My birth story

18 May 2013, Saturday

1. 2:00 pm+: did exercises to try turn the baby naturally and speak to baby
2. 4:00 pm+: went to playground with hub and yx, having erratic contractions, sat on the bench while hub played with yx
3. 11:00 pm+: hungry, ate some porridge and on the way back to kitchen, I felt something watery down under and I realised I was bleeding. Mucous plug suspected to be out. 
4. 11:30 pm: went to sleep, whole night feeling slight cramps; did breathing exercises throughout the night

19 May 2013, Sunday

1. 2:00 pm: slight cramps, felt like pooing
2. 3:00 pm: hub went to playgroup with yx without me. 
3. 4:00 pm+ - 6:00 pm: felt like pooing again; pooed about 4-5 times in a day
4. 7:30 pm: Dinner - chicken rice
5. 8:20 pm: head to the hospital; mild contractions coming 8 mins apart
6. 9:00 pm: discussing with Dr Benjamin Tham, he was not too happy that I came in 1 day later after I had some bleeding but I told him that my contractions was not regular. Dr did a vaginal examination, I was told that:
• I had dilated 2.5 cm; could feel baby's toes near my cervix
• dangerous to try VBAC due to the transverse lie (see images below)
• Likelihood umbilical cord might be coming out first which is dangerous
• I shouldn't be too "foolhardy" (yes that's the word he used, but it's ok, I don't mind him being forthright) "to pursue a dream" that is beyond the circumstances. 
7. 9:30 pm:  decided to go for csect; Dr Lo Wai Kit, the anaesthetist suggested spinal block which is more straight forward than epidural
8. 9:45 pm: push to operating theatre
9. 10:05 pm: Spinal block given; shivering all over (side effects); could feel numbness slowly set in, surgery starts after confirmation from me that I couldn't feel any pain; used visualisation techniques to relax myself
10. 10:30 pm+: baby out; hub took pictures of me and baby 
11. 11:00 pm+: Surgery completed; wheeled to ward 

My baby was lying in this position (head on my left):

Taken from Google images search

but this would be a "better" transverse lie - less dangerous as the umbilical cord is not facing outwards but inwards:

Taken from Google images search

After surgery, Dr said that he had a hard time trying to get baby's head out first, thus I felt lots of tugging and pulling around my tummy. As expected, the umbilical cord was out and he has to shoved it in immediately. In the end, he tried getting baby's legs out and then quickly the head which explains baby was a little blue when he came out but regain colour gradually.

The next day, I asked Dr if ECV could have helped turned the transverse baby, and he replied "in retrospect, you have made a timely decision to go for csection. I wouldn't advise you otherwise given the circumstances. I can't forecast accurately but given the position and your dilation, it is fortunate that your waterbag did not break, else it could really have been a mad rush." 

After thoughts

I am really glad that both baby and myself are safe and healthy.

If only:

• I have done more exercises to try turn the baby naturally (but then again, I knew on Friday after seeing Dr Paul Tseng that the baby turn again from head down to transverse; and even if I have known earlier, it is also unknown that if the exercises would successfully turn the baby - but the thought of - at least "I did ALL I can" would reduce my guilt.)
• I see Dr Paul maybe 2 days earlier, actions would have been taken earlier - more exercises and make appointment with Dr FM Lai for 2nd opinion. (I am supposed to go see Dr Lai on Monday but just too bad....)
• I go for chiropractic therapy as advised by Eunice - another vbac mummy few months ago. (not 100% guaranteed but at least just try.)

Fortunately, I was mentally prepared for csect and also given the types of anaesthetic a thought so the experience was not as bad as before. Am I going for number 3? haha, it's almost definite that the answer is negative. I can't imagine having an unsuccessful vbac2. It's gonna be quite a toll on me I guess.

Well, if only, if only. Life's like that. There is nothing I can do now but just give my best to baby and my family. We love you yr. 

Birth plan

I have submitted my birth plan last month to Dr Paul Tseng for his review and I am surprised that he actually endorsed it immediately after reading it although he expressed concerns on sweeping membranes as that may cause waterbag to break. I intended to reword it and bring next session after the discussion but I think it doesn't matter since he mentioned that he will still seek my opinion even if I have a birth plan in place. Well, at least he understands my preferences and concerns. I trust his judgement and appreciate that he respects his patients.

Why I do not want a C-sect again

As the saying goes, "once a c-sect, always a c-sect". I don't think I want to subscribe to this. Then again, I am also weighing the other risk factors.

1. Recovery period is longer as compared to natural delivery
2. Bad experience with c-sect and I didn't want to get cut up again
3. 3rd Child? (ok, this is just in case. I know I wanna "close factory" after my 2nd cos er, I don't wanna give birth after 35 ;(  But, who knows for sure until later? Urgh. Maybe I am just giving myself a third reason to justify a VBAC. Anyhow, it is also a legitimate reason. If I can do a VBAC for number 2, why wait till number 3 due to even higher risks?)

Factors against me having a VBAC:

1. Previous history of infection
2. Duration of only 1.5 years between the first and second child
3. Condition of CPD unknown*
4. Risk of Uterus Rupture (so induction is definitely a no-no for VBAC, contractions has to come naturally)
5. Baby's health is at stake

* Whether my pelvis is too narrow as mentioned by my previous gynae is questionable:

• It is also likely that the baby is in a Occiput Posterior - or also known commonly as OP position, given that the baby's head is said to be at pelvic station approx -2, ie not fully engaged few days before induction and delivery at the estimated due date (week 40). 
• Baby is at 2.75 kg at birth, so the size is not huge.

Thus, after a thorough discussion with Dr Paul Tseng, I have decided to confirm him as my gynae for my number 2.

Decision to be made later after the following is confirmed around week 36-37:

1. Position of the baby 
2. Size/Weight of baby
3. Width of Uterine Scar Tissue 
4. Position of Placenta

Damn, I feel as if I can be a gynae cos I know all of the above facts (haha, but too bad, I am just not cut out to be a doc given my mediocre grades) except that I need his professional advice, judgement and experience to figure out whether I am good candidate for VBAC. The most important thing is his willingness to support, and his experience in VBAC. He is also very frank by saying that he has seen "successful cases but also casualties too." 

I know one might ask,"why don't just go elective c-sect? Why take all these trouble?" since you: 

1. can choose the date (whatever auspicious date/time you want, but of course subject to availability of your gynae) 
2. can also have your third child (if you still want) by c-sect too
3. don't have to go through labour pain, just cut, take baby out. Very fast, no sweat!
4. don't have to suffer another round of infection (choy!) by going for emergency c-sect if after TOL (Trial of Labour) and you still can't make it.
5. already gone through c-sect before, why have another "hole" down under (since there is a risk for urinary incontinence via natural delivery)? might as well continue with c-sect.

So, let's wait till week 36/37.

Gynae Comparison

My experience with the following doctors:

Gynae	Dr Michele Lee Sook Ling	Dr Kenneth Edward Lee	Dr Fong Yang
1 - Personality	Reserved, gentle, assuring	Jovial, outgoing, chatty, down to earth	Steady,meticulous, patient, unassuming,
2 - Waiting time	half to 45 minutes	15 mins (- if you have appointment and you are on time) to half hour	one hour
3 - Speciality Inclination	Unknown Pro natural	Caesarean Caesarean	IVF Programmes Pro natural
4 - Consultation charges^	$80 per visit	$80 per visit	$100 per visit

Just my opinion. -__-

Note: 
- I see Dr Fong Yang only once to date as Dr K.E. Lee is on vacation after my delivery and Dr Fong is his "back-up".
^ May be subjected to changes, packages to check with clinic

I wonder why most gynaes doesn't really tell you much - unless you ask. Are they afraid that we have information overload and worry too much if they tell us more?
Conclude: We just gotta read and find out more ourselves too. Think I read, but still insufficient. 


What I can say now is feeling comfortable with your gynae is important, but it is also equally important that one gets a gynae who has similar birth values as you. 

Pre-natal Massage

I went for a  recommended by my gynae to go for a back massage at Novena and the masseur is really good. My muscles were loosen and not so achy after that. If not for my gynae's recommendation, I don't think I would go for a massage as I am afraid the it might affect the baby. The only slight discomfort is the tilting position cos I have to tilt one side for the masseur to massage my back, but after a while, you get the hang of the position.

After the massage, you will also feel:

• hot due to blood circulation
• super hungry and thirsty

Dinner was Cedele's rosemary chicken wrap. Yum!

Choosing Gynae II

I have just changed my gynae to Dr Kenneth Edward Lee instead of Dr Michele Lee after much deliberation:

1. Dr Michele Lee charges additional $200 for delivering at Mt.Alvernia since her clinic is affiliated to Thomson Medical Centre.
2. I would like to get myself familiarised with Mt. A. since I am delivering there and Dr Kenneth Edward Lee's clinic is there.
3. Dr K. E Lee's delivery fees are slightly more expensive than Dr M. Lee but not to the extent of being exorbitant.
4. I feel more at ease since he is more experienced. (although initially I mentioned that my gynae must be a female. seems like a male gynae is also not too bad afterall.)

On a side note, he is a very jovial and down to earth person, (but my hub's impression of him is "lao-beng"- haha.) Anyway, I believe I am in good hands. : )

Choosing Gynae

My criteria:

1. Must be female
2. Patient and experienced
3. Can deliver at Thomson Medical or Mount Alvernia 
4. Able to understand 1st time mother worries
5. Reasonable fees 

Currently, I am seeing a female gynae at AMK Hub. 

So far so good, let's see how it goes.