Maternity Clothes

If you are a fan of Brazilian style clothing (very high heels and inappropriately tight pants), then you are in luck!  If not, shopping for maternity clothes in Brasilia may be a bit of a challenge.  Similar to everything else in Brasilia, maternity clothes here are very expensive.  The best advice is to borrow from friends!  However, if you find yourself needing to add to your monotonous rotation of maternity wear, here are a few suggestions;

Feira do Guara - Moda Gestante

I found two stores at Feira do Guara (there may be more).  I found that sizes here run small.  I'm used to maternity clothes that are comfortable (yeah, I finally get to wear an elastic waistband) but some of the Brazilian styled pants leave you wondering if you should actually diet in order to fit into their "skinny jeans."  Most jeans were around $R250.  Tops averaged around R$80-R$120.  There were a range of shirts from those with tacky logos to those that are work appropriate -- although, a lot were polyester.  I finally did succumb to Brazilian fashion and bought myself a simple, black, cotton jumper - it was on sale for R$60.  I only wear it around the house, but was very impressed when I saw a pregnant woman wearing it in bright blue at Tower TV (she had the full jumper version with pants)!

A Barriguda

I actually found some really cute maternity dresses here.  Although most of the prices were somewhat high -- typically around $350 - $400 for a dress. I also found some very Brazilian looking jean overall type outfits.  

Here is a brief list of maternity stores in the area that I know about (I’m sure there are more):

A Gestante

Asa Sul 510, Bloco B, Loja 69

3304-2244

http://www.agestante.com.br/

A Barriguda
Patio Brasilia LOJA: 508, Piso 3 

Asa Sul, CLS 315

102 Sudoete 

http://www.abarriguda.com.br/

Moda Gestante (Feira do Guara) 
Corredor C - Box 75
3382-4163

Pagamento no ato

When I was pregnant one of the first things I realized I didn't know how to say in Portuguese was "I don't have health insurance and I'll be paying cash." And you need to know this because you are constantly seeing a doctor or blood technician and even if the doctor speaks English, odds are their receptionist does not. So for those who haven't already gone and figured it out the hard way (with pleading smiles, hand motions, and the pre-emptive handing over of credit cards), here's my experience with paying for medical services, as well as a couple of common phrases you may need to understand.

"Particular ou Convenio" or "Pagamento no ato"

At a doctor's office usually Brazilians arrive and hand their health plan card to the receptionist/assistant. This identifies them to the receptionist and gives their payment information. Most embassy folk, however, will be paying up front and requesting reimbursement from their health insurance back in the States (or other country of origin). So I suggest that upon your arrival in the office, go to the desk and tell them your name. "Eu sou [Donna Brown]. Tenho uma consulta as [oito e meia]." It isn't always necessary as frequently the receptionist knows you are the foreigner due to your having worn jeans and flats instead of a dress and heels.
The next thing they will ask is "Particular ou convenio?" or "Pagamento no ato?" If you are paying up front, you say, "Particular." or "Pagamento no ato." Particular means that you will be handling the payment yourself, Pagamento no ato basically means "Payment up front". Then they will calculate your fee and you usually pay before seeing the doctor. For some reason I typically paid after the appointments with Dr Rachel Santos dos Reis. But her assistants won't let you forget so don't worry about walking out without paying. It won't happen.

At Sabin you take a number from a little box and you have the option to choose preferencial - choose it. Pregnant women and the elderly are expedited - people expect you to do this and will encourage you to go to the front of lines. Don't be shy!

My experience with the clinics and medical offices is that doctors don't accept credit cards, but clinics do. Sabin will accept cards, but my OB and ultrasound technician did not. So always have at least R$350 with you when you go to a doctor.

What did I miss? What is your experience with paying for care at doctors and medical offices in Brasilia?

Alexa: Medevac to the USA

How do you feel about your birth experience?

I feel good about it. It was tough being away from my husband for a long time, but I had a great support system of family and friends to help me before and after my daughter's birth.

What would you change and how?

I wouldn't change much, although I ended up having to be induced in order to deliver my baby before my husband had to leave to head back to Brazil. It was a very tough and lengthy labor and delivery, as a result. I hope to not have to repeat that in the future.

Why did you chose to go for your delivery?

I chose to go back to the states because I felt like I had more good reasons to go than stay. Primarily, because this was my first baby and I didn't really know what to expect with childbirth as it was, let alone giving birth in a foreign country where I don't speak the language well and medical practices are different than in America. The rate of C-sections is extremely (and in my opinion, alarmingly) high in Brazil, and I didn't want to worry that my doctor might not be familiar with vaginal births, epidurals, etc. or might even be unwilling to help me try to have my baby the old fashioned way. My husband expressed an interest in me staying and giving birth to our daughter, Ava, here, but also told me he wanted me to be comfortable and that he supported whatever I decided. I ultimately decided I wanted to feel as comfortable as possible -- physically and emotionally -- and back in Texas was where I could do that.

I am also very close to my family and so I was happy to spend such a long time at home with them, despite the fact that I obviously missed my husband, Jeff. I definitely felt his absence the most after Ava was a week old and Jeff had to leave to come back to Brasilia and back to work. I was staying with my parents, and they helped me with Ava all day and in the evenings, but I did not ever wake them up to help me with her in the middle of the night, as I sure as heck would have done to Jeff, had he been around. I felt a bit like a single mom to a newborn during some sleepless nights and early morning feedings, and that was tough. Another plus, though, was having a lot of family come in from out of town to see us. I didn't have to worry and wonder about when everyone was going to get to meet my baby. If they wanted to come we were just a few cities or states away, not an international flight away.

Although it wasn't a deciding factor for me, the shopping that I was able to do before and after my daughter's birth was a major positive to being back in the states. Need one more larger pair of pants? I'll just go pick one up. And after Ava's birth, once I had a better idea of what she needed or didn't, I was able to easily and inexpensively go buy everything we wanted.

Why did you chose your doctor/midwife? Were you happy with your choice?

I chose my doctor here based on recommendations from the Health Unit and word of mouth. Dra. Salete Rios is a good doctor and a very nice person who also speaks English. She gave me her cell phone and told me to call her if I ever needed her, and meant it. She has a small office that was often packed, and I sometimes had to wait a long time past my appointment time. You can't be in a hurry for regular check ups. Dra. Salete doesn't do sonograms in her office. She sent me to a female radiologist in Victoria Medical Center, the same building where Dra. Salete's office is located. Her name was Dra. Luciana Souza at Santa Clara, and she was very nice, very professional and spoke great English.

I chose my doctor in the states by going through the list of doctors in my insurance's network, then narrowing them down by location and whether or not they were board certified, which was important to me. I also looked for reviews online from real past patients. I chose Dr. John Thoppil at Cedar Park Medical Center and was very happy with him.

Did you feel like you had control over your labor experience? Is there anything you would do differently?

Yes and no. My daughter was slightly overdue, and my husband had to leave within the week, so my doctor suggested I be induced. I was induced, according to plan, but my body must have really not been ready yet because I was in labor with painful contractions for more than 15 hours before I was dilated enough to push, and before that things were progressing so slowly that my doctor suggested a C-section at one point. I ended up pushing for FIVE hours before Ava arrived. It was a very tough labor and delivery. I was, however, aware at all times of what was going on, and able to talk to my doctor and the nurses about what our next move should be, my pain levels, my concerns, etc. These were conversations I couldn't have had in Portuguese. Looking back, I wouldn't change much of anything, because we had to do what we had to do in order for my daughter to arrive before my husband had to leave, but I hope to not have to be induced in the future. My nurses, doctor, aftercare, etc. were all phenomenal. Everyone worked hard to make sure that I was as comfortable and cared for as possible, my delivery and recovery rooms were clean, comfortable and state-of-the-art.

Did you find Brasilia to be a pregnant-friendly place? How so?

Most definitely! In the states, you are lucky to find a "mother-to-be" parking spot outside a store and that about ends your maternity benefits. Here in Brazil, there is a preferencial line or "caixa preferencial" in pretty much every type of store or bank, which lets you get fast-tracked through a special checkout line. You can even cut in front of other people, if you are ballsy enough. (I never really was... it's so foreign to me.) During a Carnival event in Brasilia last year, I had to use the bathroom and went and stood at the back of a line of, like, 30 drunk women at a gas station. Within a minute of catching sight of me and my huge baby belly, they all unanimously agreed, and in fact, insisted, that I go to the very front of the line. Amazing! Having a baby with you also gets you preferencial treatment. I still get this VIP treatment at most places when I have Ava with me.

How was the treatment of your newborn by the hospital staff?

Wonderful. Couldn't have been better. They were there to help and checked on me and the baby often, but weren't overbearing, either. They tried to be as respectful as possible of our need for family alone time, but also were there in a jiffy to help with Ava if I was struggling with something or needed some rest. They also sent me home with all kinds of freebies -- for Ava and for me. I still use the baby brush they gave us on her.

If you had assistance with breastfeeding, was is useful?

I did have assistance with breastfeeding that was helpful. I took a childbirth class and a breastfeeding class in the states while I was home at the end of my pregnancy. (I had looked into doing this with my husband in Brasilia, but the only people who offered such a class in English charged an arm and a leg for it, and I didn't get the sense that I'd be learning the same kinds of things that classes in the states offer.) Both of the classes I took in the states had good information about breastfeeding. After Ava was born, I fed her successfully within about an hour to establish a bond and get things going, but I still needed help along the way, in the following days and weeks. My nurses at the hospital were there to help when I became very exasperated with my lack of sleep and a little trouble with our latch. They helped me a great deal to relax physically and mentally. A week later, when I was back at my parents' home where I was staying, I was so engorged that I was in pain, and the hospital's lactation consultant helped me with some tips. She had left me her card and told me to call anytime. She was very accommodating.

Anything else we should know?

If you are going to go back to the states, or even considering it, read the packet on what to do when you are Medevac'd, available from the Health Unit, and contact the nurses in D.C., as you will be instructed to. Study up on what you will need to do to get your baby his or her passport and visa and don't delay on any portion of this stuff if you want to be back with your spouse within six weeks after the baby is born (about the shortest, fastest possible turnover time for all the required documentation to get you both home). Don't be shy about writing "URGENT!" "DIPLOMAT WITH NEWBORN!" and things like that on the outside of the FedEx envelopes that you will have to send in for you baby's passport and visa. The paperwork on maternity medevacs even suggests that you do so. I also emailed and called the people I was sending this stuff to. It helped. I got Ava's passport within maybe five days and the same with the visa. Be pro-active.

Stacy: Delivery experience at Hospital Brasilia

Q&A with Stacy, who delivered her baby at Hosital Brasilia with Dr Salete Rios. Stacy labored for eight hours with no progress before delivering via Caesarian section.

How do you feel about your birth experience? What would you change and how?

I feel great about my birth experience. I would say it was on par or above the experience I had in the United States. Fortunately for us, Morgan and Phill had already compiled a list of paperwork items that needed to be addressed for our baby, so we didn't muddle through the experience, we knew exactly what to do because of their research and experience.
One thing I would change was my aftercare experience. I did not like that for the aftercare of a c-section, I was prescribed a headache medicine. I found the pain was much more profound and needed more pain relief. My Dra. refused to help, but our Med Unit at the Embassy took care of me when she didn't.

Why did you chose to stay (or go) for your delivery?

I chose to stay here in Brasilia because I did not want to be away from my husband and other baby for the minimum 6 weeks I would have had to, had a chose to give birth in the States.

Why did you chose your doctor/midwife? Were you happy with your choice? Did you feel like you had control over your labor experience?

I chose my doctor, Dra. Salete because of her close location to our house and once I got to know her, I felt very confident in her abilities and felt her love toward our family. I wrote a birth plan out for her and she was bewildered. No one had ever given one to her before. We went through it line by line and she did whatever she could to accomodate me, reminding me that the ultimate decisions would be up to her.

Did you find Brasilia to be a pregnant-friendly place? How so?

Yes I did. Besides all of the other women who were pregnant at the time, I felt like I had a great network of ladies to share with. Brazilian people also adore pregnant women and I was given special attention and consideration whereever I went - the grocery store, the bank, etc.

Describe your labor. Is there anything you would do differently?

I have what is known as cervical stenosis, so every part of me goes into labor, except my cervix, which refuses to open. It happened with both of my deliveries. However badly I wanted to give birth naturally, my body would not cooperate. Dra. Salete knew about my condition, but she also allowed me to labor as long as I wanted as long as the baby and I weren't in danger. When we reached a certain point, hour 8, she suggested that we move towards a c section. In my state of crying as I was wheeled into surgery, she gave me another option to continue labor if I so chose. She was accomodating on every level.

Would you have gone to the hospital sooner? Later?

I went to the hospital when my contractions were 3 minutes apart, figuring there is no way they could force a c section on me at that point. Ends up that they didn't force me, but it was still the only way my baby could be delivered. I would still have gone in at the same time. No reason to sit around the hospital and not be allowed to eat or walk or do whatever I wanted.

How was the treatment of your newborn by the hospital staff?

They treated my new baby beautifully. They also treated me very well. They came in all the time to check on her and me. They bathed her daily.

If you had assistance with breastfeeding, was is useful?

I received a run down in Portuguese on how to do it, by a male nurse, no less. I found his advice very helpful, but my baby was a natural pro.

Thanks for sharing Stacy! I know many women will benefit from hearing about your experience.

Circumcision

The procedure for circumcision in Brasilia is typically quite different than in the United States. As such,  some families who considered having it done have forgone the procedure on baby boys born here. In Brazil the procedure is more commonly done on boys once they reach the age of 4 or 5. When it is done on babies, it is typically performed when the infant is 7-10 days old, as a surgical procedure at the hospital. Surgeons require general/mask anesthesia. The procedure is performed using stitches.

One family here had the procedure done by a local doctor but have said subsequently that they wish they had not.

I know of one family who found a doctor in São Paulo willing to come to Brasilia to perform a circumcision. The doctor is Dr. Decio Blucher from Hospital San Luiz. Dr. Blucher charged R$1800 for the procedure, and the family paid for his flight to Brasilia. He performs the circumcision like it is commonly done in the United States, with no sedation, just some sugar water and a numbing shot. They were happy with the results.

DECIO BLUCHER (CRM:63233)
Especialidade: Cirurgia Pediatrica,Cirurgia aparelho digestivo; orgaos anexos e parede abdomin.
Endereço: R.PEDROSO ALVARENGA - 1245 - CJ 22
Cidade: SAO PAULO
UF: SP
CEP: 04531-012
Telefone: (11) 3071.0695

If you are unsure of the risks and/or benefits, here are a few links to help you get started with your decision.
Circumcise or Don't - Quandary For Parents - NYTimes.com
The Case Against The Case Against Circumcision - NY Magazine
Why A Growing Number of Parents Are Saying No - NY Magazine
Intact America
AIDS Prevention Inspires Ways to Make Circumcision Easier - NYTimes.com

If you know of a doctor in Brasilia that you would recommend for circumcision, or if you'd like to weigh in on the question of circumcision in general, please comment below.

Documenting Your Brazilian-born Diplomatic Child

DOCUMENTING YOUR BRAZILIAN-BORN DIPLOMATIC CHILD

1.     Brazilian Birth Certificate

a.     Comments: Children born in Brazil to diplomatic parents do NOT receive Brazilian citizenship. The Cartorio will register the child as a non-citizen diplomat in the computer, but the birth certificate will not look any different from that of a Brazilian citizen.

b.     Steps and Required Documentation:

                                               i.     Go to O Cartorio Marcelo Ribas next to Patio Brasil

                                             ii.     Need the hospital certificate of live birth or two witnesses for a home birth

                                            iii.     Bring marriage certificate

                                            iv.     Carteiras and diplomatic passports of parents

                                              v.     Birth certificate will be issued on site in less than an hour

2.     Consular Report of Birth Abroad (CRBA)

a.     Comments: The CRBA documents that the child is an American Citizen. In most cases, it will serve as the child’s birth certificate, but not always. You may still want to consider getting a certified translation of the Brazilian birth certificate, but it is not necessarily required. CRBAs are adjudicated at post, but no longer issued here. It could take more than a month to get the CRBA back from the United States.

b.     Steps and Required Documentation:

                                               i.     DS-2029

                                             ii.     Brazilian birth certificate

                                            iii.     One passport photo (2” x 2” or 5cm x 5cm)

                                            iv.     Marriage certificate

                                              v.     Passports for both parents

                                            vi.     Other documentation may be required as explained here.

                                           vii.     Fee: $100

2.     Tourist Passport

a.     Comments: You should apply for a tourist passport for the child at the same time as the CRBA.

b.     Steps and Required Documentation:

                                               i.     An unsigned but completed DS-11 (N.B.: The online application might not let you proceed without a social security number. Fill out the pdf version instead.)

                                             ii.     One passport photo(2” x 2” or 5cm x 5cm)

                                            iii.     Fee: $105

3.     State Department EFM

a.     Comments: Your HR Tech in HR/EX can help you officially add your child as a dependent and Eligible Family Member, but it is up to you to know what to ask for. Children born at post are not typically added to your current travel orders, but will be added to your next travel orders for your onward assignment. The child does not need to be on your orders to go on R&R with you because R&R is funded by post and not Washington.

b.     Steps and Required Documentation:

                                               i.     OF-126: Fill out a new OF-126 on HR Online. Your HR Tech should send you an email after the OF-126 is submitted asking for documentation. You may typically send a scanned copy of the CRBA or the Brazilian birth certificate with certified translation.

                                             ii.     DS-1640 (Request for Passport Services): After your OF-126 is approved by the HR Tech, your child should appear on your Employee Profile on HR Online. Ask your HR Tech to email you a DS-1640, which is a memo to the Special Issuance Agency requesting passport services for you and all dependents. Make sure your new child is on it.

                                            iii.     Travel Orders: Your new child will not be added to your current orders if born at post. Children born in the U.S. will be added. Your new child should automatically be on your next orders for your onward assignment once the Medical Clearance is finished. If not, work with your HR Tech.

4.     Medical Clearance

a.     Comments: The medical clearance is needed before your child can be added to your next orders. So, it might not be needed right away, but start early because Med in Washington can get heavily backlogged.

b.     Steps and Required Documentation:

                                               i.     You should schedule an appointment in the Med Unit at about 30 days after birth.

                                             ii.     After the appointment, the Med Unit will send the paperwork to Med in Washington for approval, which can take several months during busy times.

                                            iii.     You will receive an email notifying you when the medical clearance is approved.

5.     Diplomatic Passport

a.     Comments: The diplomatic passport cannot be issued until your CRBA is back and you have the DS-1640 and/or new travel orders.

b.     Steps and Required Documentation:

                                               i.     Schedule an appointment with the Consular Section and bring

                                             ii.     CRBA

                                            iii.     Diplomatic passports for both parents

                                            iv.     DS-1640

                                              v.     Your current travel orders and next orders if available

                                            vi.     An unsigned but completed DS-11

                                           vii.     Diplomatic passport application

                                         viii.     One passport photo

                                            ix.     Both parents and the child must appear

6.     Social Security Number

a.     Comments: You can apply anytime after you have the child’s passport, CRBA, and birth certificate. Might work best to apply at the same time as you do the diplomatic passport.

b.     Steps and Required Documentation:

                                               i.     Fill out form SS-5 and bring

                                             ii.     CRBA

                                            iii.     Brazilian birth certificate

                                            iv.     Passport (tourist or diplomatic) of the child

                                              v.     Apply at Consular Section

7.     Brazilian Visa and Carteira

a.     Comments: Post’s HR office will help you apply for a visa and carteira.

b.     Steps and Required Documentation:

Pregnancy/Delivery Panel - Feb 2012

Earlier this year a group of women got together to share their experiences being pregnant and delivering babies in Brasilia. The audio file below is a recording of the discussion. Minute notations to follow soon.

Click here to download the file.
(FYI: It's big, the meeting was 90 minutes long.)