It was one year after I got married when my husband and I planned to build a family; it has been almost 24 years since then. I was living in Cuba. My first pregnancy had many expectations for us as well as per our relatives. What does my baby will look like? What name will he be called after? Will he be healthy? My family was much protected and showed me their love and happiness by cooking the food I liked, following my doctor’s appointments and helping me doing the chores at home. Almost everybody wanted a baby boy. I was waiting with anxiety for my first ultrasound. I was very athletic and kept safe, healthy and eating habits despite my country socioeconomic conditions. I remember walking long distances since my house was far from my mother’s house. After the third month of pregnancy, I stayed home due inadequate public transportation. Cuba's maternity and parental leave legislation allows pregnant women are entitled to 18 weeks fully-paid leaved. Although, my husband and I did not have enough information about prenatal development and the consequences of any conditions that may harm our future baby; our priority was to keep myself healthy and to have a healthy baby. I visit the obstetrician periodically. My thirty-eight weeks of prenatal development when without complication until birthing time!

I had my first baby in a Maternity Hospital in Cuba back in 1991. I was there for a week prior delivery due to a pick of high blood tension. Obstetricians keep me in observation and prescription treatment. By the seventh day, I was ready to leave when that night I started having sporadic contractions. It was Sunday early morning when I told the doctor who does the walking routine about my condition. He pulled me into the room to check for dilatation. By 7:30 am I had 2-3 centimeters, he told me “you can no leave, your baby is coming." My mom, who was with me that night at the hospital got very excited and helped me to take a bath and pick my belonging from the room that I share with seven more, we slept in bunk beds. I was moved to another room, by 9:30 am they broke my water and some progress become, by 12:30pm I have 5 centimeters. Then, the doctors moved me to a delivery room, and the worse part was about to begin! I was keeping my maternity dress because they did not have a hospital gown. From that moment, contractions were intensive, then by three o’clock my blood pressure got higher, and they gave me a pill that put the baby to sleep, contractions went down in insensitive and intervals. By six, o’ clock, they checked again and decided to check if I have small cervical capacity. Time was passing by I was alone, no family was alone allowed to stay with me; I was worry for my baby and the isolation and communication with my husband and my parents. The hospital does not provide a midwives o doulas, so nurses and doctors from different shifts passed by, other ladies had their babies and I was still waiting. By nine, o’ clock, I was very tired of walking from one place to another, breathing exercises and starved because I did not eat food since early morning. The doctors decide to give up for a natural birth and proceeded for epidural anesthesia and the use of Obstetrical spatulas to assist in helping my baby head to exit from the pelvic. Finally, our first son Ismel arrived at 11:30pm with a healthy cry! He was born at 7lbs, 9oz, 28” long. His grandpa arrived to the hospital about the same time who suggested his name. The nurse showed my baby but I could not touch at that time.

After recovery, I was sent to the post-delivery care room where my families were anxious for the waiting hours of birthing. I was desperate to have my son in my chest and feel the emotion have it alive and healthy. Ismel arrived few minutes after and the rest is another story.

Postpartum effects to me and baby: An allergic reaction from epidural anesthesia and the assumption of epidural anesthesia side effect in Ismel because he was hyperactive for many years.

My second baby came in a different context. My husband and I were out of the reach of our family support and close friends. It happens six years after our first conception, and I was living in USA then. We were trying to adjust to a new ecological system and so, the new baby, and the one that was about to turn six years old. Still, I was continuing having excellent husband support and keeping good healthy and eating habits, going to my obstetrician checkups. At this time, we want just to have a healthy baby and gender was not a predominant expectation. Different social programs helped me during my pregnancy. During this context of life, I had a lack of exercises and more than eight hours of stressful work. The blood pressure was stable, but I developed hypothyroidism during pregnancy. It was a mild disease and appropriated treatment with sufficient amounts of thyroid hormone reduced the risk of pregnancy complications such as, premature birth, preeclampsia, miscarriage, postpartum hemorrhage.

I had my second baby in a Hialeah Hospital in Florida back in 1997. I was shopping with my husband on Friday afternoon, when my water broke. My husband called my obstetrician, and he told us got to the hospital by 9:00 pm. Since we do not have any family member around, we made the arrangement with some friends to kept Ismel with them. After arriving, we were accommodated in a private room. A friend of mine came later and stayed with my husband and me until delivery. They assigned a nurse who helps me through my first hours of preparation for birthing. By 11:30 pm my obstetrician who followed the thirty-eight weeks of my child prenatal development and keep me healthy, arrived. I also started feeling how the contractions were gained strength and insensitive hour by hour. The obstetrician checked for dilatation around 12:30 am, I had 5 cm. It was a cuddly night around my husband and my friend. I rested during the down-times and squeezed my friend or husband hands during contractions. My mother and family insisted my husband to record this important event in our life since they were not able to be with us. I felt their support when I was talking in the video; it was emotional and positive to me. Sometimes talking, others resting and others in contractions, the time flied in a pleasant atmosphere. By 4:30am I had 7cm of dilatation, and the doctor and nurse started the last stage of delivery and by 5:45am. Ariel, my second son, was crying for the life. I am here! He was born in 8lbs, 10oz, 26” long. After the nurse cleaned and prepared she brought to me and I kissed his head. My husband took him in his arms and smiled at him. “Now we are four”- he said, “Welcome to the family”.

After the obstetrician finish and I was ready to go to the post-delivery room with my husband who did not separate from me. Ariel was set to the neonates’ room for more blood test and check-up, thanks, God he was a healthy baby and my hypothyroidism did not affect him. Our son, Ismel came later that Sunday during visit time to meet his brother. After two days, we were backing home.

I chose these two examples of prenatal contexts, as well as, births experiences to show the differences in two new lives from the same mom and dad, as they are exposed to different approaches due to all the multi-contextual factors in two countries and the context of their parents’ life.

I am being able to experience how births happen in two countries. Cuba is not more different for what were 24 years ago. There are a lot of similarities in the approach and awareness of the Cuban government with the rest of other countries in the world to keep low rate of death in births and babies.

Relevant information about benefits designed to promote healthy births and babies.

• From the time the woman becomes pregnant, she can have six pay days off.• By law, she can stop working at 34 weeks (32 weeks in cases of multiple births), and granted

fully-paid leave until the birth, after which she receives another 12 weeks of fully-paid leave.• After the child is born, Cuban law facilitates regular well-baby check-ups during the first year

of life. So, if parents did not take the subsidized leave, then either mom or dad are entitled to take one day off a month to take the child to the pediatrician, also they may take additional days off without pay if the child becomes ill.

These articles will add more information about Cuba and the approach to prenatal development and birth.

F. (n.d.). Cuban Maternity Homes: A Model to Address At-Risk Pregnancy.

doi:http://www.scielosp.org/pdf/medicc/v13n3/04.pdf

Medicc Review. (n.d.). Retrieved from http://www.medicc.org/publications/medicc_review/0605/mr-features.html