Child-friendly Society

One of the great things about living in the Dominincan Republic is the fact that children are welcome pretty much everywhere. This is so different from the U.S. where people look at you like you're crazy upon entering many sit-down restaurants with children. And if your children laugh just a little too loud or have a meltdown then everyone (employees and patrons) turns around and glares at you with that "Well, I never" look. So basically, many parents make the decision to just not go out at all or hardly at all for the first 4 years or so. Well luckily for our family, that's not the case in Santo Domingo. We can go to nice restaurants, ballets, and even the movies without worrying about feeling out of place. One time we went to a nice restaurant on a Saturday night and the kids were restless while waiting on the food to come. K. Amiri was banging his knife and fork on the plates (and we were constantly trying to shush him), so two different waitresses came by to give the kids balloons and a face mask so they could play with something more age-appropriate and less annoying. Last weekend Z. Mulenga and N. David and I went to a modern dance performance at the Palacio de Bellas Artes and a little boy started crying while and saying "yo tengo miedo" (I am scared) over and over again while a masked performer was on stage. As his mother stood up and walked the long walk from the front row to the back of the theatre to leave, the audience just laughed - no dirty looks. Dear hubby and I were even at the movies one night watching something for adults and a couple walked in with their young children who weren't the quietest and no one complained (no one but me secretly because frankly I don't think kids should be watching adult movies with adults at 9 p.m.). So although I do think there should be limits on where children are allowed, the child-friendly culture here in the DR is a welcome change.

On my soap box about women's rights

Something has been bothering me for a few months - the push for c-sections in Santo Domingo and the scare tactics used by these obstetricians and the impact this is having on the Dominican culture surrounding pregnancy, birth, and postpartum periods(at least in my eyes). Santo Domingo is very similar to many other U.S. cities and is also similar to the U.S. in the fact that the rate of birth by cesarean is unconscionably high. As an aside, the country also has the lowest breastfeeding rate in all of the Americas with only 8% of mothers providing breastmilk as the main source of nourishment for the first six months.

Why is this issue tugging on my heart now? Because in the past few months, I think every locally engaged staff member who gave birth plus every friend of a locally engaged staff member who gave birth did so by c-section. I'm upset because I've listened to the conversations of these educated women in this society talk about how they can't have a vaginal birth if the baby is too big although the pelvis opens up 33% wider than usual and really only about 3% of women truly have a condition that prevents babies from making it through the birth canal, or if they are 40 weeks or approaching 40 weeks then the doctor is ready to schedule surgery, and how they found a doctor that supports vaginal births (yet the same doctor makes other statements that indicate otherwise).

It is disheartening to hear these women talk like they don't have a choice at all or worse, to try and encourage a woman who actually fought for her right to choose a vaginal birth!!

I mean how can an experienced OB explain to a woman that if she doesn't start labor by day X then they will skip the pitocin and induction and just schedule major surgery?!?? And not for someone with a high risk pregnancy?!? How can the same OB (supposed last of the OBs that still support vaginal births in the capital) schedule a c-section for a woman days prior to the due date only because that woman got anxious and grew tired of waiting??? Where is the professional integrity? Doesn't anyone care that healing from surgery AND trying to take care of a newborn baby is not the ideal way to enter the postpartum period?

To say that I'm disgusted by this birth culture is an understatement. Not only are women having c-sections more often than not, but there is also this unspoken pressure to look pretty at all times...so much so that some O.B. practices have on-site hairstyling services where a woman can have her hair done DURING or immediately after delivery. And in this same upper middle income country, a disproportionate amount of infants are malnourished, in part due to a very low breastfeeding rate - even for mothers that are poor and cannot afford to provide the amount of formula necessary to adequately feed their babies.

In my non-qualified, non-scientific opinion, the choice not to breastfeed, elective c-sections (elected by the patient or doctor), and physical beauty above all else (including healing) are all indicative of a culture that undervalues women's (and by extension their babies) rights to adequate healthcare and to make informed, educated choices about their bodies.

Where in the World Should We Go Next?

I know I've had to make major decisions that will impact my life and the lives of my family members before, but for some reason I feel so nervous about the decision facing me now. In about one week, I need to rank order the positions I hope to occupy next year and in essence I will be rank ordering the places I want to live next year. Deciding on where to live for the next four years means that I will essentially define the school options for my three children, the professional development and employment opportunities for my husband, and the quality of life for all of us. Last week I found myself half-wishing that the agency would just give me a flag and direct me to my new home.

One year ago when I thought I knew what my options would be, I was so sure that Kenya was the best place for all of us and I spent so much time doing research and convincing dear hubby and my teenager that it would be a great place for us. I even visited Nairobi in June for a couple of days to get a feel for the place and visit the school and I was even more excited about the possibility of moving there next year. But then the list came out and a place I never dreamed would come up for me appeared on the list along with an invitation to consider a place that I had mentally dismissed because of malaria.

So now I'm just confused!!

Kenya is still so attractive for many reasons (no need for anti-malarial drugs in the capital, great schools, good weather, lots of activities, friendly people, good housing, the list goes on and on) and it's the top choice for my hubby and eldest son; however, I'm worried about the high crime and Somalians and stories like this are not helping me feel better.

But now the Southern African nation of Zambia is appealing too and a bit slower-paced. There, too, we would have great weather, a moderate amount of stuff to do, low malaria risk in Lusaka, and friendly people, but there is also LESS CRIME and I haven't heard of any terrorist threats. BUT, it's more expensive and I've heard the high school doesn't compare to the schools in Nairobi.

Or What about the West African nation of Ghana? Rich in culture, enough activities to keep the whole family busy, a supervisor that I already know and like, great seafood options, beaches nearby, safe community but HOTTER THAN THE DOMINICAN REPUBLIC with a very real malaria threat and an o.k. American-style high school.

Knowing that my family will face some level of risk no matter where we go is probably the heaviest weight on my shoulders. I've had a couple of people tell me that in this business, your decisions come down to you "picking your poison" since no place will be perfect. My only prayer is that we move to the place where all of my family members will thrive, where I'll be able to positively impact the lives of people that are less fortunate than me, and where my children and hubby can feel safe, happy, comfortable. Whew!

Is this the kind of anxiety that awaits me every two to four years until I retire? Somebody please tell me no!