Tuesday, August 18, 2009

Now I know what is labour... (Warning: Long long post)

It’s just another very normal day on the 11th and I still have no signs of labour at all. So at 10pm, I took a nice shower, checked my hospital bag and confirmed that everything is in and talked to my mother for about half an hour just to get some encouragement from her. She delivered me and my twin sister naturally without any painkillers about 30 years ago, and 3 years back my sister delivered my cutie niece, Cherry without epidural... Thus I got most of my knowledge on labour process from both of them, and set my mind strong that I would want a natural virginal delivery also. Before this, I really have not watched a single video on actual labour process at all, as I don’t want to freak myself out before the day comes…

I kissed my mother goodbye and set off with Win from home at 11:30pm, and reached Thomson Medical Centre (TMC) at 12:00am. I was pretty excited at that moment because as compared to those ladies rushed down to hospital with a burst water bag or with contraction pain, at least I could walk, talk and take care of myself happily. After we settled the admission (yes we, although most of the time the wife should have been wheeled into labour ward while husband is the one doing all the paper work), we were guided by the kind admin staff to a 3 bedded room (seriously I did not take note what room is that though Win said it is also the labour ward), and Win was asked to wait for me at the family waiting lounge while I spent my first one hour in that room alone.

What they did to me? First I was asked to change to an operation gown (a piece of blue cloth with a tie at the neck only, so when I walk out the room they got to cover my back with a big towel), at the same time they collected my urine, and asked me to lie down on the bed and put me on the CTG again (okay I’ve done this twice before at Tow Yung Clinic so it is a very familiar process, the only difference is the nurse here at TMC are way more experienced, I can tell that from the way they put on the belt, immediately baby’s heartbeat is captured). After this the nurse manager (as indicated on the name tag on the blue uniform) Grace asked me some routine questions about my medical history, she’s really nice to talk to and she strongly encouraged me to go on total breastfeeding. After that she explained to me that Dr Lim gave instructions to insert the pill into my cervix in order to soften it and make it open faster before he induces labour. Then she got another nurse in and told her what to do and left me in her hands.

This other nurse, whose name and face I do not remember, is one I had my worst experience in TMC with. She shaved me a bit (standard procedure, not a Brazilian wax of course and it only takes less than 40 seconds), for Dr Lim to do stitching after delivery, then she pumped something into my anus to clear my bowel and asked me to hold as long as possible before I pass motion. After I came back on to the bed, the nightmare started. She first checked on my cervix and said it opened for 1cm (Dr Lim checked and said the same thing on our previous visit so for the past few days there’s no progress at all), and god…I am 100% sure she’s not experienced at all from the way she checked me. She kept saying sorry to me because she just couldn’t seem to get her fingers into the right position, till she finally inserted the pill into my cervix (thank god this was the last time she touched me there). The burning sensation from the pill was really really painful, and I had to keep telling myself that feeling the pain meant it was working on me and that this pain is nothing compared to real labour pain. The nurse asked me to rest and called Win down to accompany me.

I couldn’t really sleep well so I asked Win to monitor the contraction graph for me. It reached somewhere around a bearable 80-100 and I was just wondering what will be the highest level (No answer to that though) ?

Around 5am I was asked to bathe myself and then walk to the labour ward together with Win. There is a single bed there and it is really soft and comfortable, not really big though. Pain from the pill was still eminent but not as strong. I was again put on CTG and waited for Dr Lim who was supposed to come and break my water bag at 8am. At the time Win was trying to sleep on the chair besides my bed, there was this poor lady in the opposite room was screaming like hell (I wonder how Win eventually got into deep sleep with such loud screams), the nurses and doctor kept telling her, “Don’t scream, just push, don’t stop.” Finally she stopped screaming and concentrated on her pushing. A baby girl was born after dozens pushes, I told myself, “Gosh… her job is done but mine is just started.”

At 6:25, Dr Lim came in a Polo-T, looking relaxed, said “Let me check how’s the pill working on mummy.” And he quickly checked and commented that my cervix opened for 1.5cm. 1.5cm? ONLY? After 5 hours of pain, it just opened another 0.5cm as compared to last check? I felt so depressed. Dr Lim just carried on to break my water bag with a long stick (at least 50cm? I can’t see it clearly from my angle). The process is painful, but he did it really fast and the damage is nothing as compared to the previous check done by that inexperienced old nurse (yes age doesn’t mean anything in this case). I felt a gush of hot water coming out and Dr Lim said, “Good. Water is very clear. I’ll induce you and most likely you’ll deliver in the afternoon, ask for painkillers when you need and they will help you”, then he just left happily with a big smile on his face, and left me to the nurse for induction. Luckily they changed shifts and I have another 2 kind nurses with me. They put me on drip which I later told Win that the process of inserting the needle is the most painless process although we were quite shocked at the length of the needle when they pull it out after my delivery.

From 6:30am – 12:00pm, Win helped me monitor the contraction graph and I do feel it getting stronger and stronger, but still within my tolerance level. It comes in about 1-3 minutes interval, based on the graph, once it comes, I just breath in and out through my nose slowly, and count for about 9 times, it’ll off (Win reads out the figures on the CTG as it goes from 40 all the way to the highest at 135). And during the period my sister called a few times, and she was surprised that I could still happily chat with her on phone. She said she was not even able to talk to her hubby during her labour, but my voice still sounded strong enough, haha.. At that time I really have to thank my yoga practice, because the inhaling and exhaling technique I learnt from yoga is definitely helpful in easing the pain.

At 12:30pm, Dr Lim called a few times already to check my status and this time he chased the nurses to check for my dilation. “It is at 5cm”, said the nurse, and she tried to stretch for me and ended up with 7cm (that’s just according to her, you will know why I said so in a while). I was so happy and told my sister about it, and she suggested me to quickly ask for laughing gas as she started using that at 6cm. So I waited for another 1 hour and requested for laughing gas just to standby. Around 1:30pm, I tried to breath in the laughing gas and immediately felt giddy so I was quite happy with the effect. And from 1:30pm to 3:30pm, Win went back to sleep again, and I just went through a much stronger contraction with the laughing gas (the laughing gas seemed to have no effect at all during this period, but since I read online that some people said it does not work at all, I just take it as normal and didn’t bother to think too much about it).

Around 3:30pm, the nurses changed shifts again and I got another 2 nurses, only one of them is super nice, the other one is just ok nice and when she check on me, again it was painful but she said I am 9cm dilated. Then she setup the apparatus for labour like doctor’s gown and all that and I was so excited because it seemed that I can deliver soon, although the contraction pain started to become unbearable. And she asked me if I need any painkiller after seeing me in deep pain, I told her that it is definitely too late for epidural injection (just for records, never in my mind have I considered using that), and I said I should be fine with the laughing gas, then, here comes the shocking news, I was told I was totally NOT on any painkillers at all!!!! All this while I thought I have been using the laughing gas as the mask is just in my hand and I breathe in and out through it whenever the strong contraction comes. But the nurse said: “Baby’s heartbeat drops when contraction comes, so we have to give you only oxygen and laughing gas cannot be used.” I looked at Win and felt extremely helpless at that time. I didn’t even know when they changed the gas to oxygen gas and no wonder after I inhaled twice from the mask, I have not been feeling giddiness anymore, that’s simply because it is nothing but purely oxygen only!!!

Then at about 4:15pm, they slowed down the drip for induction and I could feel that my contraction slowed down tremendously, although still as painful, but it came once in every 15 minutes and I dozed off a bit as I have longer time to rest between contraction. I kept telling the nurse I had an urge to pass motion (so that she will check on my dilation), but ended up she just shaked her head and told me, "Nope, not yet, still about 9cm only".

At 5pm, my savior came in and did a super quick check.
“7cm dilated,” Dr Lim said.
“7cm? I thought they said 9cm???”
“Different people have finger size different”, he casually replied before turning to the nurses and blurting a lot of medical terms to them (I guess he just want to increase the dosage of my drip and help to stimulate the labour process.) He had go for a C-section operation with another mummy-to-be and would come back at 6pm to review. But most likely I will need to go for C-section also, because baby’s head is still high (yes I felt that he was still at stomach level and haven’t move down much at all).

The next one hour is the toughest period in my entire life, Win was again helping me with reading the CTG figures, and trust me this machine just behave strangely, it showed my contraction level around 40-60 only, but the pain is just at least 50 times worse than first few hours when the reading was at 80-120. I only know that contraction comes every 2-3 minutes and I just need that time to rest and get ready for the next one to come. It felt like someone was pulling my lower tummy and it tensed up with a strong feeling of passing motion. The pain is definitely different from menstruation cramp. I would say that for 1cm – 5cm dilation, the feeling is more like menstruation cramp but stronger of course, from 6cm - 7cm onwards it is a totally different kind of pain. And every contraction just got stronger and stronger. I still remember Win told me at 5:38pm, “there’s about another 10 contractions to go, you’ve gone through many already, maybe just another 7 more…” I was thinking if every contraction gives me same level of pain, I still can endure but if it just gets stronger every time, I do not know how long more could I take. I asked Win to talk to our little Renzo, “beg” him to be strong and go down faster to birth canal, or else mummy has to go through operation after 17 hours of painful labour process.

At 5:57pm, my savior was back to the room again, I immediately grabbed his arm but couldn’t say a single word, I am sure he knew that I am begging him for big help. I only heard him mentioning to nurses about operation room is ready, blah blah blah. And asked them to get strong nurses in to help with the push. He said, “I want all the strong ones, good pushers all come and help!!” Then another nurse came in (supposedly the strong one) they started to teach me how to push, and with the help of Win and 2 nurses, we tried to push a few times before Dr Lim is back again. He told me, “We can start now, 90% you can deliver naturally.” So how about the 10% man?? C-section?? He told the nurse to prepare vacuum cup as baby’s head was still high and he expected baby to be big and cannot come out easily. Then he quickly cut me (episiotomy process but by then most people should not feel much pain there because the contraction is just way too strong), and inserted the cup, okay that is extremely painful again and I am sure it is not a small cup. And he said, “Now you go back must thank your mother for bringing you into this world, it is really not easy!”, and he asked me to push hard. “Tell yourself that your baby needs you to save him, and you definitely can make it.” Nurses told me to push like I have not passed motion for 10 days (come on, I do that everyday and thus do not know the feeling of never doing it for 10 days…plus, now what I need is strong pelvic floor muscles, not relaxing my anus!! Can’t believe I could be so logical at that time!!)

The actual push started, and I am so grateful that Win was there with me, because the 2 nurses somehow couldn’t synchronize themselves, and didn’t seem to give me correct instruction at the same time. But Win seemed to know what’s going on very very well, and even corrected my way of breathing (I supposed to hold the breath and count for 10 while pushing, but I exhaled immediately and started pushing). So every contraction I change breath about 4 times (means push 4 times, each time 10 counts), and after 2nd contraction, Dr Lim said to the rest, “She’s doing good, one more push baby should be out.” And when the 3rd contraction came, I told myself I really could not endure one more contraction to come so I must try my best to push him out, and at about my 2nd or 3rd time of changing breath, Renzo was OUT!!!

I thought normally doctors will let baby’s head out and wait for the next push then baby’s shoulder will come out, but seemed that Renzo was out with just one push, maybe that’s the effect of vacuum? Anyway he just threw Renzo on my tummy and our small little boy is so light!! The first thing I saw is a big bump on the left side of his head! I turned to Win immediately and asked what happened, he kept telling me not to worry and it is alright. (later we were told that it is because of the suction and it will go off in 3-5 days). Then nurse carried Renzo away and asked Win to follow to check on his physical condition. After Win came back, he told me that our little prince weighed 3.195kg, 51cm long and head circumference is 34cm. Dr Lim and all nurses commented that Renzo is really light, and Dr Lim even jokingly said, “I expected him to be 3.6kg at least, maybe the weight gain all goes to mummy then”. Fine, fair enough, I did put on 11.9kg throughout my pregnancy..

The third and final stage of labour was just to push out my placenta (no feeling as compared to pushing Renzo out), a big bloody organ and Dr Lim still asked me, “want to stir-fry this with ginger and spring onion?” Then he carried on with the removal of the cup and the stitching of the wound. It was again painful, and despite him putting local anesthetic, I could still feel every pull of the thread. My sister previously said stitching is a fast process but mine was at least 25 minutes, guess the tear must be serious due to the insertion of the vacuum cup.

Just when I thought everything was done, Dr Lim told me he needed to remove the cotton (err why that is needed?) and blocks of bloods and I really felt his hands touching my uterus, painful again! Luckily it is all done in seconds. Then he told the nurse to inform the anesthetist who was on standby in operations room, that the delivery was smooth and operation is not required.

Pic courtesy of Renzo's Godpa, Mike Tan (http://4stillangles.blogspot.com/)

Finally he gave us his well wishes and told me that he would check on me the next day. I couldn’t even find the words to thank him. Really without Dr Lim Teck Chye, I am sure I would have ended up in operations room already, just imagine I am not on epidural, so they got to shave me again and give me injection, let me read through the document and sign, while I am still suffering from great contraction pain…

After the nurse sent me back to my ward, I saw my sister there, the first person to visit me right after my delivery. She told me she felt tummy cramp at about 6pm (that’s the time I started pushing), and coincidentally, 3 years ago I woke up from tummy pain at 3am and suffered till 620am which was when she was having active labour, and about 15 minutes later her hubby called to inform me that my little niece Cherry was born.

Now it’s my turn and she really felt it too. Even my mother had a bit of a headache at 610pm which is also during my pushing time, interesting isn’t it? I am sure without their support and care, I really couldn’t make it on my own.

Now to think back, Win really gave me a lot of support during the labour process, although I let him leave me alone to fight with contraction pain most of the time. But when comes to actual pushing, I am so lucky that my husband can be so calm and organized and even knows better about what to do than me or some of the nurses. With him and our little Renzo, life is complete ^_^

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