Transition to Fall

This week was the official transition from summer to fall. Though practically, it’s still warm and beautiful, like summer. But the hints of change are in the air – the slight yellowing of some leaves, the drying of the forest, the temperature that changes from warm, hot and sunny, to cool within a day.

I’m enjoying living here. We’ve finally gotten unpacked and organized and feel as though we have our first home together. Our street is quiet, with a view of a cemetery and the sounds of church bells and squealing children in the daytime, crickets at night. People seem calm and comfortable. I see a population of immigrants that concentrate in a certain area, and I imagine life is more challenging for them. But even they benefit from the calm and quiet here, the good public services, and the good, neighborly spirit that’s easy to generate when people are living comfortably.

I’m readjusting to having frequent internet access and to the experience of online shopping. I’m impressed by how many of our purchases we can do online. Every few days, a package shows up on the doorstep – anything from a pillow to a swim cap to peanut butter. As long as it’s not needed urgently, I can easily do research on quality online, find a cheap price, and then have it head toward my house – all without taking a step outside. I suppose many Americans have long been accustomed to this. I’ve certainly been using the internet to buy things while away. But in the years of living overseas, I’ve missed out on the transition from using the internet for certain objects (like books, electronics and clothing) to a far wider spectrum that can include toilet paper, milk and furniture.

Yesterday Mark and I had the unique experience of interviewing a doula – a birth attendant. Neither of us had any idea what a doula was as of a couple of weeks ago, but now we are considering hiring one. We felt the need for some personal care even more after visiting the doctor today. The doctor was nice enough, and if we could keep him as our permanent doctor, it would be fine. However, we found out there are six doctors in the practice, not five like I thought. So somehow, by early December, I need to have appointments with the four I haven’t met yet. That will give me about 15-30 minutes of contact with each one before the due date. And then it’s a random lottery as to which of the six will be my attending physician. I have a 16.7% chance of getting any particular one – the one I like the most as well as the one I like least.

A doula would be a person we’d select in advance, who would take the time to get to know us and our wishes. In the course of a couple of meetings, our time spent with her would be a vast multiple of the time spent with any one doctor. She’d then be with us from the very start of labor until the end, and visit us once more post-partum. Her job would be to help make the process more calming, relaxing, comfortable, and safe. She’d also be our advocate with the doctors and nurses, helping to ensure our wishes are carried out as much as possible, at a time in which we might not be a good position to argue. According to doula advocates, by reducing stress and making the experience more personal and comfortable, it can speed up labor and reduce the chance of complications. If nothing else, it seems likely to make the process less impersonal, bureaucratic and uncertain.

We’re entering the phase of active preparation. We bought our first big-ticket item today – a used carseat. Slowly, we’re collecting a pile of stuff for this future being. I don’t want it to enter a world of materialism, and we’re trying to stick to the essentials. But I do want it to be comfortable and well taken care of. And we want to be as comfortable as possible ourselves while adjusting to the changes in our lives.

Speaking of materialism, I thought it was amazing to see orange and black aisles full of Halloween candy over a week ago – a good month and a half before Halloween. But even more amazing was that today I received several holiday catalogs in the mail. Holiday meaning Christmas. They were selling things like hot chocolate in red and green tins a full three-months before the holiday! An entire quarter of a year is spent marketing this holiday to people, during which they spend an average of $800.
Mark and I have decided we will not celebrate Christmas as a family holiday. Instead, we’ll follow the example of the Russians and others in making New Years our big annual event. I’m sure we’ll still get drawn into Christmas to a certain extent from the celebrations going on around us. No matter what, we’ll be subject to the ads and the pressures to spend more and do more. But we’ll have the benefit of celebrating once everyone else is already tired out. But really, no need to think about that three months ahead of schedule.

Searching for quality maternity care

My husband and I had another pre-natal doctor’s appointment today and again, the quality of the visit was disappointing compared to Bolivia. At my last appointment in Bolivia I received quite a bit of information. In addition to 3-D pictures, the doctor spent a good 45 minutes examining the fetus, he provided detailed and helpful responses to my questions and I learned a lot. I was told the fetus was almost one kilo, and was in the top 3% for height-weight at its point in development. He showed me a chart indicated that if that rate of growth continues, I could expect the baby to be between 3.5 and 4 kilos at birth.

The American doctor listened to the heartbeat and measured my abdomen, saying “OK.” That was it. The answers to our questions were extremely terse and I had the feeling we were taking his valuable time. We asked if there were any doulas he’d recommend. He gave us a single first name.

“Any ideas on how we could locate Gloria?” Mark asked.

I asked why he recommended this particular person. “Because she knows my name,” he said. “The other don’t.”

Is that really a reason why we’d hire someone? Because she knows the doctor’s name?

Mark’s impression is that the doctor is flakey and he isn’t impressed with the knowledge levels displayed by the staff we’ve had contact with. Now, when we still don’t have full confidence in our primary doctor, we have to begin to rotate through the other four doctors in the practice, so that we’ll have had at least five minutes of contact with the random person who will deliver our child.

It’s understandable, with such a low level of personalization, with no single individual really paying attention to the needs of the couple throughout the pregnancy process, that demand is growing for non-medical staff like doulas. I almost look back nostalgically to the local country doctor – the person who knew his client well, who was available to come in the middle of the night if necessary. Since doctors have moved so far from this model, people have to look elsewhere to find a person who will listen, provide personalized advice and promise to be available over a period of several months.