He told me to hold my breath and to push at the same time.
-A la proxima, detenga el aliento y puja fuerte-
As the contraction pushed my hip bones apart, I held my breath for two unbearable seconds. In those two seconds, I forced myself to be present with the intense sensation. I willed myself to push. PUSH! But after two seconds, I let out a stream of profanity.
My OB didn’t like that. We (he) agreed that I could only curse if I could push.
I asked my doula, “If I get an epidural now, what are the chances of a c-section?”
She winced and said, “They’re pretty high.”
This was the right thing to say. With her eyes, she reminded me of how important a non-medicated birth was to me, she reminded me of all the hard work I put into preparing for this day with hypnobirthing, saying my daily affirmations and exercising until I was 39 weeks pregnant. With her eyes, she said, “You can do this, you’ve got this!”
So I said:
-Vamos pues, no epidural. Siguemos por una hora más. -
I pushed for another three hours and Santana was born at 12:14 AM.
A Continent with a High C-Section Delivery
Colombia and Latin America, in general, have a high C-Section rate delivery (see source here and here) but I didn’t have to look it up to confirm this. Before settling in Medellin, Colombia, my husband and I had travelled through Latin America for two years so I got to chat with plenty of moms. One of the things that I kept hearing was that women are concerned about stretching and weakening their vaginal muscles by delivering a baby vaginally. The average mom I met typically had their first child when at 16 or 18 years old so I suspect that lack of education about one’s body also has something to do with it.
Once I started talking to the doulas, I became convinced that the main reason is that it’s just easier, faster and more profitable for doctors to pump babies out via C-Section. With all of that in mind, I still wanted my girl to be born in this continent. Since we were going to spend the next five years living in Colombia as expats, we wanted her birthplace to become a sense of Latin pride for her.
I wanted to have a water birth at home! With my cat nearby and hear reruns of Seinfeld in the background. But this isn’t Los Angeles (where I’m from) and I knew that I would have to compromise.
If you want to have a natural birth in Colombia and are not sure if it’s possible, then read on! Here’s how it went for me. But first…
Why I Wanted a Non-medicated/ Natural Birth
I often tell people that I was able to give birth without an epidural thanks to my ego. But of course, there’s a lot more to it. The main reason is that I wanted to avoid going through surgery at all cost.
Another reason was gravity.
Years and years ago, I was in the back of my first anthropology class. I was struggling to keep my eyes open when Dr Marie Womack piqued my interest by explaining how our closest relatives, the bonobos, give birth vertically and that we humans used to give birth that way, too. Then birth became medicalized when doctors decided that having the pregnant woman in a horizontal position suits them better. Nevermind that gravity works against you this way, that it hurts like an inferno — creating fear, tension and pain in your pelvic region — causing the women to require all sorts of medical (medieval?) interventions like forceps, epidural, Pitocin, arggh.
Ever since that gloomy vignette, I thought, if I ever decide to have kids or a kid, I want gravity to be on my side.
I told my husband that if we have a baby, the birth will have to go my way. I wanted a home birth and I wanted a midwife to deliver our bundle of joy. This birth plan sounds hippy-dippy — what? No doctor? My mom was horrified and my husband didn’t like the idea of not having a doctor in case things went wrong. But the more I read about natural birth, the more confidence I gained in doing it.
Besides having no ailments, I exercise, I eat healthily, I meditate, I eat kimchi, and I live a low-stress life. I should at least try to give birth without medical intervention.
Are There Midwives In Colombia?
As I said, I wanted a midwife and to give birth at home. However, as of 2020, midwives in Colombia are not recognized professionally by the Colombian medical community. There are midwives in the native communities of Colombia and I found one in Bogota. I got a good feeling about her but was I really going to fly to Bogota, with a six-pound meatloaf in the oven, and check into an Airbnb just to give birth at a home? The more pregnant I became, the more unlikely it became. The Arctic Monkeys had a concert in Bogota and I ended up not going because I was too pregnant.
The point is nesting. I got nesting syndrome. But I digress.
Are there midwives in Colombia? Yes, but I did not find one in Medellin. Had I searched harder and asked around more, I would’ve eventually found one but I got, “My Eyes Hurt for Staring at a Screen” syndrome so I stopped. For that reason, a midwife would not deliver my baby and I had to compromise.
Are There Doulas In Colombia?
Since a midwife wouldn’t deliver my baby, I wondered if a doula could. There are many doulas in Colombia. If you are as confused as I was, there is a world of differences between what a doula and a midwife can do.
- A midwife is medically trained to deliver a baby.
- A doula is like a birthing coach. She can accompany you before, during, and after birth. She cannot deliver your baby. In Greek, doula means slave.
I found my doula through the Facebook Groups. There are Colombian doulas and American doulas that live in Medellin. Two of my friends in Medellin hired a doula and I met many other women this year who have hired doulas as well. According to my doula, hiring a doula has become popular.
Why Hire a Doula?
For me, my doula, Maria was like my personal assistant and birthing coach. In our four or five prenatal meetings, I explained to her what kind of birth I wanted. She knew that my biggest desire was to have a non-medicated birth. She helped me create a birthing plan and she helped James and I pack a bag for B-day (a task about which we would’ve naturally procrastinated till week 40).
If you’re not from Colombia, a doula can help you navigate the medical system, she can help you find the right OBGYN, and, most importantly, if Spanish isn’t your strongest suit, she can help you communicate your needs to your OBGYN.
Before you go out and interview a few potential doulas, it’s important to understand why you want one in your B-Team. The reason why I hired Maria was that I wanted to increase my chances of delivering vaginally. Becoming a first-time mom, I knew that I didn’t have all the answers no matter how much I read.
While the majority of my doula’s clients strive for a natural birth, a doula can also assist you with a planned C-Section. I know a doctor who practices what people call, A Gentle C-Section.
Finding a Doula in Medellin
I found many doulas inside the expat forums but I only had the time to interview three. The three doulas that I interviewed were great. If I could hire all three, I would’ve! To give you an idea of what’s in store for you if you decide to give birth in Medellin, here’s a bit of info about them.
Doula #1 — We’ll call her Cindy
Cindy is a mom of two. She gave birth naturally twice and gives prenatal yoga classes. She was born in Colombia she spent some time in the UK so she speaks English. When we met at a coffee shop, we chatted for about an hour almost entirely in English.
Cindy did a three or four-day quest where she camped on her own without water and food. To her, being a mother is a spiritual journey. Whether she is religious or not, you couldn’t tell and that was a selling point for me because I’m atheist and I meditate. Cindy and I had a lot in common. I was tempted to hire her on the spot but I owed it to myself and my baby to take my time and see what else is out there.
Doula #2 — We’ll call her Maria
Maria was 30 minutes late. At least she texted me in advance. It’s a good thing that I brought a book. I had a hankering for the Thursday tuna sandwich special so I suggested meeting at a Subway. When we met, she apologized and I told her why I fired my first OBGYN.
“She said I wasn’t allowed to have sushi and ceviche,” I joked.
Maria had worked with the OBGYN I had fired, we’ll call her Luz, and told me that Luz has a high C-Section delivery rate. Doula #1, Cindy, had recommended a male OBGYN who supports natural birth and Maria had worked with him, too. She gushed about what a great person he is.
Did we talk about cats? I can’t remember but Maria has three. Her English is good and she spent some time in Jersey. Since our entire meeting was in Spanish I didn’t know how good her English was and it didn’t matter. I was going to speak to my daughter in Spanish only so, better to get used to it now. One other thing, Maria has no kids.
Doula #3 -We’ll call her Sandra
I spoke to Sandra over the phone. I couldn’t meet her in person because I was in Florida for work. Her consultation fee is around $15, which, for the amount of information I got from my previous meetings with Cindy and Maria, was worth every cent. Sandra is like Cindy in that she too teaches prenatal yoga, has kids, and speaks good English.
As I said, I would’ve hired all of them. They were all a pleasure to meet so how did I choose?
Choosing a Doula is Personal
I had to be picky. I had decided a long time ago that I would raise a multilingual child and practice OPOL (One Language One Person). My husband would only speak English and I would only speak Spanish.
I chose Maria because, during our meeting, she did not revert to English for my convenience. When she met James, she switched to English proving that she has an above-average grasp of the language.
The other reason was my intuition. It was odd. Maria has no kids. She never gave birth. She was late to our first meeting. I waited three whole days for her to return my text. I could’ve moved on but if I had, then she wouldn’t have introduced me to Vito Corleone. You see, Maria lived in the forest of Santa Elena with her three cats. Once in a while, a stray cat would meander in and try to make himself at home so Maria would give the cat its shots, spay or neuter it and care for the feline until she found a home. It was perfect timing because we were looking to rescue a cat. We named him Vito Corleone and he used his litter box on the first night.
Update: Maria adopted a fourth cat last month.
American Doulas in Colombia
Of the three doulas I met, one of them was also certified in the US. This could be a selling point for some but the reality is that the medical systems are different. Even though I’m a native Spanish speaker, I still needed a doula who knew her way around the Colombian medical system. I wasn’t sure if I was going to pay out of cash for my girl’s birth or use insurance and yet, I needed my doula to understand how SURA insurance works just in case. I hate calling hospitals and insurance brokers, etc. The sound of an automated machine saying, “Please press 1 for billing, press 2…” makes me cringe. But a doula can do all of that for you!
For this reason, when two American expat doulas reached out to me and left messages on my Facebook messenger in their perfect American accents, the first thing I asked them was: Which doctors did you work with in Medellin?
They both admitted that they were just starting out in Colombia. Hey, if you have the funds for it, hire two doulas. And if you earn US dollars or Euros, maybe you can afford it!
How My Doula Helped Me
My husband enjoyed the prenatal meetings. Since I had read a lot and was doing an online hypnobirthing class, I didn’t have too many questions. I knew that I would need Maria most on B-day.
Maria was great. She insisted that one of the meetings be held at her home in the forest. This is where we met her three cats.
The morning of B-day, I called Maria around 8 and she arrived around noon. When my contractions became more intense in the evening, she applied hot water bottles on my back. She massaged my lower back, she used her fanny pack with aromatherapy oils to relieve my stress. She guided me through vertical positions to help the baby descend using a pilates ball, the wall and the bed. She gently encouraged me not to lie down and fed me snacks, got me water — anything to keep my energy up.
My husband was there too of course. But I didn’t feel comfortable having him see me in that state so I asked him to stay in the kitchen while I labored in the bedroom.
When it was time to go to the hospital, Maria drove my husband and my OBGYN drove me to the hospital. And as you know, Maria was there with us at the hospital. She saw Santana pop out at 12:14 AM the next day.
Cost for Hiring a Doula in Medellin
The cost of hiring a doula in Medellin ranges between 1,000,000 to 2,000,000 Colombian Pesos. That’s $266 to $530 in US dollars. I based this range on the prices I received from the three doulas I met. Their services are pretty similar but here’s what they have in common:
- 3–4 prenatal visits
- 1 or 2 postnatal visits
- Immediate attention via phone and text
- 24 — 48 hour companionship on labor day
- Massages, nutritional help, aromatherapy
- Backup doula
Doulas offer a wealth of information about local OBGYNs, local hospitals, nutrition, exercise, etc., and they are so supportive. Every woman whom I met in Medellin who hired a doula has nothing but amazing things to say about them. I am so glad that I added Maria to my B-team. I don’t think I would’ve given birth without an epidural if it weren’t for her (and my husband, thank you, James).
In my next article about Natural Birth in Colombia:
- I’ll share how I found an OBGYN who fully supports my decision for a natural birth
- I’ll share how much I paid the hospital and my OBGYN
- I’ll tell you why my husband and I found it easier to pay for everything out of pocket
- The cost of insurance in Medellin
- Where you can find classes for the Bradley Method in Medellin
- Can you give birth at home? Is that allowed?
- Where to find prenatal yoga classes in Medellin
- Can your husband be in the delivery room?
- Placenta shake anybody?
Are you thinking about giving birth in Medellin but have doubts? Maybe you’ve decided to schedule a C-Section and just need a kind doctor to deliver your baby. Maybe you need the name of a few good doulas or OBGYNs. Whatever it is, you can tap me on the shoulder on Instagram @wanna.juana
What doula should you go to?
If you want to hire my doula, you can find her on Instagram at @lalaossa Tell her that Juana sent you. More importantly, I beg you to not go with the first doula you meet. Please interview a few doulas before making a decision and listen to your gut!
About the Me
I’m a serial expat working from my laptop since 2015. I gave birth to my daughter at a hospital in Medellin, Colombia, in 2019. My husband and I have been living in Medellin since the summer of 2018.
Follow me on Instagram @wanna.juana
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