It would be my third warm shower at the hospital since Rene and I were admitted at 2pm the previous day. This was my attempt to facilitate the progress of my labor which has moved so slowly. In truth, I was also scared of my impending delivery (and the fear may also be delaying my labor). Yes, I had delivered Umi and Pax through unmedicated natural births more than 5 and 3 years ago, respectively - each a different experience - but I have somehow forgotten how it is to deliver naturally again. I wondered whether my body and psyche can still handle the stress and trauma of childbirth, more so naturally.
Hinting that I had finished showering, Rene came in to the toilet and offered to dry me with the towel.
Perhaps a residue of my shower reflections, I told him, “Tumatanda na ata ako, bii.” (I think I am getting old already, love.)
"Why do you say that, bii?" Rene asked.
“It’s because I am not as energetic as before. Remember Umi’s delivery when I mostly walked for 5 hours (from 2 to 7pm), which may have likely increased the dilation of my cervix from 1cm to 5cm? I even continued to walk during the active phase of labor until around 9pm. This time around, I get tired easily.” I explained.
Rene replied, “Kaya bii this is your, our last. Had you gotten yourself pregnant with me when you were in your 20s, then yes maybe we could have had 10 kids by now.”
I was caught off guard, then laughed at Rene's half-meant joke. Rene was poking fun at me, after I earlier said that I want to have at least three kids, which would imply that I am still hoping for more after the birth of Paco. I am just kidding though, perhaps also half-meant. But really, if money and time are not an issue, which to us are, why not have 5 kids? The more, the merrier!
9:30 - 10:30pm, 10 March (Saturday) - 7cm dilated
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| The long wait - one of those false alarms |
In my last attempt to do some physical activity to hasten my labor and save face among the staff at the delivery suite (hopefully, this is it this time around!!!), I decided to walk the 200-300 meters distance along with the nurse and Rene, instead of being transported on a wheelchair. Since Friday when I was admitted at 3cm dilated, Rene and I had been walking around the hospital, taking the stairs from the fourth to the ninth floor several times in order speed up my labor.
We reached the delivery suite and were immediately placed in the water birthing room. We were lucky that the room with the biggest tub was always available in the times that I checked in at the suite. After some minutes of waiting, the resident doctor came to do a vaginal examination (VE) on me. The VE indicated that I was 7cm dilated. He strongly advised to break my water bag. He had earlier advised to break my water bag, when I was 5cm dilated earlier in the afternoon. But I did not agree as there was no assurance that my labor would progress. I might just end up being induced, which I strongly tried to avoid after my experience with my second delivery.
Into the bath tub after water bag was burst
This time, the doctor assured me that with my body having committed to labor already, albeit progressing slowly, breaking the bag of waters would speed up my labor. I finally agreed. And the actual breaking was not painful at all, I just felt a small gush of warm water came out of me. Then by some miracle, I felt the need to groan with the next contraction, a sign that the contraction had further intensified. I heard the nurse saying that she will be preparing the tub already. Two to three more contractions and I was told to get to the tub. But that before that, I had to pee. From the bowl to the tub, I was caught in the middle of another contraction. When I finally immersed myself in the warm water, which to me felt like it was not even warm enough, the pain of the rest of that contraction somewhat subsided. The pain did not totally go away though - I still made the same noise, groaning and crying. But the warm water definitely eased the pain.
A few seconds earlier, I remember the nurse asking my husband whether he would like to join me in the tub. I sensed some hesitation in him, although he immediately decided to get into the tub as well. I tried to figure out what position would help ease the pain I was feeling, and I thought it was going to be on all fours. But the nurse advised me to lean back on my husband’s chest.
Why I had to go through this pain?
I groaned and cried with every contraction that followed. I noticed that the pain was more bearable this time than with my previous childbirths (I didn't have to pant and do ha-ha-hu's which was my experience with Umi at the most challenging transition phase of labor), but they were nonetheless very painful. I thought then that no one should go through this pain at all. Why was I here? I wanted to do natural birth; it will be good for my baby. But make it longer for me, and I was afraid that I would just snap with the pain. I thought to myself, this would be my last childbirth.
Some more contractions of the same pain intensity and I heard my OB, Dr. Vanaja, enter the bathroom. I heard her commenting to the nurse that she heard me groaning from the other room. She stayed to sit by the tub. In between contractions, I would ask the nurse to add more water to the tub - I would have wanted my shoulders to be immersed in water, too, but to no avail. So I asked my husband to pour water on to my shoulders and chest. At the same time, I found the gush of running water to be very comforting during contractions.
8cm to 9cm dilated, then push!
Perhaps three to five more contractions of the same pain intensity and I heard the nurse say that I was already 8cm and then 9cm dilated. I suddenly had the urge to push which I uttered for everyone to know. To my surprise, Dr. Vanaja, encouraged me to push (in my previous deliveries, I was only allowed to push when I reached 10cm as doing so prematurely would lead to a swelling and bad tear of the vagina).
The science of pushing
There was a science to the pushing. Proper pushing required taking a deep breath and then holding it in (and pushing it down) as you tuck your chin to your chest with mouth completely closed and as you spread out your upper thighs with your arms. I failed in the first three attempts to push, which came with every contraction. I found that every contraction would give me an opportunity to push three times, each 6 to 8 seconds long. After taking in my breath, I would also partly open my mouth to exhale as I pushed down slightly. With a forceful voice, Dr. Vanaja reminded me that I was doing it wrongly. She reminded me again, step by step, how to do it properly as I prepared for the next contraction.
Somehow, probably in the fourth and fifth attempts, the steps sank in to me. And I began to gear up for the next contraction and simultaneously, the urge to push. I remember, as I felt the earliest sign of contraction, I parted my upper thighs and felt like floating in the water, like I was swimming again. The situation, all of a sudden, became familiar to me - I was suddenly brought back to the feeling when I would swim in warm water in the months and weeks approaching this moment. This was of course not to discount the fact that the pushing stage was the most difficult part of my water birth experience. It felt like the pain was never going to end. I wondered when I would ever see Paco. I wondered if I would end up delivering Paco via c-section.
1:32am, 11 March (Sunday) - Welcome to the world, Paco!
Fortunately, I was encouraged to hear from Dr Vanaja, the nurse, and Rene that Paco was already crowning. And that I was doing it right. I think it was in the 6th contraction that Paco finally slipped through me. Just like that, I was already holding Paco in my arms. I couldn’t help but utter ‘Oh my God’ and sobbed. I couldn’t believe that it is over (according to the hospital record, Paco came out at 1:32am on 11 March so it took me about 3 hours from 7cm to delivery, although it did feel much shorter). I couldn’t be bothered posing for the camera. I just wanted to stare at my son, until Rene reminded me to smile for posterity's sake.
Rene cuts Paco's umbilical cord
Past 3 minutes and after all the posterity shots were taken in the bath tub, Rene cut Paco's umbilical cord. It would be my very first to see the umbilical cord being cut among my three children. The beauty with a water birth is that everything seemed to be close by. Had I wanted it, I would have touched and felt my baby’s head as it crowned from my opening. I would have also caught my baby as he slipped through me. And now, the umbilical cord is being cut right before my very eyes. The water birth experience was far different from when you are lying on the hospital bed and there seems to be a division between the upper and lower half of your body.
When the tub water turned red
The baby was eventually taken from me for the standard measurements and I was led to stand and walk back to my bed. The moment I stood in the tub was the moment the water, which was getting drained, turned into red. I hadn’t delivered my placenta then yet. I overheard Rene asking how he could change and take a bath. He was advised to do so in the tub. He later shared how he ended up showering with an ankle-length of blood-filled water. Sorry bii, but I admire your courage.
Third stage of labor - delivering the placenta
Back on the hospital bed, Dr Vanaja assessed that I had about 1cm of natural tear from the delivery and this would require a few stitches. There was also some discomfort and pain as the placenta was delivered. This is what I don't like about childbirth - you think everything is over with the baby's delivery, wait until your placenta has been fully delivered and you have been stitched. The latter would involve another round of pain and discomfort. But thanks to local anesthesia, things were a bit bearable.
The ordeal post delivery - uterine atony
Except that I bled profusely. The nurse had to keep on massaging my tummy to encourage the uterus to contract and ease the bleeding. Everything seemed manageable though at the delivery ward, not until I was transported to my room after Paco had latched on each of my breast for about an hour. Rene and I were initially looking forward to celebrating with a chilled Pokka carrot fruit juice and Burger King taro pie. Imagine - we made it together with this child birthing the third time around?!
4:00am, 11 March (Sunday) - Back to the ward
It was around 4am when I arrived in my room and the nurses and midwives started to congregate around my vagina, worrying why the blood flow wasn’t stopping. I heard Rene asking them whether I needed a blood transfusion. The nurse answered that I didn’t need then as my vital signs remained normal, but that the trolley has been prepared outside just in case. It felt forever being attended to by the medical team, with someone keeping on massaging my tummy as if she were stirring a bowl of sticky porridge. The blood flow didn’t seem to ease and I wondered when this will ever end, will I ever see the light of day. My children are so young.
6:00am, 11 March (Sunday) - Wrapping up
I overheard a staff say it was 6am when they wrapped up with me. They ‘overdose’ me with oxytocin (to use Rene's words) to encourage my uterus to contract and close the blood vessels and ease the bleeding. Rene was asleep, out of exhaustion. I, on the other hand, was wide awake. I couldn’t sleep. Every time I tried to sleep, I would be startled in my dream, ultimately leaving me awake. I was starting to get bothered (I thought then, 'This is the start of anxiety and depression - this cannot be!'). I called for the nurse to massage my head, recalling that I had a bottle of virgin coconut oil in my bag. That nurse turned out to be a good masseuse, lucky me! I also shared how I couldn't sleep, to relieve myself from the worries. She comforted me, explaining that maybe it is my body’s psychological reaction to the recent turn of events.
The redemption
Still I couldn't sleep after the nurse left. So I prayed the rosary. I was able to finish the whole Glorious mystery. It was quite symbolic - we arrived at the hospital on a Friday starting with the Sorrowful mystery (the agony of labor?), carried on on Saturday with Joyful (the excitement of seeing Paco?), and finally the Glorious mystery on a Sunday (with Paco finally out - he and I surviving it all). There is redemption after all.
Rene woke up past 7am and he shared to me what had transpired just hours earlier. It seemed that finally, things have come under control. We waited for the doctor’s go-signal for me to take a meal. Finally at around 10am, we were able to enjoy our much-awaited celebratory meal - the carrot juice and taro pie.
Postscript
Being inutile during those hours of severe bleeding (I lost about 800mL of blood, but still lucky me I didn't lose more!) and even when I was recovering at the hospital were totally humbling (I couldn't even pee on my own without a catheter or a staff to help me.). I look up to the medical professionals who attended to my needs with great care - from the EMMa Care staff and nurses/midwives at the Delivery Suite to the team at the Coral Suite of NUH, my utmost gratitude. Thank you as well to the team who took care of Paco at the Nursery Room while I was recovering after the delivery.
I would also like to thank Dr. Vanaja for supporting me in my desire to do water birth. She has been very objective in providing me reliable information on the pros and cons of water birthing. I also appreciated her strong voice and clear direction when I was at the pushing stage; it made things a lot more efficient. Apart from the heavy bleeding (which may have come with age?), it was really a pleasant water birth experience. Indeed, I got what I wished for - a different, albeit still pleasant (yet risky?), birthing experience the third time around.
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| The joy of holding Paco after the agony of labor |
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| Hello, baby Paco Matthias. |
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| The family is delighted to welcome baby Paco. |
