Lupe’s Story

The last couple weeks have created a happy exhaustion in me.  This morning I slept in until 7:30, which compared to my usual 5-6am wake up time felt luxurious.  I needed the rest.

So much has happened in the last few weeks that I’m not sure where to start.

On the night of April 16th, I witnessed one of the most moving experiences of my life.  Baby Lupe was born here at ACAM to her parents, Andrea and Hector.

They were one of the sweetest families I’ve had the pleasure of caring for in my midwifery career.  As a midwife, my typical experience is to feel most bonded to the woman in labor.   However, this time, I actually felt an equal affection for the father, Hector.

Hector and Andrea are a young local couple from Concepción, thrilled to have their first child.  I have never seen a more supportive Father during labor here in Guatemala.  His love tenderly palpable for his wife and child, Hector guided Andrea through labor with the skill of a seasoned midwife.  As she walked through painful contractions, he walked behind her, his arms loosely around her waist, ready in case she needed extra support to stay standing through the pain.

He selected special classical music for his daughter to hear, since he himself is a violinist.  He told the midwives he had made a special playlist for the birth.   Imelda and Fabiola were amazed, as this type of behavior from men in this culture is extraordinarily uncommon.

Lupe was born without complication, weighing in at a healthy 7lbs 5oz.  Her birth was quick and simple, however as we did her initial exam and went to suction out her mouth with the bulb syringe, we saw that she had a significant cleft lip and cleft palate.  The hole extended from the lip up to her nose.   Imelda, who had delivered the baby, covered her with a blanket and motioned for me to come over, unsure of how and when to show the family members.

I’ve observed that here in rural Guatemala, due to machismo and a lack of understanding of why birth defects occur, Fathers sometimes want nothing to do with babies with deformities or get angry and blame the woman for the problem.  I’ve seen Fathers storm out of the delivery room simply because the baby is female.  Though I doubted this would be the case with Hector after witnessing his love and support throughout Andrea’s labor, I still feared how the family would react.


We had wrapped baby Lupe in a blanket and I asked Hector to come see his daughter, bracing for the grief and shock I knew would come over him when seeing his baby girl for the first time.  His wife, Andrea, was still working on delivering the placenta and the midwives wanted to wait to show her the baby until she was more stable.  I uncovered Lupe and quietly told Hector she was a beautiful baby, but that she had a defect that would require surgery.  He saw his daughter and tears welled immediately. He gasped.  Overcome with emotion, he left the room.  I feared it was too much for him and that he would leave.   Come on come on…..I prayed silently, please come back.

After less than two minutes, Hector re-entered the room and went straight to his daughter.  He sat down on the bed, put his arms around her, and held her tight and gave her first kiss.  He told her that her violin was waiting for her at home and that she was going to love Mozart.  Now my own tears welled as I watched one of the most heart-warming interactions I had ever seen between Father and daughter.  My fears washed away and I knew Lupe was in good hands.  She had been born into exactly the right family.

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Lupe’s Father Hector, just before giving her her first kiss

Another 20 minutes passed before we told Andrea about Lupe’s cleft lip and palate.  After the delivery, she was so tired that she had closed her eyes and drifted off to sleep.  I wasn’t sure how much of our conversation she was hearing or able to take in.  After some time, however, she awoke and Imelda asked me to explain to her what had happened.   I knelt down next to the bed, eye to eye with this young new Mother.  Hector sat on the bed with his arms around her, telling her to be strong.  I explained that Lupe had been born with a cleft lip and palate.  I briefly explained what this was and how it occurs and how it could eventually be resolved.  I looked for the balance between a thorough explanation and not overloading her with information she couldn’t fully take in.  After our discussion, I handed Lupe to Hector, feeling it would be best if he showed Lupe to her Mother for the first time.  As Hector placed Lupe next to her Mother on the bed and revealed her face, Andrea didn’t hesitate for a second.  She simply threw her arms around her baby and held her closely to her chest.  The love of a Mother is something so great, so sacred, and so unconditional.

Lupe stayed with her parents and family for about an hour and a half before we sent her with her Dad and Grandmother to the hospital for further evaluation.  Her breaths were quick and labored and it didn’t seem likely that she could breast feed because her cleft was so large.  We hand expressed several syringes full of breast milk from Andrea and fed them to Lupe drop by drop, carefully observing whether she could swallow.

Lupe’s cleft extended from her lip to her nose

Lupe stayed in the hospital for her first 12 days of life.  The most pressing concern was getting her adequate nutrition and making sure her breathing was normal.   As soon as Andrea was able, she began going to the hospital daily to hold Lupe and give her breast milk.  Lupe came home this Wednesday, April 25th.

Lupe finally home with her Mom Andrea.  A chunky 8lbs and doing great.

Yesterday I went to visit Lupe and her family at their home.  She is now 8lbs and able to drink a combination of formula and breast milk in a special bottle designed for babies with clefts.  Her breathing sounds much better.   On May 22nd,  we’ll go with her family for an evaluation with a non-profit organization in Guatemala called Tess Unlimited.  They will likely operate when Lupe is 3-6 months old.

Visiting Lupe and her family.

While Lupe’s surgery will be free through the foundation, the family will incur many other costs in the coming months and even years with transport, dental care, speech therapy, lab work, and more.   I created a fundraiser for the family, whose resources are extremely limited, to help cover all of their additional costs and get Lupe the best possible care.    We are about halfway to our goal!  Please consider making a small donation to help Hector and Andrea at

I will plan on presenting the donation to Hector and Andrea within the next week and update all the donors with photos and Lupe’s progress.

Imelda, who delivered Lupe.

Soon after Lupe was born, one of my dearest friends in the world came to Guatemala to visit me for over a week.  Melanie traveled from her home in Puerto Viejo, Costa Rica to attend a mutual friend’s wedding with me at Lake Atitlan, and then came back to ACAM with me for 5 days.  She was here for my 32nd birthday, which made it so special.  She attended two mobile clinics, witnessed her first birth, and won over the hearts of the midwives with her bright and infectious energy.   Her visit reminded me of the deep gratitude I have for friends who love us unconditionally, who accept us exactly as we are and remind us of our strengths.  Melanie wrote a really lovely account of our trip together on her own blog:

Melanie and I at the Tui Canabaj mobile clinic on my 32nd birthday
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Birthday love from the mobile clinic crew.  Imelda, Nancy, myself, Doctor Valeria, and Gricelda.



2 thoughts on “Lupe’s Story

  1. Really beautiful story!! Thank you for all you do here. We had a patient give birth last month to a baby with a cleft lip and palate and she is going through the exams right now. We have collaborated with World Pediatric Project, but it is good to know about Smile Foundation as well.


  2. Hi Mallory,
    I have just read all of your blog posts. These are compelling and insightful stories which are truly heartwarming. I am so proud of the work you are doing and all that you are learning and sharing in
    Guatemala. This is a life changing experience for sure!
    Best to you,


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