Kate’s Story

November 28, 2012

Here is the birth story of our baby Ethan.

My due date was 26th Oct, but I was overdue so we went to our hospital Tokyo Medical Center (Japanese public hospital) on 31st Oct for our planned induction. My husband and I arrived at the hospital at 8:30am, checked-in at the front desk and then went up to the maternity ward. It was my first time to go to the maternity ward and I was a bit overwhelmed by all the mothers and their babies, and the nurses station which at 8:30 in the morning was packed with about 30 nurses and doctors all organizing the work for the day. It dawned on me then that we were finally going to have our baby and I nearly started to cry:)

Induction of Labour

First the Doctor checked how dilated my cervix was – at this stage it was 1cm dilated and slightly softened. I was happy with this because I had noticed over the weekend that baby had moved lower and there was increased pressure on my pelvis. A good start!

The nurse then showed us to our labour room (my hospital has a LDR room – which means you stay in the same room for labour, delivery, and 2 hours recovery). She gave me a hospital gown to change into, and I went to lie on the bed ready for the induction with my bottles of water, novel and snacks ready on the bedside table. The nurse then hooked me up to the fetal heart monitor and put the IV into my arm and started the oxytocin drip. The oxytocin was started at a low dose of 10, and gradually increased every 30 min to a maximum dose of 120 after 6 hours. We could see my contractions increasing in frequency on the monitor (and I could feel my uterus tightening) but I still had no labour pain. Only slight twinges of period pain. During the day the nurses and my doctor checked my cervix regularly to see if it had dilated, but there had been no changes. At 4:30pm the doctor came to check again – it had dilated to 1.5cm and there was some loss of the mucous plug, but still no labour pain. After the examination, the doctor explained to my husband and I that, as labour pains hadn’t started yet, I would be taken off the drip at 5:30pm and would sleep in the hospital overnight, and then start the oxytocin again in the morning. We had kind of been expecting this as the doctor had told us previously that on average the induction would take about 1.5 days. BUT THEN, just as we were talking, I could feel a pop down below and my water broke! Water started coming out all over the bed and there was no way I could stop it. I must have had a worried expression on my face, because my doctor kept reassuring me this is completely normal and to not worry about the bed getting wet. I was so surprised and excited that my water broke so soon, and this really sped up the labour. In the next hour I started having labour pains, which felt like strong period pain at the beginning, and then gradually started to extend around to my lower back. When I was taken off the oxytocin drip at 5:30pm, the labour contractions continued so I stayed in the labour room. The doctor explained that the oxytocin from the drip would stay in my body for 2 hours after the drip was stopped (until about 7:30pm), but even after that my labour contractions continued and seemed to switch over to my natural hormones, so all was progressing well.

As the contractions extended around from my lower belly to my back and increase in intensity, My husband started to use all the tools we had brought to cope with the pain. We had tennis balls, aromatherapy oil, hot water bottle, and face washers. At 9pm the doctor came to check my cervix, and it had dilated to 5cm! This was very good progress, and he said that usually the cervix will open 1cm per hour from now, so could expect the baby to be ready to be born at around 2-3am. We were so excited (or as excited as I could get between the painful contractions:))!

However, when the doctor checked again at 11pm, my cervix had only dilated to 6cm, indicating the progress had slowed down dramatically…He checked again at 12:00 midnight, but no progress at all. Dilation had stopped. We continued through the contractions (which were still extremely painful and coming every 3-4 minutes) to 2am, but there was still no progress.

(Btw, during all these contractions I was lying on my side on the bed, which the nurses had recommended me to do in order to save my energy. My husband and I had been planning on using the special labour rocking chair that was in our room – which you can straddle and lean forward on the head-rest, and rock back and forth while your partner massages your lower back – but the nurses were concerned I would consume too much energy if it was a long labour and therefore reduce my chances of being able to push out the baby. So during the whole labour I was basically on my side on the bed gripping the side rail with both hands during contractions, and then trying to let go of the rail and relax between contractions. The contractions were so painful that I would often forget to relax in between, and I could hear the nurse reminding me in a big voice “RELAX!” and literally taking my hands off the rail and forcing me to rest. She was very good– it was kind of like an order to relax, but it was very helpful to focus and force myself to try and let go between contractions).

So, my cervix had stopped dilating and at 2am our doctor discussed the options with us – there were 3 options: 1) Continue with the labour, which was very painful and no guarantee if it would progress, 2) Start using the oxytocin drip again, which could increase the strength of the contractions to get the cervix to start dilating again, however the downside was that if it didn’t work in another 2-3 hours then there was a possibility I would need a caesarian. Also, there was another risk as it was night-time and therefore less staff on duty to monitor my progress, and 3) Pain relief (I can’t remember the name of the drug, but it was an injection in the arm) which would allow me to sleep for 2-3 hours and then continue with the labour when the drug wore off. (I did ask for an epidural at this stage even though I knew my hospital didn’t offer it:) My doctor said it was not possible…it was worth a shot though:)!)

The contractions were so painful that I could not concentrate enough to think about the three options, so I asked my husband to make a decision. He discussed with the doctor, and the decision was made to take option number 3 as I was so exhausted and it might help the labour progress. (Btw, my husband was fantastic like this during the whole labour. I had read previously that this was an important role of the husband, as often you are in so much pain that you are unable to make decisions or even think about the options during labour. I had explained this to him in the months leading up to the birth, so that he was aware of this, and that even though we didn’t have a set birth plan, I would be depending on him to communicate with the doctor and make the decisions for us. He took on the role and responsibility wonderfully and straight away I felt such relief that he was there – it was wonderful to have someone there who I could completely trust in and meant that I could focus 100% on just getting through the contractions).

So, option 3 was chosen and the nurse injected the drug into my arm. My husband dashed home to have a quick shower while I was asleep (we live only a few minutes away from the hospital). The only problem was, the drug didn’t work for very long!! It helped me to get a deep sleep in between a few contractions, but my body seemed to burn through the drug so quickly (or it wasn’t very strong to begin with) that the contractions were back to the same intensity within what I assume was about 30 min – 1 hour. My husband returned expecting me to be in a deep sleep, only to find me in the same pain as before and the nurse massaging my back through the contractions! But the pain relief had worked well – when the doctor checked my cervix at 3:30am, it had dilated to 7cm!

Unfortunately this progress was only short lived – my labour slowed down again and at 5am there was no further dilation. At this time I was put back on the Oxytocin drip at the lowest setting of 10, and the Doctor said he would come back at 7am to check if this had helped to speed things up. These 2 hours were the most excruciating pain yet, and I remember gripping the sides of the bed and violently shaking the rail and screaming at the top of my voice just to get through the contractions. In my mind I knew I had to focus and do the proper slow breathing (and I was constantly guided to do this by the Doctor and nurses who tried to breath with me so I could copy them), but it was so hard. After I had let out a few uncontrollable screams, I forced myself to try to breath slowly and deeply. My breathing-in was a bit shallow, but I really focused on breathing-out as slowly as I could. All through this, my husband was with me every step of the way. Every time a contraction came (which were less than 3 min apart or sometimes back-to-back contractions), he would be there with tennis balls in hand and putting counter-pressure on my back. I couldn’t have gotten through the labour without him – we had actually put the two tennis balls in the legs of some old stockings (so they wouldn’t go bouncing away if he lost his grip), and I have this vision of him hurrying over to me at the start of every contraction with the stockings around his neck like a stethoscope and the tennis balls ready in his two hands! My love for him at these moments multiplied a thousand times more.

Finally 7 am arrived and the Doctor checked my cervix, only to report that it hadn’t changed – it was still less than 8cm dilated. When I heard this news I knew that I couldn’t go on anymore. The doctor was saying that we could continue if I was mentally strong enough (our baby’s heart rate had remained strong and steady during the whole labour so we knew he wasn’t under stress, so it really depended on how much longer I could go on). But I knew I was at the end of my pain-tolerance. I started saying in the middle of contractions “I can’t do this anymore” and “Mou Muri” in Japanese, which means that it’s impossible for me to go on. I asked about a caesarian and the Doctor said “Are you sure?” and I said “Yes”. I think my Doctor had thought that I was determined to have a natural birth, as I had always asked about the percentage of caesarians after induction, etc. So when I suggested it, I think he was surprised and wanted to double check that I was comfortable with the decision. In my mind, I was thinking that even if I continued on for another few or more hours, and even if my cervix did eventually dilate to 10cm, could I actually push this baby out into the world? I knew our baby was at least 4kg from our pregnancy scans, and I knew there was a possibility that even if we waited until the pushing stage, that there was a chance he wouldn’t be able to come out, and we would have to have a caesarian anyway. Some of my friends had had similar experiences, and my sister had had a caesarian, so I think it had always been in the back of my mind as an option. So, the decision was made to have a caesarian.

Caesarian

Once the decision had been made, it was all action to prepare me for the operation. The Doctor scheduled the operation for 8am, and I remember asking him when I could get the epidural as I was still having the excruciating contractions. He said at 8am, and I said “8am?!!” – that was another hour away and I couldn’t bare to think of going through the pain for another hour. He said he would try to get it asap, and I accepted this and mentally prepared myself for another hour of contractions. The nurses came in and changed me into the operation gown, put a hairnet over my hair, and helped me move onto another bed with wheels. My stomach was so painful and I had contractions the whole time, so it very difficult, but finally made it onto the wheely bed and lied down on my side. The Doctor and nurses then wheeled me to the operation theatre on a different floor of the building. I remember us waiting outside the lift and another contraction coming and me screaming out in pain as other people exited the lift. I was thinking they must be surprised to see this screaming foreigner on the bed! My husband was unfortunately not allowed to come into the operation theatre and he had to wait outside in the waiting room. Before I was wheeled away though, he came to me and held my hand and we kissed and said see you soon. By this stage, even though on the outside I must have looked like a wreck, in my mind I was starting to get excited that it would all be over soon, and soon we would finally get to meet our baby and hold him in our arms. Once we were in the operation theatre, the anesthesiologist put a cold gel on my back and stuck paper on my back in preparation for the spinal block. Just when he was about to insert the needle though, I had another contraction and was gripping the nurse on the side to get through the pain. Once it was over he inserted the needle, but again I had another contraction coming and I said this to the nurses, and they said “but the spinal block is already in!!”, and I said “but it still hurts!!”. And then suddenly I could feel this warmth spread down my lower back and through my legs. It was the most wonderful feeling. As the warmth spread through my body and I could feel my legs gradually go numb, my spirits lifted dramatically and I thought finally I don’t have to go through this pain anymore and will soon see our baby!! I was so excited that I became quite chatty during the caesarian. I had a curtain over my chest so I couldn’t see what was going on, but I could hear the Doctor talking and, even though I could feel no pain, I could feel the touch sensation on my stomach and legs. The nurses put a catheter in, and wiped down my stomach with what I think were alcohol swabs. Another nurse did a needle prick test to make sure I couldn’t feel pain – she first touched my upper chest and I could feel a tiny pain, but then when she touched my lower chest, I could feel the spot but couldn’t feel any pain. Then the operation started. In about 10-15 minutes, our baby boy was born into the world at 8:34am!! I could hear him crying and was so happy. They took him to the side to remove any fluid from his lungs, and I was trying to look past the curtain and was saying “Where is he? Where is he?” and the nurse was telling me not to worry and he would be ready any second now. Finally they brought him to me so I could see him. He was cocooned in a little towel, and the nurse put him up to my face so I could kiss him and have some skin-to-skin contact. I started saying hello to him and he suddenly stopped crying which made me feel wonderful:) The nurse took the pulse monitor off my left finger so I could raise my hand up to him and touch his tummy and face. I gave him another few kisses and the nurse pressed him to my check, and then she took him out to meet my husband. It was such a wonderful feeling! Our baby Ethan was born! The Doctor stitched me up and they lifted me onto another trolley bed (which would become my bed for the next 8 days in hospital). I am quite heavy so it took about 8 people to lift me onto it! Even the Doctor lent a hand! The nurse had my pajama-nightie ready and waiting, and they helped me put my arms through and buttoned me up. Then they wheeled me out and I could see my husband – it was so exciting and he took my hand and I asked him “Did you see him?!!” and he said with a big grin “Yes!”. He said he had been able to hold him for a few moments before they took him upstairs to be weighed and checked. Our baby Ethan was 4.1kg and born on Tuesday 1/11/2011!

Recovery

After the operation I was wheeled into my room (I stayed in a 4-bedroom share room) and soon afterwards the nurses brought Ethan in on a little crib. My husband picked him up and placed him on the bed with me – I was in a lying position and still couldn’t feel my legs, but I cradled him under my arm and soon he started to suck my skin on the side of my breast. I couldn’t turn my body yet to breastfeed him, but it felt wonderful to have that contact.

Gradually the sensation returned to my legs and I could start to move them, but I wasn’t allowed to sit up until the next day. Ethan stayed with us all day on the Tuesday, and then the nurses looked after him overnight. They were feeding him glucose water as I couldn’t breastfeed yet, and I asked them to bring him to me the next morning before they gave him glucose water so that I could try and breastfeed (we had found on Tuesday night that Ethan wasn’t interested in trying to breastfeed as he was already full from the glucose water). The nurse was very understanding and brought him to me first thing in the morning at 6:30am – she helped me turn on my side, and finally Ethan and I could have our first breastfeed! After that the nurse helped me sit up in bed, and then later I was able to get up for the first time to see if I could walk to the toilet on my own. Even though it was extremely painful and I was hunched over and shuffling my feet slowly (my uterus hurt the most from the hours of contractions), I managed to show that I could get to the toilet and back on my own and showed that I was strong enough to move onto the next stage of recovery, so they took the catheter out and from then on I was free to get up and go whenever I needed. I still wasn’t allowed to eat food though – I had to stay on the drip for a few days, and was allowed to drink water the day after the operation, and eat food from Day 3. Ethan stayed with me 24 hours from Day 2, and my milk finally came in on the evening of Day 3 so he didn’t need the glucose water anymore. Each day I walked a bit further and my stomach hurt a bit less, and gradually could try to stand up straight. Sometimes it was difficult to get out of bed if I was holding Ethan due to the pain, but I developed a technique where I could place him in his crib first before getting out of bed. This seemed to work well and I could gradually feel my independence coming back:)

Breastfeeding

I stayed in hospital for 7 nights (it’s usually an 8-night stay for caesarian but I was able to go home one day early. It is a 5-night stay for natural birth). This 7-night stay after the birth was really wonderful – it was like an intensive course on how to look after your baby and how to breastfeed. I ended up having some blocked milk ducts, and had many one-on-one consultations with the nurses to get them unblocked and learn different breastfeeding positions before going home. The nurses were so helpful and supportive, and I am so grateful that they were able to solve my breastfeeding problems just before going home. My hospital had a special breastfeeding room where all the mothers with their newborns would go to get help on breastfeeding, or just for the company of fellow new mothers in the early hours of the morning (this room was open 24 hours with nurses there to help anytime). You didn’t have to go there for every feed, but it was encouraged to go there at least a few times a day and weigh your baby before and after feeding. This way you could calculate and monitor how much breast milk the baby had actually drunk, which was particularly important when you’re waiting for your milk to come in. My baby Ethan was drinking only 4 ml of colostrum on Day 2, but once the milk came he was drinking 50 ml of breast milk per feed, and this shot up to 100 ml on Day 7. I know overseas it is common to go home soon after the birth, but if you can, I highly recommend staying in hospital for the full week so that you can get as much support as possible and solve any breastfeeding issues before going home. I didn’t solve my blocked ducts issue really until Day 7, so I was so glad I could do this just before going home!

Medical Check-ups

While I was in the hospital, every day there were medical check-ups for Ethan and I. I was closely monitored after the caesarian and a nurse came to see me several times a day to check my body temperature, blood pressure, and the progress of my uterus contracting down to its normal size. Ethan was weighed a few times, had blood tests for anemia, tests for jaundice and metabolic diseases etc, as well as a hearing test. Every time the nurse came to get Ethan for a medical checkup, I would always ask her what the test was for and the details. I also would ask if I could come and watch the test being conducted, which they always said yes. This was great and something that other mothers didn’t seem to do (maybe they took that time to have a rest?). I highly recommend going to see these tests being conducted though so that you are aware of what your baby has been tested for. For the hearing test I could also take a photo which was cute:)! It is also good to be there with your baby, as sometimes it is a bit like a production line with all the babies – the Doctors and nurses at my hospital were fantastic, but if Ethan started to cry at least I was there to pick him up straight away and comfort him before or after the test.

Well, a long story, but in the end we are so happy and overall I look back on our birth as a positive experience. Our doctor and the nurses were amazing – so professional and at the same time so caring and supportive – we couldn’t have asked for a better support team:)! We are so happy with our healthy baby boy and enjoying spending every minute with him.

Kate, from Japan

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