Thank you Larissa for sharing your birth story with such detail. It has been a roller coaster ride for this first time mummy and I thank her for giving permission to share this on my blog. From changing gynae at 39 weeks of pregnancy to bloody show, contractions, having epidural and developing a low grade fever, to pushing for 1 hour and finally giving birth naturally with assistance at just a few hours short of baby’s EDD, Larissa and her supportive hubby has been very strong in the entire process of labour and probably even stronger as they depended on God!
Read her account here:
MY STORY ON BABY ELIEL’S BIRTH
WARNING: Especially for unmarried male readers, this birth story contains GRAPHIC details of the female reproductive anatomy and what happens to it during labour and delivery. Read at your own risk! BUT… it is a nice testimony of God granting prayers to the undeserved.
My birth story began some days before the actual labour, at the beginning of week 39 of gestation, when I made what many consider an insane, unthinkable decision to change my OBS & GYN doctor – the doctor who would deliver my baby, commonly termed gynaecologist or “gynae” in Singapore.
I had carefully prepared my birth plan, highlighting my strong preference for a natural delivery. I am not disdainful of c-sections and I do NOT believe that having a c-sect delivery makes you any less of a mother. However, I wanted to keep open the option of having more children if God may be so generous to grant them, but I was aware that multiple c-sects may limit the number of births I can have in a lifetime. I was also hoping for a quick recovery after childbirth.
My usual O&G doctor, who had been caring for me since my first trimester, was highly skeptical of my physical ability to deliver naturally, repeatedly citing my short stature and tight pelvis. During the last month of the pregnancy, she upped the ante by repeating her favourite phrase – “High chance of c-section” – and constantly encouraging us to decide on an elective c-sect. She also said she hoped the baby would come out earlier before he got too big (for me), which led me to lower my food intake and to try to induce myself naturally – not necessarily the healthiest decisions for baby and me. I felt miserable.
Anxious to find out if it was indeed medically necessary for me to undergo a c-sect, on Thursday 15 January, I sought a second opinion from one of the more famous pro-natural O&G physicians in Singapore – Dr. Paul Tseng. His answers were the most comforting words I have ever heard on the issue – first, the baby would not grow too big in proportion to the mother’s body (so there was really no need to starve myself to control the baby’s weight or to induce to try to get the baby out earlier); and second, the pelvis would expand during labour to allow the baby to pass through the birth canal (why didn’t the other doctor tell me this simple fact?!). He even addressed my fears on shoulder dystocia without my asking about it – the condition does not happen unless the mother has gestational diabetes (which I don’t). In other words, there does not seem to be a medical necessity for me to have a c-sect, and there is no reason not to try for a natural delivery. Hurray! But I still had to deal with my usual doctor who wanted to put me under the knife.
On Friday 16 January (the start of week 39), at a routine appointment with the usual doctor, she did an internal examination on me and repeated her “high chance of c-sect” trademark phrase with a determined tone in her voice. That was when I knew enough was enough – it would not be her, but Dr. Paul Tseng, who would deliver my baby. We made an unscheduled visit to his clinic to announce we were switching to him; though surprised, he accepted me without hesitation and approved my birth plan.
The rest of the day was spent doing catch-up at record speed – paying the deposit for the new doctor’s fees, pre-admission into an unfamiliar hospital, and the hospital tour etc. – and trying to wrap my head around the fact that I was going to deliver in a different hospital under a different doctor!
SIDE NOTE – God actually spoke to me through the Holy Spirit during my 2nd trimester that I would be delivering naturally. I clung to the hope of this promise whenever I heard the words “high chance of c-sect” from my former doctor. In light of this, it does not sound so insane to change to a physician whose position is much more consistent with God’s revealed plan.
On Wednesday 21 January, the brown discharge I had been spotting since after the internal exam on 16 Jan turned fresh red with a mucous-like texture – my “bloody show” had started. I also started having contractions but the pain was manageable. We called the hospital emergency hotline at 3.30am which transferred the call to Dr. Paul and frankly, all parties were so sleepy I doubt any of us remembered anything meaningful from the short conversation. I managed to fall asleep from 5am to 9am, then dropped by the doctor’s clinic for another unscheduled visit. It turned out that I was having irregular contractions and that my cervix was soft but not dilated, so I was sent home as I was told it could be days or weeks before I could be in labour.
From Thursday 22 January midnight onwards, however, the contractions started getting more regular, intense and painful. They prevented me from sleeping; I stayed awake the whole night monitoring the frequency and intensity of the contractions on an iPhone app, and trying to ascertain if they fit the doctor’s criteria for hospital admission – 30 – 40-seconds long, 10 – 12 minutes apart and on a pain scale of 7 out of 10 (meaning that it was so painful I could barely walk or talk). Not fun! I was hesitant to go to hospital for fear that it was a false alarm again, like the day before. When dawn came, I went under the sun and told myself that if the pain did not go away in the sunlight, it was likely to be the real deal. It did not. So hubby and mum-in-law bundled me into the car, with two small apples and a bottle of coconut water for a quick breakfast. Morning traffic was horrid, and I used breathing and relaxation techniques to cope with the pain, while MIL tried to massage my shoulders.
9am – The moment I could barely walk into the hospital building while hubby parked the car, the concierge noticed me and ushered me immediately to the labour ward floor. I was put in the observation ward while waiting for a delivery room to be available. The nurses found that I was already 2cm dilated and quickly gave me enema to clear my bowels, as they were afraid I would be in too much pain to walk to the toilet when I was further dilated. I checked to make sure I was allowed to still eat during the day, as being kept awake the whole night had made me hungry and I needed energy for the eventual delivery. Hubby joined me after doing the admission procedure. The observation ward was an unpleasant place. I had to walk past an occupied bed beside mine to reach the toilet. The occupants were talking loudly on the phone and watching some garish programme on TV with the volume turned up.
11am – I was relieved to be finally wheeled to my private delivery room, but was shocked when I realised I was assigned to one without an ensuite toilet! So I made a strong request and was transferred to a pricier but bigger delivery suite with ensuite. Hubby realised that this was the same luxurious delivery suite that was shown to us at the hospital tour. We were pretty much left alone waiting for the labour to progress. I received egg sandwiches and milo to eat.
1pm – When I thought of standing up to take a walk, I was suddenly hit by a massive wave of excruciating pain in my tummy, back and ribs, as if a few major bones were being simultaneously crushed! I bent over in shock and had to lie back down, whilst emitting low-pitched screams. That was when Dr. Paul visited for the first time, with hubby joking that he probably heard my screaming from outside. The doctor was pleased that I was “well established in labour” but cautioned me not to eat too much as I might vomit.
2pm – When hubby was out for lunch, the main nurse in charge of me, Sister Irene, found that I was already 5cm dilated. She asked if I wanted epidural as she observed that I was in distress from the pain. Really? I was in distress? I thought I was coping quite well, sans the sporadic screams. Knowing that 6cm was the maximum dilation during which epidural could be administered, I caved in and asked for epidural, as I felt I needed to conserve what little energy I had left for the delivery instead of for pain management. This was the only deviation from my birth plan that I decided on.
15 minutes later, the most gorgeous female doctor I had ever laid eyes on entered the room. Dr. Yvonne Lim, the anaesthetist, told me that the epidural would take away 90% of the pain and made me sign a form stating the risks and possible side effects. The epidural administration was painful! I was made to lie on the side and breathe in entonox (laughing gas) to help me relax during the procedure. The entonox only made me light-headed but I could feel the sting of the needle. Sister Irene had to hold down my arms and legs to prevent me from thrashing about. She commented that I was tensed up, making it more painful than it would have been.
The epidural came into effect and I could feel numbness spread over my lower body. The painful contractions were now barely noticeable. I was given a urine catheter and belatedly realized that I had to lie down all the way and could no longer walk myself to the toilet, hence defeating the purpose of having an ensuite! Oh well…
3pm – The doctor dropped by again and I apologized smilingly for opting for epidural and hence deviating from my birth plan. He smiled back and said there was no need to say sorry as it was my personal choice. He proceeded to break my water bag with the sharp end of what looked like a white fine-toothed comb, saying that it would help the baby move further down. I felt a big gush of water flow out and it was swiftly cleaned up. Hubby returned from lunch and I joked that he missed all the action. He regretted not returning earlier to check on how pretty the anaesthetist was.
As time slowly went by, the epidural made me shiver uncontrollably. Sister Grace, who looked like she was a senior staff nurse, visited occasionally to provide emotional support. The epidural made me relaxed enough to catch up on much-needed sleep. But the best thing about it was that in my quiet moments, I was able to pray peacefully for a safe, natural delivery without the need for an emergency c-section and to imagine how the birth process might pan out.
Eating and drinking, however, was a delicate tug-of-war with the nurses. I wanted to drink milo and coconut water but was advised to only sip plain water, as a side effect of the epidural was vomiting. When I did not show any signs of vomiting, I quickly asked hubby to feed me milo when the nurses were away.
3 – 4pm – I was woken up by the doctor’s arrival. He found that I was still only 5-6cm dilated and ordered for syntocin to be administered in a drip to speed up the labour. “Did the epidural stall my otherwise smooth-flowing rate of dilation?” – I thought in panic. There was a change in nursing shift and Sister Josephine, who looked young, fair and pretty but went about her job in a methodical, no-nonsense manner, replaced Sister Irene.
4 – 5pm – The shivering had stopped but I was spotting a low-grade fever of 37.5°C and was prescribed panadol. I was also told that the baby’s heart rate was dropping so I was given oxygen to help him relax. This got me very worried and I fervently prayed for the baby’s safety and that it would not lead to an e c-sect. Despite all these, I was famished after that meager brunch of sandwiches so I asked for more food. The nurses tried to stall my requests with various reasons – they needed the doctor’s approval; they had to monitor the baby’s heartbeat on the CTG machine first; they were waiting for the food to be delivered etc. etc. I repeatedly asked for food until my voice turned hoarse. When they finally brought in tuna sandwiches and milo, I was told to eat only one piece of sandwich and to have hubby hand-feed me. After the nurse walked out, I got hubby to feed me ALL but one sandwich.
6pm – My fever had dropped to 36.9°C and I had dilated to 6-7cm. At the (slow) rate this was going, we estimated that the baby would be out around 12 midnight. Sister Grace assured me that the drop in the baby’s heartbeat was nothing to worry about and was not a cause for an e c-sect – he probably didn’t like one of the things (read: drugs) going into me and was getting used to it.
Evening time was the best part of the day so far. I was satisfied from the sandwiches and milo, and feeling relaxed with the epidural numbing away all the pain, I fell back asleep.
8.30pm – By the time Sister Grace checked on me, to everyone’s surprise, I had fully dilated to 10cm! I could even vaguely feel her hand turning somersaults inside me. She said she could feel the baby’s hair! We were asked if we wanted the baby to be born on 23 Jan (for which we would wait until past 11pm before I should start pushing), or 22 Jan. I quickly replied to get it over and done with. Sister Grace quipped, “It’s time to work hard!” and left us while Sister Josephine got things set up.
To distract myself from the nervousness over the impending birth, I asked Sister Josephine what my chances of a natural delivery were, telling her my former doctor said I had a tight pelvis. She replied that from her 30 years’ experience as a midwife, she was absolutely confident I could deliver naturally. I said she looked very young! However, she said that Asian women would definitely suffer perineal tears, but after probably seeing my horrified reaction, quickly assured me that the area is well-suited for tearing. She also told me that after the delivery, I would be given an injection to the thigh to cause my uterus to contract, but I initially thought she was joking and that the injection was some form of vaccination for the baby. I was probably getting sick of the increasing number of needles being inserted into me.
9pm – Sister Josephine taught me how to push with very precise instructions, with hubby holding my right hand to support me – (1) Feel the contraction coming; (2) Lift my calves close to my thighs; (3) Take a deep breath; (4) Put my chin down and count to 10 while pushing with all my might, directing the force of the push towards where the baby would come out; and (5) Repeat Steps 3 and 4 two more times. There were lots of don’t’s too – “Don’t arch your back”, “Don’t lift up your bum”, “Don’t make any noise”. I did what she called “rehearsals” for a good 15 minutes.
There was a change in nursing shifts again and two older looking midwives came in while Sister Josephine bid us goodbye. I did not know their names as their nametags were hidden under plastic aprons. They said the doctor would only come in at the last minute to receive the baby in his arms (what a nice job!) and we would be here for a good one hour of pushing at least.
We continued the process of pushing, with the midwives telling me I needed to gather all my energy to push in order to get the baby’s head past the pelvic bone. They also tried to get hubby to encourage me by showing him the hair on the baby’s head, which he claimed he did see. On hindsight, the whole process felt like military or bootcamp physical endurance training!
After an hour of pushing and with no baby in sight, one of the midwives looked defeated and said, “Look here, honestly-speaking, it has been an hour and I can see you’re getting exhausted. You probably should call the doctor in now for vacuum assisted delivery. Even with the vacuum, you still need energy to push as the vacuum will only guide the baby’s head past the pelvis but will not pull him out all the way. If you continue pushing like this without assistance and the baby still does not come out, you will be completely drained and even the vacuum will not help you later. What is your choice now?”
I looked at hubby who only returned a blank stare and the same question, “What do you want to do?” Then I asked the midwives whether I was headed down the e c-sect path, to which the emphatic answer was no, as the baby was already so far down that his head could be seen. So I made the decision to call the doctor for assisted delivery. I was told it would only take 10 – 15 minutes for the doctor to come over as he lived nearby.
One more precise instruction for me – I had to look straight at the doctor while pushing during the vacuum delivery, otherwise the force of the push would go in the wrong direction and it would be futile. I was then left to take a quick rest while the equipment was being prepared.
As promised, Dr. Paul appeared shortly, dressed in casual wear. He changed into waterproof rubber boots and looked like a high-class fresh seafood seller having returned from a game of golf. I belatedly realized the bloody mess that was soon to come when hubby innocently asked why the need for boots. The vacuum looked like a small yellow toilet plunger and I saw the doctor put some blue balloons (they looked like the kind you see at children’s parties being twisted into animal shapes) near/into me. Then I was directed by the doctor to push. I pushed as best as I could for four times, focusing my sight and direction on a spot on the doctor’s green garb. Hubby exclaimed, “He’s coming out! He’s coming out!” At the same time, I felt a big load slip out of me, leaving an emptiness in my tummy.
Baby Eliel was born on 22 January 2015, at 22:18, just a few hours shy of his EDD. Hubby sounded like a nervous wreck when he was directed to cut the umbilical cord (in line with my birth plan). Eliel was lifted up onto my belly, slimy and wet, for skin-to-skin contact. Some brown liquid that flowed out of his mouth was quickly wiped up. He was not crying, and I anxiously asked whether he was breathing just to make sure, although I could see that he was. Instead, he was quiet but alert and inquisitive, scanning the new environment around him with big brown eyes. I noticed poop on one of his legs and realized that he had made his first poop just before he came out.
Hubby squealed excitedly, “Look! Here’s your placenta.” A midwife held up a big, red and juicy organ. I could only stare in shock and mutter, “The placenta came out?! I did not feel it come out at all.”
I silently gave thanks to God for the natural delivery, cried tears of joy, then thanked the doctor and midwives profusely for enabling the same. Feeling more relaxed and happy, I thought aloud that the vacuum delivery was easy and wondered why it was not done earlier. I never expected a reply, but the doctor immediately said something like, “But then you would not have known what pushing in a natural delivery was like!” That was when I noticed the red (stained with my blood) thread and scissors the doctor was holding, and had a silent freak-out moment. I asked about the extent of the perineal tear, and was told it was a straight-line second-degree tear all the way to the anus but would not affect passing motion. With the epidural still in effect, I did not feel a single thing of course. Later, hubby would recall to me that the doctor had told me that I was receiving an injection to the thigh, but I did not remember hearing that, neither did I feel or see the injection.
The midwives suddenly lifted up my top and put Eliel on my bare chest, telling me to let him latch. It was awkward as I had not yet learned how to latch a baby and Eliel was a little too overwhelmed to try to latch.
The doctor finished up the stitching (which seemed to take a while!), shook our hands to congratulate us, and was gone in a flash – guess Superman needs his down time too. Hubby was like a distracted child – he was all over the place trying to take photos but not really knowing where to be or what to do. The midwives measured Eliel – he was 2.685kg heavy and 49cm long, with a head circumference of 33cm. They then placed him in the warmer box and got daddy to count his fingers and toes. Everything happened with clockwork efficiency.
Eliel was wrapped in a towel and tugged snugly beside me. I felt him squirm contentedly, just like his squirms back in my tummy which I would surely miss. Side by side, we were wheeled out of the delivery suite, ready to face the world. It was magical. And God is awesome.
Larissa with her gynae Dr Paul Tseng who delivered her baby Eliel naturally.