don't know how strict they are with this; I think they speak to Sam mainly in Spanish, though judging from the leaps and bounds Sam's making in English, I assume he talks a lot to his classmates in my mother tongue. I now sometimes worry that Sam, who until two months ago only formulated phrases in Spanish and needed my constant reminding to speak to me in English, is now putting his Spanish by the wayside. He still speaks perfectly with his mother and other Spanish-speakers, but it sometimes seems as if his attitude is seeing English as more "cool" or desireable or something.
The school's outside area really is outside, beneath one of the towering shingle oak trees that characterize this region. They do have a child-friendly astroturf instead of real grass to avoid too much mud, which I understand on a practical basis, though I don't like the idea of my child's missing out on that good exposure to soil microbes. One of their selling points that really resonated with us was that they have an industrial kitchen on-site, where they prepare only healthy food (some of which comes from a garden the kids plant during the summer). This healthy focus leads to some snippiness from them on certain points--parents can only schedule four cake birthday parties a year for the whole school, and this well in advance. Everyone else gets a watermelon party or something of that nature. Anyway, we like their focus on real food. It's nothing too alternative or outside of the norm--it's not like they're doing raw-food diets or anything--it's just the common sense of not giving reheated junk to your kids, which in today's dysfunctional food system can seem like a revolutionary idea.
This choice of preschool was a bit cheaper than the others, though not by much, and that wasn't a deciding factor. At any rate, the going rate around here of $1500-$2000/month for full-time preschool is just appalling to me, and we certainly couldn't afford it if my work didn't provide a very generous subsidy to defray the cost. My wife has often commented on how sad it seems to her that preschool isn't considered or sought after as a right for all kids in the US. Many countries don't provide universal preschool, but plenty of people there at least see it as a noble goal to strive for. In the States it sometimes feels to Caro that we are resigned to things like preschool being available only for those who can pay a lot for it. She always feels bad when she sees kids with their parents during the day in our apartment building, and those kids get all excited when they see a preschool group that they're not a part of walking around the premises. Of course we've also discovered that many parents in our social group don't want to send their children to preschool until they're 3 or 4 years old. Some of this is obviously a cultural difference or a personal choice, but the economic hardship of sending kids to preschool is surely a contributing factor to this custom of keeping young kids at home for a long time.
Preschools in the DC area all seem to have long, exclusive wait lists, and as such mark parents' first introduction to that ratrace, treadmill mentality to frenetically strive to get your kids into the "best" schools and programs, before the kids themselves start to stress out about getting into the best jobs and moving up the corporate ladder. I think that the staff of the preschool we chose liked the fact that Sam was a native Spanish speaker. They talked to us conspiratorially in Spanish during our visit, and helped us along the waitlist, saving an open spot for us to enter immediately (pending the gauntlet of prior medical checkups etc.). We have since seen that there are in fact a number of middle-class Latin American parents like us with native Spanish-speaking kids, but I guess that the majority of kids enrolled in the school are still Anglos learning Spanish, such that it is attractive to the administration to attract Spanish-speakers.
Once Sam entered school, Caro's life became a lot easier (if a bit lonelier), since she didn't have to entertain an energetic kid all day that was yearning to be with other kids. We made it a point for me to always pick up Sam in the afternoon, so that he would know he could count on me. This was especially important looking to the future when Paulo would be born, since we didn't want Sammy to feel like he'd been discarded or something. Our afternoon walks have become a special routine with us, first in the balmy, sunny evenings of early Fall, and transitioning into the cold darkness of late November, when Sam points out Venus and the Moon in the sky, and the catalpa trees that I've taught him to identify have gradually lost their leaves. It's a six-block walk, filled with landmarks like Roxy the dog who fetches her ball for us and gives Sammy kisses on the face, or the five-foot-high brick wall Sammy climbs up and walks along (and from which he once fell face-first onto the sidewalk below). For certain stretches Sam rides on my shoulders, and at other parts he runs like a maniac (though always very careful about stopping and waiting for me before crossing the myriad driveways that interrupt the sidewalk). We sometimes recite poetry or sing the alphabet song as we walk, and sometimes we just walk in silence. In terms of sustainability and bucolic childraising, you can't ask for more than a healthy walk twice a day in which Sam can learn the local landscape (suburban as it may be) while it transitions through the seasons.
Despite all our fears about Sam's feeling left in the shade when Paulo was born, I at least have become more attentive to Sam. Now that Caro is loath to be outside much during her first post-partum month, I both take Sam to school in the morning and pick him up in the PM. In fact, for most of Paulo's gestation I was fretting that I was focusing too much on Sam. An out-of-the-womb, real-live, active kid has a way of demanding a dad's attention that is hard for a fetus to compete with. Unlike during Sam's gestation, I was rarely able to read to Caro's belly with Paulo in it. I didn't talk much to him, rub Caro's tummy, or anything of the sort. Of course my wife reminds me that Paulo still heard me talk, listened to the books I read Sam, and felt my embrace when Caro and I slept together. But I felt bad for neglecting him. One big difference from Sam's gestation was that I was working full-time throughout Paulo's, not to mention our big move and the general stress load in our lives. Frankly, this time around I often felt like I wasn't even able to pay much attention to Sam, mired as I've been in work and other things. But as I said above, towards the end of this pregnancy I've been able to step up and really take responsibility for my firstborn.
Of course for all its merits, the preschool we chose is still ensconced in a car-centered, suburban mentality. While the employees all commute by public transport, most of the parents bring their kids in cars. Sammy usually takes a toy truck or something to play with on our walk to school, and then puts it away in his backpack during school hours. He's always done this in Colombia, and knows he isn't to play with his toys in school. Anyway, it seems that sometimes the toys get out of his backpack (I don't know if he asks for them and the teachers oblige him, or if other kids open his backpack and take out the toys--I assume the latter, since his juice always arrives intact at day's end). Recently we were scolded by the school's administrator for bringing toys to school, because then at the end of the day the teacher has to take time to find Sammy's toy for him to take home. I was kind of pissed off, because the "toy" in question that day was a rock he'd picked up on the way to school, and I know that at least for the last year and a half, he's never taken his toys out during school hours. Mainly though, it made it clear to me that they were assuming that everyone brought their kids in a car, so it was no problem for the parent not to leave any toys with the kid. But we're on foot, and I'm going straight to work from dropping off Sammy in the morning. I'm sure as hell not going to lug around a toy tractor all day just because the professors can't keep the kids from opening their bags during school!
My other little annoyance thus far with the school has just come up this week. I am beginning to think that they have the kids watch a bit of TV every day. Of course it's nominally educational stuff, but I am not paying good money to have my kid sit in front of a black box and fry his brain. I'm going to have to look more into this. If this is so, it would be especially ironic that they are showing Sam the television that we prohibit him, and then scolding me for letting him bring to school a rock that had sparked his imagination!
Getting my health insurance lined up hasn't been that big of a challenge. My work provides me with the insurance, and plays a big chunk of it. But our coverage didn't start until October 6th, 3 weeks after our arrival in the US. This was obviously stressful for us as we awaited our new child, though there was really very little chance of Paulo's being born before that. I did have to submit and re-submit many forms, and make a lot of phone calls, before we were finally signed up and in the system for my insurance policy. But at least until now, it's all worked out for the best. We still have to see if they'll honor our claims for the medical expenses we incurred while we were waiting to be assigned a member number. Maybe I'll be writing an irate post in a few weeks about the injustices and inefficiencies of the insurance companies. I sure hope not.
Perhaps the most important arrangement for us was figuring out where we'd have Paulo. We are not opposed to having a baby in the hospital--in fact, that would seem like the most logical place to have a baby, and we did have our son Sam at our Colombian town's public hospital. We'd been very satisfied with how they treated us, and especially with the free price tag. However, having a baby in the US is apparently a very different proposition. From what we've heard, hospitals pump mothers with lots of stuff they don't necessarily ask for, like IVs, epidurals, oxytocin, etc. They also charge a lot for everything they do, some of which is of questionable medical merit (doing a metabolic screen on newborns when that test doesn't give any meaningful results until the child is at least a day old, keeping mother and baby in the hospital for hours if not days after labor, etc.). We were especially concerned with horror stories of parents who were saddled with huge hospital bills that their insurance wouldn't cover. Even if the insurance would cover the costs, we were offended at the idea of hospitals' charging $20000 or more for a childbirth. Plus there was no hospital near our apartment.
Caro had been doing research on non-hospital options since we were in Colombia. We saw that there were a fair number of midwives operating in the Washington DC area. There were even quite a few birth centers, where midwives attend births outside of people's homes. We didn't want a home birth for a number of reasons. For one, we really are pretty orthodox at heart, and that just seemed a bit too alternative for us. More than that, we wouldn't be very settled in to our apartment by the time Paulo was born, so it made more sense to have the baby somewhere where they're specially set up for childbirth. The problem was that many of the birth centers, from low-cost inner-city options to high-end centers affiliated with hospitals, were all in heavy demand. They wanted you to get in touch before you were even pregnant, or at least very early in your pregnancy, to get a spot and set up everything for the birth there. The centers usually offer integral service, seeing the mother for all her pre- and post-natal visits, in addition to attending the birth. We, on the other hand, would be arriving barely a month before Paulo's due date!
There was one place in particular that Caro had fallen in love with even before we got to the States. It was near us, was well established, and had a full staff of midwives to do office visits and be on-call for your birth. Like many of the birth centers we investigated, they didn't post many details on their website. We didn't know how much it would cost, nor how to become a patient there, but when I called, they were quite clear that they had no availability for late October, when Paulo would be born. Nonetheless, Caro pressed that we should give them a try. It is a tribute to her personality, as well as the general Colombian way of doing things, that my wife didn't simply accept an official no, but pressed on to see if they might be able to accomodate us somehow. We booked a place in their upcoming weekly tour, and afterwards we spoke to the director about our tricky situation of having just arrived with the baby due soon. To my amazement, she squeezed us in for a late October birth slot. I think she liked that we were not first-time parents, and that we seemed confident and laid-back about things. In our regular checkups over the next few weeks, we confirmed that many of the parents-to-be at the birth center were very nervous and had a constant onslaught of worries they saddled the midwives with. Many of the midwives commented that they enjoyed dealing with us and our calm attitudes. I think the director also might have accepted us due to a small administrative misunderstanding--the secretaries had let us come to the tour as a courtesy, but made it clear that we couldn't be accomodated at the birth center. I think the director might have assumed they'd told us there was a space for us, otherwise they wouldn't have let us on the tour. At any rate, it worked out to our advantage!
Having the birth center lined up was a huge weight off our shoulders, and we were thrilled not only at their all-inclusive price of $4500 for the delivery and all visits, but even just at the fact that they could give us a clear, flat price for their services. Most hospitals and other clinics are not able to do this.
Over the next few weeks as we waited for Paulo to come along, we had a few worries related to his gestation. Caro didn't gain weight for the last month or so of her pregnancy, and I was worried that maybe the stress and chaos of our moving and reestablishing a home was impacting her and the baby. Her belly kept getting bigger, but the rest of her sort of shrunk away. In retrospect, many women would be thrilled to slim down at the end of their pregnancy, but at the time it caused me a bit of worry. Also, ever since Colombia, doctors had been expressing their concern that Paulo seemed to be small for his fetal age. He kept showing up normal in the sonograms, but for some reason both our Colombian doctors and the US midwives remained preoccupied about it. It sometimes seems to me that kids in the US these days are simply immense, so maybe a normal-sized kid looks small. The 50th percentile isn't what it used to be! Flipping through the scrapbook of babies recently born at the center, I was amazed that a good deal were over 8 pounds. At the same time, when you talk to parents, you get the feeling that everyone's kids are in the 99th percentile. It reminds me of Lake Wobegon, where all the children are above average.
Are kids really getting bigger? If so, I'd wonder why. I know that people in a country become physically bigger once they transition from widespread undernutrition to eating enough. But the US crossed that threshold long ago, so you wouldn't think that we'd keep getting bigger. Anecdotally, I've observed that I'm taller than many older guys, whereas among white men my age and younger I'm just in the middle of the pack for height. Demographic statistics seem to bear me out on this, and obviously people are getting not just taller but also fatter in the US. Could it be that our widespread overeating in this country also makes for much bigger babies? What about all the substances in our environment that can affect hormonal levels? I weighed 8 lb at birth, and was considered a pretty big baby, but now 8 pounds is about the minimum of what baby boys are expected to weigh.
Caro had been doing research on non-hospital options since we were in Colombia. We saw that there were a fair number of midwives operating in the Washington DC area. There were even quite a few birth centers, where midwives attend births outside of people's homes. We didn't want a home birth for a number of reasons. For one, we really are pretty orthodox at heart, and that just seemed a bit too alternative for us. More than that, we wouldn't be very settled in to our apartment by the time Paulo was born, so it made more sense to have the baby somewhere where they're specially set up for childbirth. The problem was that many of the birth centers, from low-cost inner-city options to high-end centers affiliated with hospitals, were all in heavy demand. They wanted you to get in touch before you were even pregnant, or at least very early in your pregnancy, to get a spot and set up everything for the birth there. The centers usually offer integral service, seeing the mother for all her pre- and post-natal visits, in addition to attending the birth. We, on the other hand, would be arriving barely a month before Paulo's due date!
There was one place in particular that Caro had fallen in love with even before we got to the States. It was near us, was well established, and had a full staff of midwives to do office visits and be on-call for your birth. Like many of the birth centers we investigated, they didn't post many details on their website. We didn't know how much it would cost, nor how to become a patient there, but when I called, they were quite clear that they had no availability for late October, when Paulo would be born. Nonetheless, Caro pressed that we should give them a try. It is a tribute to her personality, as well as the general Colombian way of doing things, that my wife didn't simply accept an official no, but pressed on to see if they might be able to accomodate us somehow. We booked a place in their upcoming weekly tour, and afterwards we spoke to the director about our tricky situation of having just arrived with the baby due soon. To my amazement, she squeezed us in for a late October birth slot. I think she liked that we were not first-time parents, and that we seemed confident and laid-back about things. In our regular checkups over the next few weeks, we confirmed that many of the parents-to-be at the birth center were very nervous and had a constant onslaught of worries they saddled the midwives with. Many of the midwives commented that they enjoyed dealing with us and our calm attitudes. I think the director also might have accepted us due to a small administrative misunderstanding--the secretaries had let us come to the tour as a courtesy, but made it clear that we couldn't be accomodated at the birth center. I think the director might have assumed they'd told us there was a space for us, otherwise they wouldn't have let us on the tour. At any rate, it worked out to our advantage!
Having the birth center lined up was a huge weight off our shoulders, and we were thrilled not only at their all-inclusive price of $4500 for the delivery and all visits, but even just at the fact that they could give us a clear, flat price for their services. Most hospitals and other clinics are not able to do this.
Over the next few weeks as we waited for Paulo to come along, we had a few worries related to his gestation. Caro didn't gain weight for the last month or so of her pregnancy, and I was worried that maybe the stress and chaos of our moving and reestablishing a home was impacting her and the baby. Her belly kept getting bigger, but the rest of her sort of shrunk away. In retrospect, many women would be thrilled to slim down at the end of their pregnancy, but at the time it caused me a bit of worry. Also, ever since Colombia, doctors had been expressing their concern that Paulo seemed to be small for his fetal age. He kept showing up normal in the sonograms, but for some reason both our Colombian doctors and the US midwives remained preoccupied about it. It sometimes seems to me that kids in the US these days are simply immense, so maybe a normal-sized kid looks small. The 50th percentile isn't what it used to be! Flipping through the scrapbook of babies recently born at the center, I was amazed that a good deal were over 8 pounds. At the same time, when you talk to parents, you get the feeling that everyone's kids are in the 99th percentile. It reminds me of Lake Wobegon, where all the children are above average.
Are kids really getting bigger? If so, I'd wonder why. I know that people in a country become physically bigger once they transition from widespread undernutrition to eating enough. But the US crossed that threshold long ago, so you wouldn't think that we'd keep getting bigger. Anecdotally, I've observed that I'm taller than many older guys, whereas among white men my age and younger I'm just in the middle of the pack for height. Demographic statistics seem to bear me out on this, and obviously people are getting not just taller but also fatter in the US. Could it be that our widespread overeating in this country also makes for much bigger babies? What about all the substances in our environment that can affect hormonal levels? I weighed 8 lb at birth, and was considered a pretty big baby, but now 8 pounds is about the minimum of what baby boys are expected to weigh.
Anyway, with the major institutional arrangements taken care of (insurance, a birth center, Sam's school), we were finally able to have the baby in peace. I was put in the uncomfortable situation of having to negotiate leave, telework, and vacations with my boss before even really starting work! We'd been praying that Paulo would hold off until my insurance kicked in on October 6th, and thereafter I hoped he'd still hold out until I finished my work orientation (and gotten over a long-lasting cold that I didn't want to pass to his fragile immune system). This was especially the case with the final details to be prepared for the childbirth; I simply hadn't found time to get everything together, and I was terrified that Paulo would come calling and we wouldn't have our house ready for him. Very early on, Caro had conscientiously packed a small go-bag with the items recommended by our birth center--towels, clothes, vaseline, etc. We also had brought an entire suitcase's worth of diapers and clothes for Paulo from Colombia (all donated either from his brother or a friend who recently had a newborn baby). I packed a lot of food to keep our energy up while Caro was in labor (and to provide for the midwives), and my mother's taking care of housekeeping during her two-week visit allowed us to really get our other ducks in a row. Mom's offer to take care of Sam during our labor was also a huge boon to us, because we were worried about what to do with him.
My cousins held a sort of virtual baby shower for us, and their check allowed us to get a stroller, carseat, bathtub, and other accoutrements that we never think we'll need (fancying ourselves as non-consumerists, as we do) but always end up needing. We got a double futon
bed for ourselves to replace the uncomfortable, bouncy single bed we'd
been sharing. Our furniture still hadn't arrived from Colombia, but I
made a makeshift crib from a cardboard box I'd salvaged from the
garbage. In particular, our birth center was adamant that we have a carseat for the baby to go home once he was born (again, no consideration that people might walk or use the Metro). This was good in the end, because we did end up getting a ride from a friend with a car after Paulo's birth. Furthermore, until we got his crib shipped from Colombia last week, Paulo preferred sleeping in his carseat instead of my box-crib I'd made for him. The birth center had also essentially insisted that we somehow magically have a car, which we don't. I guaranteed them that we had a 24-hour taxi service on call, as well as multiple friends at the ready to drive us if need be. They didn't like this, but I guess they didn't have much choice, unless they planned on buying a car for us!
Most important, and put off by me for the longest time, I put together a list for the birth day, with numbers to call in their respective order, an inventory of food and suitcases to bring, etc. I made two copies, one for me to have on hand at all times, and one for Caro in the house. With these last preparations, we were finally at ease, ready for Paulo to come along (and after the 39-week mark, we were really rooting for him to get moving already). In fact, writing this blog post was the last thing I had pending before Paulo's birth. I got some of it under my belt before he came along, but as you can see, it's been over a month before I could really finish writing.
As I mentioned above, though the birth center we worked with does at-home births, we opted to have Paulo at their center, since they have everything set up there (as opposed to our half-moved-in house). This seemed like the most logical, easiest choice, but of course it implied having everything ready to grab and go at a moment's notice. And though on the day of the birth, Caro was in fine condition to have gone to the center on the nearby Metro, the quantity of junk we were hauling demanded that we take a taxi.
Though I've always found it weird when people schedule their exact birth date, that's essentially what we did. Our birth center's policy was that for women over 41 weeks pregnant, and over 35 years of age, they would refer the case to a hospital. We didn't want that--didn't want the IV drips and the staph infections and the pathologization of a natural process, and certainly not the exorbitant, arbitrary prices a hospital would charge--so we were hoping that Paulo would decide to come before that point. But by about midway through week 40, we were getting fidgety. That week's routine checkup revealed that Caro was already fairly dilated. Not enough to have the baby, but enough to tell us he'd be coming soon. So they sent us home that evening to think about their options for induction.
The next day, October 30th, we called the on-duty midwife, and went into the center to get started on the birth. They prescribed us cervidil, which is a hormone that promotes the birth process (I won't go into details on this or much else, since I don't intend for this to be a blog post about my wife's or anyone's anatomy!). The birth center uses this vaginal insert as opposed to a oxytocin IV drip, simply because the latter requires equipment and monitoring that the birth center doesn't have capacity for, while the cervidil can be physically removed if its effects ever become too intense or it's no longer needed. Anyway, I had to go to the pharmacy and buy the medicine. Aside from this the birth center employs nipple stimulation (provided by Dad), and finally breaking the mothers' water, to speed along the birth process.
The childbirth was much more difficult than we'd experienced with Sammy, who popped out six hours after we'd gotten to the hospital, after barely an hour of hard contractions and just two real pushes. In retrospect, I guess Paulo's birth was normal--ten hours of gradually-increasing contractions, quite a bit of pushing that didn't seem to get us anywhere, lots of waiting and pacing and pain. But for Caro it seemed like a really complicated birth. One comment she had was that the birth center was great for this birth, but if it were her first time and she were ignorant and uncertain about how things were supposed to go, she'd have wanted an authoritative doctor telling her what to do, instead of the excessive freedom of choice as to whether to push, what position, etc. Towards the end, she told the midwife and me that she just wanted us to stop asking her questions about what she wanted. The midwife really stepped up at that point, and saw that what was needed was for her to tell us what to do, and me to gently force Caro to do it! In the end they broke Caro's water, and Paulo came out pretty immediately; who knows if this could have saved us hours of labor if they'd done it to begin with, or if those hours of labor had been effective at preparing Paulo to come out well?
Paulo was born just after midnight, thus making him a Halloween baby. Sam had been born with a full moon on the winter solstice, while Paulo was born almost with the new moon, on the traditional festival of Samhain marking the symbolic start of long, cold winter nights. So both our sons have good pedigrees in terms of pagan astronomy.
For this birth I was much more involved, helping Caro to brace herself and push, and cutting the baby's cord. Most impressive for me was to see up close the baby's dusky, slimy head emerging from the womb. I couldn't believe this little alien thing was our baby! He looked really scrawny and skinny, but I guess that's because we're accustomed now to our big three-year-old. In fact, Paulo was slightly bigger than Sam when he was born.
The next day, October 30th, we called the on-duty midwife, and went into the center to get started on the birth. They prescribed us cervidil, which is a hormone that promotes the birth process (I won't go into details on this or much else, since I don't intend for this to be a blog post about my wife's or anyone's anatomy!). The birth center uses this vaginal insert as opposed to a oxytocin IV drip, simply because the latter requires equipment and monitoring that the birth center doesn't have capacity for, while the cervidil can be physically removed if its effects ever become too intense or it's no longer needed. Anyway, I had to go to the pharmacy and buy the medicine. Aside from this the birth center employs nipple stimulation (provided by Dad), and finally breaking the mothers' water, to speed along the birth process.
The childbirth was much more difficult than we'd experienced with Sammy, who popped out six hours after we'd gotten to the hospital, after barely an hour of hard contractions and just two real pushes. In retrospect, I guess Paulo's birth was normal--ten hours of gradually-increasing contractions, quite a bit of pushing that didn't seem to get us anywhere, lots of waiting and pacing and pain. But for Caro it seemed like a really complicated birth. One comment she had was that the birth center was great for this birth, but if it were her first time and she were ignorant and uncertain about how things were supposed to go, she'd have wanted an authoritative doctor telling her what to do, instead of the excessive freedom of choice as to whether to push, what position, etc. Towards the end, she told the midwife and me that she just wanted us to stop asking her questions about what she wanted. The midwife really stepped up at that point, and saw that what was needed was for her to tell us what to do, and me to gently force Caro to do it! In the end they broke Caro's water, and Paulo came out pretty immediately; who knows if this could have saved us hours of labor if they'd done it to begin with, or if those hours of labor had been effective at preparing Paulo to come out well?
Paulo was born just after midnight, thus making him a Halloween baby. Sam had been born with a full moon on the winter solstice, while Paulo was born almost with the new moon, on the traditional festival of Samhain marking the symbolic start of long, cold winter nights. So both our sons have good pedigrees in terms of pagan astronomy.
For this birth I was much more involved, helping Caro to brace herself and push, and cutting the baby's cord. Most impressive for me was to see up close the baby's dusky, slimy head emerging from the womb. I couldn't believe this little alien thing was our baby! He looked really scrawny and skinny, but I guess that's because we're accustomed now to our big three-year-old. In fact, Paulo was slightly bigger than Sam when he was born.
In terms of sustainability, I think our birth center birth was by far the best option. Little waste, few drugs and chemicals, no ambulance or long-distance drives. And cheap! They gave us the standard $4500 package that covered prenatal visits, the birth itself, postnatal, everything (of course the first part of our prenatal care was in Colombia, so we didn't take advantage of the whole package here in he US, but everything was free in Colombia, so we didn't lose out on anything either). Labwork cost a bit extra, but never the ridiculous prices a hospital would charge. The birth assistant (a nurse that helps the midwife during the birth) cost $900 and usually isn't covered by insurance, who consider birth assistants as an unneeded luxury (which might be the case in a hospital, but certainly isn't true when it would otherwise just be you and the midwife in a room trying to juggle gauze, pads, scissors, flashlights, etc.). Since we helped the labor along with the prostaglandin insert, we had to buy this for $330US. Because my wife is over 35 years old, the birth center's new policy wanted us to do weekly sonograms for the last few weeks to check on the volume of amniotic fluid. If it were in Colombia, where such sonograms cost $70US a pop, we might have done it, but the radiology place charged us $600 per sonogram, half of which was for a procedure we didn't need or ask for (the observation of blood flow in the umbilical cord). So we ended up doing just one of these sonograms, and then putting off the follow-up, until we finally had Paulo! Our insurance would have covered the sonograms, but we couldn't brook the idea of saddling our medical system with even more frivolous charges for something that was simply an institution's new procedural requirement and not a medical necessity. At any rate, a healthy pregnancy and birth with top-notch medical attention for around $6000US, most of it covered by our insurance, is a pretty good deal. Certainly a sight better than the arbitrary, exorbitant prices charged for most childbirths in the US.
The evening after Paulo was born, I was understandably tired as I went to pick up Sam from preschool. It was Halloween, and I'd had grand plans of going trick-or-treating in our building with Sam, in addition to attending a building party the night prior. We of course missed that party on the 30th, busy as we were giving life to a new child, and frankly the prospect of going door to door in dimly lit hallways didn't seem that appealing either. The neighborhood we walk through to get to Sam's school is a typical high-income inner suburb. Since the beginning of October, there had been lots of Halloween decorations on front lawns, many of them surprisingly gory. Sam noticed these, and would sometimes say, "Look, a skeleton!" or, "That's a spider," without understanding the ritual context. I wonder what he thought--maybe that some people simply decorate their houses with fake tombstones and severed limbs. On her visit, my mom brought two Halloween picture books, made Halloween-themed cookies with Sam, and decorated a pumpkin with him, in addition to a pumpkin he'd decorated as a school project. She even made a fruit-filled jack-o-lantern out of a hollowed-out orange skin. Initially Sam was bemused and sort of lost as to what all these green women in black hats and skeletons meant, and at some point he got an idea that he should be scared. And he was--Caro was a bit shocked and dismayed at the whole ritual fascination in the US with scary things and the occult, though at the same time she was fascinated to see Halloween as a genuine, autochtonous, complete cultural manifestation and not just the watered-down commercialism that has begun to arrive in other countries.
At any rate, in the course of October Sammy started to make the connection as to why the lawns were all decorated with skeletons and the like. He would sometimes remark as he looked at Halloween decorations, "That's just like in the book that Grandma brought me." So by Halloween night, though he didn't expect to do trick or treating, and in fact didn't want to wear the mapale AfroColombian outfit we'd repurposed from his June school presentation to be his Halloween costume, he knew that Halloween was a thing. And he wasn't surprised when I decided that we would take advantage of our walk home to do trick-or-treating, though I did have to explain the concept to him some. We asked his school for a spare shopping bag, and headed out into the balmy night. There were many groups of kids about, most with parents but some of the older ones on their own. Sammy got down pat saying "Trick or treat!", and even parts of "Give me something good to eat!" We only went to a few houses, and Sammy isn't even that into candy, but I was really glad we got to partake in this fundamental US rite. Indeed, I don't know if he'll get another chance to do so, since most of his childhood will likely be spent outside the States.
When we got back from our outing, we returned to a warm house, Grandma cooking a delicious meal, and a one-day-old baby. This was the best treat we could have asked for on Halloween.
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