When I was in high school, my Biology teacher showed a natural birth video in class. I got traumatized when I saw episiotomy being performed. For a long time since, I questioned if I would want to put myself through birth pain. More than a decade passed and I clearly decided to bite the bullet and make a baby.

That didn’t mean I was no longer fearful of birth pain. But there was no turning back when I got the big fat positive on the pregnancy test so I tried to prepare myself…by watching more birth videos. 😂

This time, the viewing wasn’t traumatizing anymore though. Maybe because I knew I had no other choice anymore. Also likely because the shock on RK’s face when we watched the videos together made me laugh. 😂

Expectation of Labor Experience

So after watching those videos, my expectation of my birth experience at PPUM was that I’d start active labor at home first; I’d take a long hot shower, frantically pack last-minute items into hospital bag, brace through early contraction pain with RK in all kinds of positions, and wait for contraction to progress to 5-1-1 (5 minutes apart, 1 minute long for 1 hour) before heading to hospital. Then in the hospital, I’d be squirming in pain up to 24 hours, before I eventually give birth naturally or end up with emergency cesarean.

Spoiler alert: my actual birth experience was completely different.

Reality of Labor Expectation

Firstly, I didn’t go into labor naturally. At my Week 38 prenatal appointment, doctor recommended me to induce labor at Week 39 and participate in a labor study for first-time pregnancies. PPUM had a previous study done with better outcomes for baby and mother who go into induced labor at Week 39. This time, they wanted to study the difference between the way induction is administered.

After thinking about it for a week, RK and I decided to induce labor at Week 39 Day 4 because baby would be full-term already anyway. And based on doctor’s estimation, baby would be born only 2 days short of her EDD (expected due date). Moreover, we were concerned that baby would get too big for me to push out if we let her take her own sweet time. Lastly, the entire labor timeline would be more planned instead of being spontaneous.

A Day Before Labor

So with that, we went to the hospital on Monday morning for the scheduled induction. This first induction that I received was a mechanical induction using a Foley catheter. Basically, the doctor inserted a tube into my cervix and inflated a little balloon that sat between baby’s head and my cervix. The balloon would be in my body for a maximum of 24 hours, during which baby’s head was supposed to press on the balloon and my cervix to ripen the cervix.

I was only 1cm dilated when the procedure started. If I were to dilate enough, the balloon would drop out and I should then head to hospital on Tuesday morning. Even if the balloon didn’t drop out (which was the case for me), I had to go to the hospital on Tuesday morning either way.

I spent the rest of Monday going through the day as per normal, which included a long nap because I was (physically and mentally) exhausted. The balloon itself didn’t cause much discomfort; Week 39 pregnancy was more uncomfortable. I even managed to go for long walk in the neighbourhood to facilitate the induction.

The Labor Day

On Tuesday morning, RK and I got the hospital bag and headed to the hospital. He dropped me off at the entrance of labor ward in PPUM and left because he’s not allowed to accompany me due to COVID-19 SOP during CMCO. 😭

I changed into ward gown and got into a labor room. It’s not a big room but it’s single-bedded and had an attached toilet, which I never got to use. Little did I know also that I’d spend 15 hours straight on that bed, under a spotlight pointing at my vagina. Oh man…

The day started with a medical officer going through my long list of medical history while I was strapped on fetal monitoring. He was very thorough and made me feel very assured that I was in good hands already. He was very nice and polite also even though I was super blur — I didn’t know I was already having real contractions (but not regular yet). I thought it was Braxton Hicks or baby moving because the pregnancy has progressed to the stage where I couldn’t tell the difference between those discomforts anymore.

As he was still verifying and clarifying my medical history, quite a few doctors came in for different matters.

One doctor inserted IV needle to my right hand; that really distracted me because for some reason, that spot hurt so much from blood drawing the day before.

Then two doctors came in to check on me and asked if I wanted any pain management i.e. epidural; I said yes to epidural without a qualm because I had them during my cancer surgery and had good experience with it. I was so relieved when I heard she’d let me have the epidural because PPUM only administer 2-3 epidurals simultaneously on a first-come-first-serve basis. I was afraid I wouldn’t get the slot.

After that, another doctor came in and did a physical examination on me. He removed my Foley catheter and informed that I was 3cm dilated. I got started on oxytocin via IV drip to induce labor; oxytocin is a hormone that causes uterus to contract. He also broke my water bag and reported that my amniotic fluid was still clean.

P/s Ever since RK learned that there’s risk of baby pooping inside the womb and contaminate the amniotic fluid the further the pregnancy progresses, he has been annoying worrying me about the risk whenever I mentioned baby was not moving much. This was one big reason I didn’t want to wait for labor to start naturally. His worry made me so anxious!

The Epidural

Lastly, an anaesthetist came in to administer epidural! Woohoo! Actually I haven’t even really felt the contraction pain when he came in. I was still rating my contraction pain at about 2 out of 10 (which was less than what I felt at home sometimes!) even though the medical officer was telling me my contractions were already quite strong (though not regular yet). Funnily, my IV site was hurting me more than my labor contractions. I suspected that I was tolerating the contractions alright because it’s so similar to the intestinal spasm I often feel. #coloncancer

Anyway, the last time I had my epidural, I was knocked out already. I’ve heard about how scary epidural administration is so I was quite wary. The caveat for some people is that by the time epidural is administered, the contraction pain is way more uncomfortable so the epidural administration pain pales in comparison. Since my contraction pain was still very much manageable, I mentally prepared myself for the epidural administration to be disturbing in comparison. 😣

They made me sit up on the bed and told me to stay still. The anaesthetist narrated every process he was working on so that I can anticipate the sensations. To my surprise, the whole process was very much bearable! In fact, I felt like my quarterly chemo port flushing are sometimes more painful! That’s a pleasant surprise. 😄

Another surprise for me was that I didn’t feel contraction pain magically disappear after epidural. Perhaps it’s because my epidural was administered before my contraction pain became overwhelming so there’s no noticeable difference for me.

…And that’s it. I was left in the room with the medical officer who watched the fetal monitoring system the entire time like it’s some intense live election result. Based on what’s happening to baby’s heart rate and my contraction progression, the oxytocin level was adjusted up and down the entire day. As I was all strapped up with drips and monitoring, I couldn’t leave the bed and thus he had to empty my bladder with a catheter manually every two hours.

The entire labor process up to this point felt very scientific — controlled and systematic.

You bet I was feeling bored a few hours into this long wait. I didn’t even have to do anything. My job was to just lie on the bed and don’t move much so not to disrupt the fetal monitoring. I didn’t have my phone with me in the labor room so I ended up chatting with the super nice medical officer throughout the day. Fun fact: he’s from Klang! Haha.

5 hours since my water bag was broken, a doctor came in to check on my dilation and guess what?! I was still 3cm dilated even though my contraction was “beautiful”, “perfect”, “quite strong”. OMG. At that point, I started to mentally prepare myself for emergency cesarean…within the next 13 hours. That’s still a long time to go I know but the mental preparation was important. Even the doctor started briefing me about how he was planning to do my cesarean (while taking into consideration of my previous abdomen surgery) in case I needed one.

At one point, my oxytocin infusion was slowed down and subsequently turned off because my contraction was already very regular on its own. It’s great to know that my body was in labor mode based on the contraction pattern but it was disheartening to know that my cervix was not dilating despite that. Bleh.

So I was feeling very meh and decided to just take a nap. The medical officer finally left the room to take his long overdue lunch anyway. The hours seemed to pass so slowly by then. My legs were becoming numb (side effect from epidural) and the anaesthetist was worried so he kept checking in on me every 15-30 minutes despite running in an out of emergency cesareans! It was a peculiar day where they already had 3 emergency cesareans by late evening. My medical officer and I hoped that I’d break the “egg” with a successful natural labor that day. But we still had to wait and see.

3 hours passed and another doctor came in to check on me. Surprise, surprise! I was 6cm dilated already! Wow! My eyes brightened even though she told me she’d come back again in 4 hours to check on me (“Why so long more~”).

She also kept the possibility of emergency cesarean open so she briefed me about the plan and told the medical officer to get a specialist on standby in case I have major adhesion issue from my previous abdomen surgery. Oh well. The possibility of complication from emergency cesarean was the reason I chose to deliver at PPUM so I was mentally prepared for that.

The anaesthetist told me that as the labor progressed, I’d feel more pain, more pressure in my pelvic and subsequently an urge to push because the epidural was effective on my upper abdomen only. So as time passed, I did feel more and more pressure.

45 minutes since the last cervical check, two doctors suddenly walked into my room and said baby’s fetal movement wasn’t looking good. Oh oh. I thought that’d be the start of evaluation for emergency cesarean. But it was the opposite.

Upon checking, fetal movement “reduced” because baby has moved down my pelvic, away from the sensors still strapped higher on my belly. One of the doctors checked my cervix and realized I was 9cm dilated! Wait what?!

The medical team then declared that I’d definitely see my baby within the same day. OMG OMG! I quickly asked if they can inform RK so that he can be on standby because it’s almost dinnertime. They said they’d only inform him after labor though so I was hoping I could start pushing quickly before dinnertime. It didn’t work out. 😅

The doctors wanted me to wait out a little longer until full dilation and when I feel the urge to push because I was on epidural and I could still bear the contraction pain. I started scrunching my face in pain already but I was wearing face mask so who could tell? 😂

We waited and waited until my dearest medical officer finished his 13-hour shift. I’ve been in labor for over 10 hours and he was with me through it all. I was hoping he’d be able to witness the labor and close this case himself. Oh well. Another medical officer took over and it was push time very quickly after!

The Push

It felt like there were about eight people in the labor room when the doctor said it’s time to push. All of them were wearing face masks and face shields while I was still wearing the same face mask I had on since morning. Yes, I had to push my baby out with a face mask on!

The team dismantled my bed and setup a pair of leg bracings. I put both my legs up wide apart. The doctor turned on the spotlight and made sure it’s shining bright and clear at my vagina. My epidural was turned off so that I could feel the pain and urge to push better. I was totally wide eyed when I heard that but became puzzled when the contraction pain disappeared after I got into the push position! I guess that’s my sweet spot? I don’t know.

The doctor quickly taught me how I should push also: take deep breathe, hold that breathe, prop my body up, chin towards belly, engage core and push for 10 seconds straight before repeating continuously throughout every contraction.

Since I could no longer feel the contractions, one of the doctors put her hand on my belly to feel the contractions and time me to push. FYI, my hands were holding on to the bed railing to prop myself up as I pushed.

There’s a wall clock right in front of my bed so I stared at the clock and gave myself “targets”. The first target was 8 minutes; totally failed. The second target was 20 minutes; it got so much longer because I realized I wasn’t pushing as well as I hoped. There was no third target because it got very intense already by then.

I barely made a sound the entire day but during the push, I was grunting so much and close to crying. My brain was screaming, “Wait, am I really doing this?”, “How is this even possible?”, “OMG can someone just cut me and take this baby out already”, “Let me just try one more time”.

It’s so hard to push with all your might for 10 seconds every time! I kept running out of breathe. Also, as I didn’t have any urge to push, I was really forcing it. Absolutely felt like the worst “constipation” ever and having to push like never before.

My biggest fear (episiotomy) came true but I didn’t even feel the cut. Nothing at all. That’s how labor pain paled in comparison to someone cutting your vagina with a scissors.

FYI, as I was pushing, the doctor was reaching into my vagina to guide baby out. I don’t know what exactly she was doing. It felt like she put her entire hand inside and was digging baby out. And the entire time, the entire entourage was cheering non-stop, encouragingly me to push. If they had a pom pom in their hands, I bet they’d be shaking them with enthusiasm. At one point, I felt like asking one of them to just keep quiet 😂.

After 30 minutes of pushing, baby was out!

Side track. When baby’s head was crowning, the medical team very excitedly told me baby has a lot of hair. When baby’s forehead was out but we had to wait for the next contraction to continue pushing, the doctor asked me if I wanted to touch baby’s head. Sorry, baby. I said no. The doctor probably thought it’d give me motivation but I could clearly feel baby’s head stuck in my vagina so I didn’t need to touch to verify. Also, I was afraid that I’d freak out at sight of blood; I tend to faint when I see blood so I didn’t want to take a chance!

Needless to say, I was so relieved (and in disbelief) when baby came out. I was crazy, crazy tired. They brought baby to me and asked me to validate her gender out loud, to make sure that I’m still conscious. Looking at the level of detail of this blog post, I was super conscious and alert through the labor process la k? 😂

Baby didn’t cry super loud and long like in the movies. In fact, I asked the medical team at least twice why my baby wasn’t crying much and one of them asked me back why I wanted my baby to cry much. My perception was that loud baby equals to healthy baby so I just wanted to make sure she’s healthy by listening to her cry. 😅

In fact, I got super worried when baby was not sent back to me quickly when doctors were done stitching me up. Doctors took half an hour to sort me out (deliver placenta and stitch me up). This afterbirth procedure was crazy painful and I may have made more noise then vs during the push. It took another half an hour (or more) before I saw baby again! I thought I was supposed to do skin-to-skin with baby for an hour right after birth so this got me super worried.

Little did I know that baby didn’t come back to me because she was with RK at the ward lobby 😅. Nurse showed baby to RK for verification after being cleaned and the new dad happily played with baby for far too long.

Another anticlimax to the labor story was that when baby came back to me, I vomited. Right after birth, I kept asking for food because I’ve been starving for 13 hours and felt like I could faint anytime. I probably drank the Milo too fast (I wanted to finish it then carry baby) and ended up vomiting 1 cup of Milo, 1 bun and 1 pack of cracker.

After cleaning me up, nurse placed baby on me again to breastfeed but guess what. Another anticlimax. The nurse realized I was very warm. She checked my temperature and realized I had fever. Baby was taken away from me again as my room was emptied and the medical team tried to rule out COVID-19. 🤒

I was left in the room to wait for fever to subside. They usually monitor the mother for an hour after delivery before sending to postnatal ward but I ended up being kept for four hours due to the fever. Aiks.

There were more anticlimax incidents after that so let’s just end this super detailed labor story here before I share more realities of the full labor process 😅.

TLDR: I didn’t get the birth I imagined. Everything was more calm and organized vs my expectation; yay! Baby was delivered safely and healthily via induced and medicated (epidural) vaginal birth after 11 hours of labor at PPUM.