Tuesday 14 July 2015

Step by Step Journey of a C-Section (Day 3)

This was the final full day at the hospital, and it was where I had to make sure I was ready to get discharged the next day. Less of lazing around and more checks so I wouldn't be at a loss when I go home.


  • By Day 3, I was no longer consistently being monitored for my heart rate and blood pressure. I was officially "ok" from the epidural and other drugs I received during the caesarean. 
  • In the morning, no one came to wipe me down. I guess I was expected to have taken a shower myself already. But it was scary to even think of walking to the toilet, let alone strip myself and get myself all wet! So I shamelessly requested for a nurse to give me a wipe down again. It felt so refreshing after that, without having to go through the daunting process of showering with a raw wound :P
  • The 9am gynae and pd check ins were fast and smooth. My lovely gynae happily reminded me to start walking today :O
  • And so I did, the way I was instructed. I shifted the bed to full sitting position, and stayed there for a couple of minutes to get my blood flowing well. Then I shifted slightly to the edge of the bed, letting my legs dangle at the side of the bed. I stayed there for a few minutes too, because my legs had to get used to not being on the bed. After that, I called for a nurse. She and my husband stood by and gave slight support as I stood up. Again, paused for a minute or two, then started walking slowly to the toilet. Each step was extremely tiny, and I didn't move my legs much but rather shuffled them along. I held my breath most of the way. This way, I reached the toilet smoothly and almost painlessly. Using the toilet was tricky too. Since I couldn't use any abdominal strength, I had to use the hand support to sit down and get up. This is when I finally know which muscles are required to do simple tasks like this! Even turning to get toilet paper was tough, because I couldn't put stress on the wound by turning my body. 
  • Toilet trips were thus a big adventure the rest of the day - but I made sure I went every 3 hours or less, to prevent urinary tract infections. According to my gynae, I wouldn't really feel the bladder much because of the surgery, so I just had to time my own toilet breaks. (or toilet adventures). I got better and faster each time I went, and was more used to walking around. I actually felt better getting out of bed more frequently, so I had to agree to all the comments from doctors and friends who repeatedly told me before giving birth that I had to make sure I walked more during my hospital stay in order to speed up the recovery process. The only times I felt pain was when I forgot I was recovering from a surgery, and ended up walking too fast and making movements that were too big. Otherwise, it wasn't as bad as I had feared. 
  • Besides making sure I could walk, I also made sure I learnt all styles of nursing from the nurses at TMC. Every few feeds, I called for a nurse to teach me a new position of holding my infant, so I could utilize my favorite position when I reached home. All the nurses were very experienced, and helpful in teaching me. I'm glad I made sure I learnt as much as I could from them during my stay (though after reaching home, I actually settled for the cradle position). 
  • Because I was slightly more mobile and independent on Day 3, my husband could also take more time away from me to settle the paperwork - including my son's birth certificate, and to collect all the special congratulatory gifts from the hospital and the government. I must say, that I was going through a lot while recovering physically, but my husband was also running so many errands that he was probably also exhausted physically in the few days I was resting and trying to recover well and fast. I don't know what I would have done if my husband wasn't around with me throughput my stay. :)

Step by Step Journey of a C-Section (Day 2)

Although a Caesarean takes only 1 day, the recovery is a looooooooong process. The first few days, in particular. For those going through this for the first time, it's a freaky process, so I hope my account here helps ease some doubts and help you get prepared mentally. (it's not that bad actually, but it's nicer to know what's going to happen, usually)


  • During the first night, we didn't room in with the baby - we forgot. But it was a blessing in disguise, as my husband and I both had more rest. The nurses brought the baby in for feeding, only once in the middle of the night. That meant about 5 hours break in between feeds. The baby slept a lot more, so he didn't cry for feeds and we had to wake him. But on hindsight, we should have requested to feed more often (more on that in another post).
  • Early in the morning at about 6am, 2 nurses came in to clean me up. Oh it was soooo welcome. They turned me this way and that, and wiped me down with a wet wipe. It felt so refreshing, after lying in bed and not moving at all for a whole day. 
  • By morning, I was ready to take a regular meal. Semi- inclined in my bed, that is.
  • My gynae came by to check on me at about 9am. All was good. We chatted about how I should take care of the wound, and how long it would take to recover. She made me touch the wound site (which was covered by a waterproof plaster). I was so scared!! But surprisingly, it wasn't painful. More numb, actually. She told me the wound dressing would be changed just before I was discharged, then a few days later (on day 6) at a visit to her clinic. After which, I would be able to remove the dressing in another week. So the external skin wound should take just less than 2 weeks to fully heal. 
  • Before she left, she dropped another bomb on me - she instructed that I should get out of bed and try walking to the toilet by the next day!! I wasn't looking forward to the pain I would feel... but she said I had no choice but to try it. Better try it at the hospital than at home. Anyways, I was scheduled to have my urine catheter removed on Day 3 as well, so I didn't have much of a choice unless if I wanted to wet my bed. >.<
  • Slightly later, the pediatrician came to visit. She was Dr Janice Wong from Thomson Medical Center. She gave the all pass to my son. Quick, meaning all was fine. So that was a good thing. 
  • The rest of the day, it was just a routine of meals, painkillers and nursing. I was appalled at the amount of painkillers I was on (3 different types!), but totally welcome to it because I didn't want to feel pain. I was able to sit up a little more, high enough to feed myself. I also started nursing in a cradle position, which required me to sit up a little more than on Day 1, when I nursed while lying down. 
  • I didn't arrange for any hospital visits after Day 1 from my immediate family members, and I was glad about it. There was just not much more time to rest after meals and nursing! I'm glad I got to rest as much as I could, without having to entertain guests. (well, ample time to have guests during confinement after that!)
  • With complete feelings in my limbs, and the ability to sit up a little more and thus be a little more independent, Day 2 was slightly more comfortable. I was probably also more accustomed to life in bed. :S

Wednesday 8 July 2015

Step by Step Journey of a C-Section (Day 1)

Since my baby refused to turn, I was scheduled for a C-Section on week 38.5 of my pregnancy - late enough for his to grow a fair bit (estimated 3.2 kg by scanning), but not too late to risk the water bag breaking or any form of contractions before the scheduled C-Section, to avoid an emergency C-Section, which is more risky. Below is my personal experience of the few days in the hospital:

Day 1

  • Arrived at the hospital at 6am, for a C-Section that was scheduled at 8am that day. Thomson Medical Center has a very tiny reception, which happened to have only 2 people serving 3 couples scheduled for C-section that day - I was the 3rd. It took almost 30 minutes to register each couple, so by the time I was done with registration (oh the amount of paperwork!), it was almost 7am. 
  • I was brought up to my ward. I had reserved a single room, which was unfortunately not ready (yes, the hospital was FULL), so I was given a temporary bed in a 3-bedder room. There was a MAN sleeping on one of the beds, and snoring really loudly. But it didn't bother me since curtains were drawn, and I was just there to change and get ready for the Operating Theatre. 
  • A nurse came to take some measurements (heart rate, blood pressure, etc) and confirm my personal details. I changed into the hospital gown, and she then proceeded to inject the solution to clear my bowels. It was awkward, having a tube being inserted into my rectum. But it was just uncomfortable, not painful. While waiting for the solution to take effect, another nurse came to brief me on some procedures and double check some details again. 
  • Within about 5 minutes, when the second nurse was just about done with the procedures, I felt an urge to poo. It was sudden, and very strong. I couldn't even hold it back a few seconds. I rushed to the toilet (with whatever dignity I had), and started pooing. It was first all diarrhoea-like. When I thought I was done, another wave came. Then another. And another. And it was all so fast and furious, I was embarrassed with the sound I was making in the toilet. I was surprised at how many waves of poo there were. I probably had stored more than 5 times my usual poo amount! And I clear my bowels everyday - or so I thought. That was quite an experience, but by the time I was done, I felt 5 kg lighter, and it felt great. :)
  • By then, it was almost 730am, and time for me to head to the OT. The nurses did one final check, my husband took out his DSLR, and I passed the nurses a binder that I had prepped before hand. (as per instruction from my doctor. If not, the hospital will provide one) I got onto to the bed, wore a shower cap, and was all ready. 
  • The nurses pushed me through many many doors and corridors. I could see nothing much except for the ceiling. My husband left halfway, as he had to take another path to the OT. I missed him there and then. 
  • I reached a waiting area, where a man came by. He introduced himself as Doctor Chew, my anesthesiologist. He was very nice and friendly. He explained the procedure briefly, and told me firmly that in order for him to do his job well and safely, I would need to curl myself up as much as possible - like a shrimp, he said. That was a superb analogy, because I immediately knew what to do. He reasoned that the more I curl, the wider my spine would open up so he could aim properly. I decided then that I would curl myself up until I could no longer breathe. 
  • Dr Chew joined the nurses to push me into the OT. They kept chatting with me, and that helped keep me a little calm. The OT was bare, white, and very cold. I was surrounded by unfamiliar objects, and I saw the typical OT lights shining right above me. Everyone around me was very busy, hooking me up to machines, setting everything up, and getting ready. 
  • Then it was time for the injection. It was really really scary. I knew the risks and side effects of epidural, and I didn't look forward to any of them. The least being shivering and vomiting. A nurse helped me curl into the shrimp position - it was more difficult than I imagined. I curled with all my might, but they kept asking me to curl more. The nurse was strong and pushed me hard. I really appreciated it. During the entire process, no one stopped talking to me. They asked me about my son's name, and I told them it was undecided between 2 choices - which we had a fun time discussing the merits of each. For a few minutes, they successfully took my mind off the injection and the OT, and I'm so grateful for that break.
  • Slowly, I felt my body numbing. I could feel my chest getting heavier. It felt uncomfortable, but I saw that Dr Chew was monitoring me well, and never left my side. I felt reassured, despite the discomfort. 
  • At that moment, I saw a familiar yet unfamiliar figure walking in. My husband! He was all wrapped up except for his eyes, it was the DSLR hooked around his neck that gave him away. hahaha! I was so relieved to see him with me again, for I was getting scared of all the unknowns around me. And the fact that I was about to get cut up 'volunteerily'.
  • By about 810am, my gynae (Dr Joycelyn Wong) was in the OT and getting ready swiftly. She greeted me, and proceeded to explain briefly that I would not feel anything, and just some tugging and pulling at some point. My husband started taking pictures. I heard the doctors and nurses talking amongst themselves, so I knew the procedure had already begun.
  • Sure enough, a few minutes later, I felt some strong tugging. It was a strong pressure, but no pain (phew!). Then Dr Wong exclaimed "oh he's big!". And in a jiffy, my boy was out! My husband started snapping loads of pictures, including the clock to record his birth time - 827am - just 17 minutes after the doctor started work. Dr Wong warned that the baby would look darker than expected, and sure enough, he was all purplish. If she hadn't warned me, i would have been frightened! He was whisked away to get checked, cleaned up and warmed up, before he returned to me. Meanwhile, I was getting all cleaned up and stitched up, of which I felt nothing. My baby's cried filled the air of the OT, and it finally felt less uncomfortable and cold. 
  • My baby was wrapped up warmly and snugly like a cocoon, and rested on my chest. We took a few photos, and Dr Chew happily volunteered to help us take a family photo. He was very generous with his service, and took many many shots at different angles. Once again, greatly appreciated. 
  • Soon, the baby was taken out again, and my husband followed. He was going to get weighed and measured. Dr Wong proceeded to stitch me up, while Dr Chew continued to monitor me. By then, the climax was over. The doctors started chatting about their kids and stuff, and left me alone there (to eavesdrop). 
  • Before 9am, everything was completed, and the doctors waved goodbye. The nurses wrapped me up in the binder I had provided earlier, and pushed me back to the waiting area that I had been earlier. There, I was constantly monitored by nurses on my heart rate and blood pressure, for about an hour before I was pushed back to my 3 bedder ward.
  • Back at the ward, my husband was waiting. I was again glad to be reunited with a familiar person. The ordeal was pretty much over. I could still feel nothing except my hands and above, and it was extremely uncomfortable.  
  • At this time, my husband was making multiple phone calls and whatsapp messages to report that mother and son are well :)
  • Despite the nurses' assurances, it took my son a couple of hours before he was ready to be pushed to me for a second look. Apparently the shower and 'quick check by the pd' took hours. Unhappy about it, but at least my son is well.
  • I believe it was only about noon time that I got to move into my single bedder room. It was all the way at the other end of the entire level. 
  • Family came to visit, though for just a short while. It was awkward not being able to move at all to chat with them. I had my hands on my chest all the way from the OT until late afternoon, because I didn't dare to move. I was that afraid of pain. Every hour, the nurses would check on my vitals, and every 3 hours, my baby was brought to me to nurse. He was such a cutie, though he was asleep 99% of the time. The nurses at Thomson Medical were very helpful in teaching me how to nurse while lying down, since I could still not get up nor move much. 
  • By evening, I was able to feel some of my toes and feet. I started doing some simple exercises as instructed - just bending my feet up and down repeatedly. Not sure if it was the effect of the medication, but even that felt like a lot of work, and I only did a few each time. Since I was on morphine, I didn't need to take painkillers the entire day. Yes, I didn't imagine that one day I would be on morphine. But I was glad that day I was. 
  • Dinner time was late, but I was finally given the go ahead to eat. It was almost 24 hours since I last had food, and I craved for it. I wasn't hungry due to the medication, but I love food, so I craved it. I had fish porridge - light, soupy, and nutritious. Yummy. Eating in bed was a new experience too. I had to incline but not too fully because of the pain and discomfort... but at least I got to eat.
  • By bed time, I was able to feel most of my body. But I barely moved, for fear of pain. I was also given the pass by the nurses to stop monitoring me every hour, but rather every 3-4 hours. Yes, they did that throughout the night.
  • That was my first day after C-section. Extremely uncomfortable, but made better by the care and service of all the hospital staff. At least, I survived :)

Tuesday 7 July 2015

3 Ways of Turning a Breech or Transverse Baby Naturally

Having had to deal with a stubborn baby who refused to turn the right way round, I did a bunch of research to find out how best to turn a breech or transverse baby as naturally as possible. There were many recommended ways online, but here are the 3 most common and safe:


  1. Yoga Doggy Style. If you're flexible, stand with legs shoulder width apart, and touch the floor with your palms. Stay in this inverted position for 10-15 minutes, once to twice a day. If you're not as flexible (like me!),  get on all fours, then lower your elbow and chest to the ground. Hold this semi inverted position for 10-15 minutes, once to twice a day. For safety reasons, it is best to do this on a cushioned surface, such as a yoga mat or a bed. Do not do with a full stomach. The idea is to let the baby descend out of the pelvis to have more space to turn the right way down. Some sources say this helps in up to 75% of breech pregnancies.
  2. Walking. This is probably the simplest to do. Walk at least 30 minutes a day, and allow gravity to do the work - the baby's head is supposed to be heavier, so getting off your butt and walking more is supposed to help the baby's head turn downwards. Do be cautious not to over walk though, and do NOT do this if your doctor has indicated you should be walking less (for conditions such as low lying placenta). If you're walking more than 30 minutes, remember to rest every 30 minutes. This usually works for earlier in pregnancy when there is still enough space in the uterus for the baby to turn.
  3. Swimming. This is the same concept as the first suggestion. While swimming (usually breast stroke, which is less intense), your body is held in a horizontal position that allows the baby to emerge from the pelvic bone area and thus have more space to turn. Again, do only under doctor's permission, and do not over exercise. 

There are also other ways to turn baby
  1. Massage. This is done by an experienced person who can feel the baby's position, and will massage in a direction that will physically push the baby to turn. It can be quite painful, but has a higher 'certainty' of working, since you can actually feel the baby turning. It used to be more popular, until the massage resulted in a few babies dying as a result. That was probably due to the turning of the baby getting the baby entangled in the umbilical cord, and not being detected until it was too late. Because of these incidents, massaging to turn the baby has become much less common.
  2. Extreme Yoga. This is a variation of the Yoga Doggy Style mentioned above. Instead of going on all fours, the inversion is done on a elevated surface - with the legs on the elevated surface such as the bed, and the hands and head on the floor. This is to provide even greater incline to increase the success rate of turning the baby. It is, however, in my option, very unsafe to be in such a position, especially late in your pregnancy and sporting a big belly. You definitely do not want to fall in that position, much less fall on your belly. Weighing the risks and benefits, I would rather have a C-section for a breech baby than fall on my belly in this case. 
That said, I've tried the first 3 methods myself, but it didn't work for me. My little one was stubbornly transverse all the way until delivery. Hope it works for you though, so you can have a natural delivery for your beloved little one :)

Tuesday 24 March 2015

Baby is Breech!

Little Baby has been a "lazy" one throughout this pregnancy, always in a lying / horizontal position when scanning. It's good for the scanning because he's always facing the right directions to make the gynae / sonographer's job easy. But as the pregnancy advances, I've been waiting for him to start turning the right side down to get ready for labor. It's supposedly a natural process for babies to turn head down - due to effect of gravity, according to my gynae. However, even at week 29, he was still in his comfortable, horizontal position. It's surprising, because I have a tall and slim physique, and he's a tall baby. I'm not sure how he finds the space to remain horizontal, but he seems to find it more comfortable than being vertical where I imagine there will be more space with my slim but long torso.

At the 33 week checkup, gynae said he should have his head down for natural delivery. At that check up, he still insisted on remaining in a horizontal position. Ok, slightly diagonal, which I attribute to him needing more space as he grows. But to the gynae, it's still considered a transverse baby and only C-sect as an option. However, because there was a lot of amniotic fluid space all around the baby, the gynae was very hopeful that the baby could still turn in the next couple of weeks. We scheduled a closer checkup at week 35, so we could monitor his positioning. Dr Wong also recommended I do some exercises to promote his turning. Since I was already walking quite a bit (to no avail!), she suggested I do an "inversion" exercise in addition to walking. This involved me first getting on all fours on the bed. Then lowering my head and chest down to touch the bed, to create a maximum tilt for the baby to "sink" into the large space in my uterus. I was supposed to do this twice a day, a minute each time, before doing 30 minutes of walking. The idea was to get the baby into a large space, then walk to use gravity to pull his head down. Some online sources indicate a longer 15 minute inversion, but 30 minutes of walking was the maximum to avoid inducing early labor. The inversion part was really tough on my arms and neck, but for the sake of the baby (and myself), I did it daily. To be honest, I sometimes only did once a day.

By week 35, just before the checkup, I could still feel my baby in a transverse position. I told him if he doesn't turn, he will get a scolding from the gynae! Miraculously, right during the gynae's scan, he turned!! YES, HE TURNED!! But, he turned the wrong direction, and ended up vertical - with his head up and legs down. O.o I guess the "scolding" and "warnings" worked, but my baby has a sense of direction as poor as his mom's. So now he's no longer a transverse baby, but he's a breech baby. Still scheduled for C-sect. And the gynae noticed significantly less space left in the uterus for him to turn. Furthermore, instead of needing to turn 90 degrees, now the baby needs to turn 180 degrees. So we made plans for a C-sect, which will probably happen in 3 weeks' time.

Til then, I'm not giving up yet on my baby. There are many advantages to natural birth (more on that the next time), and I'm educating both my husband and my baby on that on a daily basis. I know he's a smart boy and he will listen. He's just, maybe, a procrastinator who likes to do things at the very last minute - just like his dad. So I'm giving him the benefit of doubt, and will keep my fingers and toes crossed until our next checkup at week 37.

For now, I'm going swimming to create turning space for my baby :)

Sunday 15 March 2015

What to eat - Diet catered to fetal development

During pregnancy, everyone advises you to eat more, eat better, so the baby can grow well. How much more is more? How much better is better? What exactly do you need to eat to help the baby grow better? Eat healthily, people say. But that's still too vague. What exact nutrients does my baby need, and when? Every week, the baby is developing a different organ, and thus different nutritional needs are necessary at every developmental stage. Instead of saying "just eat everything healthy!", I prefer the more targeted approach. So below is a table I've tabulated, which describes each week of pregnancy, the corresponding developmental milestones the baby is expected to be undergoing then, and thus the type of food that I should eat more of. Hope it helps in your diet plans, as well as add some joy in knowing what your baby is working on that week! :)


Note: Some weeks are "empty", which means no change, so just continue eating what was recommended in prior weeks. Also, suggested food sources are just examples, there are way more food sources that provide that nutrient, so feel free to diversify your intake to make life colorful!





Despite our more "nutritional" diet, the baby sometimes needs even more than what we can generally get in our diet. So usually gynaes will recommend taking supplements. below are a list of supplements that we should be taking:

First Trimester: 
  • Folic Acid (~400-800ug, up to 4mg if you are assessed to be high risk for neural tube defects)


Second and Third Trimester: 
  • Calcium (~600mg). Essential for bone development. Total daily requirement is ~1200mg, but body intake maxes out at ~600mg, so either take calcium pills twice a day, or get the remaining from your diet of milk / cheese / dairies.
  • DHA (~300mg). These are necessary for brain and eye cell development. 
  • Prenatal Vitamins. These should generally include Vit A, Vit C, Vit D, Vit E, Vit K, Vit B6, Vit b12, Folic Acid, Calcium, Iron, Zinc, Thiamin, Riboflavin, Niacin.  
These are just a rough gauge. Everyone is different, please consult your O&G doctor for a customized nutritional and supplement need for yourself and your little one! 



Wednesday 11 March 2015

Recommended Baby Weight Chart

At my 20 weeks detailed scan, the sonographer gave me a shock by telling me there were a few things she needed to "double check" with a more senior and experienced sonographer. Apparently, my baby's thigh bone length and abdominal width is way higher than average. In fact, when the experienced sonographer came in to check, her re-scan yielded even larger figures that were off the charts. They then decided to take the original, smaller number that would at least fit within the regular charts at ~95th percentile. Talk about trying to make us first time parents feel a little better.

During the review of the results with my gynae thereafter, she was not too concerned with the thigh length being long, as both my husband and I are considered tall for Asians (and myself even tall amongst some caucasian ladies). However, abdominal width was a small concern, because big babies tend to be more difficult to deliver naturally. Her comforting words were that "at least the head is of average size, because the head is of a fixed size, if it is too big, it cannot be pushed out easily. As for a big tummy, since it is slightly flexible / malleable, you can do it with just a slightly harder push". Also, this being only a 20th week scan, there was still alot of time for "weight correction". Furthermore, at only 360g (average is ~200-300g), my baby was actually just 60g "overweight". Which isn't too big a number actually. If, at 37 weeks he was still just 60g "overweight", that was just within standard error of the machine's calculations. So, conclusion was, it's not the end of the world.

With the sonographers' and gynae's reassurances, my hubby and I returned home with a calm heart but strong resolution to stop all excessive tonics I had been given from the start of the pregnancy. I also decided to check websites for a comprehensive table so I could continue to track the progress of my little one as he grows in the next couple of months. After some searching, to my dismay, there were either a lack of measurements in metric units, or differed largely in recommended weight/length to gestational age. Hence, I decided to compile my own table, pooling together various resources and doing my own calculations, so that I can see both weight and length on any preferred measurement unit of choice in a single table. I also added an additional column to the right to suggest how that length equates to, so that it is easier to imagine how the LO looks in terms of size. (I really loved doing that... every week I would update my husband by saying "He's a little Mango now!" And that association really helps us to connect the numbers to something we see on a daily basis)

One note about the table though, since it is compiled from websites that do not really cater specifically to either the caucasian or asian population, it may be neither here nor there. Measurements and estimations also vary according to gynaes and clinics, because different machines use different formula to calculate weight, so there can be a systematic bias. Just take it as a point of reference. For example, although my baby has since become "average weight" according to my gynae, he has always appeared to be ~1-2 weeks faster if I compared his weight to the table below. As long as the growth remains consistent (i.e. progress 2 weeks in 2 weeks, not gain weight equivalent to 4 weeks in 1 week), then I believe you will be fine :)