Birth Experience
The birth of my first son nearly ended in my death. He was fine, but I was not.  The birth of my second son, however, nearly took us both.  Both of my pregnancies were high risk as I had preeclampsia. Doctors were monitoring me the second time because it caught them by surprise the first time. At the first sign of fetal stress, I was placed on bed rest for a month and then placed in the hospital for observation with 8 weeks left to go.  After monitoring my levels, it was decided that an induced labor would be best as my blood pressure had not yet begun to rise but I was showing signs of kidney and liver damage from the pregnancy. They began to prepare for a delivery within 24 hours when his heart rate suddenly dropped.  The room went from calm to chaotic in less then 10 seconds.  I found myself being unplugged and rushed to the operating room while signing a permission form for a c-section all while rolling down the hallway still in bed.  Within 45 minutes of the heart rate drop, my son entered the world.  He didn't cry, and he didn't open his eyes. He had no body fat and weighed only 3 pounds. They immediately wrapped him up, showed me his face, and ran down the hallway to the Neonatal intensive are unit.  Somewhere just outside the operating room doors, he finally gasped for air and let out a scream. He was angry!

The placental pathology report revealed that the placenta had been operating at half capacity for two weeks.  We were told by his pediatrician to consider him to be 10 weeks early rather than 8.  In addition to my physical inability to carry a child to full term (his brother was 5 weeks early), he had been exposed to magnesium sulfate for two days prior to birth as well as the overwhelming stress levels of his mother throughout the pregnancy. His brother is only 15 months older than he is. Do the math: I was pregnant only 7 to 8 months after I had his brother. He was not planned and I was still not fully recovered form my first pregnancy.  It took months for me to figure out I was even pregnant. I was still nursing and had not yet had cycle.  I suspected many times that I was pregnant and took multiple pregnancy tests. My hormone levels were so low, that I did not have a clearly positive test until 3.5 months.  I was told at my first appointment, that I might want to consider an abortion.   That wasn't an option for me.

I chose to share this story with all of you because despite this experience and the struggles we still endure, I do not regret having my son.  His level of autism is low, and he's actually quite entertaining. He is literal and truthful. Anytime I need to go shopping for an outfit for a public appearance, I take him with me.  If it looks terrible, he tells me.  I have watched that child fight and struggle his entire life but he never quits. He could truly care less what other people think of him. He's different but he's amazing.

Development Related to Birth Experience and Prenatal Experiences
      Within his first few weeks at home, it was obvious we had prenatal and birth related trauma to contend with.  He cried all the time, ate constantly, and had a difficult time bonding with me. In addition to what we later discovered was autism, he and I had been separated for several days after his birth making our initial bonding time non existent. Clearly, his birth experience had an impact on his development.  His unhappiness led to frustration and his inability to effectively communicate led to violent anger as he grew older.
      When we register children with our Head Start program, we have parents complete a health assessment. A sizable portion of this assessment is about prenatal healthcare, prenatal drug use, birth weight, prenatal nutrition, and the delivery method.  Several years ago, my teacher's assistant and I began to notice odd behaviors in our students after just a few weeks of school.  The new student behaviors should have passed. We noticed and inability to grasp the rules, the routine, to maintain self control. We also noticed high levels of anxiety in certain children despite our peaceful setting.  She walked straight to the file cabinet and pulled the health assessments. Over the course of the next two hours, she charted similarities and discovered that over half of our students had prenatal substance exposure ranging from alcohol to heroin to marijuana.  Needless to say, we changed our approach, decreased our expectations, and extended our timeline for learning.

Puerto Rico
Birth in Puerto Rico has some slight differences despite Puerto Rico being a United States territory. Mothers report receiving an ultra sound at every appointment to monitor fetal development.  They also report that most obstetricians are male and female obstetricians can be requested.  Mid wives and doulas are not as common in Puerto Rico as in the United States.  Regulation of midwives is still an area that many believe needs improvement. Currently, there is only one regulated birth setting and that is solely a clinical one in a hospital.  Fertility rates have been on the decline for many years. In 2003, the average woman was estimated to have 1.9 children. In 2013, this number was down to 1.3 (Krogstead, Lopez, Desilver, 2013, p. 4).  Krogstead et al. (2013), claims that this is due to the increase in people moving to the United States and delivering here.  Currently, however, Puerto Rico and the United States only differ in 5 births per one thousand people.

                                   

References:
Krogstad, J. Lopez, M. Desilver, D. (2013). Puerto Rico's losses are not just economic, but in people         too. Retrieved from http://www.pewresearch.org/fact-tank/2015/07/01/puerto-ricos-losses-are-             not-just-economic-but-in-people-too/