Looking Back: We Managed It Well

Now that I am a bit more settled at home with fairly regular nursing activities, finally I now have the chance to try to write something about what had happened on Tuesday, March 15.

Part 1 – Last Pregnancy Exam

The check up on the last week before March 15 Dr. Chang has become worried because the baby did not gain much weight inside the placenta. The placenta has started to become calcified (with calcium deposit, that is), which means that the pregnancy condition has started to become over mature. Together with my unstable blood pressure, high content of uric acid in blood, and swelling all over the body, all adds up that this pregnancy can become high risk and not conducive for the baby’s growth, hence delivery is required. Since I also did not show the sign of going into labor soon, the doctor recommended labor induction, which we agreed to. Doctor asked me to take a rest on Monday evening, before proceeding into labor on Tuesday.

Part 2 – Labor Induction Progress

On Tuesday morning, March 15, we are prepared to go to the hospital. Ibu prepared a nice breakfast of rice and fried chicken.

I was admitted into labor ward at 08.20am. The nurse put on device to monitor the baby’s heartbeat and administered enema to clean my bowel. In merely 10 minutes, I had a great urge to pass motion and very quickly my bowel was cleared.

At 09.20am Dr. Chang came and gave me Prostine to induce the labor process. It was just slightly painful because the tablet was put deep into the cervix. From then on all can be done was just wait. It will take at least six hour until the labor process starts. I managed to finish the book that I bought the day before “The Trouble with Islam” by Irshad Manji.

At around 10.30am I was transferred from the labor ward to observation ward while waiting for the medicine to slowly work. At that stage I still did not feel anything, so I decided to just take a walk around the ward area.

At 11.30 I got toast and Milo for snack. It was just the right time, as I was really hungry. Soon after, the baby monitor continued to run. I started to feel small pain and pressure in my womb area.

At 1pm Dr. Chang came back to monitor my condition. The opening was 2cm. He also said that the baby is doing really fine, his heartbeat was stable. He then broke the water. Half an hour later, the pain became more pronounced and more regular in interval. I could feel when the pain came and Indi assisted me with his inner-power breathing exercise that really helped alleviate the pain. He learned that from martial arts guru named Kang Dicky in Bandung 5 years ago.

At 3pm I was re-admitted into the delivery room. Internal exam was done and I was still at 2cm, but the pain became stronger. Indi prepared the hydrotherapy tub – simply, an oval shaped bath tub. The hot bath was really soothing and helped to reduce 75% of the pain. I became very relaxed, and this helps the cervix to open up even more. Even my mucous plug was released in the water. After one hour in the tub, Dr. Chang re-checked the opening and it was at 6cm opening. He then said that the labor may start four hours from now, since usually the opening increases by 1cm every one hour. Then the nurse re-attached the baby heartbeat monitor.

After one hour monitoring the baby heartbeat, the pain becomes stronger and a bit more frequent. Indi stayed by my side all the time, helping me with the breathing – 5-second inhale via nose, 5-second hold in chest and 5-second exhale through hissing. Since the pain started to become less bearable, I asked the nurse whether I could return to the hot hydrotherapy tub again. The nurse checked the opening at about 5pm and it was already 5-6 cm and hence she did not allow me to go back to the tub. The nurse asked me to call her when I felt the push against my pelvic area, somewhat similar to the urge of passing motion. Then the nurse then started to prepare all the necessary things for labor.

Part 3 – Labor and Postpartum Hemorrhage

After the last cervical check, the pain peaked for half an hour. The pain was really great that I could not handle myself to do the breathing relaxation exercise anymore. The nurse pass me the oxygen-nitrogen mixture to help me to relax, but did not really alleviate the pain. I became really devastated and Indi kept encouraging me to hang on to it. Each time the pain came, I wailed “it’s coming, it’s coming!”, but I did not scream. I asked Indi to call the nurse. The nurse asked whether I felt a push in my pelvic area, and I said yes. She asked me to hang on to the pain and she called Dr. Chang in. She said, “Don’t push yet, hang on!” and I tried really hard.

While Dr. Chang prepared himself, the nurse put my legs against the leg rests, and taught Indi how to help support by back and exert my body forward when I pushed. Then I wailed “The pain is coming, it’s coming!” The doctor and the nurse asked me to push really hard. And indeed I tried really hard, although I was unsure that my push would help the baby to get out of my belly. But it turned out my push really worked.

Two pushes, the baby was out crying in his high pitch tone. Dr. Chang commended my effort for the smooth delivery saying that I should have more children – five or six more, he said.

The nurse put the red baby on my arms, and I started to count the fingers and toes. All are complete. He was indeed a boy. Indi was really excited and started to take pictures and video – I think he was not sure which one to use for this magical moment. Then the nurse took the baby out to be cleaned and weighed. Indi followed the baby and called my mom.

The doctor continued with taking the cord blood out. Then he proceeded to get the placenta out and to stitch my lower area. He commented that I was lucky to only have minor stitches, not needing epiostomy (perineal incision).

Then the nurse informed me that the doctor was cleaning the inner part of the cervix. I started to become uneasy and wish that the process will end up soon, because I was really hungry and thirsty.

But the last part of the process seemed to drag a little bit longer than expected. I felt some liquid gushing out of my lower part in large quantity. Observing the doctor’s reaction, I suspected that I was hemorrhaging. I then remembered one scene of a movie where a mother died from childbirth hemorrhage and I thought, “oh no, not now”. Slowly I started to lose my energy and getting thirsty. The doctor started to administer emergency procedures. All the nurses were called in to help in the ward. Indi and Ibu said that they were enjoying Noe ‘s company outside in the hall way but they were curious why there were so many nurses coming in and out of the delivery room.

An IV was required really fast, but the nurses had difficulty finding my veins. After several painful punctures, the nurses managed to put on the IV. But the doctor said that I was not responding to the medicine, and he asked the nurse to increase the dosage. Meanwhile, I still felt blood gushing out. Then three nurses gave me a very painful uterine massage in the abdominal area which was supposed to help the uterus contract and thus stop the bleeding. It was so painful but I did not have the energy to scream, and one nurse forced me to breathe in the oxygen, perhaps to reduce the pain. It was the most painful part of all, and I wailed in pain. The nurses kept saying, “I am sorry, I am sorry”. They’re sorry that they have to give me such a painful procedure.

I did not know what else that everybody was doing on my womb. I saw ultrasound equipment being brought in. I also saw big metal equipment being taken out from the shelf to be inserted inside me. I just closed my eyes to it; I did not want to see. I thought, “Whatever, I just hope this ends soon”.

Amidst the emergency situation, Dr. Chang asked me, “Rani, I am getting Dr. Tan here, she is a very senior doctor and she will give second opinion, are you OK?” I just nodded weakly. Meanwhile, the nurses kept giving me the painful uterine massage, but I was too weak to scream or wail.

After that, a good sign. Dr. Tan said that the bleeding has started to stop, and the uterus has started to contract. After re-checking everything, indeed the bleeding has stopped. The nurses then put my legs back in normal position. But I had become really weak. I felt really cold and thirsty, and I started to shiver. The doctor asked, “how do you feel?” and I answered, “I am cold”. It was really comfortable when the nurse put on warm blanket on me. I think the doctor kept asking questions to me to ensure that I am still conscious.

The first question I asked the doctor after the fiasco was, “Can I eat? I am very hungry”.

Too bad, I was not allowed to eat for the next 12 hours. I can only have water.

PS: When I went to the doctor for check up the week after, he informed me that I did not lose one liter of blood, but in fact, THREE LITERS, which is half of the content of my body's blood.

Part 4 – The aftermath

After everything’s over, Indi and Ibu finally entered the room. I was so exhausted and weak that I needed to tell Indi that I would not able to breastfeed until tomorrow. Little I knew that I would regret this decision, because our baby was given formula in bottle until the next day. The first nipple our baby sucked was bottle’s nipple, and I believe this is one factor contributing to my sore nipple condition later on.

My condition was being monitored in the labor ward until 9pm. I was so thirsty but could not be quenched no matter how much water I was given. In the mean time the nurse repeatedly took samples of my blood. Was it ironic; I lose so much blood yet they kept pricking my veins to take more sample of my blood? I don’t want to lose more blood.

I was then transferred to the High Dependency unit (some kind of Intensive Care Unit) to monitor my condition for the next 12 hours, while administering the necessary drugs to avoid further hemorrhage. Should something bad happen, I presume I would be immediately operated, that’s why I was not allowed to eat nor drink. The monitoring device kept making beeping sound and I was unable to sleep at all. There was minor bleeding at midnight and the nurses gave me another painful uterine massage.

The next morning Dr. Chang came and informed me that my condition has been stabilized and I could be transferred to regular room. I guess the critical stage has finished.

Then at 10am the nurse brought Noe near my bedside so that I could start nursing. But Noe has been given bottled formula and hence he couldn’t correctly latch onto my nipple and this caused sore nipple a few days later. I still regret that I was too weak to nurse him within few hours of his life.

Later in the evening after having difficulty brastfeeding, I was offered fresh A+ whole-blood. 2 bags of 450ml came in handy when you needed as badly as I did. It took about 3 hours for each bag to finish. Oh yes, many people came that evening… I think Indi has mentioned all the names in his previous entry last week.

I was allowed to come home on Friday, March 18 soon after we felt the next pain: paying the bill that ended up being 300% higher than our budget. Indi felt that he deserved detailed explanation for all the fees and he did receive satisfactory info from the admin folks. So much about understanding how healthcare business works in Singapore but it sure was efficient!

Part 5 – Naming our baby

How about our baby’s name? Do we have a full 3 part name yet?

We’ve been consulting many friends and Hawaiian name experts which produced the following combo:

• Kai = Ocean/Sea
• Noe = Mist

Kainoe (phonetic: ka-ee-no-ey)

Why Hawaiian? That’s the place where Indi proposed to Rani.

Last week before going to bed Indi said to me and asked Bapak Hindro, Ibu Tuti and Oom Anto via SMS:

“KAINOE _ _ _ _ _ _ _ _ SOEMARDJAN. Apakah ada nama tengah jawa dengan 8 huruf dan dimulai dengan huruf “O” ? Jadi jumlah hurufnya 6, 8 dan 10 sedangkan urutan abjadnya K, O dan S. Interval nya sesuai dengan order yang berlaku. Noe sifatnya sepertinya serius, terutama pas ngeden e’ek.

Rani said:

“Ontoseno?”

Bapak Hindro said, at about the same time Rani did:

“Ontoseno, abangya Gatotkaca yang hidupnya di dalam bumi. Atau Ontohod?”

“Sakti, dia jilat jejak orang, mampuslah orang itu. Dia nggak bisa dikalahkan. Akhirnya ditipu Kresna, disuruh jilat jejaknya sendiri, mati. Ngga ada cacatnya.”

Ibu Tuti said:

“Cocok, Ontoseno yang muncul akibat dari pada sebab dalam suasana Kainoe. Saudara dia bisa ambles laut, Ontorejo. Tapi bagusan Ontoseno, bunyinya lebih enak.”

“Ya bagus! Ok, sudah Kainoe Ontoseno Soemardjan. Ralat: yang ambles tanah Ontorejo, yang ambles laut Ontoseno. Jadi sudah pas sekarang.”

Oom Anto said:

“Ontoseno itu kakaknya Gatotkaca, anaknya Bimo dari Ibu Nagagini, putri dewa laut. Dia gak ada lawan, bisa masuk bumi, bayangan orang kalau dijilat aja orangnya bisa mati. Makanya dia gak boleh ikut perang Bharatayuda sebab gak ada lawan! Boleh juga tuh nama!”

Yodhi said:

“Onaniwae, 8 hurup!”

“Kainoe Ontosoro-h” (ref. nNyai Ontosoroh adalah karakter seorang wanita kuat di Buru Quartet nya PAT)

Anggi said:

“Kata Atik nama jawa nya “o” pada di belakang, jadi harus dibalik: Otrahus, Okranus, Oles….”

Bratasena dengan Arimbi mendapatkan putra bernama Gatotkaca, yang dapat terbang tanpa sayap. Dari perkawinannya dengan Nagagini memperoleh putra bernama Antasena yang dapat masuk ke dalam bumi dan menguasai samodra.

Yesterday Indi went to ICA to register the birth certificate and it is now set in stone, ladies and gentlemen... the one and only....

"Kainoe Ontoseno Soemardjan"

Would you like to see more photos of us at home?

"Noe enjoying his first morning at in the morning sun at home"

"He was in the womb a bit too long, many says, that's why he has lots of baby skin to peel off... by boy, look at how long those toes are... definitely a Soemardjan baby!"

"Doctor Nenek Airiza (Rani's mom) takes care of Noe like a pro... Noe is the 8th grandchild and one more coming soon from Vienna"

"Finally, we took our first family picture when WenWen and Darwis came to visit us yesterday"