Why, amma, why ?!

My day began like any other day. After a good breakfast and a short nap, I dressed in new clothes and got ready for my daily walk. The weather was sunny and I was happy during the stroll in the fresh air. Suddenly I realized that I was on a different route. I wondered if it was one of those spontaneous outings that seemed to happen over the weekends but before I could wonder anymore, I came to a halt and to my intense surprise, was undressed. I was then measured (I tried to cheat by stretching my legs and toes) and weighed (was I looking too chubby wearing just my diaper?).

For a while, amma was playing with me and I didn’t understand why we bothered to come all the way to play when I had a perfectly good playpen at home ! Then she introduced me to someone else who looked a lot like amma – dark curly hair, similar build and complexion. Maybe this is one of my aunts. She smiled at me sweetly and tickled me. I was laughing, I turned and looked at amma. She looked worried. I was confused, amma usually smiles when I laugh. Then the lady started massaging my legs, uhhh…that felt nice. Just as I was getting comfortable enough, I felt a sharp sting and was shocked ! I thought it would stop, but it became more and more painful and I started screeching.

I turned and looked at amma again. Tears were streaming down her cheeks. I was even more confused. Why wasn’t she doing anything to stop the lady from hurting me ?! Then the pain stopped and I was beginning to relax, when I felt a sting on my other thigh. Now the pain was unbearable and I was screaming again. More tears from amma, but she still wasn’t stopping the lady. Why, amma, why ?!

Amma then hugged me with her tear stained t-shirt. I felt her warmth and it was comforting. She kissed me, patted me down my back and hugged me again, even more tightly. She then shook hands with the lady. The lady patted amma on her shoulder and said something I didn’t understand. Then I got dressed and we went home. Amma didn’t look happy, she grumbled to thatha and paati. She then called appa and grumbled again. I heard her but didn’t quite understand what she meant when she said ‘’Oh…God, what are these doctors doing in the name of vaccination, giving a one month old baby 2 big fat injections ?! Can they not with all the science and technology figure out a painless way?!’’

When I grow up, I should ask her to explain.

Finally, the beginning....

You can read the previous posts here.

When I opened my eyes, Ashok was carrying me ((I made a mental note never to make fun of his body building again) with an extremely concerned expression . After he laid me down on the bed, he told me I fainted. I was shocked, I had never fainted before, ever. For that matter, I had never been admitted to a hospital or had IV and various things stuck to various places ! It was a day of firsts !

The nurse then explained to me that I had lost 1.7 litres of blood (women normally lose 0.4 to 0.5l during delivery) since it took a while to locate the source of the bleeding and stop it. She said it was a miracle that I actually wanted to stand up and managed to do so. The reason she let me do it was because she wanted to see how far I could manage. She gave me a couple of tablets for the pain and I slept and I slept while Ashok took care of both his girls.

In the morning, after spending time with Sahana, I was getting restless waiting for the doctor. I wanted to know when I could take our little girl and go home. When the doctor arrived, she checked me and the good news was that the tampon had successfully stopped the bleeding but the bad news was that it had to come out. If inserting it was painful, removing it was 10 times worse ! When I think about it now, I am actually immensely proud of myself and my pain threshold !

The doctor then asked me if I could stand up. After the previous night's episode, I was a little wary and when I stood up, I was relieved that everything in the room was still in focus. The relief encouraged me to slowly walk around the room. The doctor was happy. She was trying to decide if I would need a blood transfusion. As I displayed reasonable energy levels, she thought that I would do well just with an iron injection (that would help generate my own blood)  instead of a blood transfusion. She only cautioned me that I would have to take a lot of rest and avoid any stress (which included taking long walks, climbing stairs etc.) in the first couple of weeks to give my body time to generate all the blood that had been lost.

A couple of hours later, after thanking everyone, we finally took Sahana and headed home. 

When Ashok was fixing her car seat, I looked at him and vowed to myself that I would never again fight with him for petty things (notice the hidden disclaimer ''petty'' - how can I completely stop fighting with him....life would then be too boring :D). For all the love, care and support he gave me throughout the pregnancy, during the delivery (and now), I was (and am) immensely happy and inordinately proud to be his wife !!

Some words for wisdom for all moms and dads-to-be:

• Stop trying to plan and control everything - Be it the birth plan or anything else, pregnancy and child birth come with their own load of surprises. So go with the flow. Just breathe, relax and believe that things will go well. This is especially a learning curve for when the child arrives because then things are truly out of control. 

• Trust your midwife and/or doctor: It is extremely important to have a midwife/doctor you completely trust. Irrespective of everyone around you, they are the medical experts whose opinion counts when its time to make a crucial decision.

• Remember, pregnancy is not an illness: Just because you are pregnant, it doesn't mean you have to stay in bed all day (there are exceptional situations). You can stick to your routine as long as you are not exerting yourself too much. For example, my colleague is a runner (i.e she runs every day) and since she is used to running she ran until her 34th week ! Obviously you can't begin training for a marathon when you are pregnant, but you can continue doing what you did before, as long as your body can handle it.

• Natural childbirth is preferable but keep your options open: While natural child birth without any medication or induction is definitely the way to go, have a plan B when there are complications. Look into pain medication options (there are quite a few) so that you understand the pros and cons. For example, not everyone can have epidural. One criterion is that you should not have had back problems or pain. Also not everyone reacts to the epidural the same way, for some women, the pain relief is only partial or its too late in labor for epidural to be administered. 

• Keep the communication loop as small as possible: While you would need support from the family, there is no need to inform every aunt, uncle and cousin that your labor has started, especially if they do not live in the same city or country as you do. This will only make them feel helpless and anxious, which would result in multiple phone calls that you neither have time nor patience to handle. For example, we only informed appa and amma after calling the midwife. Similarly we didn't inform anyone in India (including Ashok's parents) that I was in labor. Ashok only called them after Sahana was born.

• Remember the value of positive energy: The more nervous you get, the more adrenaline your body produces and this inhibits oxytocin (the hormone needed for contractions), so remember your breathing exercises and do them. Listen to something you like or do something you like (read a book or watch a funny movie), recollect all the happy memories from your pregnancy and above all, remember all the good wishes from near and dear ones. There is immense power in positive thoughts !

• Find the line between well-informed and ''over-informed'': Attend a maternity class or a course to understand the various terms and to be prepared, especially if you have a desi family, you might have to contend with a lot of superstitions and knowing the actual facts would help. Note that there are a lot of beliefs based on actual facts but telling them apart is not easy, if you are not well-informed. At the same time, reading every thing that Google churns out will only give you nightmares ! 

• Keep the Dad involved: Even if you have a big family of aunts, grandmothers and a whole horde of women to help, it is always important to keep the dad involved. This not only enhances the emotional attachment between the child and the father, but it also helps keep husband and wife close. Many couples drift apart once a child arrives, because the woman is always busy with the child and the man feels left out and less loved. Remember that the grandmothers and aunts can't be around for ever, so it always helps if the dad knows how to change a diaper or sterilise a bottle !

And above all, cherish this time - pregnancy and child birth come with a load of work but also bring with them tonnes of happiness and joy and as years go by, its the happy memories that will stay with you !

With all this behind you, you then have something wonderful to look forward to - being a parent ! 

My more-than-perfect little one - Part III

In case you missed the previous part, you can read it here.

I woke up, saw Ashok and wondered when I got back to my hospital room from the OR (where the epidural was administered). I was told that I had been asleep for nearly an hour. I was shocked and asked ''Does that mean I am not having any contractions at all?'', the doctor smiled and said ''No, it means the pain medication is working perfectly''.

She checked me and found out that I was 4cm dilated, still a long way off from the needed and elusive 10cm. I gave a wry smile - I had thought of a Friends epsiode (the one where Rachel has a baby), where Rachel's dilation is really slow and after nearly 24 hours when the doctor says she is 4cm dilated, Ross who has been by Rachel's side all along and is exhausted and is taking large sips of water, stops and shouts in desperation ''How can she be only 4cm dilated ? I am dilated 4cm'' ?!?

The doctor suggested giving me oxytocin intravenously. Oxytocin is generated by the body to help increase the frequency of contractions and hence dilation. Giving oxytocin via IV can make the contractions more frequent and hence, more painful. Since I was already on pain medication, the doctor wanted to take advantage of it and help speed up the dilation process. Once again, after making sure that it cannot have any negative effects on the baby, I agreed, only after shedding a few more tears (well, I am likely to blame the hormones). When I think about it now, I am glad I cried instead of being mean and rude to the people around me, like Rachel does.

Once the IV was in place, I drifted off to sleep again. 2 hours later, I woke up feeling undue pressure on my pelvic floor. I informed the nurse who was checking on me and she immediately fetched the doctor. I was nervous - was something going wrong ? The doctor came, checked me and when she said I was 10cm dilated and the pressure I was feeling was nothing but my body's way of asking me to push, I couldn't believe my own ears !! It was then 6:30pm on monday, June 24, exactly 41 hours after my first contraction.

I steeled myself to push (I was always told this was the hardest part). I pushed 4 times and at 6:42pm, our beautiful little girl was born !! She was perfect - weighed 3.54 kg and got an apgar score of 10 !! In 30 minutes, she was cleaned up, dressed and was drinking from me. And yes, the cliche is totally true - Once you hold your new-born, you forget all about labor and the pain and at that moment, nothing else matters ! And I cannot describe the happiness I felt, when smiled at us (yes, she did, on the day she was born!!)....

Even during pregnancy, I always told Ashok that if they took the baby out of the room, he was to leave me and follow the baby instead, just to know what was happening. Truthfully though, I always had this irrational fear (probably from watching too many bad movies) that the baby would get switched. I don't mind getting a different baby but my question always was ''what is the guarantee that our baby would end up with parents as nice as us?!'' and Ashok would always respond the same way ''oru payithiyatha kalyanam pannindu kashta padaren'' !!

The reason for the digression was because MMC Veldhoven made all this irrelevant. The room was completely equipped with everything needed for the baby, so she never had to leave the room and was always in my view.

Photo shows the kraamsuite (delivery room) in MMC Veldhoven. Restroom, changing table, sink/cleaning area are not shown in the picture. I was in this room throughout my stay (except when I was taken to the OR for epidural)

Seeing my little girl, all the time, definitely made things a lot easier. Sahana had happily gone to sleep.

But my ordeal was not over yet. I had only a couple of stitches and they were done long ago. But still the doctor was busy with me and I failed to understand why. Then she explained that I was still bleeding and they were unable to locate the source. After nearly 40 minutes, they determined that it was a ruptured blood vessel. Unfortunately they were unable to access the blood vessel, irrespective of using all kinds of paraphernalia. So they were contemplating whether to take me to the OR to surgically stop the bleeding.

Since any surgery comes with inherent risks, my doctor came up with another suggestion - to stop the bleeding by applying pressure on the blood vessel using a tampon (the size of a kitchen sponge, I am not kidding!). The term ''dying of pain'' suddenly became all too clear to me. I later remarked ruefully to Ashok that for all the pain, it would have been nice if we had had twins !!

I was too tired to eat, but managed to have some brown toast with jam (perfect food for labor actually, easily digested and gives a sugar boost), fed Sahana again and then after a short nap, asked the nurse if I can stand up (I had been lying down for nearly 12 hours). She helped me with all the gizmos I was attached to and I got up after what seemed like gymnastic manoeuvres. I thought standing up would make me feel better, instead I felt like the room was spinning and the next minute, everything became dark.

I promise there is just one more post on this subject. The reason I am going into detail is because I want to share some lessons learnt with moms and dads-to-be and if my story helps even one of them, I would consider these posts time well spent !

The less-than-perfect Delivery - Part II

You can read about how it was already a week past my due date here.

In the wee hours of sunday morning (1:30 am to be precise), I had my first contraction or atleast what I thought was a contraction. I  wanted to see how far apart they were to make sure it wasn't false labor, before I woke up Ashok. The contractions were nearly 30 minutes apart. So I knew I was a long away off from having the baby. So I went back to bed and ran a checklist in my head - hospital bag packed ? car seat ready ? all needed numbers saved in the phone ?

I was too excited to fall asleep, so waited until 5am, took a cold shower, wore comfortable clothes and started googling for dos and donts during labor. Ashok and I decided not to tell amma/appa anything until the contractions became more frequent. The day went on and by evening, my contractions were still 20 minutes apart. So I went to bed tired and confused.

Around 3am, the contractions became more painful and were 10 minutes apart. So I called the midwife. She came home** at 3:30am and checked to see how dilated I was. I was only 1cm dilated (it has to be 10cm before the baby can be born) but the midwife said this was good news because the process had begun. I was relieved.

She came back at 6:30am and I was 2cm dilated. She came back at 8:30am and said I was still only 2cm dilated. This was a problem.

I had already been in labor for nearly 31 hours and had not slept well for 2 nights in a row. The dilation was really slow and this meant it could easily take another 10 hours or more, until it was time to push. The midwife was worried that by then I might be exhausted and might not be able to push at all.

She looked at me and said ''I know you said you wanted no pain medication, but its time to consider epidural''.

At this point, I burst into tears and expressed all my frustration in a volley of words ''I am healthy, I did yoga, I exercised, I ate right, why is this happening to me ?!?''. My midwife calmed me down and then asked ''Do you realise that there are not many women who can take 2 sleepless nights and 31 hours of labor ? Even after all this, you did not suggest pain medication yourself - do you realise that such will power comes only from being strong physically and emotionally ?''. She then went on to explain that the speed of dilation, especially for the first delivery, varies from person to person and has no direct relation to one's health and humourously remarked ''If yoga and exercise were enough for dilation, then why would anyone go through labor !?!''

My mind was racing to remember everything I had read about the use of epidural. After having the midwife reassure me a few times that it has no side effects on the baby, I looked at Ashok with tears welling up in my eyes again. He took my hand, squeezed it and said to the midwife ''lets do it''.

2 hours later, I was admitted to the MMC Veldhoven (which incidentally is the best hospital to give birth, if you are in Eindhoven, take my word !) and was answering questions from the anesthesiologist (personal details, allergies etc.). Minutes later, the epidural was administered.

Since this post is getting longer than planned, I will save the rest of the story for the next post.

**In NL, the midwife comes home to check on the pregnant woman and only when labor is well underway, she is taken to the hospital. This is based on their belief that if the labor is long, the woman (and her family) will feel far more comfortable at home than in a hospital. 

The Perfect Pregnancy - Part I

Yes, I can truly and honestly say I had a perfect pregnancy.

I was flying the day I found out....not figuratively, literally. I flew a small aircraft (was a birthday present from my husband) and then we came home only to realise, there was another birthday surprise waiting for me.

I cannot describe the dhaam dhoom on the day I told our families....fire crackers and sweets everywhere ....again, literally, because it was Diwali !

Ashok and I finally decided to grow up and moved out of our city centre apartment (where people kept partying at all time and restaurants/cafes were just a few steps away) to a residential neighborhood and replaced our bikes with a car (well, we still have the bikes).

People kept warning me about morning sickness, food cravings, feeling tired etc. I waited but none of these came, I went about my life as usual - having fun with Ashok, work and travel.

People cautioned me against air travel. But I was in Chicago for work, in India for my baby shower and except for the slightly big tummy, I felt no difference.

I dutifully joined pregnancy yoga and even started with something new called ''dancing for birth''. Truthfully, I had more fun dancing than doing yoga. Ashok and I also started attending maternity classes and the more they told us about what would happen before and after, I was getting intrigued but not scared.

Every appointment with the midwife (in NL, a doctor is called for only when there are complications with a pregnancy) was the same - everything was normal with me and the baby was growing well.

At 21 weeks, we started shopping for the baby and planning the nursery. I was so overjoyed that Ashok had so many ideas for decorating the nursery (Like our wedding, I thought he would just leave all the creative ideas to me! But I was so glad he proved me wrong)

At 34 weeks, the ultrasound showed that the baby height and weight was above the Dutch average (and this is saying something if you know how well-built the Dutch are!) and that he/she was very active. We also created a birth plan with the midwife and I confidently said I would need no pain medication or any other medication for that matter and would prefer a completely natural child birth.

At 35 weeks, the baby's head was down (this is needed for a normal delivery).

At 36 weeks, the baby was ''engaged''. I also started my maternity leave (obligatory in NL from the 36th week). I had a great send-off at work. My boss was extremely happy that I had transitioned my projects very smoothly to my back-up.

At 37 weeks, we took my parents to Germany, to Cologne. It was my father's childhood dream to walk along the Rhein river one day and it made me feel extremely proud and happy that I was able to make that happen (Life sure take its own interesting turns - whoever knew that I would actually live only an hour from Cologne some day or was it my father's dream manifesting itself in my mind as a desire to study in Germany ?!)

At 38 weeks, we took my parents to Amsterdam. During the Amsterdam canal cruise, my amma marveled at the beauty of the Dutch architecture and their design of the city with canals and told me ''Lifela idhellam parpenu nenachu parthadhe illa....''**....I was elated....it was one of these little pleasures of life to realise that something so simple from me could give her so much joy !

At 39 weeks, we went to Ardenne, Belgium (Ardenne is a hilly forested region like the black forest in Germany) to a small and picturesque village (La Roche en Ardenne). Appa tasted his first Belgian beer there and enjoyed it immensely.

At 40 weeks, even though, appa, amma and Ashok kept looking at me for signs of labor, I displayed none. So we went to IKEA for some left-over shopping. A note (for those unaware of the pregnancy science): A normal pregnancy lasts 40 weeks, even though a baby can be born anywhere between 37 and 42 weeks.

At 41 weeks (since I was one week late) my midwife referred me to a gynaecologist to make sure that everything was normal with me and the baby. It was, in fact it was so normal that my gynaecologist was convinced that my due date estimate was wrong (it is impossible to predict when the egg was exactly fertilized, due date is approximately estimated based on the menstruation cycle and size of the baby). She also asked me if I wanted labor to be induced (In NL, a choice is given to the mother until the 42nd week about inducing labor, when there are no medical complications) and I confidently said no. I was determined to have a natural child birth.

A day later, I had my first contraction. While I was excited that I was going to see my little one soon, I was also a teensy bit upset that my perfect pregnancy was coming to an end.

Want to know if my delivery was as perfect ? I will get to that in Part II.

**Translation: I never thought I would see these things in my life.