Birth in the Dominican Republic

This is a summary of my column this month in Expat Focus. You can read the full article here.

According to the World Health Organisation, the recommended rate of caesarean sections in a country should be in the range 5% to 15%. The rate in the Dominican Republic is 31.3%.  The main reason for the high level of C- sections is that it is easier and quicker for the medical profession and also a way to make money out of the patient. If you are to have a C-section you have to buy blood – whether it is used or not, and when it is not used you don’t get the money back.  The women will be told that they need a C-section as they are too short, the baby is too big, the baby is the wrong way round, has its cord around its neck, they are too old, their hips are too narrow – a whole variety of reasons none of which are usually backed up by scans.
Unfortunately, according to UNICEF, the Dominican Republic has one of the highest maternal mortality rates in the world, at 127 for each 100,000 live births, which is 7 times higher than the US.

Mother and daughter

A couple of years ago, a Haitian woman asked me to go and help another Haitian woman who was giving birth. She was illegal and had come here, already pregnant, after the earthquake which claimed the lives of her husband and only child, and was scared to go to the local public hospital.  I have delivered puppies and kittens, but have never had children nor delivered them, so I called a friend of mine who had had a child and asked her to come and help. We went to the lady’s wooden hut which was around 8 foot square, and found her kneeling on a torn up cardboard box on the dirt floor.

Mother, daugher, Dana and Avery, Dana's son

I decided to take the safer end and had her head in my lap, pushing against my rib cage whilst I yelled “pousse” and my friend, Dana had the business end.  Luckily it didn’t take too long and due to a few well timed shouts of “pousse” from me, the head soon appeared, the next “pousse” delivered the rest of the baby, and then I was rewarded by my first sight of a placenta, which was whisked off by the Haitian ladies to be cooked as a nutritious late night snack.  Dana cut the cord with a razor blade and tied the cord with dental floss. She wrapped the baby in a sheet and gave her to the mother. The mother was very grateful and named the baby Dana.

Once the child is born however, there are several traditions. The mother is not allowed to leave the house for 41 days being in ‘quarantine’ or ‘at risk’. During this time apparently she has her pores open and therefore is prone to infection. I am not sure if this dates back to times when there was a high risk of puerperal or childbed fever, but the tradition continues. During the 41 day period, as well as staying in the house the mother cannot wet her hair and some women say she cannot bathe at all and certainly never in cold water. She has to have her ears plugged with cotton wool, as if she does not the air will enter through her ears and as they are ‘open’ the air will go into her brain and give her a headache.  She cannot eat anything acidic such as oranges or limes and although she should not leave the house, if she has to it must never ever be at night and certainly not if the moon is visible.  In fact no one is allowed to visit the baby or mother if they have been outside in the moonlight or the night air. It must be quite a lonely time for those 41 days for the mother.