S1 Ep16: Birth and hospital requirements

[Music] Hello and welcome to our Mexico City edition of my Sirugacy Journey, the podcast. And don't look at me like that, Michael. That's how you do it. You do. You've got it to your tip. I have. So I'm West. I'm one of your hosts. I'm one of the co-founders of my Sirugacy Journey. And when we created our organisation, one of the key kind of elements, one of our guiding principles is about education. And this podcast is really designed to help you understand all of those. Now, if you've listened to the previous episode, you'll have heard all about the pregnancy process. Yes. Now, this episode, before I move over to my co-host, Michael and husband, this episode is designed to help you understand the birthing process, what happens, pre-post and everything in between. I don't need to say anything else, West. Apart from who I am. Yeah, please do. Hello, I'm Michael, the better half of West. And I am also obviously a dad through Sirugacy and Egg donation. We have two beautiful children, Talula and Duke. And an a third journey bubbling here in Mexico City as well. So we are very immersed in one of these gorgeous country, but to helping set the standard. Aren't we, where is that? We're doing here. And Michael, why don't you introduce our amazing guest? Well, if you did listen to the last episode, you would have heard the wonderful story of how our circuits and our pieza supported by the incredibly wonderful and talented Dr. Florentzia. Hello. Hello. I'm Dr. Florentzia Cooarruea. I didn't want to completely get that wrong because it sounds so gorgeous. The way you say it, and I just. I've been practicing. It's great to be back. Good. Good to have you back. So yes, we're talking birth and hospital requirements. And I think some intending parents will come with this preconception of what to expect in Mexico City. So let's go straight into it, right? So what should intending parents expect from a typical birthing experience in Mexico, particularly with your team? Everyone's included in the experience, and we take care of everyone's experience. So intending parents can expect to be informed of everything that's happening. Today, what we can do in the hospital is one of the parents can come inside the birthing room in fits the C-sectionary fits of vaginal birth. After the birth, they can both see the baby in the nursery and then spend the whole day with the baby in their room. That's like a very short way to say everything that's going on. But just to make sure that you know IPs that you will see the baby when the baby is born and be with them the whole time when the baby's in the hospital until discharge. That's an important element. I think we need to be really clear about the difference you see in life. That isn't just because this is a surrogacy birth. That's what happens to everyone, right? Sure. So every parent can come inside the surgery or inside the vaginal birth room and see one of the baby is born and hold the baby right after they take their very first breath and as soon as we cut the umbilical cord, parents can spend time with their baby. Yes. Because in a non-surrogacy scenario, that would be typically the mother and the father potentially. They would both access and be able to see that process of the child being born. Yes. So we used to have an insight. And in a scenario where it's a surrogacy birth, we're looking at the surrogate obviously being there because she's playing a major part here, right? And then one of the intended parents. Exactly. That might be a difficult decision for some people and some people may say, well, if and like we did, if one of us can't go in, then we're buffed, not going to go in, we're buffed, then experience. That's a choice. And you make that choice. But I think what's important here is that that decision is for everyone. Unfortunately, that's how it is. That's kind of the standard rule over here and that particular hospital. And we have to just respect it. And I think this is how births happen in Mexico City, right? And we have to manage expectations. And that's why I think this podcast would be a really good tool to do that because it helps people right from the start of the journey manage their expectations. So they're going into it, knowing that this is what I'm going to get. Yes. And they can take pictures so they can show the other IP, how the baby was born. Yes. Yeah. And one of the differences to in the UK when babies are born here is the nursery setup, which if you've watched a lot of American TV or cartoons and you see these rows of little crimps with babies all in them, I didn't think that actually exists in actual real life. But that's the nursery. That's where the babies will go and be careful. And that's the normal. And the hospital that's meant for the babies on only the babies, there's always a neonatologist that's a specialized pediatrician who specializes in newborn babies. There's a neonatologist on call 21st 7th. So babies are taking care of. And also I think it's very important for the IP to know that the only way that a baby can go out from the nursery is with police from the hospital and a nurse. So they're all identified. So there are not babies just going around the hospital. Yes. So the police and the nurse go with the baby from the nursery to the intended parents and the surrogate. Yes. Amazing. And the nursery scenario is that just for overnight and they can the baby be with the surrogate and the intended parents in their room or throughout the day so they can manage all the feeding and all of the access and changing. So babies can spend the whole day in the room where the surrogate and the IP are. And then just spend the night and the nursery. Sometimes they take them to the nursery if they need to check their vital signs or maybe to give them a bath. That's once before they discharge them. But most of the time they are in the room. And how long typically? So you know, babies have been born. How long will the baby stay in the hospital for before discharge? So usually the same time the surrogate spends in the hospital for a vaginal birth is one or two nights, most typically two. And it also depends on what time this baby decides to be born because it's not the same 2 a.m. Then 2 p.m. And for C section two or three nights. When a baby is in the nursery overnight, who feeds the baby through that night period? IPs, surrogate and pediatrician can come to terms, what are they feeding the baby? But it fits formula, for example, then the nurses in the nursery feed the baby here. The baby, okay. Got it. Good to know. Good to let people away. One of the advantages of this particular hospital that we work in is that there's a hotel on site, right? So intended parents can be as close to the baby as possible so that the minute that they can access the room to be with the surrogate and potentially the baby the next day, they can be there, right? Yes, they don't have to go out to the street. They just cross the parking lot and then the hotel is there. We have seen it. It's a great hotel and to be found some amazing hospital. But I think having that hotel there is just another benefit of a great hospital. And MSJ team will help you manage that, we'll help you book it, we'll, we'll, we'll for somebody to get to it. We'll do all of the, all of that. Let's, let's just go back one. Just tell us a bit about the hospital because I've seen it. You've seen it, Wes and it is out of this world. Tell us a bit more about just how wonderful it is. Describe it all to us. So as we tell you, this is the best hospital in Mexico City and most probably in the whole country. We send why I work there and why I receive babies there is because we have all the quality of current that we want for surrogates and also all the resources we need if something comes out of plan. Just like the construction is beautiful, but it's also what they can offer. It's what's best for our surrogates and our patients. And some of the services that, I know we should start in the last episode, but just in case you skipped that episode, you want to come straight to this one because you couldn't hold itself any longer. So what are those vital departments that are there that are really going to keep everybody safe? So we consider the most common, they are not that common, but the most common complications in pregnancy that could be bleeding in the surrogates. So she needs a blood transfusion and we need and we have in hospital and I call it a blood bank. If the baby needs to have some different care, we have neonatal intensive care unit and if the surrogate needs some extra care, we also have an intensive care unit for adults. So let's skip back to, I mean, we've gone to the most important and like the baby's been born and we're looking at how that care goes on. But so let's get to the point where we're preparing for the birth and how is that approached and who's considered, you know, is there a bedding preparation plan and how do you approach that doctor with the team? So I know some people recommend the birth and plan to be done like getting to the end of the pregnancy, but honestly, I've been pregnant and that's something you think and it's going through your mind since the beginning of the pregnancy. So this is an ongoing conversation in every consult. If the surrogate has any kind of questions, what does a vaginal birth mean? What does the C section mean? We can be covering it during the prenatal control. What I always tell the surrogates and patients is the most important thing about a birthing plan is it has to be flexible because sometimes you want to stay home with contractions and until you have six centimeters of dilation and then your water breaks and babies do whatever they want. I told you. So it has to be very flexible, but you can have non-negotiables. So who's going to take care of you? What hospital are you going to go with? Who's your first one to call? The first call you're going to make if you have any contractions or the water breaks. That's part of the plan. And they can have some preferences on the birth if it's vaginal or abdominal. That's important to state. Yes. The surrogate has the last word. you can decide about her body. and everyone around her will agree. - Yeah. - Quite rightly so. - Yes. - And I think that's really important to emphasise is that I think that sometimes there's this misconception that, there's a higher than average C-section rate in Mexico city, but no matter why you've listened to, you've heard it directly from Dr. Forensi, he was like, "Does Surrogate has autonomy "to choose the type of birth?" - Detroit, I think. - The type of birth that she has. And we absolutely advocate for that. It's a really important decision. I think it should be in close conversation with the intending parents and everyone should be considered in it, but ultimately she has to feel comfortable and to be able to deliver in the way that she wants to. - Of course, there are some cases where I recommend some of this way of birth. If the baby is on a breach position, that's not the head down. If there are twins, there are some very specific situations where the C-section is programmed. - Yeah. - And then there are other C-sections that we make the decision during labour. - The emergency type situations. - Exactly, emergency. And also, there's like the elective C-section, that's when the surrogate doesn't wanna go through labour and then we can schedule a C-section just because she wants to. And that's okay. - And what weeks are you allowed to do an elective C-section in Mexico? - 39 weeks. - 39. - If we can get there, 70. - 70, okay, yeah. I was came at 39, didn't I? Both of them. - Is when we know the babies will most probably don't need any extra attention or extra care, yes. If we choose the date, we wait until 39 weeks. If the baby chooses the date, then we do whatever. - Yeah. - So let's look at who is then present at the birth. So tell us how does that look when we're working with you and you're working with our surrogates. - So the birthing room is crowded. Honestly, everyone has an objective. There is no one only seeing or watching. Everyone has like a reason to be there. But usually we are two gynecologists. Hospitalanjeles has some residents, OBGYN residents, so there's three gynecologists. The end is the sociologist. That's four people. Two nurses, one the skincare of the medical team and another one who's going outside to bring material. From pediatrician, one or two pediatricians and then surrogate an IP. So almost 10 people. - Almost 10 people. That is a team. - That 10 people for a vaginal birth? - Maybe only one nurse for a vaginal birth. - But that's still a significant team. - Yeah, anything. - You want to get on the UK? - No. - And for me, it fills me as this organization full of absolute confidence that they're getting the best care and everyone that needs to be there. - He's there. - So we're also very excited to meet this baby that we've been taking care for the last 10 months, almost. So everyone is like a cheerleader for the surrogate and we're always expecting to know the baby and their name and it's like a very nice experience and the most important moment for her and also for our peace. - It's like you get a world up. - It's that continuity of care all the way through. In that process through pregnancy and birth in the UK, you just would not have that continuity of people to that manage your case all the way through. And I think that's another massive advantage to this process here and your team because you know them and you know them all the way through and you've built that rapport with them because then the intending parents and the surrogates, they trust you, they become confident with you and they are reassured because you've been dealing with them from 12 weeks. - So we make a very big effort that everyone feels seen and listened to and part of our team and part of something. My nurse, my assistant, my medical team, we always speak to a surrogate's by name, speak to the APs by name, speak to the BPs by name. So like we have a very close relationship. - And this is why we're doing what we're doing to the level that we're doing yet. We could provide a service that was okay, this is all right, you know, it's run-of-the-mill average but these people deserve much better than average. These surrogates that are doing incredible jobs building families for people and these intending parents that have been through loss and stillbirth and miscarriage and all of this pain and that's why I find it really emotional that you said, you know, everyone is so excited to meet this baby and want to know the names right away and you just think of all of that vulnerability and the moment for some of these people listening that this is that last page of that book that has been so grueling for them and it's so nice to have people that have got them and are caring for them in every single way. So I just want to say a massive thank you for that 'cause I just think it's just amazing. - I really don't want to brag about it. I can't see how this can be done differently. It takes for me the same effort to be very, very kind and inclusive than to be harsh and rude. I'd rather be very kind with patients. So surrogates go through pregnancy that's very hard. Their body changes, they're going through some kind of surgery could be a vaginal birth, but their bodies change in that moment and then the eyepiece are forming a family. They're receiving a baby. So I don't think any other team can just say, we're delivering a baby and then go home but we're forming a family, yes. - And that's why we're working with you. It's exactly why we're working with you. - One thing that is really we kind of need to just like map through is what's the discharge process and what should people consider? And then I also think about, let's talk as well about vaccinations 'cause I think that's another thing that people might want to think about and consider. So question one first, sorry. (laughing) What's the discharge process? The day of the discharge, I go and check the surrogate that everything is okay with her vital science and her recovery from vaginal birth or C-section. And then in a team with the pediatrician, he's gonna discharge the baby. The only thing the hospital asks us is that when the baby is discharged, the surrogate needs to sign and then the baby can go with the eyepiece. - Just give us a quick overview of the type of checks that the pediatrician does. - So he's lovely. (laughing) So he's very also very experienced oriented, he's very kind. So some of these couples who are these eyepiece are received their first baby. And as we all did with our first baby, we have a lot of questions, a lot of fears. So first, they can have a pre-nail consult with the pediatrician so they know what to expect from the day of the birth. And also he explains what happens inside the birth in room and also the first day at home. How often the baby is fed, how do they change a diaper? Hospital, Ankelyas, the day before this charge has a bathing class. - No. - They teach, yes. - Oh, like did you know this? - Not to this extent, no. - Yeah, so they teach you how to give a bath to your baby. It's very exciting also because there's a lot of questions that have to take care of the umbilical cord and how to change a diaper and want to know if they're enough diapers a day. So that's like a tutorial of first baby. - That's amazing, no more. That's with the pediatrician. - We provide our inteny parents with some support from the mindful birth group. So they get some of that in advance. But I think having some more. - At the hospital. - At the hospital when the baby's there is a really nice touch. And I think when you're first a parent and you're given this baby and you're not - Terrifying isn't it? - Terrifying, like what do I do? - Yeah, it's like he's been so wanted, but then you're like, "Come on, I'm gonna break it." But you know what I'm saying? Bendy these little things are, they're great, you know? - But I think that's gonna be a really nice touch. And I think it's gonna give our inteny parent. - I didn't know that. - And the surrogates, because the surrogates are really, they want to ensure that the inteny parents are confident. - And then watch with joy, you know, you can see surrogates looking them. And I'm feeling really proud and accomplished with themself, what they're just doing, you know? Surrogates in the UK, you know, I've shared out to Gina and Haley in particular, they have said that they film the most empowered watching the parents with the baby, they just delivered. And seeing that, I did that, I'm, you know, I've just, I'm just getting, - I'm just getting family. - Goose people is talking about it. - And they're part of this happiness, right? - Yeah. I didn't realize you did that level of, almost like education with the parents. - No, but I think it's a wonderful. - I think it's a wonderful. - The inteny parents have access to the pediatrician pre-birth, because then it is about managing expectations and helping their anxiety around what's gonna be happening and how is it gonna work and what's that gonna look like? - And why I love that and why you're, we're both gushing over that is there are, and we know of cases in the UK where the intended parents are just ignored. They will not be spoken to. They may have a rather unpleasant experience previously with Surrogates. I don't know what it might be, but we've seen it where IPs of just, you stay in the car park, you can have this baby when we're ready. - It's just unkind. - Unkind. - Yeah. - That's my side box piece. - So you should have 36 weeks is when I suggest the IPs meet the pediatrician. Even with my patients who live in Mexico City, this is an online consultation. Just so you get to know the face of who's gonna be inside the breathing room. - And do you deliver all the babies? Is that mainly you or is it a couple of you? - Mainly me. (laughing) - I think I love you even more now. - So let's, before we finish then, let's talk about vaccinations because I don't know what the standard protocol is in Mexico City for vaccinations or what type of vaccinations the baby would automatically get and how that would differ from any country that they're coming from. But I'm assuming doctor that this would be a conversation, pre-birth around vaccinations. What are the standard days? - What is standard? - Do you know them? - Yeah, I don't know. - So first we have vaccinations through pregnancy. If the Surrogates pregnant around flu season, we need to put a vaccine to the surrogate, that prevents her of having any complications if she gets the flu. And is that winter time? Winter time, yeah, around from October to maybe February. Okay. Then T-Dap, that's Tetanus. Tetanus, yeah. So this is to prevent the mother from getting the infection and also giving some antibiotics to the baby. This is from week 27 to 36 of pregnancy. In every pregnancy, I think that's one of the guidelines. So I'm most probably the same as in the NIH. And then COVID vaccine, that's what we suggest. And then when the baby's born, Mexico gives tuberculosis to be because we're a country with high cases of, I've never seen one in private practice, but we do it as part of the guidelines. Hippatitis also when they're born. Do you do like a bit of in K injection? Yeah. That's the heel precony. And some drops in the ice to prevent eye infections. But I think it's about a conversation. And if an intending parent has a very specific due on types of vaccinations, then they can obviously have those conversations with you through the pregnancy and you could medically advise them about whether it's possible or not. And do they take that vaccination record with them? So they've got that history. Because in the UK, we used to get these red books with all of the vaccinations in. So you have a vaccination card. And then depending on how long the baby is going to stay in Mexico City, if he will need more vaccines during this first month. Okay. And then once the intending parents and baby are back in their accommodation back in Mexico City, there's then follow-up appointments or consultations with the pediatrician as well. Yes. So usually one week after the birth, the pediatrician has an appointment with the baby to see how the baby is growing and how's the feeding and gaining weight and everything. That's what I mean, just doesn't end just from that birth moment. There's still fun. No, no, it doesn't. It's still access to the routine. And then what we would also be looking at as well is then when we understand the point on which the baby and the intending parents are going to be flying back home, we would then offer a consultation with the pediatrician again just to make sure that they have no concerns and the baby's fit to fly. So the pediatrician and his team also have like a 24/7 telephonseo neck. So why peace can just call them and if they have any questions, yes, our concerns. And also maybe I didn't cover this, but during the birth, we follow the World Health Organization recommendations of humanized or respectful birth and that's delayed court clamping. Okay. To wait around a minute until the baby's blood, umbilical cord stops feeding. Then we clamp that. That reduces the risk of anemia on the first year of the baby. And then we put it skin to skin with one of the IPs. Amazing. We also have access to cord blood banking and stem cell. There's a company that we partner with in the UK that does that. Is that common here? It's one of the services that the hospital has. It's not very common because it's not very cheap. Yeah, it is quite an expensive treat. Yes, but some families can afford it and prefer to do it and it's also an option. Yeah. Yeah. Okay. We would have done it, wouldn't we? We were doing dental pulp. We do now, when our children lose their teeth, we did the same, but with their milk teeth. So we've stored their dirt. If you've known about it, that's absolutely. Absolutely. And we do, we've had some members in the UK that have used it. They've done it as well. Yeah. I think it's a lot of biobank. Big shout out. Yeah. There we go. Well, look, I think I think it's been a really comprehensive episode. Yeah. And I think you've added all of the questions. And I think anyone listening to or watching this episode will be really reassured. And I think often will be quite surprised at the level of care and everything that's considered, you know, from your team, the consistency, that they care all the way through. And not just for the surrogate, but for the intending parents, and I'll consider they are. And I think it for me would give me absolute confidence in the process, your team, and that all of them are in absolute safe hands in Mexico City. So we're very happy to go along with surrogates and IPs through this process. Just so you know, everyone in my team and the peer tuition and the anesthesiologist, and most probably in House Bill speaks English, because I think some people might be afraid that they can come to Mexico City and then just want to be able to communicate. And that's not the case. So I'm looking forward to meeting all your IPs and all your baby. We're looking forward to it. I think just to find kind of fall up on that point as well is that I know that I mean, look how what I'm amazing English you speak and I'm sure your team are just exactly the same. But our team will accompany all intending parents. So I'm really looking forward to our team building your relationship with your team. And I think it's going to be because our team like yours have been so invested all the way through the process and absolutely want to be there to see that baby. So thank you again. Thank you. And really, really cracking episode. Yeah, this was a lovely way to end my day and nearly the end of this season. Yeah, and we're about to go for a drink because it's very much neat. And you're coming with us, right? I'll join you. Yeah. Okay, well, thank you ever so much. If you still need your fix, there are still episodes available. You can either head to mysorixegerni.com or just Google our podcast and you can either find them on the app. What's about to say the app? Yeah, yeah, yeah, find them on the app in the educational content section or wherever you get your podcasts. And if you want more information about our services, our pathways or whether it's anything else than have a head over to our website, which is mysorigacygeni.com. We'd love to help you figure out the best way to build your family. Have a lovely rest of your day or whatever you're doing and I still have a way to go. Bye. Yes. Today's podcast was brought to you by Tulumur and the Joot Productions. [BLANK_AUDIO]