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. 

Weight and baby position as at 6 May 2013

I am 65.5 kg today ! I have gained another 3 kg.
Prior to second pregnancy = 52 kg
Weight gained: 13.50 kg ={

Baby weighs approximately 3.30 kg !

Dr Paul shows us our baby's face and hub commented that he is a chubby baby. hmm.

Guess what?! Baby has turned his head down..but head not engaged yet. I was quite surprised when Dr Paul kindda knew it when he touched my tummy and then confirmed with a scan. Prior to that I was still asking him about ECV so now the 1st factor (1 position of the baby) is cleared.

2) Size/Weight of baby = est 3.30 kg (which is heavier than what i expected) Although I am happy that baby is growing well, I am worried about the size being too big to try for VBAC but Dr didn't mention that this is a cause of concern.

3) Width of Uterine Scar Tissue = scan today and it was found ok. The uterine walls must be at least 2 mm thick, and mine is 4.37 mm.

4) Position of Placenta = not low so ok.

When I asked him towards the end what he thinks of my case - if I am a good candidate for VBAC, he commented "Except for the previous csect, there is no other reason why you can't go for a natural this time". I am really glad so now what I really need is to stay positive and focus on my breathing.

Then again, he will be away for holiday from 18-24 May so baby please say hello to daddy and mummy when Dr is back...preferably on the EDD 28 May or few days after!

I wonder .....

....... if giving birth is like the feeling of going to poo poo, then why can't the process be quickened when you are nervous? cos when we are feeling nervous, we tend to have "butterfiles in the stomach" and the next thing you know is you get the feeling to go to the toilet. So why can't giving birth be the same - the more you feel nervous, the easier it is for the contraction to come naturally and easily and thus you "poop" faster instead of the opposite? I guess I am going on the slippery slope ......

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.

VBAC - email from another mummy

Email received on 9/3

Thanks Sasha for sharing your experience with me.  -__-

My C-Section

Although my gynae mentioned that my c-sect wound is healing after the post-partum check up last week, I am still having a tugging feeling about my wound. It supposed to become a light brown line but it is still looking quite raw-a blackish line across. I think I have exerted too much initially due to breastfeeding thus the delayed healing.

Totally no mood for Chinese New Year...just exchanges the usual CNY greetings sms, going with the flow...

I am applying 2 creams now alternately:

• Centella asiatica phytosome Lanakeloid E-cream (to prevent keloid)
• Forsuderm ointment (antibiotic)

好好的身体 then now become like that...really hope it will heal completely soon.

VBAC

I really want a natural delivery for my second kid but I am afraid there might be some complications. In order to find out if it is really true that "once a c-sect, always a c-sect", I did some research:

1. Natural birth after C-section: Is it really safe ?

10-Feb-2011 (Thu) Mind Your Body, The Straits Times

By Lea Wee Doctors here may advise women against it, but recent findings suggest uterine rupture risk is small. Madam Joanne Koh had a caesarean section eight years ago. When she found she was pregnant again last year, she wanted to try a vaginal delivery, but her doctor advised her not to. The 32-year-old office manager said: 'He said the old scar may tear.' So she had another caesarean section. Last week, Mind Your Body reported how caesarean birth rates are rising because of women who, like Madam Koh, find themselves having such births for a second or third time, whether or not they intended to in the first place. A third of all women giving birth at the KK Women's and Children's Hospital do it through caesarean sections. Doctors estimate as many as six to eight out of every 10 women who have had one caesarean section in Singapore will end up with another. In the United States, the figure is as high as nine in 10. But the conventional wisdom of 'once caesarean, always caesarean' is now being challenged by both the American and British colleges of obstetrics and gynaecology. They think women who have had one prior low transverse incision, the most common type of incision used in caesarean sections nowadays, are suitable for Vaginal Birth After Caesarean (Vbac). Last July, the Americans further relaxed their guidelines to say that most women with two such caesarean incisions as well as those pregnant with twins are also suitable for vaginal deliveries. Doctors here are cautious There are no corresponding guidelines in Singapore but three out of five doctors MYB spoke to say they would discourage women who have had two caesarean sections or those pregnant with twins to try for a vaginal birth unless they fulfil certain conditions, such as they have had a vaginal delivery. But all agreed that women with one former caesarean birth could indeed try a vaginal delivery. This is especially so if the first caesarean section was done for a condition that is unlikely to recur - such as a breech baby - and the baby was not larger than normal, said obstetrician gynaecologist Chong Yap Seng from the National University Hospital. Doctors here are cautious about Vbac because of the risk of the old scar rupturing during labour. If that happened, the woman would need an emergency caesarean section and the baby may die from the lack of oxygen or have brain damage. The mother may also die from massive bleeding. The chances of massive bleeding and death in the woman during an elective caesarean section is much lower, said obstetrician gynaecologist Benjamin Tham from the Thomson Medical Centre. Lukewarm attitude Doctors say many women do not want to take the risk, once they are told there could be a chance of a rupture and harm to the baby. But even those who are willing to take the admittedly-low risk may be faced with a reluctant doctor. Housewife Tham Yin May said she had to search online for a doctor willing to let her go for a Vbac after her own doctor discouraged her from doing so (see story below). One reason for the lukewarm attitude of doctors here towards Vbac could be the fear of legal repercussions if something goes wrong. Dr Benjamin Tham said some women may accept the risk of uterine rupture when it is first explained to them, but when something happens to the baby, they will blame the doctor for allowing them to go ahead with the Vbac. Some doctors may also prefer elective caesarean sections because they are convenient and predictable. In contrast, a vaginal delivery after the woman had a caesarean section is unpredictable and the patient needs to be monitored continuously throughout labour, said Dr Paul Tseng of TLC Gynaecology Practice. He has come across two cases of uterine rupture in his 15 years in private practice. The United States guidelines say the risk of uterine rupture is less than 1 per cent in women who have had one caesarean section and that 60 to 80per cent of vaginal deliveries in this group are successfully completed. The risk of rupture is twice as high in those who have had two caesarean sections and for this group, only half the vaginal deliveries are successful. But these figures are not from controlled studies so it is hard to conclude how reliable they are, said Dr Benjamin Tham. No reliable data yet Doctors say up till now, there has been no reliable data to show that a vaginal delivery after a caesarean section is safer than another caesarean section. However, a recent study in the medical journal Lancet may provide some answers. It found that women who undergo caesarean sections for non-medical reasons are three times more likely to have problems like bleeding compared to those who give birth unaided. The US guidelines also said that compared to those who had a successful Vbac, mothers who underwent elective caesarean sections appear to have a higher risk of infection and the potentially fatal condition of pulmonary thromboembolism, a condition where a blood clot gets lodged in the lungs. But this also has to be balanced against women who begin labour and then need an emergency caesarean section. They have the highest risk of all. In conclusion, there is no easy answer as to whether a woman should have a vaginal delivery after one or two caesarean births. Said Dr Chong: 'The doctors' duty is to help the patient find out what is best for her.' And what many women want is a vaginal birth, regardless of its risk. Said Dr Tseng: 'It could be a psychological need which should not be ignored.' Businesswoman Thasneem Begum, 30, wants a vaginal birth for her twins in March. 'Having experienced a vaginal birth for my first child and an emergency caesarean section for my second one, I must say a vaginal delivery makes me feel more complete as a woman.' This is the second in a series on women and childbirth Up to 8 in every 10 women here who have had one caesarean section will end up with another

2. KKH Article

What Is VBAC?

VBAC is the acronym for "Vaginal Birth After Caesarean section".

If I Had One Pervious Caesarean Section Birth, Can I Go Through A Subsequent Vaginal Birth?

Women who have had one previous uncomplicated lower segment caesarean section (LSCS) and no other adverse obstetric feature in the current pregnancy are suitable candidates for VBAC. Generally, the relevant factors to determine suitability for VBAC are as follows :

    The previous caesarean section

        Type of incision: This refers to the manner in which the uterus was incised during the delivery in the last pregnancy.

        "Classical section" refers to a vertical incision on the upper part of the uterus. Women who a previous classical caesarean section should not opt for VBAC as there is a higher risk of uterine rupture or tear.

        "Lower segment caesarean section" refers to a horizontal incision on the lower part of the uterus. This method is associated with a lower risk of uterine rupture and women with this type of incision may opt for VBAC.

        Reason for previous caesarean section: If the reason for the previous caesarean section is a recurring one such as contracted pelvis (i.e. where the pelvis is too small to allow the passage of baby due to some form of obstruction), then VBAC is unsuitable.

        Complications during the previous caesarean section: If the previous caesarean section was complicated by unexpected tears in the uterus, the obstetrician may advise the need for repeat caesarean section in the subsequent pregnancy. VBAC should not be considered in such a case.

    Current pregnancy: Certain conditions such as low-lying placenta or abnormal presentation of the baby in the present pregnancy may prevent a safe vaginal delivery.

    Other medical / surgical problems: Certain medical conditions such as certain heart diseases or severe hypertension would prevent a woman from enduring the physical stress of a vaginal delivery. Previous operation on the uterus to remove fibroids may result in weakening of the muscle wall of the uterus and increase the likelihood of uterus rupture during labour. In such cases, VBAC may not be suitable.

What Is The Chance Of A Successful VBAC?

The chance of a successful VBAC is between 60% and 70%. It is generally higher for women who have had previous successful vaginal deliveries. The chance of success may be lower if the reason for the previous caesarean section was due to cephalopelvic disproportion (i.e. where the baby is relatively too big to pass through the maternal pelvis).

What Are The Advantages Of VBAC As Compared With Elective Caesarean Section Delivery?

A successful vaginal birth is beneficial to the mother as it is generally associated with less bleeding, less blood transfusion, less infection, faster recovery with shorter hospital stay and less post-delivery pain and complications.

Successful VBAC has also no proven adverse effect on the baby. In terms of cost, a successful VBAC is cheaper than caeserean section birth.

What Are The Complications Associated With VBAC?

The primary concern associated with VBAC is the risk of uterine rupture or tear. The incidence of uterine rupture is quoted as:

    Less than 1% after one previous lower segment caesarean section

    1 - 5 % after two previous lower segment caesarean sections

    4 - 9% after a classical uterine scar

The risk of rupture is also increased in induction. Uterine rupture can be life-threatening for both the mother and child. It may also result in the need for surgical removal of the womb (hysterectomy) for the mother as well as neurological impairment of the child (cerebral palsy).

In addition, if the trial of labor fails and the mother needs an emergency caesarean section, there will be higher risk of complications for the mother as compared to an elective caesarean section or a successful VBAC. The costs of a failed VBAC would also be higher.

What Are The Precautions My Obstetrician Will Exercise To Minimise Complication Associated With VBAC?

Before the decision for VBAC can be made, the obstetrician would:

    Review the medical records for the previous pregnancy to assess the reason for the last caesarean section and the operation procedure to determine if there were any complications during the operation and the possible need for repeat caesarean section.

    Assess the current pregnancy to see if the patient is suitable for vaginal delivery. Relevant factors include the location of placenta, baby's presentation and the adequacy of the maternal pelvis relative to the baby's size.

    Discuss with you the suitability for VBAC and the associated risks and benefits.

    If desired and found to be suitable for VBAC, you will be allowed a short trial of labor. During labour, your baby will be continuously monitored to ensure his well-being. The need for induction or augmentation of labour is left to the obstetrician's discretion based on his assessment of the situation. An emergency caesarean section would be performed if there are signs of fetal distress or if the labour is not progressing as well as expected.

Can I Opt For Epidural Relief If I Have Decided To Go Through VBAC?

Epidural is commonly used in labour to provide effective pain relief. It is safe and not associated with late detection of uterine rupture.

In addition, if trial of labour fails, epidural can be continued as a form of anaesthesia for emergency caesarean section to be carried out. Therefore, epidural can be chosen as a good form of pain relief while undergoing VBAC.

Apart from epidural, there are other options for pain relief such as breathing exercises, back massage, entonox gas, pethidine injection etc.

Can I Make My Own Decision For Or Against VBAC?

A decision for or against VBAC should be a joint decision between you and your obstetrician after having taken into consideration the pros and cons of VBAC in your situation.

I also managed to contact Eunice via Singapore Motherhood forum and she shared her experience and I must say it has been very encouraging. However, I still have to bear in mind that I need to discuss with my gynae (whoever it is then) and make a decision based on my situation at that point in time.

Base on my findings and my conversation with her, it seems that there are very few doctors in Singapore who are supportive and confident of VBAC. So far, there are only two: Dr Paul Tseng and Dr Lai Fon-Min.

Let's see how it goes.

Major Event Log II

4 Dec, Sunday

1. 6:00 am: Slight cramp, went to poo, then shortly after - "show".
2. 6:15 am: can't sleep, ate light breakfast, bathe, to prepare to go hospital any time. 
3. 7:40 am: 1st contraction. poo again. (seems like the contractions is good for pooing!)
4. 8:40 am: 2nd contraction, another "show". decided to wait for more contractions.
5. 8:45 am: on PC, started blogging to relieve some tension. Read to distract myself.
6. 9:00 am: Mucous Plug is out. To continue monitor for more contractions. On music.
7. 9.15 am: Hubby back from supermarket. Ate carrot cake.
8. 10:00 am: 2-3 contractions- irregular. each lasted around for 1 min. Felt butterflies in my stomach (like the nervous feeling you had when you for your 1st school exams or whatever test you might be going...) Completed blogging. 
9. Stayed at home the whole day ....

5 Dec, Monday

1. 12:00 am+: to hospital
2. 1:00 am+: Nurse started monitoring, CTG on.
3. 3:00 am+: CTG off around, advise to sleep till 5 am+
4. 5:00 am+: CTG on again
5. 7:00 am+: Doc came and check, options given. Thinking of going back home and come back on 7 Dec or when contractions become stronger but not allowed to go back home. Regretted coming earlier. (cos doc advised me to come for induction on 6 Dec 12 am)
6. 8:00 am+: Move to room to check to rest and ponder on options.
7. Options: 1. C-Section immediately, 2. Put on Prostaglandin pills for dilation of cervix (max up to 4 pills) - if all pills fail, then C-section.
8. After Lunch: Put on 1st pill. Contractions getting more gradually but still irregular.
9. After Dinner: Put on 2nd pill. Contractions getting more intense after midnight.

6 Dec, Tuesday

1. 1:00 - 5:00 am: Quite bearable until 3:00 am when the contractions every 10 mins and then every 5 mins. hub suggested a hot shower to lessen the pain, and apparently it worked. I went on my knees on all fours with some pillows supporting my arms on the floor. Hub reminded me again on my breathing techniques and visualisation. I kept visualising I am floating in the air tied up to a huge balloon and it is carrying me high up and away from the pain ...... as the contractions intensify at my 8th count, I raised up my hands like a conductor in front of an orchestra which helped to alleviate the pain and breathe in deeply. Hub kept stroking my hands to soothe me while I concentrate on the breathing techniques. At one point, I felt like I am getting used to the pain, hub kept repeating "yes, you love contractions as they are helping you to birth the baby...yes you are loving it..." I just repeat whatever my hub said like a mantra and this continue...
2. Contractions intensify....coming in waves (or think Tsunami?) where there is a peak- where the pain is the greatest and as each wave travel, you can feel the pressure pressing against your lower back, squeezing both your tummy and lower back, as if your tummy is like a packet of chilli sauce, and someone is trying to squeeze through last bits of the chilli sauce. Through the CTG machine, hub is predict the next peak, and alerted me while I make my own breathing preparations and this went on ....
3. Cervix dilated to 5cm. (yes, I am half way there!) Pethidine was injected at my thigh to lessen the pain  and I continue with my 'contractions journey'.......
4. 8:00 am+:  doc broke my waterbag to induce labour; put on the drip to intensify the contractions further. ( Just another 4-5 hours more, it would be 10 cm, hang in there!) 
5. 11:00 am+ (the nurse increase the level of drip gradually throughout): Nurse checked and I have only dilated by 1 more cm. There is not much progress. Then suddenly, baby's heart beat went down to 90 - Fetal distress. Doc immediately asked for a C-section. I looked at hub with the 'laughing gas' mask on my face, nodded my head and that was it. I signed the papers that I agreed with the operation and I was whisked off to the operating theatre. I remembered that I was tearing heavily, overwhelmed with frustration and self-reproach that why can't I just have a natural delivery.
6. Before I know, I woke up in a dreamy state. I heard voices telling me that the operation was over. My eyes were heavy, but I could tell what was going on...transferred from operating theatre's bed to another bed...went into a lift...voices...hustle and bustle around me...i was moving fast...transferred onto the room's bed....and then my hubby's voice telling me that the baby is fine and doing well. Drank 100ml of milk when they feed her. Must be really hungry after whole night of contractions.

After thoughts

I had no regrets as I know I have tried my best. Baby has also tried her best to pass through the pelvic cos apparently her head was elongated and reddish with a circular mark on her forehead. The head went back to normal and mark subsided after a while. 

It was an emotional ordeal for me cos I didn't expect a C-section (even though Doc did mention to me of the possibility.) I was totally distraught - never did I realise that I did not think of the worst-case scenario (from the very beginning) when I should have done in normal circumstances.

I know I should not take it to heart, it's not a big deal. The only thing I have to deal with is my expectations.

Popped!

Finally I have delivered today.

Method: caesarean
Why caesarean: cervix dilated to 5-6cm. Can't continue further as baby is in distressed. So after 1.5 days of induction, I gotta go through caesarean.

Overwhelemed with all sorts of emotions. Gotta sort out all negativity and get over it soon. I know I am getting really emotional - my pragmatism is fighting against this emotional turmoil. My frustration is beyond what I can imagine buy I know I gotta look forward.

Hopefully it will be over soon.

Will definitely do a proper update once my condition and situation has stabilised.

P/s: after all said and done, I am glad that I did my breathing and visualisation exercises which has tide me over 1.5 days of intense contractions without epidural (which I have been working on- natural without epidural).of course, I gotta thank my hubby for being super supportive throughout the whole process.

Lost

Checked in hospital after 1 day of monitoring after show. Reality bites. Going for induction after whole night of irregular contractions.either baby's head will engage and contractions follow or c-section. Pray that everything goes well. 😔

Eliminate Fear (of child birth)

I refuse to believe that I can't go through natural delivery without epidural (although there is nothing wrong with medical interventions but it's just me. I do not want any) given that my mum can do it (cos at that time, everything was simple- and that's the key - Simple - know nothing, bring in No fear. and just do it!), so can everyone else. I mean, ok, I am stubborn but I just know I gotta do it, else I would regret. Reading hannabi's and verieying's comments are comforting and inspirational to me. 

I have been reading the following books and I highly recommend HypnoBirthing: The Mongan Method - if one doesn't have time or doesn't want to read too much, this one book is something you could count on. (Yes, it 's kindda "intensive" reading for me but I know I need to do it. I wish I could discover much earlier then again, but NOW than never.)

KEY POINTS:

Eliminate fear cos Fear > Tension > Pain (theory pioneered by Dr Grantly Dick-Read)- and the cycle goes on.

We have natural endorphins and they are 200 times (!) better than morphins as painkillers. 

"To those who say it is just not possible to birth naturally and without pain, I say, "But what if we're right? Wouldn't it be wonderful?" Lorne R.Campbell, M.D.

The power of mind: "The mind is capable of anything - because everything is in it. All the past, as well as all the future." - Joseph Conrad.

Conditioning of your body and mind = stress-free



Powerful Laws of the mind- The Laws of: --
1. Pyscho-physical : Mind > Body >Action (think:Pavolv's experiment with dogs)
2. Harmonious Attraction: Words > Feelings > Beliefs > Behaviour > Success/Failure
3. Repetition: Repeat positive thinking (see2)
4. Motivation: Focus ! (think: sportsmanship) Mind Focus on winning> No pain stimuli > No pain !

4 Techniques:

1. Breathing - 1. Sleep Breathing, 2. Slow Breathing 3. Birth Breathing
2. Relaxation - facial, body, "limp", Light Touch Massage
3. Visualisation - floating in the mist on the 7 colours of rainbow, visualise the lower circular muscles as soft, satin ribbons, flexible and totally non resistant to the draw of the upper muscles.
4. Deepening - Glove techniques, Depthometer, Time Distortion

Meditation:
1. Practice of Opening: to relax and open your body
2. Womb Breathing: energy breathing for childbirth
3. Giving and Receiving: brings healing to childbirth

......."Feel your womb and cervix holding your child. At the right time , your womb will start to felx and your cervix will begin to respond, slowly opening, progressively releasing new life. 
The baby's head will then move down through the birth canal. The pelvis will work with the womb, yielding to growth and change. 
These are the strongest muscles in your body, fully capable of birthing your baby. Relax any abdominal tension caused by anxiety. Practice relaxing the outer and inner muscles that cradle your child. Surrender into the full support of life. Trust your ability to change. Prepare to give birth to your child............"

True Stories:
1. Birthing naturally with a midwife
2. Birthing naturally with a physician
3. Birthing naturally with a doula
4. Birthing naturally unassisted
5. Birthing naturally the first time or the next time

For me, I jump into reading some stories in 2. and 5. just to give me some insight.

- Be calm and relaxed
- Do not rush immediately to hospital, check for signs.
- Birth plan (I think for me I told gynae I want natural but still "play by ear")
- Supportive husband
- Focus on your mind, instead of the pain
- Is birth like sex? (haha, it can be!)

For now, what I have to do is to believe and count on my inner strength to go through this journey smoothly.


Update - 9.15am: 
And hanaabi's comments on visualisation reassured me and of course, and as I was typing, I experienced another "show" and mucous plug (sticky red lump) is out. And this confirms that my belief in speaking to the baby and constant visualisation works in communicating with the baby. So labour is on the way-no induction *fingers-crossed*; I gotta monitor for more contractions before heading to the hospital. Yes, I will Jia You (加油) !!

Weight and baby position as at 1 December 2011

I am 61.7 kg today !

Baby = 3.3 kg (base on my own est. this time -given the last few figures, cos gynae didn't mention her weight this time and I didn't bother to probe further cos I will get worried with the size for delivery.)

Position: Her head is now facing downwards (yeay!) but her head is not fully engaged. It is at station -2 so she has 2 more steps to go to station 0. :(

Pelvic Station

Dilemma:
EDD date is 5 Dec (previously was 7 Dec but gynae checked and it should be 2 days earlier) but the amniotic fluid is considerably lesser than last week. Then again, if I were to go under induction now, it is not too good as the head is not fully engaged - thus having a 50%-50% of a successful natural delivery and might need a c-section. Gynae also mentioned my pelvis might be too small for baby to come out after gynae did a vaginal examination. :( :(

I was feeling terribly frustrated and upset so I hope by speaking to baby, she understands how I feel and what I am going through. Hub has also been speaking to her too... I just gotta tell myself not to be overly negative else baby will get the negative vibes which is unhealthy.

Water Birth

I read about water birth few months ago from a book I borrowed from the library. However, I didn't give much thoughts but recently I chanced upon some posts from the forum.

At first I thought water birth is not available in Singapore. But water birth is actually available in Singapore, but not many people chose it cos it is not widely practiced in Singapore. One also has to understand the pros and cons of water birth.

In Singapore, the following hospitals have water birth facilities (as at of current updates):

• Mount Alvernia Hospital
• National University Hospital
• Thomson Medical Centre

One also must note that it is essential that one needs to have a doula should you wish to opt for water birth.

And it is recommended that one goes for hypnobirthing classes if you are into water birth.

The following are some of the places that teaches hypnobirthing:

1. BabyBliss
2. ParentLink
3. Four Trimesters

Channelnewsasia Article: 14 November 2009 on hypnobirthing:

Hypnobirthing ensures pain-free childbirth for some
By Venessa Lee, TODAY | Posted: 14 November 2009 1009 hrs

 SINGAPORE: Ms Regina Lim gave birth to her daughter in circumstances starkly different from most other women's.

"Actually, childbirth is not painful," said the 34-year-old, referring to her pain-free labour with Hannah and contrasting it with her experience giving birth to her two older boys, where labour had been induced.

Describing her daughter's birth at Mount Alvernia Hospital on February 20, Ms Lim said: "It's almost like your body's trying to do a split for you. If you just relax, it will gradually, over four or five hours, get into the 'split' position." Labour had been "fun", added the property analyst.

Ms Lim had practised hypnobirthing - a technique she credited with helping ensure a pain-free birth - with the help of her doula, Ms Ginny Phang. In ancient Greek, the word "doula" meant a woman of service. Today, a doula is a professional who assists women during childbirth, providing practical and emotional support.

Actress Nicole Kidman was reported to have had a doula at the birth of her daughter Sunday Rose last year.

Dr T C Chang, a consultant obstetrician and gynaecologist at Thomson Medical Centre, told Weekend Today that hypnobirthing "can reduce the need for pain relief." "Some patients will tell you ... they didn't feel pain. Others will say the pain was reduced markedly", obviating the use of pain relief during labour, according to Dr Chang, who said that 15 to 20 per cent of his patients use doulas.

Hypnobirthing, which can comprise visual and auditory cues, is "a mind-body technique to teach women to relax during labour," said Ms Phang, who owns FourTrimesters, a firm that offers doula services.

According to another doula, Ms Kiki Porter Wolff, hypnobirthing "is mind over matter, the mind controls how the body reacts. It won't get rid of the pain per se but it reduces the pain to nothing but an irritability."

Said Dr Chang: "They don't even use the word 'pain' ... they refer to every contraction as a 'surge'."

Ms Lim was part of a small but growing group of women who employ doulas, who number fewer than 20 in Singapore.

Ms Di Bustamante, the director of ParentLink, a company whose services include doula and pregnancy-related services, said the firm provides doula services for eight to 10 births a month, compared with five or six such births per month, two years ago.

About half her clientele are expats and half are locals, she said.

The numbers involved are still tiny, however. Since 2007, for example, KK Women's and Children's Hospital "has received two requests for the assistance of a doula, during delivery", according to Ms Paulin Koh, deputy director, nursing, at the hospital's delivery suite.

Ms Lim said: "In previous births, I had difficulty in getting what I wanted because I was in labour and (not in a fit state to) argue with doctors and nurses, and I wanted an advocate."

Ms Lim said her "advocate", the doula, Ms Phang, advised on matters such as when to lie down and when to walk around, and when to go to the hospital when labour had advanced. "When you're pushing the baby out, someone will, invariably, in all the births, say something like 'Shut up and push!' I will usually tell the nurse, 'you shut up'. Now I have Ginny helping me to glare at her," she quipped.

Having the kind of birth they want - which often excludes pain relief - is important for clients of doulas. "

Some doctors don't even allow birth plans. We often have people switching to us because they can't have a birth plan," said Ms Wolff, who, besides being a doula, is also a trained nurse and midwife.

For Ms Lim, as with many people who opt for doulas, having a natural, drug-free birth was crucial, especially after her unhappiness over her second son, Rupert, having to be delivered via an emergency Caesarean section six years ago.

"I felt that birthing, like eating or sleeping ... or having sex, should be something that your body is designed to do. I wanted to have a natural birth. I felt that this is the normal way to give birth," she said, in contrast to "interventionist" societal norms regarding childbirth.

In opting to give birth without drugs, Ms Lim is in a distinct minority. With regard to the women who give birth at Singapore General Hospital (SGH), for example, "over 90 per cent opt for pain relief", according to Dr Tan Lay Kok, senior consultant at SGH's department of obstetrics and gynaecology. The three forms of pain medication commonly used are epidurals, pethidine injections and Entonox gas.

"In Singapore, all births are pretty much looked at as requiring medical attention ... a medical event, not a normal physiological event," said Ms Bustamante, a doula herself, stating views similar to other doulas'. Citing the use of painkiller drugs as an example of a medicalised approach, she added: "Some doctors want to release the membranes, break the waters routinely, halfway through labour."

Asked separately by Weekend Today whether obstetricians in Singapore were generally too interventionist in childbirth, Dr Tan of SGH said: "Obstetricians have their patients' and their babies' best interests at heart. It is in this context that any intervention is discussed with the patient, taking into account both maternal and fetal considerations, and assessing the pros and cons of the intervention."

Dr Tan added: "Labour is usually managed actively in hospitals, and if the progress of labour is slow, the obstetrician may suggest breaking the waters to help augment the uterine contractions."

Ms Bustamante also said: "Many doctors require that women give birth on the bed on her back. This position is not conducive to an easy birth. It fights gravity and can cause perineum tearing."

She added that "using a birth stool, squatting, (being on) all fours, even standing are much better positions as this allows the pelvis to open an additional 30 per cent".

Asked separately about which birthing position is best, Professor Chong Yap Seng of National University Hospital (NUH), said that would depend on the individual; it would be "the position that you feel most able to push when you're in the second stage of labour".

"The training all over the world is like this: Most doctors are trained with an active management mindset. Some of the policies may seem a bit too cautious to laymen," he said, in reference to queries about medical intervention in childbirth.

However, as doctors are privy to "very bad outcomes" that may occur even with normal pregnancies, "we actually like to err on the side of caution", said Prof Chong, senior consultant at NUH's department of obstetrics and gynaecology.

Whichever birthing method women choose, there is perhaps one universal constant in all new births. In 30 years of nursing, "I've seen thousands of deliveries", said Ms Wolff, "newborn babies always look like their fathers." She reckons it's a way for fathers to bond with their new babies, even though their children's features will soon shift and change.

- TODAY/sc

I contacted Ms Ginny Phang to find out more about hypnobirthing and she was very prompt in answering my questions. I was thinking if I should go for a intensive course on hypnobirthing (given that I am into full term and I might go into delivery anytime soon) - even if I don't go for water birth, it would probably help in relieving some pain during delivery.

According to her, she has worked with Dr Paul Tseng and Dr Lai Fon-Min at Mount Alvernia on water birth.

I checked with my gynae and he was not into water birth as he believes the more "established, traditonal methods". Of course, he also shared the pros and cons of water birth with me but he mentioned that if I am really keen on water birth, he could refer me to doctors who are practicing it. 

In the end, I decided that I don't want to go through the stress of having to go for an intensive course and water birth. I was thinking if I had more time, I would probably have signed up. For now, feeling relaxed is my top agenda. Anyway, now I just gotta count on my breathing techniques I learnt during parentcraft lessons and hubby's support (to remind and reassure me!) during the delivery.

Weight and baby position as at 24 November 2011

I am 60.70 kg today !
Baby = 3.043 kg

Baby has grown about 300 g in a week !

Position: Head down but still facing upwards, then again today is more towards the side so hopefully she is on her way to face down ...

Occipito Posterior Position

Gynae said baby is in Occipito Posterior Position.

Urgh! Now that the baby's head is down, her head/face is facing upwards instead of downwards.

Gynae is quite humorous...he said baby is smart - wanna look upwards for nicer scenery rather than mummy's bottom. =|

Baby, could you do mummy a favour - please face downwards ?

Weight as at 19 Nov 2011

I am 60.20 kg today !
Baby = 2.7 kg
Growing steadily ;)

Feeling Nervous

Just gotta know that some fellow mummies in mummysg.com has just given birth/ going to be induced soon ..... and I am getting nervous.

I think baby can feel that too cos she moves quite a bit and soon after I went to the toilet to poo. eeks ! (I always get that when I feel nervous, hopefully I don't do that in the delivery room.......)

Maternity Leave

I still have 5 days annual leave to clear and I think I will carry it forward to next year. Well, my initial plans is to be on leave from 21 November and onwards but let see how it goes. Maybe I will work until I really can't take it anymore? I can't imagine me staying at home resting and then thinking of labour....then again, sometimes I just feel so sian ..wanna just laze around and do nothing, blast music, read some books or thrashy magazines...hmm.

I hope I can clear the important outstanding things and attend whatever boring teleconferencing by this week, at least I can feel at ease.

Braxton Hicks Contractions - How does it feel like ?

hub kept asking me if I experience any Braxton Hicks Contraction lately, and then I realise that I actually don't really know how does it feel although I know it theoretically.

I started googling and I saw several descriptions contributed by mummies here.

Seems like I also had some BHC too cos I can relate to the following experiences - (actually quite similar to what I have described in this post especially the hard time breathing and that tummy feels hard!) :

My stomach feels hard as a rock when I get them. And I have a hard time breathing when I get it too. Mine last at least a minute and it's hard to move during it. They do make you feel like you got to pee, even if you don't have too. Hope this helps. posted 09/04/2007 by littlemegs22

first, your stomache will get really hard... sencond, your feel your stomache push out... third, after about 15-14 seconds-it slowly softens back... sometimes it puts a sharp pressure into your back... and in my case... Ive wet myself a few times... they mostly uncomfy unless your back is being pressed on... hope my exprience helps you.posted 09/03/2007 by therex4xu 

My tummy gets hard and there's a shooting pain from my upper belly down to my vagina posted 09/08/2007 by a BabyCenter Member 

Another way to describe it is that it feels like the baby is balling up and pushing out on your belly. For my first pregnancy, I assumed for weeks that my son was just balling up and I was just feeling him put pressure on my stomach for a minute. I found out at the very end of my pregnancy that these were Braxton Hicks! I am now on my second pregnancy at 28 weeks and just started feeling the Braxton Hicks again this past week. posted 10/01/2007 by Morgan_Hill_Mom 

I hope baby can stay in tummy till early Dec. -__-

my mini CD collection

Finally finish burning 168 songs in a CD to bring to the hospital. phew! These songs can last me about 10.8 hours. Hopefully that is sufficient to soothe my mixed emotions then. =|