Birthing Ellis

Here's Ellie's birth story - so I didn't turn out to be a birthing machine like I had hoped, and it wasn't a particularly short labour, but I actually did it AND lived to tell the tale!

*This is a super long and graphic post - yes, I can be very lor sor when I want to, especially for something as momentous as this - so read on only if you are prepared!*

Tuesday, 13th November, 2007

6.50pm - Contractions Start

Barely 2 hours after this post, I found myself on fours, hunched up over the living room couch wracked with contractions in the midst of watching Season 3 of Desperate Housewives on DVD.

What I initally thought were mild cramps plus stomach upset (the briyani for lunch!) had turned into full blown contractions. We had been told by Dr Chua that if contractions started, to wait till they came 10 minutes apart (approximately 3 cm dilated) before heading to the hospital. So I had expected them to start at maybe 30 minutes apart and gradually build up in frequency and intensity. Kisu started timing the contractions and they were coming 90 seconds apart!

We thought we were probably timing them inaccurately, and I still found the pain to be bearable. But not being experienced and knowing that it would take some time for the anaesthetist to arrive at the hospital, I decided it was best to be kiasu and just get admitted as the pain could only get worse. At least we would have proper medical supervision, and besides I was pretty sure I was going into labour, so it was just a matter of time.

7.00pm - Leave for Hospital

I changed and we picked up the pre-packed hospital bags waiting by the door before hopping into the car. The contractions were coming too fast for me to even think about taking a shower (which I had imagined I would be able to do) before heading to the hospital.

This was 7pm on a Tuesday night with peak hour traffic. Major traffic jam - we were pretty much stuck along Paterson Road until we turned into Orchard Road, where traffic immediately eased up - I never thought I would be so grateful for ERP! Strange thing is that I actually felt better in the car - perhaps the distraction took the edge off the contractions. Kisu managed to snap this while waiting in the jam.



7.45pm - Arrive at Mount Elizabeth Hospital

Kisu dropped me off outside the A&E of the hospital, and got me a wheelchair before rushing off to park. I was embarrassed about having the wheelchair - I was actually feeling quite up to walking to the delivery suite myself, but he insisted. So I got wheeled up to the 3rd floor. I handed over my doctor's letter; the nurses already seemed to know that I was Dr Chua's patient. I had 2 nurses attending to me - Rowena and Sheila. Was brought to Delivery Suite 2, and given a hospital gown to change into (one of those that open at the back). It was a horrible puce colour; in the midst of the pain I remember thinking that Mt E should seriously reconsider their hospital gowns.

I went into the loo and was shaking all over from the contractions as I changed. My cheeks were also seriously flushed. I hobbled over to the bed and the nurse came in to administer the enema. Was told to lie on my side and that I would feel a bit of discomfort, "but less than what you're feeling from the contractions". Hah - the enema felt like nothing - the insertion wasn't even that deep and I just felt some cold liquid. I had to hold it for at least 5 minutes before I went to the loo.

Went to the loo to clear my bowels - I was wondering if everything was completely flushed out - it would be pretty gross to poo in the midst of pushing!

Nurse asked me what level of pain I was at on a scale of 1 - 10. I told her 7. She then asked me what sort of pain relief I would prefer and proceeded to explain the options of enthanox (laughing gas), penthadine (injection) and epidural. She said if I wanted an epidural it was best to take it early. I told her I wanted an epi and asked her to call Dr Yap, whom I had requested as my anesthetist. She said the hospital would contact her and see if she could come, if not I was to get another anesthetist from the panel of doctors that Dr Chua uses. Also told I couldn't eat! Which meant that I would go through labour without food in my tummy....sigh. I thought of all the snacks I had brought in my hospital bag...

Thankfully, Dr Yap, who came highly recommended by a friend, was available and arrived shortly after to administer the epi. In the meantime I was just riding out the contractions - which according to the CTG monitor, showed that I was indeed having them 60 - 90 seconds apart - we hadn't timed them wrongly after all! I suppose the pessary sped up the contraction process.

8.15pm - Internal Exam

Nurse Sheila said she was going to do a vaginal exam. I braced myself - it was the first VE that I received from anyone other than Dr Chua. I expected that she wouldn't be as expert as Dr Chua doing it but it was SO painful, and it was prolonged pain. She kept poking and pushing and prodding. I gritted my teeth and kept telling myself it would be over soon, but it seemed like forever. And she told me that my cervix was at the back (?) and therefore she had to feel around for it (?) I just thought she was doing a bad job. I was hoping for a good dilation, but she told me I was only at 1cm.

This was one of the worst parts of the labour process for me - I actually cried after she left the room. I felt absolutely miserable.

8.30pm - Epidural + Drawing of blood for Cordlife

Anesthetist Dr Yap arrived - and she changed the tone of the room completely - she came in chipper and reassuring. She started chatting to us and set me up for the epi (I couldn't see what was happening of course). I got on one side, curled up and she told me to cough as she inserted the needle to administer a local anesthetic, and made sure I lost sufficient sensation before she gave me the epi.

Happy with Epi


Epidural Machine


She also surprisingly did the drawing of maternal blood for the collection of cordblood. I somehow imagined that this would be done post delivery, at the same time as when they draw the blood from the umbilical cord, and I also thought my gynae Dr Chua would be doing it. I knew they needed to collect quite a lot of blood from me (I had seen the syringe for the maternal blood). Dr Yap again asked me to cough as she inserted the needle into my left arm - I didn't look because I was afraid I would be squeamish, but by the length of time she spent on it and the number of times she asked me to clench & unclench my fist, I knew it was ALOT! Also, it didn't help that she started telling us that Cordlife had complained that she drew too little blood from a previous patient, and therefore she was drawing more from me!

After that was done, she hooked me up to the drip which would keep me hydrated and to prevent my blood pressure from falling from the epi. All thoughout, I felt close to nothing from all the needles - so important to get an experienced doctor!

The Drip

Whoo hoo - once the epidural kicked in all the pain was gone! I was a much happier camper then. I thought I would be paralyzed from waist down, but the great thing was that I could move my legs - there was a tingly, mild pins and needles sensation - but I could feel them and lift them, but not feel the contractions. I started off at a dosage of 8ml/hour. The highest dosage is 12ml/hour - we asked Dr Yap what would happen in the event that we reached the maximum allowed dosage and I hadn't delivered yet. She basically told us that would never happen because if I hadn't yet delivered naturally, some action would definitely be taken before that.

One of the nurses came in to tell me that Dr Chua had been informed and was on her way in. Kisu hopped out to buy dinner around 9.50pm and I asked him to get me some magazines to read since I was now pain free and anticipating hours of waiting ahead.

10.20pm - Dr Chua Arrives

She walked in on me flipping through 8 Days and proclaimed "Can't be that bad! Can still read magazines in labour!"



She did a VE, which by now was very easy for her and comfortable for me because of the epi and told me that I was still 1cm dilated. Dr Chua said my contractions were still not great - not very regular and not intense enough. She told me she was going to break the waterbag, and took out this long, plasticky white thing. I couldn't see very well but I think I saw the pointed end! Shudder - but before she broke it she said that I wouldn't feel a thing. Again it was very easy cos of the epi. At this point I don't know why I had this strange thought "There's no going back now". It's very weird, but it was almost as if things weren't definite for me until the waterbag burst - baby would HAVE to come out! She also said they would keep an eye on my progress, and if need be, augment the labour by adding a drip to move the contractions along.

After she left, Kisu and I kept an eye on the CTG monitor, which shows the charts of all the patients in the various delivery suites. Compared to their nice little bell shaped curves, which indicated that they were peaking at regular intervals, mine appeared all raggedy and jagged looking.

I was feeling quite disappointed at the rate that I was dilating, and starting to get a little worried. I had expected the dilation rate to improve with the epi as I've been told that it's supposed to relax you and make it a little easier.


Wednesday, 14th November, 2007

1.00am - Internal Exam

By this time, the night shift nurses have taken over and I get a new nurse, a middle aged lady with a Chinese name - all I remember is that it has "Kuon" in it. She was very nice, experienced and constantly bustling about. She brought me a "Pain Scale" chart, which helps the nurses to identify the level of pain you're experiencing so that they can adjust the pain relief, my case, the epi accordingly. She did several epi purges for me when I told her I was feeling more pain - purging is where they pump in a short burst of epi to relieve the pain, but they do not change the dosage.

Pain-O-Meter

She did another VE on me at Dr Chua's instruction and said I was "At most 2cm" dilated. This VE was fast, I'm not sure if it was because she was more experience, or because I was just relaxed from the epi.

At this point I started feeling very distressed. The lack of progress in my dilation was making me panic . Although I always known that it was a possibilty, I kept hoping and praying for a natural birth and never quite accepted the fact that I might have to have a C-section. Knowing that it might be a reality was freaking me out - I also had no idea how long doc would let me wait before the ultimatum was delivered.

1.40am - Drip to Augment Contractions Added

Nurse Kuon came in to add the extra drip which Dr Chua ordered. Contractions started getting stronger and so I got my epi dosage boosted to 10ml/hour. She told me that she was going to insert a cathether to drain my bladder, as this was usually what Dr Chua did with her patients. Everytime I was told that I needed something else inserted, my heart would drop. It was quite a miserable feeling knowing that I needed yet another tube inserted into my body. Again, thank goodness for the epi - no pain with the insertion.

2.00am - Contraction Drip Increased

Nurse Kuon increased the dosage of the drip. All the while I kept praying that I wouldn't end up in a C-section, especially after enduring all the poking and prodding.

4.20am - Internal Exam

Dr Chua returned and did another VE. I was 4 - 5 cm dilated! Yay! By now my contractions were also coming at much more regular intervals.

But still no idea whether this was good enough or not...so I told her that I was worried that I would have a C- section. She declared that the possibility was "close to zero" Relief washed over me. Was told that I would probably be ready to push in about 3 hours time and that she'd get the nurses to monitor me and inform her when I was ready.

After that, I kept praying that my cervix would dilate to the required 10cm.

7.00am - Internal Exam

Nurse Kuon bustled in to do another VE, as instructed by Dr Chua. She stuck her finger in, I held my breath and before she got very far, exclaimed, "Aiyo! Her head is just there - your baby's head is very low!" I told her I wanted to feel some contractions when I needed to push, so she lowered my epi dosage to 6ml/hr, and went off to notify Dr Chua that I was good to go.

Wow! Not only was I 10 cm dilated, Ellie was already way down the birth canal! I just looked forward to this final bit of doing the pushing and seeing Ellie!

Nurse Kuon then left as her shift ended, and Nurse Audrey, a very nice Indian lady from the morning shift took over. I was so relieved, I finally relaxed, chatting with Kisu and waited for Dr Chua to turn up. Every once in a while Nurse Audrey would appear to tell us that Dr Chua was "on the way". She checked on the progress of the baby and told us that she could see her head! First thing I asked was "Does she have hair?" (I kept thinking that there was a high possibility that baby would be bald) and she said "Yes!" and asked Kisu to come see. He took a look and confirmed that she had hair! Yay!

As the wait grew longer, I kept worrying that my epidural would wear off - it was only later that Dr Chua explained that it takes about 3-4 hours for the effects of the epi to wear off from the time it's turned off. In addition, I was coming to the end of my dose - nurses had told me it would be sufficient to last till the end of the delivery, but with the delay I wasn't so sure.

8.20am - The Delivery

Before Dr Chua arrived, the nurses had already set up the trolley with all the surgical tools, laid out her surgical gown and even set out these Phua Chu Kang rubber boots. I was to find out later why she needed them.



At 8.20am, Dr Chua strode into the room, donned her gown and the midwives Sheila (who was back again after her night shift) and Audrey got me ready. The bed I was on miraculously transformed - the section of mattress under my legs was removed, bed was tilted, stirrups and handgrips installed, and my legs were positioned. A piece of cloth was placed across my thighs so that I could not see what happened below (thank goodness, because I had no wish to see anything except the baby coming out. According to Kisu, there was a plastic sheet under my butt, which draped into a big tub that stood in front of Dr Chua. He said everytime she pushed or pulled or whatever, blood would rush out. The blood would flow onto the sheet and into the tub. There was so much that he described it as a "waterfall of blood". That was what the boots were for)

I had been feeling a build up in the contractions due to the lowered epi dosage, and was instructed to take a deep breath, tuck my chin into my chest, hold it for 10 seconds, pull the handgrips and push like "you haven't been to the loo for 10 days and you need to do a big poo" plus stick my butt up as I pushed. I could feel the contractions coming, so I could actually push in time with each contraction.

I huffed and I puffed, but I just couldn't get the pushing right. Just couldn't figure out where and how to push. The midwives started off chanting "one....two....three....." all the way to ten very loudly each time the contractions came to help me with my breathing, but gradually their voices petered off around the count of seven. Dr Chua stuck her hands in me and pressed hard, telling me to push "Here!" I could feel lots of tugging and pressing, but no pain (although that in itself freaked me out already, squeamish as I am) They repeated their instructions about the poo and he breathing several times, but it didn't help me at all because to me it was just the same thing over and over. They also took my legs off the stirrups and had the midwives hold my legs instead.

The midwives got exasperated, Dr Chua got exasperated - I could tell and that made me feel all the worse. Finally Dr Chua said "You know, if you continue like this, you are not going to deliver for the next 3 hours!" She even told Nurse Sheila to leave and attend to the other patients (it was full in the delivery suite that day), like she had given up hope on me! Kisu had to take over and hold my leg. I felt SO awful then! It was like baby had done all she could to help me along, even come down real low along the birth canal and I was such a failure as a mommy! At this very critical moment, I couldn't do the final thing necessary to get my baby out! I just closed my eyes and tried to focus on doing the right thing but I was getting very discouraged. All throughout, Ellie was a little trouper - her heartrate didn't falter a bit, keeping at a comfortable 130+ beats/minute.

To make things worse, the cloth on my thighs kept slipping down, threatening to expose going on down there. I really didn't want to see, so I had to keep pulling it up. Dr Chua did not help by raising her gloved hands up whenever she talked to me - they were covered with blood. I tried not to look.

Then Dr Chua (who probably decided that I was a hopeless case) said, what about if she used the vacuum to help me? She showed me the cup and explained that she was not going to suck the baby out - she was just going to use the vacuum to hold the baby's head - I still had to do the pushing. I remember during antenatal classes at TMC, we were told that an episiotomy is always performed for vacuum extraction. Although I had hoped of escaping without one, I wanted the baby out even more. It took me a split second to decide and I said yes.

OK, this part is particularly gross - now, I saw the size of that rubber cup - it was big, man! I couldn't imagine how she was going to get that in, but what the heck - just wanted the baby out. I prayed I wouldn't feel her making the cut, but unfortunately I could tell when she inserted the scissors to make the snip, although I didn't feel any pain. Then I felt her inserting the cup - and there was A LOT of pulling and tugging and poking (again) down there which grossed me out but I tried not to think about it. Throughout, I could feel her hands stuck inside me....urgh. I closed my eyes - I was not feeling too hopeful of a quick delivery given the way things were going.

8.56am - Ellis Arrives!

Suddenly I heard Dr Chua say "Open your eyes!"

I did, looked down and there was Ellis halfway out! I could see her head, arms and her upper torso. In a flash, Dr Chua had pulled her out and placed her on my chest. Relief flooded over me, she was OUT! As I looked down at her blue-grey body, I wondered to myself, Who is this?

She looked so strange to me then, bloody (but no vernix, I noted - guess the coconut juice did work!) and not quite resembling Kisu or me, I thought. But I said "Hello!" to Ellis before the nurse whisked her away to clean, weigh and measure her in the corner of the Delivery Suite. Kisu by now had stopped the handcam and was snapping away with our camera. I was left with Dr Chua who took care of the afterbirth, delivering the placenta and the umbilical cord - a truly strange feeling, I could feel it being pulled out of me.

She proceeded to stitch me up - I kept thinking about the epi wearing off so I asked her for an LA. She was like "You're on epidural; still want LA?!" but I persisted so she gave in. Haha, I'm so kiasu! She took quite a long time with the stitching, and I had to watch the bloody thread go up and down in front of me - so I tried to distract myself by chatting to her.

I joked with her about eating my placenta, but after taking a look at it, I knew I wouldn't have been able to do it! She told me that she had to give me TWO episiotomies (hah, so much for trying to escape cut-free) because she saw that I was going to tear. Since she took so long, I assumed that I must have had 2 pretty big cuts. But she told me that she was stitching me up in layers - supposed to be less painful that way and it heals faster or something like that. Seemed like an eternity, but I was just so relieved that everything was over! Whoo Hoo!

After they cleaned her up, they brought her to me and I asked the nurses for help to start her on breastfeeding. Lucky thing she was very good and latched on immediately.



In the meantime, the nurses were removing all the tubes from me - the epidural dressing, the drip, etc. I still had the cathether on which I could only remove 6 hours later.

I managed to have the natural birth I wanted, and to top it off, Ellie had a headful of hair!

Dr Chua with Ellie


Spent about an hour in the delivery suite with them monitoring my blood pressure, temperature and bleeding before I was wheeled, Ellie in my arms, wide eyed and alert and staring up at me, to the Maternity Ward. What a feeling!

Yay! We made it, Baby Sung!