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The Albert Einstein experience

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So I’m behind on so much…new kid and all.  So a quick final having a baby in Brasil post.

It turns out you really do need to bring your own clothing to the hospital. When the nurses came in the next am, they asked me where my clothing was for the day… there was no gown (not that I would want to stay in the gown as it was completely open in the back!). They then showered me. Yeah, they walked me to the shower, then sat there and instructed me on how to shower, as well as held the shower head. When they did finally give me control of it, they sat and watched me sit (wasn’t allowed to stand) and shower. After giving birth, my sense of modesty usually goes out the window, so I really could have cared less at this point.

My first meal was an interesting one. Split pea soup, brussel sprouts and steak. Seriously, in the US, that would be considered nasty…the meat was much better than I got in the US hopsitals though. Overall, for hospital food, the meat was not bad. It was definitely Brasilian though, an interesting mixes of food though, like green grape sauce over chicken, or almond crusted salmon with applesauce… but still much more edible than I had in the US. They also brought in morning and night tea and crackers.

I had every intent of never letting my son leave my sight after the initial 2 hours “monitoring,” but it turns out that the hospital is MUCH more strict on controls, and every shift change your kid goes back to the nursery, so they can account for the kids. This was a MAJOR pain around feedings, as I had to basically try and force feed a sleeping newborn, as they are there for about 2 hours. Also, my son was completely gagging/turning purple on amniotic fluid, and keep throwing it up, so they refused to let me keep him at night, and would bring him to feed every 3 hours. They pumped his stomach twice. The second time seemed to take. Then there was the circumcision, so then again they wanted him to be watched in the nursery for a bit. Then the next day they decided he was a bit yellow and needed to take a light bath for 24 hours, so on my birthday they took him all day and night, and I would nurse him in the nursery every 3 hours. I never though I would have been okay with it, but I was. As he really does just want to sleep, so just slept calmly in the light bath, and my other son was able to come on Saturday and just spend the day with me and get mommy time at the hospital. Also, my husband got a good night’s sleep, as I had to go to the nursery all night to nurse.

One thing that I have come to really REALLY appreciate about Brasil’s hospital experience is every nurse was trained on breastfeeding. First breastfeed in the room a nurse was there helping me breastfeed. And they were knowledgeable… unlike nurses in the US, who all seemed kind of inept. Each feeding a nurse would stand by me and help to make sure I knew what I was doing.. manhandling the goods if necessary. With my first son I had to visits by the “lactitions” once at 9am … and they were NOT helpful, and actually pissed me off. For my first kid, I ended up using a shield for 3 months, as I couldn’t ever get him to nurse without it.  Also, despite the help, my son lost about 11% of his birth weight. When my other son lost 7% the US freaked out and told me I had to start using formula immediately. This time, the pediatricians said they were worried, but said to wait till my milk came in, and see my pediatrician as soon as I got home, to check to see if the weight came back.

As you can see their help has paid off, what a chunk.

Another thing that I thought was funny was that EVERYTHING had a barcode on it. My kid came in the room with a bar code on his butt, his hat, and each of his booties. It was kind of funny to watch them scan him like produce repeatedly throughout our stay.

Either way, I definitely think Brasil’s hospital is a bit tight on security, but I can understand why it happens.


The birth experience

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So I had my son on the 12th… the past 2 blog posts were “scheduled out” pre-birth, and I accidentally scheduled them for May … mostly I’ve just been sleeping 🙂

All of my “granola intentions” were mostly just that intentions.  We ended up inducing, which meant that at a certain point my contractions were so strong I couldn’t focus anymore, but my body wasn’t at the point of delivery— let’s just say I had another 4+ hours after that point, so I opted for the epidural.  My doctor actually had another woman giving birth at the same time as me, so the midwife was running back and forth between the two rooms, and at a certain point after the epidural, a doctor came and sat with me for what seemed like an hour just with her hand on my stomach monitoring my contractions— it was soothing and nice to have someone just sit there with me, and I don’t if I would have expected that type of attention in the US.  She said she was surprised I lasted as long as I did without the epidural, and that I let it wear off once so I could get the contractions to kick in and help things move along.  From what my doc said, those who do parto normal in Brasil get the epidural’s early on in the process.

When it finally came time to deliver a nurse pushed me through the door (bumping the frame) down the hall (bumping over the door frame bumps on the floor) and into the surgery room. Then I had to scoot myself onto the table, as they adjusted my legs (strapped in) on the stirrups (twice), and tilted me downward.  I told the room that had I not opted for an epidural, at this point in time I would have wanted each and everyone of them dead.  Seriously, it would have been awful to be at this stage and being moved.

My husband wasn’t around for any of this, because well he had to be sent to a totally different floor to put on his surgery clothes.  And since he had brought his laptop bag and I a backpack with random “labor stuff” for the 9 hour labor, he had to also run all of that up to our room, as we were told we couldn’t just leave it in the pre-labor room.  He ran into the room as I was making the first push, and the anesthesiologist was pushing on my stomach.  I politely said “really do we have to push on my stomach?” and he walked away, so no big deal other than they tried to push my baby out for me.  They did cut me, and there were like 10-12 people in the room between 2 obgyns, midwife, nurses, anesthesiologist, and the pediatrician.

I got to hold the baby, then they took him to get cleaned and weighed, and then he was brought back a few minutes later to nurse and bond with me. After that I was told we would go upstairs and he to the nursery for the next 2 hours to do all of the “baby stuff” that comes after birth… which wasn’t the 4 I had been told, so that was nice.

Either way, I’ve have a wonderful, sweet little bundle of joy… finally!

Hospital Visit try 2- Albert Einstein

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I’ve got to say, after seeing Sao Luiz, I’m very disappointed with Einstein.  Love that everywhere in Brasil is Valet, it was R$12 for an hour, and again LA doesn’t have hospital parking that cheap…especially valeted.  But I digress.  You could definitely tell this was the hospital preferred by the wealthy.  Just to get into the hospital they took photos of us, and we had to show our ID, and get name badges.  Our son has learned how to say web cam… one of those words that kids who live away from gparents learn early… and kept saying web cam as they took our photos.

Anyway, downstairs is a Cafe Viena. If you have ever eaten at this chain, well that’s the food you can order when you’re up in your room.  I have been telling my husband that after I give birth I want him to go get me sushi, so I thought it was interesting that they had a sushi boat… hmm between the increase security and sushi, Albert Einstein was starting to look attractive. Though hubby pointed out Sao Luiz is in the middle of many a yummy restaurant that also delivers.

As we headed up to the obstetrics floor, the hospital was noticeably different from Sao Luiz. First the elevators weren’t as slow as Sao Luiz.  But the place was SUPER crowded. Granted we visited on a Saturday afternoon, versus mid-day Wednesday. But the people were different. Everyone had an Iphone in hand, and there were kids strewn across the floor playing with Ipads.   Yes, a much wealthier crew of folks here.  At least Sao Luiz seemed to have a large waiting area for people with chairs.   They showed me that there were 4 small rooms for labor… smaller than a hospital room.  I couldn’t see inside, but I’m imagining it was about the size of the pre-labor rooms at Cedar Sinai, and if that’s the case #@$%$! no am I sitting in one of those things during labor.  Then they had the delivery room, which was pretty standard, other than the fact that they have glass windows, so if you want your family to stand outside and watch they can (creepy much?).  The windows did frost over if you wanted.  Also do you see the size of those beds? Flat, hard and kinda skinny.

The 4 Labor & Delivery rooms were being occupied, but our very un-knowledgeable guide told us that they’re the same size as a regular hospital rooms.  Seriously, she knew so little.  The Bercario was up by the hospital rooms, unlike Sao Luiz, there is not the main one and the floor ones.  In fact, if you look at the photo, you can kind of see the wood/paint on the window is weathered, this is definitely an older hospital that hasn’t been renovated recently.  Again, she told us it’s 4-6 hours until you see your baby after birth. BUT she did call and find out that we can opt out of the Silver Nitrate in the eyes if we wanted.

The hospital rooms sucked when you put them up against Sal Luiz.  They’ve about the same size as the ones in the US, and just as old an crappy as old hospitals.  The couch that the husband is supposed to sleep on was also narrower than Sao Luiz’s, and the shower just looked dingy. I didn’t even snap a photo of it, as the video I posted last time, pretty much captures it, other than the walls being ALL white.  We asked about suites, and they basically just open the door to the room next door and put a couch and stuff in there instead of a bed.

Not as cool as Sao Luiz my Albert Einstein friends.  Also if occupancy is at 85% they won’t do it.  No idea on price, as they said I could call back in and ask for pricing— um I’m here now, seriously you can’t tell me?  I get the general idea, Albert Einstein doesn’t have to try as hard, as well they are “the” hospital.

Another difference is instead of a permanent Cartorio, Albert Einstein has a table in obstetrics a few hours each morning.  Kind of odd.  In the afternoon it becomes the photo sales area.

So are you getting that I’m not really in love with Albert?  Maybe it was the fact that all of these wealthy Brasilians were sitting around everywhere, and their kids were running around like wild monsters … I’m assuming this is because the babas weren’t brought to the hospital, and parents weren’t used to watching their kids.  But seriously, there were kids literally running down the hospital halls yelling. As well as sitting all over the floors in the lobby area. I may or may not kill these children in the future if I see them after I deliver… IF I choose Einstein.  Maybe my American showing, as I guess Brasilians understand kids are kids, but after giving birth I want things quiet, as I’m sure my baby does as well.

So I’m still debating back and forth between Einstein. The main reason is the Labor & Delivery room.  The table that they do deliver on normally DOES NOT look comfortable at all, and I’m fairly sure it’s the same over at Sao Luiz.  So if I can get L&D I want that… even if my room is super crappy.  Also, the guide did confirm that the weekends are always busier at the hospital – as I noted last time. So maybe during the week things would be better . . .

However, upon further research Sao Luiz seems to have more pre-delivery rooms than Einstein, which makes me think that I have a better chance of getting one of the natural rooms than Einstein, as I can see them putting folks into the L&D rooms at Einstein when they get full. In fact, to get into a natural Sao Luiz room, supposedly your doc needs to let them know you want to have a natural birth.  Also, other than my husband pointing out that the couches he would sleep on at Sao Luiz look nicer, and he could sleep in the “adjoining suite” versus with me and the baby, the natural birth rooms (2), look SWEET, and the tub is divine.

Not sure if you can make out the stars on the ceiling, nice touch right? And there is the birth ball, and it just looks roomy.  Also, check out the bath.  If you’re into it, they do the water births here.  Not that I’m into that, but if you were…

So I’m crazy (about natural births)

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But mostly I’m crazy in the eyes of most doctors in Brazil.  Since my husband is ever so sympathetic (sarcasm), I thought a Doula would be wonderful.  She could help inform me about what positions I should move into so I can help the birth move along, massage in the right spots, and generally keep things happy and moving a long. BIG Doula fan here <<——


So I went through the list of Doula’s in Sao Paulo, and emailed them in Portuguese in English searching for an English speaking Doula, and found two.  Raquel Olivia and Cris Toledano.  I also found GAMA and Ana Cristina a midwife (who from readings seems to be the other English speaking popular expat midwife in Sao Paulo other than Marcia from Prima Luz).  They told me that I needed my doctor’s approval… um okay that’s kind of weird… this is my birth, I can have whomever I want right?! ha, this is Brazil everything is mandated by some obscure law.  In fact in 2006 they passed a law saying hospitals had to allow a woman the right to have someone with her. Random right?  Albert Einstein in fact allows Doulas up until the birth part, and then they cannot participate.

So I had a list for my doctor on what she would let me do about natural (when I say natural she hears vaginal I’m sure).  I generally got the impression from the answers that my doctor has one idea in the back of her mind, and is totally happy telling me everything she thinks I want to hear… my husband says I’m a crazy hormonal, paranoid pregnant woman…. maybe, we will see.

Here are my questions:

  1. Can I have a Doula? I only work with Midwives (that’s the Brazilian way of making it hard on me, and the short answer is no).  Marcia Koifmann was out of town, and Ana Cristina only delivers at Sao Luiz… So meeting my doctor’s midwives at my next appt.  Good thing I have super expat insurance.
  2. How many days over can I go? 10 days over, and I have to meet with her ever 2 days
  3. If my water breaks how many hours before I have to be induced? 12 hours
  4. Do I have to stay in bed during labor? Only if i get an epidural (I think she missed the natural part)
  5. Mandatory fetal monitoring? Only after epidural, otherwise every 15
  6. Can I eat once admitted? Yes eating and drinking until you get the epidural.. again with the epidural.
  7. Enema? Nope
  8. Can I keep the baby with me after birth?  30 minutes of bonding time, and then 4 hours where neither you or the father can be with them other than looking through a glass window!
  9. What tests and procedures are done? Vitamin K, Hep B and TB, hearing, and genetic blood test
  10. What do you put in the baby’s eyes? Silver Nitrate, and regular antibiotics are not an option… for the record the US switched to antibiotics like 10 years ago…tho Sao Luiz said something about lasers???
  11. When will you show up? When you are 7cm.  Midwife when you get to the hospital.
  12. How will you bill us? We will quote you up front, then send you the bill after birth and you have 1 week to pay it all, then submit to your insurance for reimbursement
  13. What about the baby pediatrician? If you can get the neonatalagist to sign off on it and take responsibility should something happens, sure (again Brasilian no there).
  14. How long is the hospital stay? 2-3 days (google translated link here from Einstein showing a 3 day package)
  15. Does that increase with C-section? Nope- 3 days.
  16. Will you wait to clamp the cord if I want? Yes
  17. Do I have to use stirrups and lay on a surgical bed? Umm yes it’s the only way. In fact, she looked at me like I was speaking Chinese…. yes people you can deliver a baby in other positions. Like maybe I want to stand on my head or something, heck if I know what I’ll feel like, but I don’t want to be told I can’t… I’m a bit stubborn.

The reality is my husband is not into natural births.  He thinks I’m a granola eating nut job.  I’m actually doing hypnobabies home study right now, so we’ll see how effective that is… and yes maybe I’m a nut job. But my mom had 5 kids naturally and said it was no big deal…. so I’ve got to be able to do this.

I have to say after the above conversation I am even more invested in making sure I have this birth 100% natural.  There’s now a level of stubborn pride attached to this whole birthing in Brasil adventure.  Either way, I’m not meeting all of her Midwives (4 of em, 2 speak English, and one REALLY speaks English), so hopefully my paranoia will dissipate.  The first Midwife pointed out that all of the women in the public hospitals have babies naturally. . .

*UPDATE* I get a lot of questions from individuals on this, so I assume like me it is a hotly Googled topic.  Deleting cleaning up some of my old files of baby prep in Brazil I found the following links on natural childbirth that I found useful … and hope you do it.  I left in Google Translate to English for everyone’s convenience.

Hospital visit 2- Albert Einstein

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So Albert Einstein is supposedly the best hospital in all of Brazil.  With traffic it’s like an hour to half an hour from us.  Notice I started with an hour, as there is always traffic here in Brazil! So thus why we debate should we have the baby at Albert Einstein.

Although I found this really great stat, that I didn’t know:

Experience of Motherhood Albert Einstein, for example, reveals that the CS rate was 18% among 239 women who had opted for the LDR between April 2000 and June 2001, and 195 normal births occurred in this group of patients.

Veja Abril

Yeah, Albert Einstein has 4 Labor AND Delivery rooms. Unlike Sao Luiz where it’s just Labor rooms, you may actually get lucky and get an L&D room, and then the C-section rate is lower than the rate I faced in California (30%).

I was all excited to see the hospital today and make the decision… but as per the norm in my life they called at 9:30 for our 11am appointment letting us know every room, every surgery room, and every Labor and Delivery room was full up. Seriously, is this what I’m going to face if I choose them?

Also, in a frantic paranoid state I googled when people in Brasil schedule C-sections. In the US it’s usually Mondays (fyi).  From googling in Portuguese- seriously honing this skill- it seems Thursday/Friday are the preferred C days here.  Then the doc has the weekend off, and the family has the benefit of friends and family not working and being able to visit in the hospital.

So this baby be born mid week darn it!!

Hospital Visit 1 – Sao Luiz

So I previously blogged a bit about the hospitals.  But today we visited Sao Luiz. It’s down the road from us, so convenient, and we know nothing about how things work here, so it was helpful to go and get their pamphlets.

Umm wow, so there is a whole entrance lobby area just for maternity— it is a maternity hospital, so that makes sense.  I didn’t see a bunch of pregnant women being wheeled around in wheelchairs, most walked in and sat down for an incredibly long time and seemed to be filling out paperwork. But overall, it was very posh.  Heck, just to get onto a maternity floor you had to pass a security guard (they love those security guards here in Brazil).

There is a Cartorio in the hospital, so you just go down to them with the certificate of live birth and your official or notarized copy of your marriage certificate, and walla you’ve got the birth certificate process completed.

The labor and delivery has two entrances… ala Brazil birthing of course.  One is the labor rooms (8) and the other is the C-section entrance.  Yeah, there’s no hiding the elective C here.  2 or the 8 rooms are for “natural” laboring.  i.e. there is a tub you can relax in and a birth ball, and music.  I take it these 2 rooms are probably nicer.  Of course they still then ship you off to the other side (C world) to do the delivery in an operating room.  Hubby has to go up get sanitized, and then can join you.

I found it hilarious, and my poor hubby was trying to understand what the tour guide was saying, when she said they provide the father a sling.  Love when Brasilians use English words, that don’t sound English at all.  And love even more that they give fathers a sling to stick their baby into for bonding. Love slings, but not for those first moments of life.. then again maybe dads drop kids on the ground all the time 😉

Post birth, the baby, a nurse, and a security guard step into the elevator with your child.  Your hubby can then run up the stairs if he’s crazy (like us), or catch the next elevator to the bercario (baby nursery).  Mom’s drugged up or being wheeled off to who knows where they never mentioned that part…and I forgot to ask.  Babe sits in the bercario for 3-6 hours … depending on when the mom is finally situated in her room and ready. I didn’t take photos of other peeps kids, but there were only like 3 newborns.  I think I may bring my pampers, as they all seemed to be using these awful plasticy blue diapers I bought once that gave my kid a rash.

floor bercario

Now for the rooms… umm okay. We gave birth at Cedar Sinai and saw their nicest rooms. .. and of course where half of Holywood had their babies.

Now let’s compare that $3784 a night room to the following R$1010 a night room.  Um seriously Brazil has got this whole pamper the mom thing down… for cheap.  Not sure who I’d put in the other area… my posse?

mac daddy suite

And of course it goes down from there:

To here:

And to the most basic of rooms, which is huge.  My husband noted the comfiness of the sofa bed compared to the pathetic cot he was given to sleep on at Cedars.  I noted that the bed actually laid flat. I hate that about US beds. I couldn’t ever just lay freakin flat.

Food wise, you either order, or the nicer rooms come with free meals, up to free petit fours and tea, etc. The photos above list what the “extras” are with each room.

But here’s the menu. I had to laugh at the extensive cafe list. How Brazilian

Also, love that the walls are not just hospital white. Way to bring in that Brazilian spice.

I know SUPER SUPER long post. Finally the bathroom. Note the complimentary slippers. Which I found ironic, since they provide those, but the tour guide told me to bring my own pads for the post bleeding.  Seriously, why the heck wouldn’t they provide pads?  She also told me to bring my own clothing.. again I find it hard to believe I couldn’t sit in a hospital gown… but she probably finds it hard to believe any self respecting Brasilian woman would want to right?

A free pediatrician visit!

Ahh something free from a doctor. It’s a miracle.  I visited my son’s pediatrician today for a “consulta,” where he explained the whole baby birth process, not the mommy side but the baby side.  My obgyn was vaguer, so it was helpful to get a good understanding. Seriously, great pediatrician, and perfect English to boot.

Immediately after birth

Just like the US they do Vitamin K shots, cleaning, weighing, and Hep B vaccination. As this is Brazil you also get a TB vaccination, which makes sense.

The eyes get Silver Nitrate put in them, but the belly button does not.  If you want to use antibiotics like the freaking modern world does then you are S out of luck.  A. Silver Nitrate is mandated by law, so there is no arguing. B. The alternative isn’t recognized here, nor is it even found in Brazil. **Update** Per Albert Einstein you can opt out of Silver Nitrate.

They will then take your child from you and put them in an observation room. UNLESS you insist on breastfeeding, if you don’t, off goes the baby for 4 hours.


The  child goes into observation in just the diaper and are under a heat lamp the whole time.  I kind of think that’s a bit much, but whatever.  I’m going to try and convince the doctors to let me keep the baby with me… I doubt they will listen but will see.

Then they do yet another exam and you get your kiddo back to bond with.

Day 2

They do the hearing tests and the genetic testing.  Your pediatrician then comes to the hospital to check the kid out if you call; otherwise you get to do the office visit afterwards.  If you are going to circumcise, you get to call a special surgical pediatrician… and here they don’t do them, or if they do they have a modified one that they’ll tell you about.

They also send you home with a little hospital grade alcohol bottle for the belly button should you need it.

Hospital Stay Length

As I’m using Albert Einstein (this echos what my ob said) the package my insurance covers is 2-3 days (you buy “packages” here, and most expats can get the nice ones). Usually it’s the C-sections who choose all 3 days.  We will see what the food is like, as I have to admit I’m partial to having an air conditioned room for 3 days, so may just push my insurance to allow all 3 days.  But I know some women want to get home after 2 days. Either way it’s your choice, which is nice.  I hear the hospital rooms are amazingly nice here, so I’m looking forward to that.