This is my personal experience at Pennsylvania Hospital… (and what I remember of the events that happened 6 days ago). Views and opinions may differ based on the doctor and nursing staff.
So w checked into the hospital PETU (pre evaluation treatment unit?? I'm just guessing) at about 10pm in the evening. The process was fairly painless since I had sent my admissions forms previously. I was ushered to bed 5A (yup it's a shared room). It felt like a campus dormitory - tight and squeezy. So a doctor came in to double check if my water bag did or did not break. Eventually after both the pH paper test, and the microscopic fern test, the doctors concluded my water bags were not broken. BUT!!! They would keep me because the baby had 2 decelerations which is a sufficient cause for concern.
If we had decided to leave, we would have to sign an "Against Medical Advice" form. I guess the Singaporean-ness in us made us stay, and also that we did not know what would happen to bean baby if we chose to leave. There were so many possibilities for this deceleration which can't really be determined - could be a 'tired' placenta, cord around his neck, etc. After all the doctors said worse case scenario was a still birth. Come on, if they scare you with shit like that, mentally, you would stay.
So by 11pm, we were moved to the L&D area. We were given all our options and procedures for inducing labour. So step 1 was to insert a prostaglandin pill. This pill is placed somewhere inside and helps ripen the cervix. So I started from a 0cm,10%,-3 (which means I'm 0cm dilated, 10%thinning of the cervix, baby not dropped - ranges from -3 to +3, where 0 means baby is at the cervix.) from the time we were procrastination about the whole inducing bit to the time they started the induction process at 4am, I had dilated 1cm. That's a good start.
The doctor returned to check later at 8am in the morning to see how well the pill had worked. I had progressed reasonably well by then : 2cm, 50%, -2. Yay to the thinning cervix and dropping baby!
But from 8am till 2pm, I had stopped making progress and then the docs recommended that the next step is to start pitocin (oxytocin). I started the Pitocin drug at 3pm. Pitocin meant that we were almost definitely going to need an epidural. Anyway, if we had to have an epi, we'll have an epi (though I would much preferred a no epi birth). After they started the pitocin at 2ml (which got cranked up to 4ml, 6ml, up to 20ml) contractions started coming. Dreaded.
Then at 9pm, my waters broke (yes on it's own). Just like what you see in the movies... A whole gush of waters flowed out. And it just wouldn't stopped. At first I thought I just couldn't control my pee any longer because of the pitocin, then I looked and saw clear liquids which was clearly not pee! So from then, the contractions only could have gone a lot stronger and more intense.
Bouncing on the birthing ball (gym ball) - maybe that's why my waters broke??
2 hours after my waters broke, I couldn't take the pain of the contractions that were coming every 2-3 minutes. There was no 'pain build up' like traditional delivery, it was more like from little or no pain, to a stabbing pain (not that I ever stabbed myself before - but I imagine it will feel just like that). It was a lot more excruciating as compared to before. So considering that I potentially could be in pain for another 12-14 hours multiplied by 2 mins intervals, I thought Epi was a more logical sense - Who wants to be stabbed more than 350 times? And who knows if I would still have energy at the end to push?
But we did have a few concerns regarding epidurals - one of which was the high chance that epi wouldn't work on one side of the body. We have had 2 friends who had partial epi and they said it hurt like hell. One of them had been re-poked (3 times) and still ended up in a C section - for reasons which I didn't ask. The other had a natural delivery but experienced perhaps unnecessary pain. Other concerns were more textbook issues which we had received education from an anesthesiologist friend, VK, a while back. Anyhow the anesthesiologist at Penn hospital assured me this was uncommon and only about 5% of his patients had experienced that.
Taking the epi is like a prick in the back. The needle and tube is really thin, so the whole process was fairly painless. So for the first 1 hour, the epi did such a wonderful job. I couldn't feel a thing! But this meant that I had to be bed ridden - with a bed pan too! So through the night (ok it was for a few hours - approx 3-4 hrs) I had an awesome sleep.
Another 20 minutes into receiving the epidural, a nurse came in to 'check' on me since she saw something amiss on the monitor Apparently fetal distress. She paged other nurses, and suddenly there were about 3 nurses and 2 doctors in the room doing multiple things, which I can't exactly remember. Apparently, Pitocin could cause contractions that are too close which does not give the uterus or the baby (something like that) time to recover and so baby goes into distress. So eventually, they stopped the drug, and jabbed me with something to stop the contractions to allow the bean to 'recover' i guess...
At that same time, the right side of my body started feeling the pains of the contractions! In my mind, I was silently swearing at the doctor - at least I am going to contribute to his statistics of rate of failed epis. I endured the pain for about 3 hours then I decided to call the doc in. He said I had 3 options (urgh, I hate options) :
1. Increase dosage of drug
2. Adjust the existing insertion
3. Re-do the entire process
We started with 1. It didn't work for more than an hour. Then decided to get a new poke in the spine. Why? Because I wasn't convinced that adjusting the current insertion would be of use, and I need the pain control!
So this time... It worked - way too well on the left leg. I was pretty much paralysed on the left but managable on the right. But because they had to insert the tube at a higher location than original, the numbing sensation was all the way up to my boobies. Anyhow, it worked, I'm happy, he's (doc) is happy - though I'm pretty sure he did crank up the dosage big time.
By morning 7am I had dilated till 6cm, 80% and baby was at -1. Almost there but still not quite there yet. At least I'm considered in active labour. BUT... I was also starting to develop a fever... The doctors think it's infection from the breaking of the waters. We think it's due to all those hand vaginal exams done by so many doctors. I must have had at least 7-8 different doctors shove their hands in there (ok too much info). The temperature started to rise above 100, and within 2 hours, it was at 102.8 degF (which is supposed to be high - i'm not sure?! - but was told anything above 100.4 is a problem.)
So the doctors came in and said that the bean needed antibiotics because of the fever and be observed in NICU (neonatal ICU) for a few hours after birth. (Did not make a difference if he were to come naturally or via C section). So what happened to all those skin to skin missed hours etc?! We have heard so much about it during antenatal class, and looked forward to that. But well, if that is what it takes to keep him alive…. FINE.
Again, I was given 2 options *eyes rolling*
1. Go for a C-Section to minimize further infection
2. Go natural, but may have to end up in a C-Section if I hadn't dilated sufficiently and delivered in the next 6 hours.
Initially we decided on option 1 - immediate C-Section. Surprisingly, the doctor in the hospital that day told us maybe we could observe to see how I progress after an hour or two. (I think they were waiting for the liquids to clear out of my stomach - my guess only). After the next 2 hours passed, I still measured exactly the same. Clearly not progressing at all, and then it was clear Option 1 became the only option.
That whole birth experience…. lasted 36.5 hours. It's like going through almost every possibility of things that could go wrong during birth. Fortunately not the C-Section though!
Waiting to go into the operating room
So… within 15 minutes, I was rolled into the Operating Room. There must have been about 10+ people in there, including this anesthesiologist who kept talking to me… (I hadn't drunk water, so felt really embarrassed with my bad breath - only later to realize they all had those surgery mask). The baby came out pretty quick (felt like it was only a mere 5 minutes, but the sewing up process took a whole lot longer. I could feel presses and tugging of my tummy. Didn't feel like an operation, but felt more like someone giving you a front belly massage.
After the bean arrived, he was weighed, and cleaned, and wheeled off to NICU. At least I got to give him a little kiss before he left.
Our first family photo...
And now, our journey as 3 begins…
1 December 2013
