Patient Citizens, Immigrant Mothers: Mexican Women, Public Prenatal Care, and the Birth Weight Paradox

Chapter 4: Becoming Patients: Birth Experiences in New York City

If María Pacheco had given birth to her daughter in her childhood home in a small rural municipality outside of Tehuacán, Puebla, her mother told me she would have been treated to forty days of reposo, rest, during the cuarentena. During that time of recuperation, her mother, sister, sisters-in-law, and motherin -law would have bathed her in hot herbal steam baths, bound her womb with a rebozo, cooked appropriate “hot” foods for her, and given her special herbal teas to componer, literally compose or repair, her insides as well as increase her milk production. Although her small town no longer has a temazcal or a practicing midwife, her return from the local government clinic would have been marked by a whole range of practices designed to care for and aid the recovery and bonding of mother and baby. Sitting in her cheerful kitchen lit by the intense Puebla sun, her mother told me the names of the herbs she had at the ready for such treatments and expressed sorrow that her daughter had been far away when she had her babies. Instead, María spent the day after giving birth alone in a hospital room, her baby shuttled off to the nursery and her husband gone to work. She cried all day long, the beginning of a severe bout of postpartum depression. After she and the baby came home, her husband, Raúl, would rise before dawn to cook chicken soup and rice for her and leave it ready on the stove before going off to his job as a busboy. She stayed in their bedroom, out of sight of Raúl’s male cousins, their housemates, sobbing and resisting the urge to spank or ignore her screaming newborn. When Raúl told María’s mother over the phone that she was covered in a rash, depressed, bleeding profusely, and still unable to nurse, her mother sent herbs with a cousin who was traveling to New York City and Becoming Patients Birth Experiences in New York City Chapter 4 81 instructed Raúl how to boil the herbs and imitate a steam bath in their apartment bathtub by using boiling water from a tea kettle. He obtained some cinderblock bricks that he stacked in the tub, and she sat on them, cloaked in a sheet, cautious not to touch the boiling water he poured around the bricks and over the herbs. The separation between María and the kinship network that would have helped her in this difficult period was produced by María and Raul’s migration but also was exacerbated by the undocumented nature of it. Even if the couple had the money to send for María’s mother, she was unlikely to get a visa, and, as an undocumented immigrant, María could not visit Mexico. Immigration laws and their immigrant circumstances made the birth of a child, by custom an event rejoiced over and attended to by an extensive network of kin, into a 82 Patient Citizens, Immigrant Mothers Figure 4 María Pacheco’s mother in her kitchen, August 2008. Photo by the author. lonely task that the couple fumbled through alone. By taking on the role of his mother, mother-in-law, and sister-in-law, not only did Raúl get María through a tough period, but also their bond was strengthened (see Hirsch 2003). Their struggles confirm their idea of themselves as a couple: a lonely unit of mutual support and affection, facing the struggles and challenges of life as migrants. This image corresponds to contemporary conceptualizations of companionate marriage, premised on romance, affection, respect, and partnership between two spouses, “characterized by sexual and emotional intimacy and somewhat less hierarchical relations between the sexes” (Hirsch et al. 2010, 10; Hirsch 2003). Although the couple’s relationship was strengthened by Raúl’s willingness to do what only female kin would have done in their hometown, María does not look back fondly on the first weeks she spent with her daughter. On the contrary, one of her biggest fears when she was pregnant with her second child, nearly seven years later, was that she would have to go through the same kind of experience again. In this chapter, I explore the birth and pregnancy experiences of Mexican immigrant women in New York City as they move through the public health care...