BIRTH, PUBLIC HOSPITAL STYLE

At 2:15 a.m. on December 21, 2010, wearing only my nightgown, I stood in an overgrown vacant lot in Brasilito, Guanacaste, looking up at a total eclipse of the full moon on the winter solstice. I wanted to see what that very special moon looked like so I could tell my new granddaughter how the sky welcomed her on the day she was born. Of the many strange things that have happened on our adventure, anticipating the birth of my first grandchild in a public hospital in Central America was among the most bizarre.

One huge challenge with living so remotely is the lack of medical care nearby. Not long after Emily became pregnant for the first time, we started talking about where she would have the baby. Crunchy people living in the middle of nowhere would naturally prefer a home birth, wouldn't they? Well, it sounded nice - the first baby of the next generation of Obremskis coming into the world surrounded by loved ones and flowers - but the reality of the risk of a home birth with the closest medical facility two hours away was sobering. When we looked into this possibility we were surprised to learn there are no midwives in these parts because everyone goes to the public hospital in Nicoya to have their babies. Maya helped with the decision by positioning herself upright with her arms and legs splayed so there was no chance she'd make it out without an operation.

Emily checked into Nicoya Hospital in the afternoon on the 20th for a scheduled C-section. Having read all about American birthing options, a Cesarian in an outdated public hospital where no one speaks English was not her first choice for a satisfying birthing experience, but it was the only practical option at the time.

Emily's room had 14 beds in it. Hers was the one closest to the door, directly under a TV blasting a continuous stream of telenovelas, Spanish soap operas. Women in labor, post-delivery new mothers, and women who'd lost their babies were all thrown together. There were no beds for infants; they bunked in with their mothers. In the center of this photo is a wooden box for the extra child of the mother in the next bed who'd had twins.

Emily arranged to have Maya on a Tuesday, when the anesthesiologist most experienced with epidurals would be available, so she could meet her new baby the minute she was born. Both the doctor and the anesthesiologist wondered why Emily wouldn't want to be knocked out like everyone else but agreed to the epidural. When the doctor started cutting, Emily blurted out that she could feel it.

In the waiting room, Chan and I wondered what was taking so long. Just as I was preparing to charge the locked door separating me from my daughter, we were granted permission to go to the maternity ward. The moment I spotted the new little pink bundle across from the nurse's station I knew it was Maya. She was the whitest baby in the hospital and it appeared that Emily and I were the only gringas. It felt as though no one knew what to make of us, so they just ignored us.

Giving Chan a turn every so often, I held Maya tightly while showering her with tears of gratitude until Emily was rolled in more than two hours later. When handed her new daughter, still groggy Emily visibly relaxed. The last thing she remembered was feeling the scalpel and then waking up several hours later not knowing where or how her baby was. They'd decided just to knock Emily out rather than mess with the epidural and when she came to, no one bothered to tell her what had happened.

Emily had to lie flat on her back with no food or drink for 24 hours, but she didn't mind. All that really mattered was that Maya had arrived safely and was by her side. There was no soap in any of the dispensers in the bathrooms and there were globs of blood on the floor in the communal shower. Two days after the surgery, we packed Emily and Maya into the pick-up truck and bounced them over two rough, steep mountains to get home.

I'm sure all new grandmothers ride an emotional roller coaster when their baby has a baby, but I think I'm justified in feeling particularly proud of my jungle mama delivering her first child in a public hospital in Central America without a single complaint.

In the jungle we learn to be thankful for whatever turns out right.

Not long after Maya was born, the Board of Health inspected the hospital and shut down all but one of the operating rooms.

A new hospital is now under construction.