The Last May Surprise

So many things happened in May. Many of them are in my last 2 posts, but there are two in particular that I didn't mention. One was how special my family made Mother's Day by hanging up beautiful homemade cards on my door to surprise me when I got home! I hadn't been feeling well, so when Ben asked what I wanted for Mother's Day, I said "some good vitamins!" And, sweetheart that he is, that's what I got. And they did make me feel better, until all the sudden I didn't. I started getting really nauseous and tired.That's when I found out my last present in May: a positive pregnancy test.

This pregnancy has been harder, so far, than others I've experienced. The nausea is more intense and I don't feel well often. It makes it easier to like that Ben says this is the last one. It would be much harder to miss easy pregnancies than to remember how disgusting this one feels and be glad it's over. International moves while pregnant are no joke. Thankfully, I think we've mostly got it down. Minimize, minimize, minimize, then pack clothes and books and go! Then, find a midwife as soon as possible. We are in the minimize stage of: separating things into storage, give away, throw away and take right now.

Previously, the saving grace of living in a desert during summer has been the really great air conditioning available. Here, that's not the case. Air conditioners are for one room only and, in my experience, barely cool that. So we do what everyone else does, spend the sweltering evenings outside where there's a breeze until the sun goes down enough that the house isn't quite boiling. As we live on a main street, any semblance of privacy goes out the window, literally, because you can't afford to keep them closed in the heat. Cabo is such a beautiful place. I will always remember that part of it. But now, I am also really looking forward to visiting family in the States with their air conditioners!

Pregnancy and the Mirage of Control

There are several ways this third pregnancy has been different from my first two. The biggest difference has been the constant contractions from early on, that have gradually intensified the further along I've gotten. Many of the other differences are mental things compounded by our location.


The hardest part of this pregnancy,  in addition to being away from friends and family and especially my midwife, is how the nature of pregnancy has so much of it out of my control: I can’t be sure I will go into labor when Ben is home, I can’t be sure that I can give birth without complications, my preferred method of birth (out of a hospital) is illegal here... Nothing that I feel responsible for is really within my control- which are reasons that were true with the first two, but being surrounded by a network of people I trusted made that easier. This time I can’t even take care of my own kids well when I go into labor, and this was the part that made me feel the most desperate.  I’m thankful that God has provided someone I feel I can trust  with my kids (which, trust is also hard to do) long enough to have this new one. With that major concern out of the way, there are only a dozen others to constantly give back to the one with ultimate control. I’m having to learn a lot about letting go and realizing that my "control" is really a mirage to begin with and that God really does order our steps if we let Him, even when everything feels so wrong and I would do it all a completely different way if I possibly could. I can’t have this baby at home, though (unless he just comes really fast, but still going for a completely natural birth, supposedly made easier in the British model approach to maternity care in this hospital...) I can’t change my location and I’m not in charge of the timing of the birth of this baby ultimately.

I've been pregnant the whole time we've been in Ruwais, since we first moved in here in October, so after the major hot months coming up (right after the baby is due,) I'm looking forward to getting back into running and other physical things. As with Elias, I haven't even reached my pre-pregnancy weight that I had with Talia though I'm in my 39th week now, and that's something that reminds me that though there may be many things I can't control, the things that I can, do make a difference.

Goodbye 2nd Trimester, Hello 3rd Trimester; (and babynaming expat challenges)

There's an issue with trimesters. While pregnancy is naturally a 40 week long thing, 40 is not naturally a number divided by 3. Hence, several different numbers are given for when one actually crosses the line between 2nd and 3rd trimester. It's a bit frustrating. I've seen the limit set at 27 weeks, 28 weeks and 30 weeks. To me, it would make more sense to just divide it into 4 terms: one for each set of 10 weeks! In any case, I'm considering this, the end of my 27th week of pregnancy, to be my end of the second trimester!

One thing that the third trimester brings with it for me, is a sense of urgency to decide upon a baby name within these last months. Something expat parents must consider with more detail than maybe those who stay in one spot are how the name of their baby will be said (and if it can even be pronounced) in the native language of the countries they plan to reside in. While I truly enjoy researching names, and believe in choosing meaningful names for my children, sometimes this is a bit challenging. A few conversations between my husband and I have gone like this:


Me: "Hey, what about this name!? It works in both languages."
Him: "Hmmmm, yeah, but you say it COMPLETELY different in both languages. Don't you think that would be confusing for the kid?"
Me: "Why couldn't we just stick with one pronunciation?"
Him: "Remember the what-we-thought-was-an-easily-pronounced-name that certain family still can't say right?"
Me: "You have a point. Let's keep looking..." ;)

Fortunately, (or unfortunately) we only care minimally about what people from the States or the next country we live in will do to mangle what we think is an easily pronounced name, so it doesn't get in the way most of the time. Even then, it just becomes something else to consider.

We've learned to prioritize to see if a name even gets on the list:
1. Is it meaningful? Do we like the meaning?
2. Is at least one of the names able to be pronounced in Spanish?
3. Is at least one of the names Hebrew to go with our family naming tradition?
4. If we choose to call the baby by the Spanish name, will our family be able to mostly pronounce it or will they disown us? (just kidding. ;))

Baby naming aside, the third trimester also has other challenges awaiting. The biggest one for me is managing weight. I have managed to walk a mile for every day of my pregnancy. Now, usually, that means I get up at 7:00 A.M. every week day and walk 2.5 - 3 miles (depending on how awake I am) before my family gets up and needs breakfast. I still say I've only walked a mile for every day in this pregnancy, because I like to round it down to be SURE I'm telling the truth. Be that as it may, that still works out to a whopping 193 miles total as of today. I truly believe that little, daily decisions and routines make big changes in our end results. It's crazy how a little bit every day has built up to so much, and probably more! I appreciate the health I have and want to keep it for as long as I can.

So, here I go into the last stretch of pregnancy! Hopefully, my next pregnancy post will be advertising the birth of our little man. :)

2nd Trimester Triumphs and Fears

If you've read about my journey to running a 10k and then running most of a 5k in my first trimester this May, you already know two things: I'm fairly new to living healthily, and I'm pregnant. Those two facts together are sometimes hard to manage. Weight gain, whether healthy and with good reason like pregnancy, or not, gives me terrible flash backs. Rooted in the fear of former obesity, I hate feeling like I'm slowly getting trapped by my old body. Some of the fear comes from the future: wanting to have the healthiest birth and baby possible. I feel like, if I don't keep moving and find positive things to do, these past and future fears will suffocate my present.

There are several ways I'm trying my best to combat this fear:
1) I walk an hour every weekday morning. If I miss a morning, I make it up somehow in the day or walk extra the next day. I jogged in the past, but ligament pain is hampering that at the moment.
2) I swim as much as possible.
3) I find physical things to do that aren't too strenuous. Raking the yard, checking the mail (at the end of a long driveway,) hanging clothes on the clothesline, playing outside with Talia... basically, just looking for ways to keep moving instead of giving in to the siren's call of technology, air conditioning and the couch!

I try to think about the good things:
1) I lost all of the pregnancy weight within the first month. Though that still left me much higher than I should have been, the pregnancy part came off.
2) I am over halfway through my pregnancy and I've only gained 13 pounds. It could be much worse.
3) Even if I do gain some weight, I have the tools to know how to fight it this time. Even if I gain as much weight as I did with my first pregnancy, I'll still weigh LESS than my first pre-pregnancy weight!
4) Though always hungry, I try to make sure I'm really hungry; stomach growling or I can feel hunger, before I eat. I try to eat lots of fruits and vegetables.


Fear can either paralyze me or motivate me to overcome it. I choose to use what I have and what I know and keep moving, and moving forward! Afterall, the best way to overcome this fear of weight gain in pregnancy is to go the whole length and prove to myself afterwards by experience that I could do it.

How did you combat too much pregnancy weight gain? Do you have any tips that would help?

Birthing Options in Guatemala City: An Interview with Hannah Freiwald

I had a "normal, healthy" hospital birth with my first child, so you may wonder why I have chosen to use a midwife here in Guatemala City instead of the hospital option.

While I don't consider hospital births evil, and I'm not bashing doctors, I do think people use them with a different mindset. When I go to a hospital, I am surrounded by people used to looking for the worst case scenario. This is what saves many people's lives. However, if you have that mindset for birth, something the body is made to do naturally- not an illness, it's no wonder that many precautionary hospital practices have lead to an extremely high Cesarean section rate in the United States... and in Guatemala. I am glad these interventions exist and am thankful for the many lives they have saved, but in most cases I don't think it is the best mindset to start with.

Looking back, it was a miracle that I wasn't pushed into a C-section at the last minute like so many hospital births are. I was very overweight. The doctor's visit that I initially went in for ended in the hospital a week before my due date because the "baby wasn't moving enough." I later found out that the reason for that was because I was in the initial stages of labor. I was hooked up to a blood pressure monitor all night, which painfully took my blood pressure every 30 minutes- effectively removing my ability to sleep the night before giving birth. Exhausted, the next morning they started me on Pitocen which began to speed up the little bit of labor I had left, since my body had almost completely stopped contracting on its own. The doctor then broke my water as the nurse kept upping the amount of Pitocen going into my system. The shock and pain of all of these things happening at once, though I didn't want one, had me asking for an epidural. This was the first time I was able to sleep in 36 hours. This rest allowed my body the time and resources it needed to hurriedly get ready enough, though everything was still so rushed. Nurses came in every two hours to check my cervix. I prayed the whole time that my body would just cooperate and I wouldn't have to get a C-section.

I'll finish this part of the story just by saying that I did give birth to a healthy little girl. I was so exhausted and disconnected from what had happened that it didn't even seem real. I couldn't bond with my baby. I couldn't nurse. This only spiraled into a postpartum depression that got worse. I fought depression and pumped for four months trying to learn how to nurse before we finally figured it out. There is nothing I have faced worse than my baby screaming because she was hungry, and I was there ready to feed her, but we couldn't figure out how.

For every physical stretch mark that I have from birth, there is a mental one as well. I hated losing control over my own body. Do I hate doctors? No. Do I think my doctor did the right thing? No. I think she did what she was trained to do to avoid complications, to avoid lawsuits, to "deliver" me from myself... but I couldn't help feeling that birth was more instinctual and that it shouldn't be like the experience I had. I know many people think I should've just been happy that I had a "normal" delivery with a healthy baby as a result. Please don't get me wrong, I appreciated those things, but I didn't want to do it again. There had to be another option. This lead me to research my options in Guatemala City; the place we are now located, pregnant with our second child.

The C-section rates in Guatemala are horrible (as high as 70%) in many hospitals. I asked around in the expat community looking for any other option and, thankfully, discovered Hannah Freiwald, the only English-speaking (she also speaks German and Spanish) midwife in the capital. Also the only midwife with her own birth clinic. Thankfully, for me, another option. I still can't believe the difference in care, just in the prenatal spectrum, from my first experience. I don't feel like "just another patient." I'm not saying my first doctor was a bad person, but the clinical environment made every part of the process feel like I was just another patient with a possible problem that could become apparent at any moment. With my first pregnancy it felt like the unspoken rule was "ask no questions and do what I tell you to do." Hannah is different. The environment is different. The approach is different. The end goal is different. I'm still learning how to ask and not be scared. I'm still learning how to be in control of my own body.

I'm not the only person like this. Many people in Guatemala have had much, much worse hospital experiences than I have. I am grateful that mine went so well. Women who can't afford care who go to public hospitals are not allowed to have family in the room with them. They labor in a room full of other women who are laboring and then, when high blood pressure becomes an issue (can you imagine it not being an issue in that situation?!) They are forced into C-sections with no family available and no second opinions possible. Many, many of these women have also found Hannah. Many of these women still face the initial hurdle of not being able to afford care... and Hannah helps them anyhow. Her clinic that helps mostly indigenous and low income Guatemalan women called "Manos Abiertas" (Open Hands) works on a sliding pay scale. This often means patients visit free of charge or pay much less than their visit costs, because most can't afford the $5 for a checkup. Still, Manos Abiertas, has to have money to survive. One of the programs they have started to help with this is the sponsor-a-birth program where people can help women like Maria Bernarda. (Pictured below.)

Here is an excerpt of an interview with Hannah explaining some of the challenges of birth, midwifery and funding in Guatemala:

What birthing options are available for Guatemalans?

•"For poor Guatemalans, there are the national hospitals: C-section rates are getting close to 50%, all kinds of other interventions are routine, and the woman is unaccompanied through her birth."
•"The IGGS, the social security hospital, is very similar."
•"Many people who can barely afford it therefore opt for one of the small private clinics, only to have the same experience but paying for it."
•"Aprofam, an organization that started out subsidized but has to be sustainable at this point, has taken the same route in order to sustain itself."
•"In the rural areas there are local midwives available, some of which are very experienced and well (mostly self-) trained, while others are not."
•"The big hospitals in the city have a C-section rate of 70 to 80%, besides being very expensive."

"In zone 11 we are facing the problem that people do not have a concept of a natural birth anymore - we have lost clients because they lost patience. People are so used to getting their babies cut out of them or pulled out of them or being hooked up to an IV that they do not believe in letting birth progressing normally. The urban clientele on one hand is used to getting things fixed "now" and on the other hand has no education to reason for themselves.
The c-section rate in Guatemala is shocking, and seems to largely come from doctors being in a hurry (lots of patients!) and having inadequate training in obstetric techniques. They also get more money for performing a c-section than a vaginal delivery (as is the case in the US as well.)"

How is what you offer with Manos Abiertas different?
"It is unfortunate that respectful, empowering, and patient-based care is not the norm, but it is clear that when women find it they will not settle for anything less. Patients came to Manos Abiertas from across the country, taking 3 and 4 hour bus trips to seek care. Patients told stories of other clinics they had visited, where they never received results, where procedures and medications were not explained, where their birth control was unreliable and suddenly unavailable, and where they were c-sectioned unnecessarily. Low income Guatemalan women have not yet grasped that they deserve respect. Teaching them this fact is a big part of our work."
"Manos Abiertas offers something different, and it is clear that it is needed. One of the most extraordinary things about Manos Abiertas is the home-birth atmosphere that they are able to offer to their clients. Women labor and birth in a quiet, comfortable, homey environment, surrounded by their family and friends (and sometimes half of the village.) They are able to deliver naturally, and usually go home to their family the next day. The new baby is celebrated and fussed over by the clinic staff, and the mom is at the center of all of the action."

I don't know how you feel about the midwife vs. hospital birth issue, and I welcome your dissent if you disagree with me, but if nothing else let's agree that no matter one's social status, they should have an option. The ability to have control over one's own body is a basic right. If that right is given away freely, that's one thing, but the ability to have a choice is necessary. Without funding, Centro de Parto Natural and Manos Abiertas wouldn't be able to offer the Guatemalan indigenous women, the ones who are constantly refused the rights to their own bodies on a daily basis, the ability to choose their own manner of birth. Please consider donating.

Spanish educational material about birth approx. 60$ or 470Q
1 professional grade, waterproof fetal doppler: $125 or 985Q plus shipping
1 complete birth package 240$ or 1,884Q

Also on their wish list is an obstetric ultrasound machine. Any donation, no matter the size, will help make a difference in a woman's life.

Thank you, from me, from countless women who would tell you if they could. Thank you.

Read the rest of the interview here.

May 2011 Arcoiris: 5k's while pregnant

May 2010 was my first experience ever participating in a 5k. March 2011 I ran my first 10k. This May 2011, I ran 3k and walked 2k... because this time I was running 12.5 weeks pregnant. (I would usually push through, but your body lets you know when you need to slow down in pregnancy.) With my first pregnancy, running any amount of a 5k would have been a difficult thing to imagine. I was 214 pounds when I got pregnant and I gained 48 with pregnancy. Most of that was due to a fear of being outside with strangers and what they'd think of me. That fear kept me from exercising the most effective and cheapest way possible: walking outside.

It's been a long and difficult transition since then, but things have changed, in a very ironic setting. Where I was once scared to walk in un-gated places without reason, now I can't walk for very real and substantiated fears. However, excuses are not an option. There is always a way to exercise, you just have to be determined to find it. I have used our 2 level stairway to run up and down, created a mini-track in our garage to run around, found numerous exercise videos on sparkpeople.com that don't require equipment and found many ways to play chase with my toddler creatively. There is always something that can be done. Thankfully, where we work has a dirt track that is free and it has come in very handy!

In addition to this, we now live in a country, Guatemala, where there are always different types of fruits and vegetables in season. Sparkpeople.com also helped me track calorie intake and make better food choices. With this mindset and available blessings, I am starting this pregnancy at 150 and have only gained 3 pounds in the first trimester.

What this doesn't conquer, but helps manage, is the paranoia that uncontrolled weight gain will still be a part of this pregnancy. I think this is something that I will have to prove to myself. Once I experience a healthy, active pregnancy, I will know that I can do it.
I am blessed with people who support me and a healthier lifestyle. While I have learned some independence, I still realize that the support of other people helped me get to the point of being able to be independent.

I would like to encourage you, whether struggling to be healthy in general or during pregnancy, with irrational fears like mine or just seemingly insurmountable weight to lose; you can do it. Don't accept excuses from yourself. Be creative and you can always find a way. I certainly plan to keep proving this to myself!