Wednesday, October 23, 2013

Labour and Delivery

On June 3rd, at just over 39 weeks pregnant, I had an appointment with my doctor. I was hoping that she would be able to do a membrane sweep to kickstart my labour. I wasn't actually even sure if they did membrane sweeping in Japan, since my doctor and I had never talked about it before. Not that I was terribly uncomfortable or sick of pregnancy, because at least the second half of my pregnancy had been the easiest of all three, but more than anything I was experiencing a restless sort of anxiousness to get labour over with and maximize the time that my parents had remaining in Japan. Also, on a more practical note, I was afraid of going over due, needing a second expensive rH shot, and possibly being induced.

I found out that was only 1 cm dilated and only very slightly effaced but my doctor did a membrane sweep anyway. It hurt like crazy since my cervix was not really that ready and my doctor has always been rough at the best of times, but did make me begin to have small contractions. Dr. Ando was very convinced that I would go into labour that day, even so far as to creepily call herself "gold fingers", and told me to go home and make sure all my bags were packed. I have learned in the past that to make a sweep more effective you have to keep on your feet and try to be as active as possible to keep the contractions going and hopefully make them a bit more regular. So, I decided to walk home from the clinic (about 3 1/2 km) and keep busy all afternoon around the house. I was pretty disappointed when after an afternoon and part of a night feeling small intermittent contractions, they petered away into nothing.

Me on the morning of June 5th looking like
I had a watermelon stuffed under my shirt. 
On the morning of June 5th, I returned to the clinic and had yet another membrane sweep. Within an hour I was having short, slightly painful contractions every 30 minutes or so and by 3:00 I was having them every 15 minutes. When Dustin arrived home from work I was having a contraction about every 10 minutes but they were still relatively painless. I didn't want to jump the gun and show up at the hospital when I wasn't really in labour, so I took a shower and tried to have a bit of a nap and see if they would go away. The contractions continued and became closer together, so after about an hour and a half Dustin and I decided to head over to the clinic. Partially because I wanted to make sure my labour progressed and partially because I am more than a little nuts, we decided to walk to the clinic (for the second time that day!).

We arrived at 7:30 pm and after about 15 minutes or so of waiting we were admitted to a very small maternity room. There was an older midwife on duty who got me to change into a gown, get into bed, strapped me to a fetal monitor, and checked how far I was dilated. The midwife forbade my husband from entering the room for all of this and was made to wait in the hall until I was decently covered with a sheet. I had a very hard time communicating with her, but I did gather that I was still only 1 cm dilated and she thought it would be a number of hours before the baby was born. This was horrible news for me since my other labours were long (22 and 9 hours) and with my boys I was 4 cm before I even knew I was in labour. I had a horrible sinking feeling that I had rushed to the hospital too soon. We asked the midwife if I could return home to labour there for a few hours but she said that once you check in you can't leave until the baby is born. I started to feel like I was in the Hotel California. 

After about 20 minutes in bed strapped to the monitors, my doctor showed up. She invited Dustin back into the room and didn't seem bothered that I wanted him to stay. Because her English is near fluent, I once again brought up the possibility of returning home for a few hours. Confident as always, she told me that she thought I would be having the baby very quickly even if  I was only 1 cm dilated and that I couldn't go home. I then told her that since the baby seemed to be doing fine I would like to get off the monitors and stand/walk around. Once again, a resounding "no". I was pretty annoyed at being confined to bed, which made the contractions hurt about 10x more, when there was absolutely nothing out of the ordinary with my labour. About this time, the midwife returned and put a saline drip IV in my arm. 

The doctor then came and sat on the bed next to me and used her fingers to check my cervix. Without saying a word (until afterward) she pinched my amniotic sac in her fingers and broke my water. I had my water broken in my previous labours too, but it had been done with a knitting needle like amnihook and with my full consent. Needless to say, I was a little shocked when she sprung that on me without asking. She continued to check my cervix with her fingers until I started to have a contraction. Then she asked me to pull my knees up to my chest and push as hard as I could, as many times as could, for the length of the contraction. This hurt. A lot. It took a contraction that what was otherwise a mildly crampy 2, on a pain scale of 1 - 10, and shot it up to a 9. I could only think that she was nuts for making me do this. I had been about to tell her "hell no, I'm not doing that again!" when she announced that I had gone from 1 to 2 centimetres dilated. It seemed to be working, so I gritted my teeth and did what she asked of me. Every five minutes I would have a contraction, pull my knees up, push, and dilate 1 more centimeter. All the while the doctor's fingers never left my cervix. Forty minutes after my doctor arrived, I was still having contractions only 5 minutes apart but I was 9 cm dilated. 

The midwife who checked me when I first arrived  came into the room with a wheelchair and helped me get in. She wheeled me down the hall to a sterile operating room with a massive light on the ceiling and a hard looking gurney bed with stirrups. Once again she tried to keep Dustin out of the delivery room and in the hallway, but he just ignored her and came in anyway. I have never been so happy for his forcefulness as when he blatantly disregarded this outdated and pointless policy. I climbed aboard the bed, laying nearly horizontal, and had my legs strapped into the stirrups. The bed was obviously made for women with much shorter legs than me because the angles were all wrong and my legs felt like they might just pop out of my pelvic joints. It was insanely uncomfortable, the bed was not at all conducive for pushing, but there wasn't much I could do other than deal with it and try to get this over as fast as possible. On the positive side, I was vaguely aware that there was peaceful classical music playing in the background. 

I had another contraction and pushed once again. I had no urge to push and the pain wasn't any different or worse than it had been for the past 40 minutes. I had another 5 minute respite between contractions to breathe and sip some tea before pushing again. This time, almost right away, I felt her crowning. It was so surprising to me, since I hadn't even felt her traveling down my birth canal, but after one or two good pushes she was born. About three minutes later I delivered the placenta with a small push and it was all over. Unlike many doctors in Japan, my doctor prefers to avoid episiotomies if at all possible and allows women to tear naturally. Lucky for me though, I won the lottery for the third time and didn't need any stitches.

For a few minutes it was all business, weighing (the nurses were astounded at how much she weighed), checking her apgar score, and cutting the cord.  Dustin and I were not given the option to cut the umbilical cord, which was okay since Dustin has never had any interest in doing it. Cord cutting is considered a medical procedure in Japan and you would need to have the most understanding doctor in the world for them to hand those scissors over. If you are interested, they did not clamp the cord with a plastic clamp but tied it off. 

The baby was handed over to us for a few minutes while they ran tests on her cord blood. I found out  at this time that she has the same blood type as me (A negative) which means that I didn't need to receive a second rH shot. After the blood test came back normal, I was made to clamber shakily off of the delivery bed, back into the wheel chair and we were all brought to the tiny room I had laboured in. 

I will definitely write about my hospital stay in detail. For now though, here are the facts and measurements of our newest (and last) addtion:

Name: Rosemary Blythe Reimer
Birth Date: June 5th, 2013
Time of Birth: 9:25 pm
Weight: 3890 g (8 lbs 9 oz)
Length: 53 cm (21 in)
Head Circumference: 35 cm (13.8 in)