Many people still have large families in the DR, basically because children are a form of pension. There is no social security, no state pension, and very few private pensions. Basically when you stop work the income stops too, hence all children will always send their parents money.
When it comes to giving birth, most women will go to the public hospital and those who can afford it go to private clinics. 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%, only exceeded by that of Mexico at 39.1% and Brazil at 36.7%. 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.Blood will cost around 150 US$. Also they have to pay for the stitches. 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. And the level of respect for the medical profession is such that the women go along with it.
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. One of the main reasons is maternal haemorrhaging. Many of the hospitals say the reason for the high numbers is the overcrowding with hospitals built to cope with 1500 to2000 births a year yet actually delivering 12,000 to 13,000 – many of whom are undocumented Haitians who have had no decent pre natal care if any at all.
A couple of years ago, a Haitian woman came running to my house and 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, not only due to her lack of papers but also as she spoke no Spanish, only Creole. Now 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. She was naked apart from a piece of dirty bandage tied under her breasts which was apparently to help push the baby out. It was stiflingly hot in the hut, and there were three or four other Haitian women crammed in there, none of whom were doing anything useful.
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. The Haitian women kept telling Dana she had to say how many inches dilated she was, and provided her with a thick pair of well used rubber gloves for the purpose. 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 much bigger than I had imagined and was whisked off by the Haitian ladies to be cooked as a nutritious late night snack. Dana cut the cord with a razor blade which we had sent someone to buy and I heated it in my lighter to sterilize it. She then tied the cord with my dental floss and we 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 which have to be adhered to here. 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.
Lindsay de Feliz lives in the middle of nowhere in the Dominican Republic with her Dominican husband, one stepson, 8 cats and 3 dogs. She was formerly Marketing Director of various financial companies in the City of London, and left the UK around 11 years ago to travel the world as a scuba diving instructor. She eventually came to the Dominican Republic on a 6 month contract, fell in love with the country and its people and stayed. Lindsay has a blog www.yoursaucepans.blogspot.com and is currently writing a book about her experiences over the last 10 years.