When we got pregnant and planned on having the baby here in Costa Rica, I had all the ideas of writing about the process weekly. In reality my pregnancy was super boring - I was teaching yoga full time, still going out to see friends - nothing to really to report that was different than in the United States and there are so so so many blogs about pregnancy. My pregnancy just didn’t have nuances. Welp, now it does. So let’s catch up.

Last Tuesday - week 37 day 3 - my midwife in Tamarindo, Janis, came to do a final checkup before we were off to Turrialba on Monday. Turrialba is where my other midwife, Rebecca, was going to do a natural home birth with us. The only thing that’s been a little off is my weigh gain - I simply haven’t gained the pound a week that they expect you’ll gain in your third trimester. I’ve been holding steady at 149 pounds for about a month. Now I can see why there would be a difference between Dario’s pregnancy and baby #2’s pregnancy. When I was pregnant with Dario I live in the States. I worked a desk job - here I taught yoga full time until week 37. I had a car with Dario - here I walk everywhere. Dario was born in November so it was less hot - here it’s the hottest summer right now. In the States I ate out all the time, any food I wanted to eat, I ate it - here I live in an expensive tourist town so I can’t afford to eat out whenever I want to. When I got pregnant with Dario I had been running 5x per week and I straight up stopped running when I got pregnant - anyone would gain weight, pregnant or not, if they went from running on a regular basis to only doing prenatal yoga. So I see lots of factors with the lack of weight gain. But still, Janis wanted me to get a final ultrasound in San Jose with Dr. Paer on our way to Turrialba just to check the weight of the baby, the amount of amniotic fluid, and how big or perhaps how small the baby is.

We make an appointment with Dr. Paer on Monday, rent the car for an extra day, and book an AirBnB in San Jose. We see Dr. Paer when I’m 38 weeks 2 days. Good news - the baby does not have any growth issues. Other news - the baby is frank breech, meaning the feet are by the face in a V shape and it’s butt down, head up. Paer literally says, ‘well, let’s schedule a C-Section for Sunday when you’re 39 weeks - no need to wait.’

No mention of waiting to see if the baby will flip on its own, no mention of trying to manual turn it, and no mention of working to deliver vaginally. Well we pay for the appointment and head to eat some dinner to take all of this in. It was quite a shock - Janis thought the baby was head down the entire time - because that’s the default and the only way to really tell is by ultrasound. So even though I was reluctant to even go to Paer because I wasn’t concerned about lack of weight gain it ended up being a very important appointment because the baby is indeed upside down. Better to know now than never.

On the plus side there are amazing birds on our front porch in Turrialba. This one is an Aracari

Monday night I read everything frank breech. It’s uncommon - like 3-4% after 36 weeks but it happens. If you are breech, frank breech is the best position for attempting a vaginal birth. You are the best candidate to try vaginal delivery if you have already had a vaginal delivery with no complications - check, you and the baby are healthy - check, you have medical professionals experienced with breech deliveries - we were still figuring this part out. There are ways to try to flip the baby with a 30-80% success rate - what a spread - and it’s not comfortable and is usually done around 36 weeks when there’s still some more room. You can also try to flip it yourself, check out www.spinningbabies.com.

I called all my midwives and was super emotional. All of a sudden I was bummed that this perfect birth I had planned was stripped away, surprised with how okay I was to schedule a C-Section because all of a sudden its literally my life in danger in case of something going wrong (because everyone will bring that up and it sits in the back of your mind all the time, the what ifs), and overwhelmed with figuring out all the options which is about to get really complicated.

This is also the time when friends and family are reaching out to me asking what’s happening and what we’re planning on doing. Meanwhile I’m weeping in our not-amazing AirBnB because I am living what’s happening and have no idea what we’re going to do. I understand that I opened the door by sharing the story on Instagram which I do not regret. I understand people are trying to support and help but often times people don’t know what to say and still they feel they need to say something so they go with what they think will be helpful. But really the best thing to say is, ‘what do you need from me’ or ‘you got this’ or ‘I love you’ or ‘I support you’ is helpful. Please hear this.

Rebecca, my midwife in Turrialba, knows and has worked with the doctor in Costa Rica that has experience with delivering breech babies vaginally. There’s one, in the entire country of Costa Rica as far as I’ve found, and his name is Dr. Freddy Perez. She tells me to book an appointment with him the next day that he’s working in San Jose which is Wednesday. Because that’s a thing - doctors have one day a week that they have office hours in different cities. When I try to call and make an appointment the secretary says the next day we can fit you in is May 8th - well my due date is May 5th so that’s straight up not going to work - I need to see him tomorrow and she doesn’t budge. So in tears I call my midwife back and say the secretary wouldn’t book me so Rebecca calls Perez directly. I call the secretary back and by now I guess Perez has messaged her directly because she schedules me for 1pm. We book a different AirBnB and head out to find lunch.

How’s the family holding up on this unplanned and unpacked for two day tour of San Jose? Dario is doing pretty good for all the car rides, nap times that are all over the place, different beds, different homes. Zac is trying to work full time as much as possible - which is extraordinarily difficult when you throw in being the only one that can load and unload the car everyday and unplanned doctor visits. Zac is also the sole driver of the rental car so that’s super taxing physically. I’m working to keep Dario entertained while being absolutely exhausted and answering questions from friends and family.

Wednesday we see Dr. Freddy Perez and when he feels my stomach manually he’s immediately ‘oh, the head is down and bum up, no worries.’ But then when he uses the ultrasound the baby is definitely still frank breech. So at this point we realize perhaps the kid has been frank breech the entire time and Janis simply thought the head was the bum and the bum the head. But the doctor isn’t fazed. I’ve delivered vaginally without complications before, the baby is a good size - meaning the bum is almost as big as the head anyways, and I’m in good physical shape. So let’s do it. He advises we wait to get to the hospital until I’m dilated 5 cm. I find out later its because when I arrive at the hospital the general staff will do a check on me and when they find out I’m breech, if they have time to prep an operating room, they will. And they will pressure Perez into using said OR room. But if I arrive halfway they’ll still call him but because I’m so far along they will let him decide what to do and he’ll say - we’re doing it vaginally. Costa Rican private hospitals have a C-Section rate of up to 80%. As a woman who’s had a baby before I’m actively avoiding C-Sections at every intersection, and they are offered along the way at every step. Friends and family also ask, ‘so you’re getting a C-Section?’ If I was a first time mom and didn’t know what to expect or didn’t have a history of successful vaginal delivery or just took the advice of the system at face value having a C-Section would be my future without a doubt. Let’s see if we can beat the odds and go old-school, non medicated, vaginal breech delivery.

After we meet with Perez we head up to Turrialba where we have a house rented for a month, where we were going to have the baby, so let’s stay and enjoy the mountains for a bit. Rebecca comes to greet us that night and we get down to the nitty gritty about what’s going to happen.

Perhaps, just perhaps, I’ll feel a huge movement of the baby and we’ll go to the public hospital in Turrialba and with an ultrasound find out the baby has miraculously turned over and now it’s head down and we do a natural birth at the house in Turrialba - huzzah! Super low chances of this happening but still could happen.
The baby doesn’t flip, I go into labor in Turrialba and we can’t make it to San Jose so I go to the Turrialba public hospital. But walking into a public hospital with a breech means C-Section. Period. So option #2 is out.
At the first sign of labor or the mucus plug comes out or the water breaks, we high tail it to San Jose and I labor in a car on a bumpy, winding road to the big city. We have a room rented out on AirBnB ahead of time and hang out there until I’m 5cm dilated. Rebecca is checking me along the way and the butt is still down so we then scoot over to Clinica Biblica with Perez and work to deliver naturally but if something goes wrong the C-Section happens. I’m not excited about that winding road to San Jose while laboring so I think it’s option #4.
Almost exactly like option #3 only we go to San Jose a couple days earlier. We head down to San Jose when I think something might start to happen and stay at an AirBnB ahead of time. We wait and see and hang out. Again, when labor starts we wait until I’m 5 cm dilated and from here its the same as option #3.
Take option 4 but image the kiddo flips head down when I go into active labor and we don’t go to the hospital at all and have a home birth, but in an AirBnB house in San Jose instead of Turrialba. This would also be a very amazing occurrence. But would keep be out of the hospital and would essentially save us $5000.

And this is where we are now. Creating a flow chart with all scenarios and all options. On top of it all, I am unsure as to whether Clinica Biblica even allows children overnight. Meaning, that if I go into labor during non-visiting hours, Dario can’t stay. So then who takes care of Dario? My parents are flying into town but literally on the due date so who knows if they will arrive in time. We know no one in San Jose. Today I reached out to some girlfriends in Tamarindo because I need help and we can’t do it all by ourselves in case of a hospital birth and they can come. We’ll have Zac leave and care for Dario. It would be a huge bummer to not have Zac be there for the birth but its the best decision for Dario. I am forever and oh so grateful for these amazing women who offered to make the 4 hour trek at who knows what time to help get me through what will probably be the scariest thing I do in my life.

And this is the most famous one, a Rainbow Toucan

And that’s it. That’s the update. Send your thoughts, prayers, good vibes, whatever you can muster my way. Now, there’s nothing to do but wait and see.

Finding out you have a Breech Baby in Costa Rica - 38 weeks pregnant