The road less traveled: Costa Rican women face prenatal care dilemma

By Kristi Luther

SAN LUIS, Costa Rica — Driving down the hill from Monteverde demands patience and a strong stomach. At times, cars barely squeeze past tourist vans on the narrow, winding 11-mile stretch of unpaved road between the town limit and paved road that leads to the highway.

But the impacts of the poor road conditions far surpass a bout with car sickness — imagine doing the often-treacherous drive while nine months pregnant and experiencing severe labor pains.

The unpaved road leads downhill from Monteverde, often leading to difficult travels for tourists and residents.

The unpaved road leads downhill from Monteverde, often leading to difficult travels for tourists and residents. Photo by Kristi Luther

On one hand, residents are worried about declines in tourism because of the poor roads surrounding Monteverde, which has more than 220 tourism businesses, according to Inside Costa Rica.

But perhaps a more pressing issue is the inability of residents — more specifically, women giving birth — to access health care quickly. Some local women worry about speedily getting to a clinic or hospital for proper prenatal or childbirth care.

Fortunately, Costa Rican women are well educated about prenatal health, especially in comparison to women in neighboring Panama, according to a 2008 study.

Señora Salazar, a San Luis woman who is married to a coffee farmer, said she always felt confident with her prenatal care because she knew she was receiving necessary supplements such as calcium, folic acid and other vitamins. Her three children were delivered by “normal births,” the term Costa Ricans use for vaginal births.

Because of the road, however, Salazar traveled down the hill to stay with relatives shortly before her due dates. That way, she was already near a hospital for delivery. She delivered one of her children at the hospital in Puntarenas, the nearest hospital for women in the area.

“But the roads are scary, and I always had to think about it,” she said through a translator. “Back in the day when the roads were even worse, I was always terrified something would happen.”

Unfortunately, knowledge about prenatal care cannot completely prevent problems. There is always the possibility of complications or the necessity of a timely ultrasound.

Margoth Fuentes Rodriguez, a homemaker in San Luis who is pregnant with her second child, faced a dilemma when she needed an ultrasound during her first pregnancy.

Because she was high-risk, an initial ultrasound was performed. For a follow-up ultrasound, however, she was told the waiting time could have been up to six months.

“By then, the baby would have been born,” she said through a translator.

Still, Rodriguez decided to tough it out and remain at home until the baby was to be born. She was overdue during her first pregnancy and had to be induced, so she was not in labor when she made the trek down the unpaved road.

She said her first experience was relatively easy, but she is very unsure of what her current pregnancy will be like.

“Of course, the road is something I worry about,” she said.

She plans to continue standard monthly checkups in San Luis until the birth and to, yet again, tough it out at home until she goes into labor.

According to the Tico Times, various area residents have reached out to the national roads council, and there was even a march to demand a new asphalt road. The debate over this road continues, and locals are left hanging on an issue that affects both their livelihoods and their health.

One thought on “The road less traveled: Costa Rican women face prenatal care dilemma

  1. Debbie Allen says:

    I enjoyed this article, addressing a topic I haven’t read about in previous years via this blog. Good work!

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