The Gill Family: Buenos Aires Birth Day: 2013 Edition

When our daughter was born in February, 2011, I posted an update on the pregnancy and birth experience in Buenos Aires. It's time for the same update, 2.5 years later and a very different experience to tell.

The whole pregnancy and birth were still very good experiences, and the two pregnancies were pretty parallel until the birth itself. The biggest difference in the pregnancies is that this time around we had local insurance, as opposed to last time when all of our appointments were paid in cash and then reimbursed through our US insurance as an out-of-network claim. It's hard to find a good doctor that you connect with and trust, so even though my OB didn't accept our local insurance, we stayed with him - Dr. Juan Carlos Proccacini, who works out of Sanitario de la Trinidad, Cervino 4720, Palermo. To maximize our coverage, we still paid in cash at all of the regular pregnancy appointments (and then submitting them for reimbursement in the US) but all additional appointments; the blood work and other analysis, we had done at the Hospital Aleman since it is the closest hospital to us that accepts our local insurance. This is a great perk of having local insurance, for the vast majority of routine procedures and appointments, all you have to do is flash your little card and no money needs to change hands.

Appointments:

The appointment schedule for my pregnancy with Alex was the same as with Gretchen until we hit 33 weeks. Since Gretchen arrived at 36 weeks my doctor wanted to play it safe and start weekly monitors early. This was an ironic twist since Alex waited until almost 40 weeks exactly before deciding to join us.
I also started weekly non-stress tests (in Spanish, monitoreo) at 33 weeks. Each week I brought the results to my doctor's appointment, and each week he said "I'll see you next week". Until 39 weeks...
I decided against the birth classes this time around, I retained enough information from the first time around that I didn't need to take the full on class. I did, however, go to meet with the midwife because 1) She didn't end up attending my birth with Gretchen, her replacement did, she was on vacation and 2) my Spanish is still at a point where, under stress, I wasn't sure she could understand me. I wanted to make sure she knew my name, my face and the fact that I am not great at articulating myself in a second language.

The Hospital:

Through our local health insurance, we obtained a "prescription" for birth at 35 weeks from my OB, submitted it to the insurance company, and then received a pre-approval paper to show at check-in. This allows the hospital to anticipate our arrival, and made check-in a 10 minute process as opposed to the seemingly endless process we went through in 2011.
With this pre-approval, we had a single room - but not the suite we had last time around. This was just fine for us, plenty of space considering that we didn't have the parade of visitors that the rest of the maternity wing seemed to employ. The biggest differences were that we didn't have a choice of daily menu items, no daily newspaper and no mini-bar.
The check out process was still really slow, but we realized that it was due to my doctor not signing a check out order until after 2:00pm. I was ready to leave around 10:00am, after 3 nights away from home, I was more than ready to get back to my own bed (even if my doctor preferred me to stay for an additional night). It was fine once I knew what time to expect to leave, but this was not made clear to me.
There is a new process to register birth in Argentina, each hospital has a central location where the original documents from the birth are sent (the birth certificate) and you can either call or go online to request an appointment. The location for the appointment is dependent on the hospital where you delivered and needs to be started within 45 days of the birth - I will write more about this new process as we work through it.

The Birth:

I had been having contractions for a number of weeks (perhaps months...) but on Thursday night they were more regular than before. I started keeping track, and sure enough, the contractions were 5 minutes apart for an hour, then two. I called the midwife, we agreed to wait another hour to see if they kept progressing. After another hour, we decided to head to the hospital (meeting her there at 12:15am, not the most ideal timing...).
Our plan was to have our beloved empleada, Candy, stay with Gretchen for the first night after the birth, she was our first responder. I was not convinced that we were going to check in to the hospital, so we woke Gretchen and brought her to the hospital with us.
We ended up checking in to the hospital, calling Candy to meet us there and bring Gretchen home, and take solace in knowing that by then end of September 20th, we would have a baby boy!
I will cut past the dramatic part, but after a number of unsuccessful hours of pushing we were not any closer to having a baby, my doctor made the decision to go ahead with a cesarean birth. Despite what I have heard about Argentine doctors, I do not in any way feel that this was a decision made for convenience, I feel that he was making the best decision for me and my baby. I know that the cesarean birth rate is quite high in Argentina, somewhere around 35% (slightly higher than the US, at 30%), but I feel that it was a necessary measure. I think the most important factor is having a trusting relationship with your doctor, this is the only foundation for feeling secure in their decision-making.
After a c-section, I was offered to stay in the hospital four nights, though we requested going home after the third night. Jon spent one night in the hospital, but then we wanted to be sure Gretchen didn't feel left out so I spent the other two nights alone with Alex. This was a good choice for us, but after 3 nights we were ready to reunite as a family.

Though it certainly wasn't what we were expecting as we packed up for the hospital late Thursday night, we are so happy to have a healthy little boy join our family. The biggest lesson for me is that no two births are the same, as no two children are the same, and the most important factor is that we did everything possible to provide for a safe birth. At the end of the day, that is all that matters.

And look at this little peanut! Such a looker! We're loving getting to know our new little guy.