Despite the common knowledge that each case is unique, I was nonetheless lured into the innocent contemplation of something quick and similar to what
occurred during Aaron’s delivery, just because the trend appeared similar. However, things turned out
differently this time. Here’s sharing on
the arrival of the youngest brother of Alvin and Aaron.
Just like the rainbow cake. Each layer has a different colour. Likewise the uniqueness in each case when it comes to the reality...
Removal of Cerclage
at 36 Weeks and Discharged
My cerclage removal back in 2014 was painless and took only
minutes. However, the process this time
was long and unexpectedly painful. The
removal was done at 36 weeks at the ward itself, not the labour room. But looking back, the discomfort experienced
this time shouldn’t be a surprise because the cerclage had been inside for quite
long, around 5 months, and as a result there was swelling
on the cervix.
Post-cerclage removal, other than spotting and despite a 3
cm os, I did not have any sign and symptom of labour. CTG showed the presence of irregular and very
mild contractions, and I did not feel any pain.
Still no progress for another 3 days down the line, I was thus allowed to discharge. Which meant going home and waiting for “the sign”.
Still no progress for another 3 days down the line, I was thus allowed to discharge. Which meant going home and waiting for “the sign”.
I wanna go home... time to clear up my mini pantry-cum-library
When, Where and How?
What are the signs that indicate it’s time to go to the
hospital? As I’ve never truly experienced
the
moment before, I was paranoid each time I went to the washroom. Or whenever I felt a mild contraction indicated
by tightening of the abdomen.
During daytime, my husband works in Pandan Indah while I’m in
Seri Kembangan. What if the need to go to hospital occurred at the most inconvenient time - Serdang, Columbia, HUKM?
25 October: Admission
Day
A little short of the 38th week, on Wednesday 25
October 2017, I had my check-up appointment at the antenatal clinic of
PPUKM. I did not expect admission into
the ward on that day but already kept the necessary bags in the car earlier.
Waiting area at the O&G clinic
While a young doctor was palpating my abdomen, a few surges
of contraction suddenly occurred. The
doctor then performed a VE, and I was told that the os was “a good 4 cm”. Upon consultation with Prof Azurah, I was admitted
into home-sweet-home Ward 2B that afternoon.
In the ward, I had a 20-minute CTG for fetal heart rate and
contraction monitoring. There were
contractions, but very mild and asymptomatic. Due to a GBS positive diagnosis at 35 weeks (never detected with one before this), I was started with a 4-hourly IV ampicillin on the same day, i.e. administered once in every 4 hours via injection through the IV line.
26 October: A Pain Like No Other
Things remained pretty much the same on the next
morning. Contraction was more regular but very mild. There wasn’t any pain too. After CTG and VE before dawn, at about 8 am, the
doctor performed an artificial rupture of membrane before I was brought
to Labour Room 5 on the 1st
floor.
At the labour room, a nurse took my temperature and administered
enema. After a few minutes, I was
directed to the toilet. The toilet at
the labour room was clean, dry and spacious.
This was the first time I received an enema before delivery although
it’s a routine for most other moms.
Back to my bed at the labour room, a doctor asked me if I
wanted epidural. Between not knowing how
painful a real contraction is and also not wanting to risk regretting a “no”
later on, I said yes. There’s no right
or wrong as this is purely a personal choice of each individual… there’s always
risk vs benefit in any procedure.
Before the doctor from Anaethesia department arrived, I had
my first taste of contraction pain in my whole life. It came once in 10 minutes. “So this
is what contraction during labour feels like… it was indeed very painful!”
The Delivery Story
I was relieved when epidural was finally on. At least I could lie down in comfort for
about an hour. Had labour augmentation –
not my decision, but the doctors’. Two
hours later, but at only 8 cm, I felt a very strong pushing urge and great
pain. The magnitude of pain this time seemed 10 times greater than what I'd experienced before.
In the past, it took me seconds and minutes to deliver,
because my elder babies had been small. Alvin
was born very premature at 29 weeks weighing only 1.16 kg, while Aaron was 36
weeks plus at 2.5 kg.
It took about 30 minutes of breathing-in, pushing and
breathing out before Baby No. 3 finally came out. He is more than 3 times Alvin’s birth weight.
The delivery of Baby No. 3 had many people in
attendance – doctors, nurses and medical students. Initially, I wished my husband was there to
witness, but his absence due to work was perhaps a blessing in disguise as I had a bit of
complication in the labour room after that - it's not something that I want any family member to see because it might create
unnecessary worry and fear.
The joy of skin-on-skin with the baby wasn’t for long before
I suddenly felt a fainting spell. I felt
extremely dizzy, drowsy, and nauseous. As
much as I feared vomiting, I couldn’t resist it and ended up soiling the pillow
and my hair on one side.
Fortunately I did not eat much in the morning or else it would have been
more.
Fainting Spell and
Deep Sleep
It turned out that I had post-partum haemorrhage (PPH), or tumpah darah in Malay. The placenta was alright as it was delivered
intact. But for reasons unknown to me, my
uterus did not contract after delivery (uterine
atony). I was given a few injections
of hemabate, a second branula was inserted onto my other hand for the Hartmann’s solution. A few
other procedures took place but I was too exhausted to
remember them.
The last thing I recalled was that a nurse told me that
they’re taking the baby to the nursery of the ward. Baby, breastfeeding, child care,
etc. subsequently disappeared from my mind.
I felt uncomfortable in a way that I don't know how to describe, followed by as though going into a deep
sleep, away and far from the reality (hypovolemia?).
I wonder now if that’s also what death feels like.
I spent the next 2 hours asleep in the labour room with my heart
rate and BP monitored by the nurses until I completed my Hartmann’s
drip, finished a cup of drink and half a cracker. I had no appetite for food until the night.
Conclusion
Back in the ward when I finally met my baby again, my breastfeeding challenge came
back to me just like three years ago. Colostrum
only began to kick in on Day 2, on the day baby and I were discharged. Prior to that, the nurses had given baby formula
top-ups (note: breast milk is first choice, but I am alright with and agreeable to mixed feeding if necessary).
On a quiet and sunny day...
I am relieved and grateful that the whole ordeal went
generally smoothly, thanks to excellent care from the dedicated doctors and
nurses, as well as the kind wishes and prayers from dear friends and family. I am thankful to Prof Azurah for promptly getting
me into early treatment and close monitoring.
I used to wonder and in awe of how it feels to be complete
the third trimester and deliver a normal-sized baby at term. But then I am not that strong after
all. A 3.49 kg baby almost made me pass out. I wonder too if that’s why a
full-term pregnancy is not something that would occur naturally for me, if not with
interventions in the form of cerclage, weekly proluton shots and bed rest.
