Kei's Birth 2 - The Day

kei's picture


Keilani getting himself comfortable under infant warmer system at the delivery room of National University Hospital, Singapore.

The last weeks

During my last hospital visit on 16 October, the CTG shows that I have been having steady contractions of 17 minutes apart. Funny that I couldn't feel anything. Dr Li Lin said that those are inactive contraction, "practicing" for the big day.

The week after that on 23 October, I went to visit dr Chong who were surprised to see me still hasn't given birth yet. I was also confused because I didn't feel any contraction at all. I even asked him whether I should try inserting evening primrose oil pills into the birth canal (as it is a natural method of induction). Dr. Chong said such measure is not necessary as he would only suggest induction if I go beyond 41 weeks or if the USG scan shows any problems. So far USG scan result was good for natural birth. I was grateful and relieved.

At the same time I consulted the birth plan with him: that I intended to be accompanied by a birth coach, and that I want to have a drug free birth. He largely agreed with my plan that drug-free birth is possible, but he needed to inject oxytocin after birth to avoid possible bleeding. I agreed to compromise to accept the oxytocin flush, considering my hemorrhage risk. Dr. Chong also advised that I have to put my state of mind as relaxed as possible to minimise the pain (sort of a "trance" state), but he also suggested me not to be to bound by the birth plan : if I can't cope with the pain I should inform the medical staff as soon as possible because such condition (tiredness or inability to cope with pain) won't be productive for the labour. I agreed with his suggestion but kept emphasizing to him my intention to try to cope with the pain as much as possible.


The day before

On 24 October morning and afternoon I was still busy to finish work and to go to campus to return the books. Ever since my last visit to the doctor my mom insisted to accompany me wherever I went so that if anything happen there's somebody to help. In the late afternoon it was rather difficult to get taxi in NUS and some inconsiderate academic staff decided to ignore my pregnant presence and she got a taxi from across the road, even though I waited for taxi before her. I wasn't speedy enough to run to cross the road to chase for that particular taxi. But that bitch did! Oh well...

Evening, 24 October, I breastfed Noe to put him to sleep. Unlike the other days when I breastfeed during pregnancy, this time the feeding session seems to increase the intensity of uterine contraction. Not long after that I began to notice faint contraction pain. I began to time it, and it seemed to be regular, coming at 10-11 minutes apart. I began to freak out because I haven't packed the suitcase for hospital. I jumped out of bed and pack the suitcase and prepare the documents to check into the hospital. Then I went to rush to finish my will, send it off to Indi to print tomorrow at the office, and back up the computer. Everything that needed to be done prior to delivery has been done, so I tried to sleep.

I couldn't totally sleep because the contraction pain recurred. I laid down and rest my body as much as possible in between the rush.


The Development of the Contraction at Home

Morning 25 October. I woke up at 5 am and spend time browsing the web and do some work. Contraction as 7 to 8 minutes apart. My mom woke up and I mentioned to her about the regular contraction. She asked whether my mucous plug has come out, and I said no. She advised me to cancel going to Little India in the afternoon and just concentrate on the contraction. At 6am I sms-ed Doris and she advised me to call the labour ward to see whether I needed to check in. I called NUH labour ward and the nurse asked whether this is the first baby and whether I stayed far from NUH. I said this was the second baby and I lived very close to NUH. The nurse advised me to come when the contraction is 5 minutes apart or when the water broke, and that she would reserve a labor ward for me. So I decided to just wait at home as per her suggestion. Besides, there is no free wi-fi in NUH and I would be bored to death there.

The contraction stays regular at 7-8 minutes in the morning. I prepared Noe to go to school / daycare, and apologized to him that I might not be home in the evening because I needed to go to hospital to help the baby out of the belly. He nodded. We decided to call taxi to send Noe to the daycare, saving us from walking 1.5 km.

Strangely, after Noe went to school, the contraction stopped! I decided to take the opportunity to have a good sleep, because if labor did happen, I should have enough energy to go through it. Contraction stops for 2 hours and I had a good sleep.

At noon, the contraction returns, further apart at 9-10 minutes, but more intense. I continued with my activity at home, and stopped every once in a while to "enjoy the contraction pain". I did the breathing out exercise to alleviate the pain. The contraction grew more and more intensely over the 5 hours period. At noon, the pain was focused in the lower front part of my abdomen, and slowly, the pain expands to envelope the sides. Eventually, at around 3.30 pm the pain enveloped into the whole lower back and got even more intense. Ibu Tuti, my mom in law, gave a massage at the low back area which nicely helped reduce the pain. It was painful, but lying down in my bed didn't help. I had to sit or walk around, keeping on with my activity, and the pain would be less severe.

At 3.30 pm, contraction was 6 minutes apart. But my mom was still doubtful whether this is a true labor because my mucus plug hasn't come off yet. Anyway, I decided to stay put and only go to labour ward when the frequency is truly five minutes apart. I kept drinking water to keep myself hydrated.

At 5pm my mom and mom in-law offered me fresh cut fruit. I made red raspberry leaf tea with honey from Katrina, which is said to help induce birth. Then I went to the toilet, as usual. I saw a surprise, the mucus plug had come off! It was exactly 5.30pm in the toilet. I called into labour ward and ask whether I need to go, and they said yes. I then call Indi to inform him, and it was just a perfect timing! He just walked out of the office! Indi decided to catch a cab to make a huge loop: first to get Noe from school, then drop him home with my inlaws, while me and my mom get onto the taxi, and off to the labour ward.

At 5.45pm Indi arrived home with Noe and amazingly Noe didn't cry when me and Indi went off in the taxi. I was so grateful that he understood what was said to him in the morning. Our neighbour also waved goodbye to us.


In the Hospital

At 6pm I arrived in the A&E. Nurse put me into wheelchair and roll me out to the labor ward at 2nd story. I timed the contraction, it was about 4-5 minutes apart. The labor ward was ready, and I put on the hospital gown. The next hour was spent doing boring paperworks while I was coping with the more and more intense pain. I also complied to CTG since the nurse said it would only take 15 minutes.






Doris, my birth coach, arrived at around 6.45pm and she asked me to move into the most comfortable position. I said to her sitting down is the most comfortable. She also prepared warm compress. It was the first time Indi met Doris and the two of them instantly joked to one another. Having both of them in the labor ward really alleviates the pain.

Doris coached me to breathe out slowly and visualize the sea, and amazingly it really helped to alleviate the pain. When the contraction came Doris taught Indi how to massage the lower back while I squeezed their hands, breathing out slowly. In between the contractions, they all kept throwing jokes to one another and to the nurse too.



At around 7.15 a young doctor came to perform VE (vaginal examination) and discovered that I am 8 cm dilated already. I didn't expect that, I thought I was only at the early stage. So we had to cancel our plan to have a warm bath in the jacuzzi as pain relief, since the dilation is almost complete.

After that came the most unpleasant moment, having IV patch installed in my left hand and blood taken for matching, while I also have to cope with the contraction pain, and my left hand unable to squeeze Indi. I really hate this moment but it was necessary to later perform the oxytocin flush. It took them about 10 minutes to complete the job. ARRGH!


The Peak

At this stage the pain reached its peak and what I'll write down here is based on my vague memory on what's going on. I could only write down what I felt and didn't really notice what happened around me.

At around 7.30 the contraction became very intense enveloping the whole lower back, and I said that "I felt the urge to push!". Doris coached me to go through the pain, telling me not to push and to just breathe through the urge slowly. For me, the effect of doing that was truly sublime and I came into the realization that I could sense what is going on during my labor! For me it was like an enlightenment, that I could understand what's going on inside my body! I realized that the "urge to push" was actually the baby's head pushing down when I was fully dilated. As I was restraining myself to push, I let my body do whatever it wanted to do with that pushing down sensation. At that time I felt that the "bulge" retracted back inside my body. Since the nurse heard me saying "the urge to push", she called the junior doctor back to perform the second VE and he discovered that I'm fully dilated and the baby's head is really really low. Someone then said to call the doctor, while the nurse midwife is getting ready for labour.

Doris asked me to go into sideways position and to brace into the bed railings, which I agreed to do. I was in the peak of pain and wanted to just fully concentrate to understand it and cope with it. When the pain began to come, I scream "The contraction is coming!", I closed my eyes, concentrate, and breathe through it. Sometimes I felt the sensation of the head pushing downward by itself, and sometimes the pain came without such sensation. What I did was just breathing through it while translating / conveying what I felt happening to my body to everybody in the room. When I felt the head pushing down, I scream "I felt the baby is coming down!". Doris then peeked into my underside and confirmed, "Yes I saw the baby's head". Then I felt the head retracted back up and I scream "It's going back up!", then the midwife peeked to see that there's no head bulging out.

Then another contraction followed but the baby's head isn't coming down.

Then another contraction followed and I really felt that baby's head IS COMING DOWN and I COULDN'T STOP IT. I scream, "The baby is coming out NOW!", The nurse scream to me to, "Hold it, hold it" because Dr. Chong hasn't arrived yet. But I couldn't hold anything because I was not pushing! I said, "I cannot hold it! The baby is coming out NOW!" Again, I wasn't pushing, I was just breathing through the force that enveloped me, my lower body just open up by itself, and my uterus just pushed the baby out by itself. It was really amazing, like, my body was possessed by an amazing external force outside my control. Really, I wasn't controlling the process by pushing because, I wasn't pushing at all. The baby just came out like a train departing from a station.

There was a bulge coming out and it was the water bag, still intact. Suddenly I felt that it popped / exploded, water gushed out, and everybody in the room scream that, "The water bag had just burst!" then followed "The baby's head is coming out!". The flow of amniotic fluid helped to ease the expulsion process. I felt the steady force expelling the baby's head slowly, and I still wasn't pushing! Then I sensed a short relief when it got into the neck part, and followed by another strong force that expelled the whole body. I kept breathing through it, and still not pushing, bracing myself to the bed railings in a sideways position. The exact moment when the baby is completely out I felt totally blissful, relieved, and euphoric which was an amazing feeling. I was also trembling and shivering like I had just finished a long run. It was 7.50 pm.

After that I just want to rest and shut my senses for a while, so I didn't really pay attention on what going on around me. I only remember asking, "Did the baby cry?" and Doris answered, "Yes really loudly". I also asked, "So he's definitely a boy?" and everybody said, "Definitely!". I also remember someone screamed, "Wow! The baby passes urine now!" Yeah, the first thing the baby did after crying was to spray pee to the people in the delivery suite. What a great way to thank them, Kei!

A few minutes later Dr. Chong arrived and said, "Congratulations, you just had a self-service delivery!" After that, my IV plug was opened and hooked onto IV drips containing oxytocin.

Meanwhile Doris commented that this is a second time seeing water bag intact during the last stage of delivery. Mine broke when it was just out of the birth canal. On another occasion, Doris saw her friend's water bag delivered fully intact and the doctor was really eager to puncture it.


First Feed

I was then turned from sideways position to semi sitting position and getting ready to breastfeed for the first time, after the baby's cord is clamped and cut. Doris wiped my perspiration using warm wet towel except for the chest area because she wanted the baby to know my smell. Kei (the baby) was put on my chest, I think, within 10 minutes after delivery, giving direct skin-to-skin contact. He hasn't been bathed yet but he was very clean, with no trace of blood at all. Perhaps it's due to the fact that the water bag only burst at the last minute when the baby is coming out, protecting the baby from any bleeding in my body. We (Me and Doris) didn't do the "breastcrawl" method, instead, we try to offer the baby my breast. The first 10 minutes upon contact Kei was only moving his head around. When offered the breast he would just lick it and play with it. Eventually, during the second 10 minutes, Kei began to open his mouth to put the breast into it. At the first attempt he was just nipple feed, which is not correct, so Doris asked me to break the suction and try again. The second time around, Kei happened to open his mouth really wide and we shoved the breast onto his mouth, resulting in a perfect latch-on. The suck felt weak compared to Noe's suckle, but he seems to actively nurse and swallowing the colostrum. Also, I know that it has been a good latch because I could felt my uterus contracting along with the suckle. Doris reminded me to work on the latch-on during the first few days, this is when both mother and baby learn the correct way to breastfeed.


 




Rani and her birthing coach Doris Fok are having a good time to get Kei breastfed for the first time. Kei did really well!

After a few minutes, I don't know how long, Kei released the suckle and fell asleep, and the nurse took him away to be cleaned. The magic of colostrum worked immediately - Kei passed motion while being cleaned. This is very good, because the first meconium passage will help expel excess bilirubin from his body, hence minimizing the risk of jaundice.



In the mean time, dr. Chong delivered the placenta and ensure that the SOP to prevent bleeding has been done correctly. He continued to examine the natural tear that happened after delivery. He said, "I need to apply LA (local anasthesia) to do the stitching, OK?" I said, "OK doctor, is the damage really bad?" He said," Yours is first degree laceration, this is considered to be normal. Even second degree laceration is still considered normal". I asked again, "Do you need to stitch a lot?" and he said, bluffing, "Yes you need a wayyyy lottt of stitches!", which means I don't need too many stitches. Dr. Chong is always joking in a bluffing manner but it really helped to lighten the atmosphere.

After experiencing it by myself, I realized the importance of breastfeeding soon after delivery. For the mother, it helped the uterus to contract, hence reduce the risk of hemorrhaging and help speed up recovery. For the baby, the laxative nature of colostrum helped expel the meconium, the first stool, hence help reducing the risk of jaundice. And not to mention the non-medical benefit, such as bonding, an opportunity for the mother and baby to get to know one another through the skin-to-skin contact, getting the warmth and scent of each other. I am so grateful to be able to experience this, and I hope other mothers would too.


Aftermath

Kei fell asleep right after his bath and he was wheeled into the nursery for check up with the neonatologist. I will write down his story of the first few days in another entry. I was wheeled into the ward and given hot Milo with toast. Indi went down to buy me big dinner, because I didn't have a chance to eat anything before coming to the hospital. I was hungry like mad.

Overall it was a really pleasant birthing experience. I thoroughly thank God for that. Everything fell into place nicely. First, Noe was not fussy at all when left alone without me and Indi, and he seemed to understand what was expected from him. Secondly, the last stage of birth began nicely, right when Indi stepped out of the office after finishing his work, giving him the opportunity to catch the cab and wrap up the tasks of the day, without needing to take his paternity leave for Thursday. Thirdly, I didn't have to go through a long and painful labor. I am so grateful to be blessed with quick and smooth delivery. Fourth, it was also a perfect timing for Doris to come, after finishing her work during the day and she was also able to go home quickly since the delivery was fast. Fifth, I was able to get up and walk around within hours, thank God.

There are a bit of downsides too. I hate having the IV plug attached to me and having the drips on the whole first night in the hospital. It really restrained my movement making feeding difficult when IV was attached. Secondly, we've booked for the deluxe delivery suite with jacuzzi and stereo, because we intended to use warm water bath as a method of pain relief and relaxation, and in the end, we only spent less than two hours there without even used the jacuzzi and stereo! And we were charged full for the deluxe suite! Thirdly, the paperwork in NUH is a pain, and checking out of the hospital was not so straightforward. Moreover there are some error in my hospital bill and the NUH staff could only explain to us about it after repeated nagging, and NUH food was not so good (Lucky there's Kopitiam).

So that's the end of the birth chronology.

Comments

a wonderfully complete and sweet account

Thank you for sharing your birth story. I love all the details you share: the setting, the physical sensations, your emotions. I wish all young girls could read lots of stories such as yours, so they could understand how childbirth should be. And congratulations on your beautiful new baby.

Such a beautiful and useful birth chronology that you wrote

Raniii!!! Congratulation on your cute new babyboy! It was very amazing experience you had. I wish someday I could experience a self-service delivery too like you had :) . I was so excited reading your story, Ran. Cheers!

What a great account!

Wow, reading your experience of birth is really enlightening! I am also going to deliver at NUH...probably next month. I have never read anywhere else about a birthing coach! Is she someone you hired independantly?

Just out of interest, what did you pack in your hospital bag?

What a wonderful story.

What a wonderful story. Belated Congratulations.

I'm so happy for you!

I've had two wonderful children, one son and one daughter, I didn't breastfeed much, but I can imagine it brings you intimacy with your newborn child. According to what I've read, oxytocin works quite well in its stimulation. I've never really heard of it until now, and that Google search. Nice account! Regards, Alice

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