Costa Rica

[Gunter]

Does anyone live here? Have any info on midwives, homebirths or birth centers?

I have a few friends doing volunteer work in CR right now and am thinking about going down to see them. Would love to check out the birth scene and help in any way. Maybe bring some supplies down.

[Sage_SS]

I'm bumping this, hoping someone will respond!

[budwana birth]

Hi,

I have family in Costa Rica and have considered doing some doula work myself. I have asked many people about the state of maternal care in CR and have started to gain a good picture of the needs in the area.

The only lead I have for you is a group in Escazu, Costa RIca (right outside of the capitol, San Jose) called the Vida Center.

I spoke with one of the midwives there about a year ago, and things were not going very well. I called when I was down in CR (last week, actually) and the answering machine mentioned only infant massage. It was Semana Santa, and basically the country shuts down, so I wasn't able to make contact with anyone.

Here is the website: http://www.vidacentercostarica.com/. If I can be of any help, please let me know... and please keep me posted.

Carolyn

[gr8fulmom]

I was in Costa Rica in February and had the honor of attending my friend's birth as her doula. She lives near Dominical, a small beach town on the south west coast, and had her baby in a birth centre in San Isidro. She had a private doctor, who I met, who was very positive and encouraging of my friends wishes for a natural birth. He seemed very hands off except they consider it very normal to have an u/s at every prenatal appt etc. (here in Canada most women had 1 at 20 weeks unless there are complications). My friends paid to have their baby in the birth centre even though I understand you can have your baby in a public hospital for free. Their doctor also attends home births. The birth centre was clean and ncie by Central American standards. We did have apushy nurse who tried to convince my friend to take a pitocin drip without really explaining what it was... The nurse actually told my friend that if she didn't take the IV drip that she would be in labour for 2 more days, meanwhile her baby was born a few hours later, but she played upon my friends worst fear: that labour would be super long for her. I could see that many women would have just done it cause the nurse said so, but I see this kind of stuff all the time in Canada too.

eek... kids up got to run... I'll cont later

[hakeber]

I live here in santa Ana about 5 minutes from Escazu...I think the public healthcare system for having babies is very good, and the private doctors run on the expensive side.

I think they are very much in need of support for natural birthing. My friend went for pre-natal care here and they pretty much treated her like she was sick all the time, like pregnancy was an illness to cure, a sentiment definitely mirrored by the insurance salesman who came by my school a few months ago. I would like to start TTC soon but I am wary about having a baby here and having my personal sovreignty over my body and my birth plan respected by the rather chauvanistic medical system I have experienced so far.

If you came in May or June of next year, you might just have a client on your hands.

[saritajoy]

I had a wonderful home birth experience in Costa Rica!

oh, I'm so glad I found this thread! (Though what a serious geography mistake to have Costa Rica included in South America!)

A little about my experience:
Our amazing baby Gabriel was born at home in San Juan de Santa Barbara de Heredia in Costa Rica on 10 January, 2009 at 3:50am. My DP Julio and my midwife Rebecca were there helping me bring Gabriel into the world. I feel blessed to have been able to have a wonderful natural labor (9 hours) utilizing a lot of walking in the full moon light outside our house and a birth pool. :

My midwife Rebecca is awesome and things worked out very well - although we were all tired since I labored through the night. However, because of this she was able to arrive much much faster than expected. Which was good because my baby was born less than 3 hours later!

I had a not-so-beautiful afterbirth - a partially detached placenta - and lost a lot of blood. I was on IVs during the day and then took iron supplements, ate iron-rich food, and drank lots of water. Because Rebecca lives farther away from my house they tag-teamed and Marie checked in on me several times on Gabriel's birth day and especially that first week. I felt so supported and cared for by both Rebecca and Marie!

In short I was very pleased with my prenatal, labor & delivery and post-partum attention from Rebecca and Marie. Their business is called Mamasol http://mamasol.com/. I clicked really well with Rebecca from long before we'd even conceived our baby - we had talked at length on the phone and I already knew that I wanted her to be my midwife. Therefore Rebecca was my primary midwife - she lives in Turrialba, Cartago. Marie was my secondary midwife; she lives in Belen, Heredia. Marie was not able to attend the actual birth, but as I mentioned she helped a lot with my post-partum visits.

In response to your comments:

It makes sense that the answering machine for the Vida Center would only say "Infant Massage" because midwifery as a profession doesn't exist (per the medical community at large) in Costa Rica. The midwives are all practicing "under the radar"; my midwife Rebecca is the only one who is also certified by the national nurse's board as an Obstetric Nurse. One of the biggest reasons I chose her was because this gives her a huge advantage (able to legally continue to attend me) if I were to have had to be transferred to a hospital.

Here's an article from last July that came out in the national newspaper in Costa Rica about homebirth: http://www.nacion.com/ln_ee/2008/jul...ea1596996.html

I believe that overall the health system in Costa Rica is excellent - both public and private. However, for labor and delivery, my opinion is that the protocols call for measures that are antiquated and over-medicated.

This is what I've learned about standard labor and delivery in Costa Rica:

The public health system was created in the 40s and modernized throughout the 40s, 50s, and 60s. http://www.ccss.sa.cr/html/organizac.../c_org_06.html With those changes the government did put a lot of scare tactics out there and effectively killed off the profession of traditional midwifery. The general public in Costa Rica now believes it is much safer to birth in a hospital than at home. There is no certification for midwives here, just certification for Obstetric Nurses. Therefore, the only midwives practicing are foreigners who have been certified in other countries. They are not technically allowed to practice here, which is why I said that they operate "under the radar" and often with the back-up of Dr. Adam Paer (more on him below). On a positive note, Midwifery Today had their 2007 conference in Costa Rica and did the first doula training with 30+ women participating. It should be fairly easy to contract a doula - any of the practitioner links I'm providing will be able to help connect you with one. I took my doula training in 2004 in Portland, Oregon, but haven't yet practiced; I would be happy to help anyone who lives in the Central Valley who is interested.

If you had national insurance with the Caja (the national health service) everything would be free but you would need to have your baby in a hospital and be subject to those protocols. You can get national health insurance as a tourist/visitor and I know it's very cheap - I heard it was less than $50 a month a few years ago. As a pregnant woman in Costa Rica you are entitled to public health care without paying anything at all, same goes for babies. This widespread availability of healthcare is one reason that the entire population is so healthy as opposed to other Latin American countries. At the public hospitals the norm is to give pitocin to speed up labor, but of course it just makes the contractions faster and more intense and more painful - they don't offer pain relief meds, birth pools, or allow you to walk around. You labor in a large room with about 20 other women until transition, then you are transferred to a more private room where you'll get a table with stirrups. My DP's sister had a hellish experience with what sounds like an overdose of Pitocin at the Hospital de Alajuela - over 100 45 second contractions with 15 seconds to recover between contractions... but a friend just said she had a positive experience birthing in the Hospital Mexico and DP's sister-in-law just had a positive experience birthing at the Hospital de la Mujer (Carid). I wouldn't judge those public hospitals on one experience each, but that's something to start with.

If you opted for private medical attention there are at least half a dozen private hospitals in the Central Valley (and others in cities around the country) - the doctors there will all do what they can to follow a woman's birth plan... though there are varying levels of belief in natural birth, just like in the US. Sadly, most of the time a woman goes in for a natural birth she ends up with a c-section in the private hospitals, simply because it's more convenient and they make more money. I think it's about $2000, give or take. A vaginal birth in a private hospital is more around $1000.

Doctor Adam Paer is about as natural as you can get for a doctor and a hospital birth - he believes strongly in the midwifery model and waterbirth. He did our 4-D ultrasounds (2 of them) and if I had needed to transfer to a hospital would have been the lead of my birth team. Here's his profile: http://www.obgyncr.com/online/modules/i/index.php?id=1 My friend Mary did have a scheduled C-section with him and was very pleased with her whole private hospital experience at La Cima.

So as you can see for private homebirths attended by a midwife it's a bit harder to get in touch with the right people, but a great place to start is with Rebecca or Marie at MamaSol. I've also heard great things about Nati and Ansu of Mamas Al Nacimiento http://www.mamasalnacimiento.com/

Good luck and don't hesitate to PM me with any questions about my experience!

[Gunter]

thanks for PMing me that this thread was updated. I am going to read through it and look up the links right now.

i did email the email address under 'contact us' for vida center about a week or so ago when i found it. have not heard anything back from them. i asked if they were looking for a doula to help out.

[thesanctuary]

dreamland

hola
we are outside of san isidro de general, where there are many ways that women have home births. going to the hospital it is almost guaranteed to be a cesarian birth, they limit labor to 20 hours. :
we welcome home births at our retreat center..www.puravidaconnections.com

[loveincostarica]

Hello, I am currently pregnant and living in Escazu, Costa Rica. Reading your experience was so inspiring. I'm currently looking for a midwife or "Doula" which is what they prefer calling themselves, since being a midwife is not exactly legal.

I know your post was back from 2009, but I looked up the info for Dr. Adam Paer that was on your post and couldn't find him. The number is a general number to Hospital Cima. Is there a direct phone number you might have by any chance? I would like to work primarily with a midwife, but would also like to have a Dr. available in case Plan B would need to be in effect at labor.

Thank you for sharing your experience!

[saritajoy]

Since writing my post back in 2009 I have been a doula for one of my best friends at Clinica Catolica (one of the private hospitals), been pregnant again and had another amazing baby also born in water.  We were transferred to a private hospital because I had another post-partum hemorrhage.  Although it was a bit rougher than being at home I had an incredibly positive experience this time around too.

Dr. Adam Paer has his private office in MediPlaza, right by Multiplaza in Escazu and I'm not sure why the number there would ring to CIMA hospital... his email is apaermd at medicos.cr 

loveincostarica, you've probably passed right by MediPlaza!  Please pm me and we can set up a time to talk - I'd really love to connect with you personally! 

[manzana]

Dr. Adam Paer was my doctor and he was a very good doctor.  He does water births in La Catolica, where my baby was born.  His cell number is 8384-8997 and his office number is 2201-7201.  If you don't want vaccinations at birth there shouldn't be any problems.  I hope this information helps you.    

[caitiebluebug]

Hi ladies, I'm a bit of a lurker, but thought I'd add my 2cents....I just had my first baby Nov 26th at the Hospital Catolica, with Dr. Paer. We arrived in CR when I was 5 months pregnant and saw Paer from then till birth. He was incredibly supportive of all our birth preferences and kindly answered all sorts of crazy text messages and emails from this FTM at all hours of the day. He recommended doulas and thought that my desire for hypnobirthing was a great idea.

In the end we didn't get our water birth because labor progressed so quickly (in fact, Paer barely made it in time). And the Catolica was full, so we ended up birthing in the fetal monitoring room! But Paer and the nurses there, I should add, were fabulous. He and my doula worked in tandem and he had great suggestions for more comfortable positions during birthing. He ended up sitting on my yoga ball when she came out - I never got to use it, but he did! And he was the 1st tomake sure the on-call pediatrician knew our prefernces on vaccines and newborn procedures.

I would definitely work with him again, though, given how fast this labor was we may go for a homebirth next time!

[rach89]

Hello Everyone,

I just stumbled across this forum and I think it is great. I am 4 1/2 months pregnant and searching for natural birth options.

I looked into all kinds of births and am leaning more and more towards a water birth with Dr. Paer. I would have loved a home birth but my home situation doesn't exactly make it a viable option. I do however have lots of links and resources which I have shared below. I would love to hear more about births that you all have had with Dr. Paer to get a better idea of what it might be like vs with another private dr who might be more insistent on medical intervention.

AMAN: http://www.mamasalnacimiento.com/index.html

Doula: nathalie steverlynck [e-mail]

Mamasol: http://www.mamasol.com/?lang=es

Paz al nacer: www.pazalnacer.com

Natalia Del Valle [e-mail]

Parteras: Monica Miranda 8818 3713 y Ansu Coto 8387 5939

[loveincostarica]

Saritajoy, Thank you for responding to my post. I sent you a pm. :)

[saritajoy]

Hooray!  I'm so glad that natural birth in Costa Rica is getting to a "critical mass"!  There is even talk of creating a birth center - I hope sooner than later and certainly I hope to be involved in some way!

I think that choosing care providers for your birth is all about who you "fit" best with... and that may be very different between two mamas-to-be... which is why it's great that there are options!  I can't recommend Rebecca of Mama Sol (http://mamasol.com/) enough!  She is intuitive, smart, fun, and incredibly knowledgeable.  She works with Dr. Adam Paer and has started to partner with Monica for some births.  Basically I see her striving for positive connections and solidarity among all the midwives and doulas in Costa Rica.  Rebecca is best to reach by phone instead of email... try calling her at 2556-5615 or 8993-9777.