Labour, Delivery & Pain Relief

Wed 11th Feb 09

Again i was the first one in. The Instructor was a first timer - excited yet inexperienced. So the "lecture" was a bit boring and took longer time to finish.

Today is the overview of the whole process.

So there are 3 stages of labour

1. First Stage - Contractions

2. Second Stage - Delivery of Baby

3. Third Stage - Delivery of Placenta

Early contractions, the instructor told us, would normally come by the hour for 10 - 20seconds. But as time passes, It will come in shorter and shorter gaps yet more intense. Something like every 5 min that lasts for 1min.

To cope with the pain, it is good for the spouse or birthing partner to know where to rub the aching body parts, to learn the breathing and relaxation exercises which is the topic for next week's lesson. I begged and begged and begged Zubair to come for just this one most imp topic and he said ok he will try to arrange. Let's hope he could really make it.

I heard gasps when the instructor clicked for the next slide on 2nd stage of delivery. I was wearing specs but still cldnt quite figure out what the picture is but i quickly trained my eye on the drawing instead of the REAL picture before i turn jelly all over!

This is the part when she said that we will have the room to ourselves in the delivery suite with a couch for the spouse to rest. She reminded the husbands to bring along sweaters because it will be very cold in there. While they provide blankets for the mummies, they cant give for the guys.

She also said to make sure the husbands have dinner if it seems to be a long haul. This is because the shops near KK close very early... but i think Z will have no problem walking to Lil India where its a 24hrs food haven as we usually do after check ups.

The other thing is really Guys dont hafta show ur machoness. If you think you can stand looking at the blood, please dont look. Because if you faint, and worse if u knock your head after seeing the goriness of it all, nobody has the time to attend to you until AFTER the team has settled mother and baby.

Lastly, Birthing partners please have some rest in between contractions or when the wife is dozing off. Dont act so gung-ho else you might be too tired you'd miss the actual delivery. This has ever happened before!!

A new thing i learnt is the position of the perenium. All this while i thought its a horizontal cut when it is actually vertical. Its the space between the V and the Anus. *shudder* The nurse actually described how the docs will decide to cut or not. Its when the area is stretch too thin it would become so white and like about to burst. so before it cracks, better to cut it clean. Jelliness!

The actual Labour - where u start pushing i think - should take only between 30min - 1.5hrs. Any longer, the gynae will hafta think of some kind of intervention. Forcep, Vacuum or c-Sect. Even after she explained, i can't imagine how this forcep thing works. Do i dare to research more by googling for its image? Maybe not. Vacuum ok its a lil cup on the head on the baby that they will pull slightly to tug/encourage it out with the next contraction.

Next she explained the Pain Relieves available at KK Hospital. There are 3: Pethidine, Gas, Epidural.

Pethidine is a drug that they will jab at the thigh. Only relieves 60% of the pain and not advisable if delivery is expected within the next 3 hours. This is because this drug has effect on mother n baby such that both will become drowsy. And if Baby is borned within 3hrs after taking the drug, baby might be sleeping n not able to cry n exercise the lung. HOWEVER, there is an antidote to reverse this effect.

GAS to me seems the safest option. A mix of Nitrogen (if im not wrong) and Oxygen, u only need to breathe in deeply with the next contraction and it will be effective in 10 - 20 secs. No effect on baby.

EPIDURAL is the last resort with 100% of the pain gone. She said the procedure to get this epidural will take about 20mins or so... i was wondering what if there's a contraction in between??? Will the needle go astray when we squirm? You can actually choose to stop the epidural when u need to start pushing but u can also have it thru out. I sincerely hope i wont hafta come to this.

I had to ask my friend the next day how does the delivery suite look like. I had the impression that we would be delivering in a communal room just like a ward with 4 other pple inside! Cos i remember my mum telling me she could hear other women screaming. But maybe those were old times. So i imagined this suite is like for private patients and not for subsidised ones like me. Then how more private can a PRIVATE delivery suite be? *looks at Ma* hehehe

Also my concern is that, do i hafta continue covering my head? Doctors and nurses are excused of course... but i was afraid there might be some pple who got lost n peered inside... or if i would need to walk out to go to the toilet... My friend assured me tho that its all in the one room.

This friend also told me that she didnt hafta fork out any cash at all for her hospital stay even tho she had an epidural for the first one and a C-Sect for the second one. She also went thru Polyclinic like i am. Although i still have yet to confirm with the hospital, I felt sooooooo relieved! I'd take it to mean that even if somehow the rules have changed a bit, can't be too high.

I was told to prepare $2k or more just for hospital expenses. Some for deposit, and then additional charges that Medisave cannot cover and the fees escalate when u take more and more services.

Do i dare to breathe a sigh of relief? Ok just a bit. But still need to keep that money on standby lah! But at least im hoping there won't need to use it so i could spend it on getting more baby stuffs. Yayyness!!

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6 glasses of Juice:

farrah said...

hey babe! don't be too worried about privacy in the delivery suite. it's really a private room with a closed door and only husbands are allowed to enter the room, besides doctors and nurses. random strangers can't walk in there coz hubbies have to wear a pass on their pockets if they leave the room for any reason. as for toilet, there is one inside the room, but if u're already in labour the nurse will tell u to do business in the bedpan :S

for pain relief, do consider very carefully. i thought i wanted to be hero when i was giving birth, i went drug free for 14 hours of torture before i succumb and by then, even the gas cannot help, i took the epidural. the epidural took away the pain but u'll still feel some discomfort coz they won't put the dosage high enough to block everything out. you'll still feel the contractions, but it will be just a slight pressure, as if someone pressing lightly on ur tummy.

Jussaemon said...

Wah so fast u read my entry and commented already! hehe

14hours huh!! eeee takutlahhhh Tapi nak amik epidural pon takut!! masuk spine apa suma. Sheesh~ Ohhh but still boleh rasa is it... i ingat bebal terus... ok tgk lah macam mana...

'azMA said...

JuS... heh...semua orang yg deliver at KKH will deliver at the Delivery Suite lah... the so-called 'labour ward' is not called Delivery the Delivery Suite, there are i think 30-odd individual rooms. Each room is furnished similarly - single bed, a comfy armchair, a smaller room a bit like a store keeping all the medical equipments related to labour, a warmer thingy to put the baby on right after delivery, a TV, etc. etc... I had the opportunity to be in 2 different rooms during my labour haha... I think the first was Room 30 before we were advised to labour in the normal ward, then in Room 7 for about 15hrs where I finally delivered.

Yeah I guess it's everyone's hope and will to labour drug-free and yeah I would encourage anyone to try really...

some tips I learnt along the way (those I learnt AFTER I delivered via vacuum delivery and succumbed to gas, pethidine then Epidural - ok people, you can do the calculations of all the added cost haha):
*labour at home as long as possible,
*hope and pray that your waterbag doesn't break too early (mine broke 30mins short of 24hrs before the baby came out) coz in S'pore they doctors will tell you to report to the hospital the moment the waterbag breaks (I haven't really read literature on this, but my hypothesis is VEs may contribute to early waterbag breakage, SO, try to minimise VEs)
*stay upright - lying down is actually one of the most unfavourable positions haha as it aggravates the pain, doesn't allow gravitational force to help the baby descend further, etc....

Oh another thing, abt the Private Suite... it's not actually a room ke's actually like a know where you have a reception counter and consultation rooms... cuma the difference between the Pte Suite and the Clinics you see the gynae at is that the former konon mcm have a nicer ambience (with free flow of coffee/ milo/ etc.), shorter waiting period, and it has a more centralised facilities (i.e. the toilettes for you to settle your routine urine tests, and general untrasound machines in each consultation room so that you don't have to go to another place to do the ultrasound during each gynae visit)... aaahh mcm tu lah...

apa yg aku nak invade orang lain punye blog space ni with such a long reply? heh..Sorry!

'azMA said...

eh I realise ada typo in my previous reply... the so-called 'labour ward' is NOW called Delivery Suite heh

Jussaemon said...

hehe Ah itulah i tot how come labour ward pulak.

Anyways ma... no invasion at all lah! I really appreciate ur reply. Hopefully it will help other pple clarify also - if they happen to read my blog and/or comments, that is.

I see i see... barulah faham skrg..

Wah Ma... parah lah ur hosp bill no wonder u had to pay a LOT of cash. Furthermore i heard the delivery suite is charged on hourly basis.

I think even after my waterbag burst early.. i will try to hold gg to hosp off as long as i can. Somebody i know waited 2 days after klw tak silap! altho of cos there's a worry of infection so was given antibiotics.

farrah said...

heheh just so happen i was taking a break from my marking at work :)

when they did the epidural for me that time, they asked me to use the gas for awhile. so didn't really feel anything coz dah high hahaha.

actually the epidural can totally numb the pain la tapi the nurse cakap better if u can feel the contractions if delivering normally so that u can time ur pushing also. kalau tak nanti tak sync la waste all the effort pushing at the wrong time. think they only give the totally numb dosage if u're doing the c-section.