A Slice of Reality: Getting Pregnant and Giving Birth in a Foreign Country

I sliced my finger on the lid of a spaghetti sauce can last night which sent me into a tailspin of panic.  Though painful and bloody, the cut was seemingly benign.  Nothing that a few stitches and a tetanus shot couldn’t take care of.   Yet my reaction was Oscar-worthy, rivaled only by the time I was dumped by my college sweetheart and slipped into a 2-month depression.

Since our move to Nicaragua, I’ve fallen down concrete hills, stepped on stingrays, and boarded down a volcano and survived, all of which resulted in memorable scars of our journey in Nicaragua.  So why was this latest notch on my bedpost of injuries invoking such anxiety?   The answer – I’m 5 months pregnant. 

Justin struggled to understand my hysteria.  As he fumbled thru the house in search of Band-aids and Bactine, I sobbed into the blood soaked towel wrapped around my finger and fretted about the possibility of a trip to the local Centro de Salud.  Having only been there once before for an anti-parasite prescription, I conjured up visions of rusty needles and disgruntled nurses.

My already pregnancy-laden hormonal thoughts had spiraled out of control into a place of utter fear that had very little to do with my finger and much more to do with this looming birth.  What if I went into labor early and couldn’t make it to Managua in time?  What if I had to give birth at the Centro de Salud.  What if I went to the Centro de Salud for this cut and they prescribed me something that could ultimately harm this developing baby inside me.  If Justin couldn’t find the Band-aids, how was he going to find the hospital in Managua, two and a half hours away?  What if, what if, what if?

As a self-proclaimed control freak/hypochondriac, pregnancy is bound to cause some level of anxiety in an expecting mom.  DSM-IV diagnoses aside, Pregnancy can cause moments of anxiety in any mom.  Mix it all together with a birth planned in Nicaragua, with Spanish speaking doctors, thousands of miles from family and you have the perfect recipe for an all out freak out, which is exactly what I did last night.  The finger will heal, with or without stitches, but what will happen to me and more importantly, to this baby that I have already been waiting 5 months to meet?

20 Weeks

Our original plan was to live in Nicaragua for a year, evaluate our experience, and then perhaps move back to the States, get desk jobs, set up home in an insanely expensive Boston suburb that we couldn’t afford and procreate.  Well, that was my plan.  But, as one year crept into two, both Justin and I began to discuss the possibility of having children abroad.  I wasn’t getting any younger and the economy in the States wasn’t getting any better.   After reviewing numerous birth scenarios (go home now, get jobs, get insurance, get pregnant; get pregnant here, get on a plane back to States for delivery; get over it and just do it), we decided to ignore the one piece of advice that my physician father tried to impart on us during regular visits, “just don’t get pregnant down there.”  Four months later, I was pregnant and we were overjoyed. 

By that time, we had met with one of the top OB-GYNs in the country at Vivian Pellas Metropolitano Hospital, discussed a prenatal plan, and witnessed some of our best friends, here in Nicaragua, get pregnant and give birth to happy, healthy babies.  Just as in the States, my OB here recommended the regular battery of pre-natal tests, exams, and vitamins. Moments after we watched the tell-tale pink line develop, we were on the phone to my OB discussing necessary appointments and ultrasounds.  Since that day, we have received top-notch care that rivals the assistance that my sister has received at state of the art Boston-area hospitals.

So, you know the old adage that “women have been giving birth to babies, alone in the middle of fields since the beginning of time”?  Well, it’s more or less true.  And more importantly, women have also been having babies in Nicaragua this whole time.   Giving birth is an incredibly natural life event.  You can prep all you want with doctors and specialists, but ultimately, this little creature is going to enter the world on her own terms at her own pace.  And that, she can do anywhere. 

Later that evening, after my finger was carefully washed and bandaged, Justin quietly offered to pack my “hospital bag” so that we are ready to hit the road when labor begins.  With more than 4 months to go until the arrival of Baby Fahey, I’m thinking that maybe Justin really will be able to find the hospital after all.    

Good Reads on Nicaragua

Thinking about visiting Nicaragua?  Read up on its incredible history first.  Below is a small sampling of books, but visit these links for more: So you’d like to… Learn More About Nicaragua  and Nicaragua: Surviving US Terrorism.

Blood of Brothers: Life and War in Nicaragua by Stephen Kinzer

In this well-written survey, the former New York Times Managua bureau chief analyzes the roles of the Sandinistas, the Catholic Church and the Reagan administration in modern Nicaragua.

The Country Under My Skin by Gioconda Belli

Motherhood and love affairs under fire, gun running and media work, poetry prizes and exile, and ceaseless combat against misogyny and despair, Belli’s powerfully told story reveals the symbiotic give-and-take of body and soul, art and politics, and altruism and pragmatism that make up the human continuum. A tribute to beauty, valor, and justice, Belli’s giving and clarion book is also an antidote to fear and apathy, and a reminder that freedom is always a work in progress.

The Jaguar’s Smile: A Nicaraguan Journey by Salman Rushdie

Written in the mid 80’s, when Sandinista was a household name in the U.S., the book recounts Rushdie’s whirlwind tour of the small “beautiful, volcanic country” for three weeks in July.
Nicaragua : Living in the Shadow of the Eagle by Thomas Walker 

This new and thoroughly revised edition of Nicaragua details the country’s unique history, culture, social reality, economics, foreign relations, and politics. Its historical coverage considers Nicaragua from before independence as well as during the nationalist liberal era, the US marine occupation, the Somoza dictatorship, the Sandinista regime, and the conservative restoration following 1990.

Staying Connected

So intrigued by the internet, my 99 year old grandmother created an email account and even joined Facebook 10 months ago!

From the time I went away to college, my parents began the weekly ritual of calling every Sunday evening to stay in touch.  When Justin and I made the big move to Nicaragua, I wondered if those calls would come to a halt.   Thankfully, they have continued this tradition even with the added expense of international calling.  The phone calls have kept us grounded over the last 2 years, allowing us to maintain a personal contact with family and making us feel closer to home. 

However, international calls are expensive and when added up over time, the bill can be quite costly.  Living abroad is an undeniably wonderful experience, but it can also be difficult to be so far from family and friends.  Thanks to technology, there are myriad ways to stay in touch with your loved ones back home.

From regular old emails to real time chats, Gmail, Yahoo, and other online mail programs are a an obvious choice as they provide a free way to correspond with people across the world.   The advent of video chat plug-ins has only boosted the appeal, as you can connect by both voice and video with just the click of the mouse!

VoIP (voice over internet protocol), MagicJack, Skype and other internet based voice communication services are all helpful, as well.

For a long time, I resisted Facebook.  As an educator back in the States, I had purposefully avoided social networking sites, as I didn’t want students to have access to my personal life.  Plus, it seemed like a tremendous waste of time.  Yet shortly after we moved to Nicaragua, my friends here convinced me to create a Facebook account.   I very quickly connected with close friends and family and also slowly began reconnecting with many old faces.   Using Facebook allows me to read updates, see photos, and share in conversations with people back home at times when neither of us has time for lengthy emails and costly phone calls.  

When our dog, Cooper, passed away, I was overwhelmed by the outpouring of love we received via Facebook.  One simple post was all it took to connect us to our support network of hundreds of friends and family back in the States.

Blogging is another great way to stay connected, as it allows you to send detailed updates to anyone willing to read your posts.  Though it tends to be a little more one-sided, it does create a nice forum for sharing information and experiences.

Thanks to the internet, home doesn’t feel quite so far away!  Of course, you can’t smell homebaked chocolate chip cookies online.  While technology is wonderful at keeping us in touch, remember that there is nothing better than an honest to goodness care package from home, complete with trashy mags, chocolate, and a piece of home.

US$ 1 Billion to be Invested in Nicaragua

“PRONicaragua, the official investment promotion agency of Nicaragua, recently reported that nearly US$1 billion are expected to flow into the country in foreign direct investment (FDI) in the next couple of years as a result of numerous FDI projects soon to be developed in different economic sectors. 2010 is rapidly becoming the recovery year for Nicaragua, as savvy investors are increasingly choosing Nicaragua as the ideal destination to start a business due to its dynamic economy, strategic location and natural beauty.”

Read the full press release here.

Monthly Budget for an Expat living in Nicaragua


A number of people have emailed me requesting information on the cost of living here in Nicaragua.  At long last, here it is.  Please note that this is based solely on my experience here, with my husband.  Each traveler will have a different set of needs and therefore, a different budget.  I would also note that if you are seriously considering a move here, it is helpful to have a minimum of a few months of living expenses already saved, as well as money set aside for a trip back home, if necessary.  Do not operate under the assumption that you will be gainfully employed here, as Nicaragua currently has an unemployment rate of 3.9% and an underemployment rate of 46.5%.  The exchange rate is approximately 20 Nicaraguan Cordobas to the US Dollar.


This number varies greatly depending on where, within Nicaragua, you decide to live.  San Juan and other more touristy areas tend to cost more.  San Juan, 1-2 bedrooms: anywhere from $250-$600/month.  We are currently living in a furnished 1-bedroom for appx. $500/month, but it includes water, electric (plus back-up), security, housekeeping 2x/week, Internet, and cable TV.


This cost also depends heavily on where you live.  If you have an apartment that draws from the town water supply, you are likely to spend approximately $10.  If you live in a development, outside of town, you might have significantly higher water bills, especially if you have a pool.


A basic monthly electric bill will run you approximately $15 via Union Fenosa.  However, if you have air conditioning and intend to use it, expect to pay a significantly higher monthly bill. 


Most homes have propane-powered stoves/ovens.  They typically come with a gas tank that you refill as needed.  A small tank costs approximately $15 to fill and will last you a few months.

Cell Phone:

Cheap, burner phones can be purchase in town starting at approximately $20.  Minutes can be purchased as needed. There are 2 phone companies here – Claro and Movistar.  People claim that Claro has better coverage, but most people I know have Movistar.  It’s helpful to know that calling between the two companies (i.e. Movistar to Claro) is almost as expensive, if not more expensive, than calling back home to the States.  But, calling within your company (i.e. Movistar to Movistar) costs very little.  So, if you already have friends here, find out what they have and consider getting that.

Cable TV:

You have 3 options for television (cable via Estesa, satellite TV via SKY or pirated satellite tv).  Cable runs about $18/month, SKY begins around $32/month and pirated is free once you buy the dish and the box.  


In order to have internet, you need to have a cable connection, via Estesa.  Internet costs anywhere from $30 – $50/month depending on your connection speed.

 Car Fuel:

Cost of fuel is hovering around 15-16 cordobas/liter for diesel.  We can fill our tank (a Trooper) for about USD$50.  Regular gas is slightly cheaper.  Premium gas is slightly more. If you plan to own a car, don’t forget to figure in the cost of minor repairs, as well.  We take our car to the mechanic on a monthly basis down here.  We haven’t had any major problems, but maintenance takes on an entirely new meaning when you are driving on unpaved roads.  


A loaf of whole wheat bread = 32 Cords (appx. USD$1.70)

A dozen eggs = 35 cords (appx. USD$ 1.80)

1 lb butter = 62 cords (appx. USD$3.25)

Imported items, such as granola bars, JIF peanut butter, will cost more.  There is a Pali grocery store, here in San Juan del Sur.  You can also purchase many of your food needs at a local pulperia.  La Colonia and La Union are larger grocery stores, located in Granada, Managua, and other larger towns.


As for entertainment, during the day, you can rent a surfboard ($10), an ATV ($20), take a canopy tour ($30), or hike to the lighthouse or Jesus, swim, bike ride, hit the beach, etc. for free.  You can also take Spanish classes, which range in price depending on the number of hours you want to study.


At night, bars are usually free to get into.  Beers are typically less than a buck.  You can also order a media, which consists of a half-liter of rum, a bottle of coke, and a bottle of soda water, a bucket of ice, and some limes for under $10.  A few places in town also have either a DJ or live music at night, including Coquito’s Bar.


For dinner, you can treat yourself to one of the finer restaurants in town, like El Pozo, and spend C$220 on an awesome steak with sides (about $12).  On the flipside, you can visit one of the fritangas (Chicken Lady) and get half a chicken, gallo pinto, salad, and tostones for C$80 (4 bucks) or the local market for a hearty $2 breakfast.  And then there is everything in between including a great Mediterranean Restaurant (El Colibri) with awesome Sangria and stuffed chicken (for under 7 bucks), and Bambu (Nicaraguan cuisine with an Asian twist) which serves incredible pizza on Monday nights and panini sandwiches every day.

Health Insurance:

My husband and I both have international health insurance through International Medical Group.  It was on the more expensive side, but we purchased it prior to moving here, wanting to ensure that we had some coverage.  We have yet to use it (knock on wood).  Since moving here, we have learned of local companies that provide coverage – Seguros America, being one that I think is less expensive and provides tiered coverage.


Medical Cost:

We have both had regular appointments with physicians at Vivian Pellas Hospital in Managua and were very pleased.  The hospital was like any hospital I’ve visited in the States and the equipment was state of the art, including a lab and pharmacy.  My entire appt., including consultation, lab work, etc. was about $50.  I would steer clear of the Centro de Salud here in San Juan, unless absolutely necessary.  However, there are local pharmacies here in town that employ doctors.  If you have a run of the mill cold or rash, you can pay C$30 (less than 2 dollars) for a consult with the physician.  


I don’t know anything about dental insurance, but I do know that there are plenty of reliable dentists in Managua and that you can get a cleaning for about $25.  When Justin and I first visited Nicaragua over 2 years ago, I ended up having an emergency root canal while in Leon.  It was the exact procedure my husband ended up having 2 weeks later back in Boston, but mine cost $150, while his cost $1,000 after insurance!  So, needless to say, we have been very pleased by both the quality and cost of medical care here so far.

I hope those of you reading this find it helpful.  Feel free to email me with any questions!

I am a big fat liar…

I am a big fat liar.  Really, I am.  Yesterday, I re-read the “About the Ex-Pats” page of the blog and I laughed out loud and thought, “what a crock of shit.”  The honest-to-God-truth is that I didn’t love anything about this country during our first visit here, which ironically was two years ago to the day.  The landscape was brown and dry.  Mosquitoes feasted on my ankles.  Chirping geckos kept me awake thru the night.  The heat was so unbearable that we stayed indoors between 10 am and 3 pm.  When we were eventually lured outdoors, it took us a minimum of 2 hours (but usually closer to 4 hours) to get anywhere thanks to pot-hole laden roads and ox-cart traffic jams.  And of course…everyone spoke Spanish.  There was no way I would be able to learn a foreign language AND make new friends.

While I am no Phileas Fogg, I am no stranger to travel either.  From a young age, my parents ingrained in me a spirit for travel and an appreciation of culture.  When my sister dropped her backpack halfway down Copper Canyon in the middle of The Sierra Madres, my mother turned to us with a smile and cheerily called, “Now isn’t this an adventure!”  She continued to use this phrase throughout our travels including the train ride when a ninety-five year-old goat farmer offered to purchase my sister in exchange for cheese and when said sister fell out of our river raft in class 4 rapids.  Hmm – perhaps we should have considered additional travel insurance for my sister?  In any case, my family now lovingly uses this “momism” to refer to some of our more challenging of travel experiences as exactly that – experiences.


at the dentist in León, Nicaragua

at the dentist in León, Nicaragua


So why did I detest this trip so much?  A little sweat never bothered me before. Well, for one thing, I had a toothache of colossal proportions the day we touched down in Managua which resulted in a root canal on day three of our “get-away.”  The pain was so unbearable that I found it hard to see beauty in anything other than a Vicodin prescription.  In addition, halfway into our trip, I learned that a dear friend and mentor had passed away after a long battle with cancer.  I wanted to be anywhere but in Nicaragua.


But less obvious at the time was that this wasn’t a vacation, this was an evaluation.  And every negative encounter was another opportunity to add a check under the “stay in Boston” column.  Because the truth was that as intrigued as I was by the prospect of living abroad for the first time in my life, I was also scared shitless.  

Incredibly, Justin and I just celebrated our one-year Nicaraguan anniversary a little over a month ago.  So how did this come to pass?  Well, the visit here handed us a huge dose of reality, which was exactly what we needed in order to determine if we could realistically live here.  We learned that we could get quality health care (cheaper and better!), we could get home for emergencies if necessary, and we could make friends that would prove to be not only great resources, but a second family.

I guess the most notable thing here is how quickly I forgot the negative. Or how I began to see it as beautiful.  As the pain of the toothache melted away, the dry season transformed into a lush, verdant landscape, each day offering a sunset more stunning than the last.  Though the drive to Managua still feels long, I now spend it gazing out the window upon the grazing cows and the billowing volcanoes.  I have come to appreciate the dichotomy of Mac trucks and ox carts sharing the same highway and I can’t fall asleep without the chirp of the geckos, my beloved friends, who keep the mosquitoes at bay.


 And now with the economy tanking, I could not be more grateful to my husband for encouraging this adventure.  Though we have not fully escaped the economic fall-out, we are certainly enjoying a more relaxed and comfortable lifestyle here in San Juan.  Am I wearing rose-colored glasses?  No.  But I certainly like that I get to wear sunglasses everyday.



This past weekend, we traveled north to Los Robles, a tiny town on the outskirts of Jinotega.  Jinotega rests in a small valley, encircled by mountains of cloud forests.  Because of its altitude, the climate is vastly different than San Juan del Sur and the south of the country, providing cool nights and temperatures hovering between 18-22 degrees.  Thanks to a wetter climate, the region stays green year-round.

Friends of ours were nice enough to invite us to stay on their organic coffee farm, Finca El Peten, which sits on the shores of Lago Apanas, Nicaragua’s first artificially created lake.  The Apanas Lake is the most important provider of hydroelectric power in Nicaragua.


View of Lago Apanas


The farm produces organic sustainable shade grown estate coffee, which essentially means that they have large shade trees of many varieties at the highest canopy level and banana trees at a lower level. This not only maintains the biodiversity of the forest but also the habitat of the birds and animals.


Coffee in its various stages

Coffee in its various stages










After a semi-trecherous, dark drive along the Guayacan, the newly constructed highway out to Jinotega, we arrived just in time for a dinner of ribs, and a serenade from some local musicians who work on the farm. Combined with a few nica-libres, we all fell into a happy stupor of rum, carne, and song.  As the night progressed, one by one, people excused themselves to their rooms in the rustic hotel for a deep sleep in the cool mountain air.

Singing along with the band

Singing along with the band

We awoke in the morning to a hearty breakfast of french toast, gallo pinto, and of course, coffee.  While we ate, El Jefe, the father of many of the guests, set about stewing up a soup on the outdoor fire.  For over 4 hours, the soup simmered slowly as he added various ingredients to the cauldron, including beef, plantains, cabbage, squash, and noodles.  Like kids at a summer camp being summoned to the mess hall, El Jefe called us all to almuerzo (lunch) in the giant family-style kitchen just after 1 in the afternoon.  Combined with a side of rice and a slice of avocado, everyone devoured the delicious sopa and promptly disappeared for mid-afternoon naps.

La Sopa

La Sopa

The rest of the weekend offered much of the same.  Though there was plenty to do on the farm, from fishing to horseback riding, we mostly relaxed and enjoyed the company of good people and warm food.  Without soup for lunch during our drive back south on Sunday, we stopped at a small trailer just outside of Sebaco for güirilas,     



sweet tortillas made from young corn, and a bit of cuajada (fresh white cheese known to the northern regions of the country).