Here is my second time story

Having had this puli varuthu episodes several times, I was little less panicky whenever I had contraction like pain after my second visit to the delivery suite.  We had birthday party for Muffin on 9th Jan and I cooked lunch for the guests. Some of the guests didn’t turn up because of the bad weather, but I had to cook for them all anyway. I baked the cake as well. I have been getting braxton hicks if there was some physical exertion  in that day. So, I wasn’t seriously worried when I had contraction like pain just before the guests were leaving.  Monitored the pain. it was not regular and subsided slowly. So I went to bed happily. On the following day, Sunday, we had many clearing up and tidying up to do. I so wanted the house to be ready as that was the only weekend we had before the baby arrival, as on Monday (11th Jan) I had Anesthetic appointment to review anesthesia option and on the following Monday, the 18th i was going to have C sec. Even if everything goes according to plan, we had just another weekend before we bring the new baby home and there is a high possibility that I may go into labour before that.  At the end of Sunday after some hectic clearing and tidying up, I had pain again. Now, I have to be really wise and sure in decisions, as Balan was also very tired and had his hectic brand new week ahead with additional school runs for Muffin.  Muffin was going to start her school from Monday. So, the plan for Monday was that We all go and leave Muffin at her school on her first day, wait three hours, pick her up, have lunch at McD or somewhere like that and then go to anesthetic appointment (Balan had taken the day off). So, an unnecessary visit to the delivery suite at late hours will only exhaust us. I started monitoring and the interval was 15 mins and the contractions were regular. It kind of gave me alarm bells that what if it indeed is real contraction and many have told me that second babies happen very quick that i have to act quick. So, I called up the delivery suite and they asked me to come in immediately. hmmm. the driving conditions weren’t best outside with snow covered slippery skiddy roads. Then there was the issue about childcare for muffin. I thought we can take muffin with us, but the delivery suite staff clearly told me not to bring her. (But we did have her with us during our previous visits). First time we had to leave her alone with my mom for a night. we sneaked out. The bags were already loaded in the car, so sneaking out was not difficult.

We checked in around 9:30. Contraction were started getting intense and I was more and more sure that this time it is going to be real. I have no idea why still i didn’t feel that i was going to deliver baby that day. I didn’t feel the first time around as well. I guess my instincts never do their job well. anyway, in we went to the delivery suite for the third time. I reported at the desk and specifically mentioned, “you might have been expecting me little later as we mentioned that we didn’t have childcare at that time but i got that arranged much quicker than I thought, so, here i am sooner than you expected…… “… always too precise with too many detail, but aim to be accurate. They were all busy. nobody attended us. Contractions were getting intense. I told balan that it is good that we decided to come otherwise we would have had it difficult.

When the delivery suite staffs finally came to talk to us, they straight away gave me a delivery roon and asked me to wait there. Balan had parked the car in 30 min parking and did not carry the bags to the hospital. The staffs did a good review of my history and decided to give me gas and air for the internal examination itself.  the doctor told that the cervix was not open. The doctors and nurses told me that they will not do the C sec yet and I will have to wait until the booked date, which was a week later. I didn’t quite understand what they meant. Are they asking me to go home and come back? how will i know when to come back as the only sign i know is the contraction, which i am already having? so i asked. they clarified that  I was going to be moved to a different ward where i was going to be kept under monitor. Again I didn’t understand. Are they going to keep me in the hospital for a week and I asked to be in pain for a week? They said that they will review again in the morning as it was Sunday and night time, the staffs on duty were not keen on doing a C sec at that time. I thought fair enough. They monitored me again and the contractions were strong and very regular but not progressing. So they told me to go to sleep if i can. I asked Balan to go home and have some sleep as he had to take Muffin to school in the morning. I didn’t want the second one already affecting Muffin’s life and that day being her first day at school, i thought it was even more important that her day goes as perfect as possible. Balan brought the bags and left them with me and went home. Nurses checked on me now and then as i was too quiet for a person having contraction. they even asked whether i spoke English.

Monday morning. A different nurse came in and informed that she was going to look after me for the day. a doctor came in and told me that he was going to review my case now. I have been just waiting for them all as the contraction was getting intense and intense and i couldn’t tolerate the pain anymore. gas and air was not helping greatly either. so i had stopped using it long before. I had to go to loo and i had bloody show. i came back. The doctor asked me whether i spoke English. The nurse immediately corrected that i was just too quiet woman. the doctor was so cruel that he thought he could use the situation, thinking that a woman in labour will give in if she was bombarded with too many arguments.  He told me that i was not in labour. what does that mean?  the contractions, the bloody show.. don’t they mean anything? he tried to argue with me that he will do C sec only on the booked date which was a week later. That’s when I thought that i must open my mouth and i did that very well. I told him in a stern voice (i guess the pain helped me to make it even more firm) that i will not go home. He said that he did not tell that he was going to send me home. Then I asked him what he meant by saying that he will do C sec only a week later, was he going to keep in pain for a week? then he again told me that i had not dilated and he will not do C sec yet. Then he did the internal exam. i had dilated 5 cm then. then he asked all the staffs to act quickly. Again he tried to convince me for normal delivery and then at least for epidural (not GA).  I just told him a clear no and asked him to stick to my birth plan request, which was C sec, GA.  Things started happening pretty fast after that. They told me that they were going to fit me in a slot they got for C sec. The nurse asked me about Balan and I gave her balan’s number and asked her to text him. I phoned balan who was already on his way to the hospital after leaving Muffin at school. An anesthetist came and started his job. Nurse was preparing me for the theatre. Balan came just before i was going to go inside the theatre. I told him that i was going to have C sec in just a few minutes. It was 10am. They didn’t wheel me in, but I was asked to run to the theatre as they had to really rush things. so many things were happening around me. I was put to sleep.

Later Balan told  me that the nurse told him that it would take few hours and so he left to pick up Muffin from school. But I was out less than an hour, which we came to know later. So, Balan was not there when the baby was out. It was the nurse who held and fed the baby.

When I woke up i saw  the nurses feeding a baby. I asked for morphine. she told that they had already given me some. I asked for more. she smiled and told me that i have been pushing my luck a lot. but they gave me some more and i went to sleep again.

when i woke up again, balan was there. and the nurse was teaching him to feed the baby. I asked balan to take photo with the nurse. we were wheeled to postnatal ward. it was 3 or 4pm. I was under the influence of heavy dose of morphine for the rest of the day, that night and following morning. i was given toast for breakfast which i couldn’t eat because i was falling asleep holding the bread in hand. Postnatal ward staffs have been feeding and nappy changing the baby. They were very helpful until i was ready.

Muffin visited us on Tuesday and was very pleased to see a baby. We taught her to “touch” and be “gentle”.

I stayed in the hospital for Tuesday night as well.  Midwife told me that i was ready to go home. The driving condition outside was particularly bad. But we took the risk and came home. Luckily we all reached home safely. Muffin was pleased to see us all back home.  We had already decided the name. so my life as a mother of two started there.

(Will edit and correct  if I get time and patience to read it again).

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Getting Ready

Keep your hospital bag packed and ready to go. There are few internet sites (babycentre.co.uk) and few leaflets from bouty, mothercare, boots telling you what to pack. Go through the list and pack according to your needs. With some additions and omissions, our bag has been ready for sometime. Keeping two bags, one for the baby and one for the mom is a good idea too.

Wax your legs and keep all the area clean of unwanted hair, if you are like me who feels embarassed about other seeing my haired legs than showing my vagina to everyone.

Keep yourself ready for the homecoming photo-shoot too. Keep a nice set of clothe for the homecoming day. If you are going for normal delivery, you may not get enough time to do it later, but if it is C sect, then you will have some breathing time to get your nice set brought to you. I haven’t got my eyeborws and underarm done yet.

Relax. Impossible to do when you know the labour has started. But try.

Keep more than one set of homecoming set for the baby, as you do not know which one will suit her/him best. As I know mine is a girl, I could narrow it down to girl’s clothes. I have more than one set but none of them seem to be the perfect one yet. I am waiting for the online order to be delivered yet. Hope it has the perfect set.

PS: I am writing this post to help me relax. Will edit/add later to make it coherent.

Contractions

Not sure whether it was true contraction or brixton hicks, but I had a very regular pattern yesterday. Tightening of abdomen accompanied by something that can be called pain as it did make me lose breath, make my eyes close and make me unable to answer or engage in normal conversation. I generally do all these when I am in any pain to severe pain. I generally go silent and do not say anything when I am in pain.  That thing happened for every ten minutes starting from 4:30pm yesterday. It didn’t stop until I went to sleep. I could easily slip into sleep though. I have been getting it again this morning, but I am not observing its pattern now.

37 weeks, 5 days. (officiallly according to the dating scan, 38 weeks finished and 39th week started today)

Update:
Just had bloody show at 11.23am. Anitha says that it took two weeks for her after the bloody show to go into labour.

 […] 37th week […] I lost my mucus plug, a very big thick brownish red mass of mucus.

But mine was not as big as that. It was just a little and was periods like reddish mucus. Had two contractions after that. Had nice shower after seeing the show. I am just going to make a note of it with its time of occurrence. Going to ring the delivery suite to inform them, knowing that they are going to ask me to stay calm and read a book or go for a walk. Balan is informed. But, I can drive if needed and if the pain is within bearable range. Taking a cab is also in the option. I have to look for cab number and keep it in the vicinity now.

Update2 (1.38pm):
Have been having back labour, but the pain is very much within my bearable range.
Have talked to delivery suite. I am asked to monitor myself, as expected. But, the lady (may be midwife) noted down all the information I gave. The lady on the other side of the phone was nice.

Baby is moving well.

Update3 (4.00pm):
Talked to the delivery suite again and they have asked me to come in for a check up, as the interval between contractions has come down a lot. It was 4/5/6 minutes apart when I was talking to them and it has come down to 2/3/4 now when I am typing this. Balan is on his way home to take me to the hospital. Still not sure whether I am going to be admitted today, as it all depends on the width of dilation.
Pain is certainly bearable. It has so far been easy on me. Drinking herbal tea. Tried to sleep, but as I have to monitor the interval of contraction now, I decided against sleeping.

Update 4 (05.00am):

I am pleased  to inform you all that Premalatha gave birth to a little girl at 12.34 am this morning(08/01/08).  Prema is recovering fine(she had C-section) and the little one looks stunning.  I just came back from the hospital to have some nap.  She will write in details soon.

Balan

Baby blues are fine

Baby blues are fine. Some tears are fine. Crying all the time means it could be post natal depression. Another link for Baby blues.

Postnatal depression is different than the baby blues, however. It can occur at any time up to about two years after the birth. 

Some reasons for PND 

• If your birth experience was not what you had hoped for, feelings of resentment and anger can build up and be a factor in triggering depression.

• Babies and children are very demanding! Poor sleeping and eating patterns, if they are unrelenting, will wear down even the most determined and optimistic person.

• At a time when you really need support and sympathy, the attention of those close to you is often focused on your new baby.

• The popular image of motherhood is of a radiant, energetic woman with endless patience. The children are always beautifully turned out, the house immaculate, and a casserole is in the oven for dinner! This is seldom the reality, but women do often try to present themselves to the outside world as if it were.

Signs of post natal depression

C section – 2

C sect is discouraged in UK for several reasons.
1. Cost cutting by NHS
2. It is a major surgery and has all the threats a major surgery poses.
3. Recovery time is longer than normal delivery.
4. Handling the baby during initial days will be difficult. Here in UK they want the mother to handle the baby before even the cutting the cord off. (they put the baby on mother’s chest to let the baby hear mother’s heart beat so that it feels some comfort by hearing a familiar sound she has been hearing until then).
6. C sect is not natural. It is medical intervention. There has to be a genuine medical reason for the medical intervention to happen, otherwise doctors do not feel comfortable with it.
7. My pregnancy so far has not warranted any medical intervention. Though my baby is in breech position now at 33 weeks, I still got time. It can change position before 36 weeks.

Doctor has agreed to let me get C section to deliver my baby as I am panicky about Vaginal delivery. The date is not booked yet.

He told me that I am making a very very wrong choice. He seemed bit dissappointed for agreeing to it.

He also warned Balan that I am a good candidate for post natal depression as he interprets I show clear symptoms already. I am not sure this statement has anything to do with why he has agreed for C sect, but I suspect there may be a link.  He did not record this statement in my notes, so there may not be a link. It may just be his concern.

The Labour

There are three stages of labour. Stage 1, the preparatory stage, stage 2, the pushing stage and stage 3, delivering the placenta and anything else remaining (including the gushing down of amniotic fluid).

The baby is pushed downwards and almost reaches the end of the birth canal, with the head (usually) to be born first – Stage 1.

This is the birth of your baby and is usually a lot shorter than the first stage. – Stage 2

This is the delivery of the placenta, which takes 15 to 30 minutes. – Stage 3

Stage 1 is further divided into latent phase, active phase and transition. Women get admitted into hospital during the active phase of stage 1.

Detailed information on all three stages can be found here as well.

More things to know:

Membrane sweeping (stage 1)

Membrane sweeping is done by your midwife or doctor. While internally examining you, he or she will simply “sweep” a finger around the neck of your womb (cervix). The aim is to separate the membranes around your baby from your cervix. This releases hormones called prostaglandins, which may kick-start your labour.

I haven’t heard anything negative about membrane sweep. I would go for it, if I have to go for normal delivery.

Episiotomy (stage 2)

An episiotomy is a surgical cut in the perineum, the muscular area between the vagina and the back passage. […..] Your midwife might suggest one if your baby is becoming distressed and needs to be born quickly, or if she thinks that you may tear very badly unless the opening from the vagina is carefully enlarged.

Spontaneous tears are less painful or at least no more painful for women in the days after the birth than episiotomies. 

After hearing some after effects of episiotomy, I have decided strongly against it, if I have to go for normal delivery.

Preferred Baby position (Edited to add)
Baby should be in a) head down position and b) anterior position for a “smooth” delivery.  Anterior position means face of the baby facing the backbone of the mother, or back of the head of the baby facing the tummy side of the mother. Babies in posterior position (sunny side up obabies r facing up babies) take longer to come out and might need some help! Posterior position is not uncommon for the first time mothers. posterior babies may change their position before coming out and vice versa (anterior babies may come out facing up). There is a theory on why and how this posterior position happens and how to help the baby to be in anterior position before delivery. I tried and hurt my back more. Related link is back labour

Positions for labour and relaxation in labour are good reads as well. Ask your partner to read on Massage in labour thoroughly. It is always a good idea for men to know all about labour process, options, pain reliefs, onset of labour and everything about this child birth process. You do not want your partner to be blank and choosing options you didn’t want when you are not in a position to explain about it. You do not want them to annoy you just by being ignorant, certainly not when you are in labour.  

Drink  as much fluid as you can before and during labour.

Eat well before labour. Do not know whether we can eat during labour (after active phase of stage 1).

Edited to add: Breathing techniques for labour

Edited to add (just remembered):
1. Ventouse used in our hospital is really cool and not at all scary. Not only that it gives a feeling of safe delivery. if I had seen that earlier I would not have minded having epidural, so, long delivery, so ventouse. I might even have asked them to go for ventouse from the begining. (OK, I need to read on what effect the suction will have on baby and how much suction is acceptable).  But not all hospitals in UK use that model. The old models look like the one we use at home to clear dainage block! 😦 I will try to find pictures of these two models and post them here.
2. Birth units are really cool. Very nicely furnished and nicely decorated. But they are for 100% sraight forward delivery (midwife led units and only midwife led units), meaning not even epidural.

Will edit to add as I remember more.

How to recognise the onset of labour

I thought water breaking is the obvious first sign. Contractions the next obvious. Now I have learnt few more, that there is this thing called “show” and there is this another thing called instinct too!!

Water breaking 
Ignorant me used to think that water should break first. Slowly I learnt that either water breaking or contraction as the sign of onset of labour.

Water breaking though an obvious sign, is not the best of the signs as told in my antenatal class. It means that, if water breaks, RUSH to the hospital.

Small amount of water stays in the front, or at the bottom depending on how one would like to call it. If baby is in head-down position, which is the preferred position for normal delivery, that small amount of water is below the baby’s head. If  baby’s position is”engaged” well position, water should not break gushing down. If water gushes down, then it is a sign that the head is not engaged well.  If water does not gush down, it does not mean baby’s head is big and blocking the water, it means the baby is engaged well for delivery and that is good. Major quantity of water (amniotic fluid) comes out gushing down and it should only happen after the baby is out.  It can happen before, but if it does, it means the head is not engaged well. The delivery process after water breaking may be slow depending upon the degree of contraction. In some cases, after the water breaking (small amount or gush), contractions may not be good enough to push the baby out, so it might lead to assisted delivery.

Contraction
Again ignorant me used to think that contraction happens at the vagina. Well the dilation, which is linked to contraction, is at the vagina, but you feel the contraction at your lower abdomen. Contractions happening at the upper abdomen (midwife told me) during early stages, meaning middle stage of pregnancy or even earlier, is called Braxton Hicks Contractions. It is a false alarm. Read on what contraction is and how it feels.

Contractions occur at regular and increasingly shorter intervals and become longer and stronger in intensity.

Dilation
Baby starts coming out when the dilation is 10cm wide. Until 5cm or so, you will not be admitted into the hospital/birthing unit. Less than 5cm wide dilated can stay for days. It is impossible not to be anxious when dilated however less it is. But it is important to keep calm, walk more, be as much active as you can, take nice bath, and what not… is the advise given to us. Dilation and contractions are linked. Midwife will examine and tell the width of dilation. We might feel the dilation is wide enough to get admitted into the hospital, but the midwife after examining, will send us back if the dilation is not wide enough. I cannot see myself doing anything calm after 1cm dilation.

Show

You may pass your mucus plug — the small amount of thickened mucus that’s sealed your cervical canal during the last nine months — if your cervix begins to dilate as you get close to labor. The plug may come out all at once in a lump, or as increased vaginal discharge over the course of several days. The mucus may be tinged with blood (which may be brown, pink, or red), which is why it’s referred to as “bloody show.”

Instinct
Midwife was not laughing when people suggested to follow instinct to identify the onset of labour. She in fact agreed with it. I do not think my instincts will be in working order during the last stage of my pregnancy which has started already for me!

—oOo—

Now I realise that I need to take notes to remember things. I have forgotten many other things I wanted to write here. Will edit to add as I remember.

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