Having a baby in China: 34 week appointment

This was an interesting and intense appointment. It included vitals as normal including urinalysis, also ECG and pelvic examination. We had our first non-stress test, which was me sat in a comfy armchair for 20 minutes of fetal heart monitoring. It was relaxing and reassuring to just sit there and listen to the baby’s heart beat, also so interesting to watch the rate change and wonder what was the cause. The doctor’s examination confirmed our thoughts that the baby has yet to turn, seems to be lying transverse across the middle of my belly. Cesarean was brought up again. After a bit of conversation we were able to get across we do not intend to plan a cesarean and would like to give this little one as much chance as possible to turn. If we get to a point that labour has begun and there is no sign of baby moving into the right position we will of course take the safest route to have a healthy baby and mum, which here in China is a cesarean. The doctor seemed agreeable to this.

It all got interesting when we began to discuss the birth plan. The hospital provides a booklet with different options (written in both English and Chinese) regarding your time in the hospital through the birth. The sections include:

Environment (Accompaniment/During labor/Mobility and positioning/pain relief) Labour (Episiotomy/Placenta/Patient transport from the delivery room to the patients room)

Newborn Care (Immediately after delivery/Umbilical cord/Newborn’s vernix)

Cesarean Section Delivery (Cesarean Section Planning/Anesthesia during the cesarean section/ Medication after the cesarean section/Company during the cesarean section)

Postpartum (Breastfeeding/Nursing interventions and newborn care/Meals/Visitors.

Within each section there are several options to choose from and an area for remarks. Mr T and I had spent considerable time going through it, as well as going through it with our doula. We handed it to the doctor, and she slipped it into the file and continued on with the rest of the appointment, from that moment we knew we had a bit of a battle ahead of us. We had to ask to go through it, and each time after we discussed a point, she began to close it up to put it away, whilst I had to say, next point please.

From the very first point, accompaniment, there was a problem. I had selected partner and friend (doula), and was told only one person is allowed. I found this frustrating, as we have been very clear since we started visiting the hospital (34 weeks ago) that we had a doula and she would be attending the birth with us, which up until today had not been an issue. The long discussion over the whole birth plan ended with a very red faced mama-to-be and a list of things that the doctor would be applying to get approval for. We will have to wait and see what types of accommodations the hospital will be able to make at our next appointment.

As you may know from previous posts we are looking to have a natural birth. I believe that a woman’s body is made to give birth and knows exactly what to do. I would like all opportunities to allow my body to do what it needs to do to birth this baby. I have read many positive natural birth stories and have the support of a doula that has given birth naturally and attended many natural births. If I were giving birth in America or the UK I would be opting for a home birth or going to a birth center. (I of course will accept interventions when medically necessary to ensure baby and myself stay safe.)

That being said we know we may face some challenges delivering in a hospital, in China. But we remain hopeful that with good communication and clear information we will have a happy healthy baby before we know it.

-Mrs T

Having a baby in China: 28/30/32 week appointments

I am grouping these three appointments together as they have all been very straight-forward and similar. At 28-weeks we began visits on a two-week cycle rather than four-weeks, this will last up until 36-weeks and then appointments will be every week until birth.

At each of the last three there have been vitals, uterine fundal height, abdominal perimeter, fetal heart Doppler and urinalysis. Two of the three appointments included a blood test and one had an ultrasound. We have continued to receive ‘normal’ results in all testing, and baby’s heart rate has remained at a similar rate all through pregnancy which is great.

The ultrasound at the 30-week appointment was a bit long and uneventful (I nearly fell asleep a few times). They again struggled to get the measurements they were after as baby wasn’t in the ideal position for them. We did get one nice silhouette of the head but just for our viewing in the room, the images they sent home with us were of the spine and some unidentifiable (to our eyes) body parts.

The 30-week ultrasound did start with the Dr informing us that the baby was in breech position and if it doesn’t move they will schedule a C-section. This was again repeated at our 32-week appointment upon Dr’s palpations. As we are planning for a natural birth these are not the most encouraging words, however I have had lots of great ideas from my doula and books and we are doing what we can to make room for baby to move around. I will say though I have been a disappointed in the hospital/Dr to not have even suggested anything to turn baby, or let us know there is still plenty of time. At least we know the position and can give proper effort to share our position with them. (Of course I will do whatever is medically necessary to ensure baby and mother are safe and healthy, but I strongly believe in the nature of labor and birth, our bodies know exactly what to do!)

Additionally, comments about my weight (gain) have decreased significantly since I spoke to the translator about being a bit more sensitive. At our last appointment we were even told that my weight was perfect! Mr T and I had a big giggle then and saw a bit of a laugh from the Dr, we thought there was even a hint of sarcasm!!

This week I will begin to scale back on my workload just a bit. Still feeling lots of energy but the heat and demands of a class of six-year olds is beginning to get challenging. I will begin my maternity leave at 36-weeks.

We are looking forward to next week’s appointment where we can check baby’s position, go over our ‘birth plan’ and organise a delivery room tour.

-Mrs T

Perfect Pancakes

This morning we ventured out to try a new spot which we found on one of our favourite parts of Tianjin (Wu Da Dao). After a quick look we thought we had finally found somewhere to get a good western breakfast in Tianjin. Despite the challenge of ordering food with no English menu and pictures we were quite impressed. The pancakes were tasty and we were even able to get butter and maple syrup on the side. Two meals and two hot drinks for 119 rmb ($19/£13), we will go back for sure!

-Mr & Mrs T

Having a baby in China: 24-week appointment

We were expecting this to be a quite a big appointment, I had read a bit about the glucose test I would be having and we had another ultrasound which we were very excited about. To make it more enjoyable our new baby friends were there for their appointment as well so we had someone to chat with whilst waiting.

We checked in, my blood pressure and weight were measured. They took my first of three blood samples and I was then given a sugary drink and instructed to drink it all within five minutes. They then let me know that I needed to go for blood again after one hour and then two hours. We had no idea we would be at the hospital for over three hours!

While waiting for the second blood draw we went in for our ultra sound and again the technician was not pleased with the baby’s position and not able to get all of her required measurements. We were sent out to walk and hope the baby would change position.

Blood draw number two, (which I had to remind the nurses it was time) was my first experience with a bad technician. I could feel that the needle was not in the vein though she still attached the tube and acted surprised that no blood came out. On her second go she had to call in for help whilst the needle was sticking out of my arm! Help arrived and blood was drawn.

We went back in the ultrasound room, this time the technician was getting a little more aggressive trying to move the baby who was still not in the right position. We were sent out again and this time I made a bit more of an effort to move around to try and get the baby moving.

Blood draw number three went well on the first try and it was finally time to eat. Hot soymilk and chocolate marble cake was the breakfast provided, it made us think why did we not bring our own snacks?? Next time…

Third time in the ultra sound room and baby was still not cooperating, though with me on my side she was able to get the measurements as well as a picture for us.

By this time it was noon and we then had to wait to see the doctor as she was out for lunch. We heard the heart beat on the Doppler and all of the days test results were normal. The doctor did say that I had gained too much weight since my last visit and I should work to not gain too much weight.

I heard the weight comments but didn’t really listen to them. I have been feeling fantastic and really healthy throughout this whole pregnancy and I am often told I look great. My doula has been really happy with how things have been progressing. Despite knowing all of this the comments did start to get to me. Whilst waiting for our taxi I decided to have a quick chat with the translator.

As kindly as I could I tried to let her know that this subject of weight gain can feel quite sensitive to a (pregnant) woman. I can appreciate some sensitivity may be lost in translation but bluntly saying “You’ve gained too much weight” is not really the best way to give this information. If the doctor has a medical concern about the amount of weight gained that should given to the patient. Additionally I said that she should maybe recognize that western women’s bodies do differ from Chinese women’s bodies. We take on weight and fat a bit differently. This point she quickly argued against and said no we are the same (western and Chinese women). I emphasized to her that I was comfortable with the weight I have gained, as was my doula, however I thought she should know how the doctors comments (given through her) may seem quite negative to the person receiving it.

I think she was very surprised by my comments but I had to do it. 16 weeks to go….

-Mrs T

Having a baby in China: It’s a small world

On every visit to the hospital we always wonder if we will see any other expats. We’ve asked our translator and have been told there is only about four other western patients at this time. For a few appointments we did see another non-Chinese couple but were never brave enough to go up and say hello.

Of all places I met this other mummy-to-be at the monthly gathering of the Sauvignon Club. (Once a month we expat ladies gather for good food and wine at the St Regis Hotel.) The chairwoman had mentioned to me that she had another woman wanting to attend but not drink any wine (which is kind of the point of the club). I was so surprised to see the woman from the hospital appear and even more surprised when she said, “I know” after I introduced myself. It turns out that for about an hour into one of her appointments they thought she was me and kept calling her by my name!

It was really lovely to meet another pregnant woman and we have stayed in touch since. She has met up with our doula to go over a few things and we were able to have a birthing class together with her and her husband. I feel extra lucky to have met her as her due date is about 11 weeks before mine so she will be able to give us the low-down on labor and birth at AmCare.

-Mrs T

 

Having a baby in China: 20-week appointment

We had been looking forward to this appointment, as we knew it was the time when we could find out the baby’s gender and so we expected a good view on the ultrasound.

It was a very standard appointment: vital signs, blood draw, ultrasound, Dr. consultation and FH Doppler. We had a bit of a hold up with the ultrasound as baby was not in the correct position and they could not see all the organs and get all the measurements. They asked me to go out and walk and eat to see if we could get the baby to change position. During this time we took the opportunity to have another tour of the hospital as our doula had joined us for this visit. It was nice to have a second look, knowing this time that we would actually be having a baby here. She was very interested to see what the facilities were like and was impressed with what she saw.

The funniest moment of the afternoon was after asking their policy of eating during labor (its the mother’s choice) we were told that a tray of snacks would be available including cake, biscuits and red bull. We just could not believe our ears, when we asked about the red bull the translators reply is that mum’s get tired in labor and need the energy! Not sure if red bull (especially not Chinese red bull) would be top of my list whilst in labor.

Back to the ultrasound room and after a bit of prodding baby did a little flip, which we got to see on screen (pretty amazing) and all the needed information was retrieved. In the end we decided NOT to find out the baby’s gender. It was something we had been going back and forth on since the start and we finally decided that we would like to be surprised.

Since our doula was with us we took this time to go through a long list of questions about labor and birth and were pleasantly surprised with the responses. In general they seem very supportive of natural birth and patients making decisions for themselves (taking into account that mother and baby are safe). At our 34-week appointment we will go through a detailed birth plan and tick our choices.

Four weeks until the glucose test…

-Mrs T

Having a baby in China: 16-week appointment

After a lovely Christmas holiday in the UK we were off to the hospital the morning after we had flown back. We were a bit jet lagged but as always excited to check on our little baby. What on paper looked to be a fairly boring appointment was far from it and it took a turn of events you would only experience in a country that was not your own.

The appointment consisted of blood tests (which I had been fasting for), urine test, fetal heart Doppler, physical examination and consult with the doctor.

Things got interesting whilst the doctor was looking to find the heart beat with the Doppler. It seemed to take quite awhile, I myself was feeling quite nervous and that didn’t even compare with how Mr T was feeling on the other side of the curtain. Heartbeat found and we all breathed a sigh of relief! Our translator then proceeded to tell me that the doctor was having trouble with the Doppler due to the amount of fat on my stomach. She continued to say that the doctor was surprised, as my face looks quite thin, she would not have expected so much fat on my mid-section!

WOW! This only partially explains how I felt and the expression on my face at the time. Luckily I was able to laugh it off for a few reasons: 1 – I have always carried extra weight in my middle, I have thanked my parents and grandmother many times for this. 2 – I have even experienced strangers and co-workers asking if I was pregnant years and years ago when I wasn’t even close. Finally 3 – I have been abroad and in China long enough to know that things do get lost in translation and sometimes different cultures do not always express the same sensitivity about things that they would back in the US or the UK.

To continue our amusement during the consultation time the doctor showed concern about my weight. Since the last appointment (4 weeks prior) I had gained 4 kg/ 8.8 lbs. In the moment I felt a bit defensive as I had just been on a three week holiday, in which I did spend a lot of time indulging in my favourite English treats as well as being off work which means a lot less time on my feet walking around and chasing five-year olds all day. Even though I knew this and expressed this to the doctor I did take the weight comment to heart and was already thinking about how I need to ramp up my physical activity and be a bit more conscious about what I was eating.

We asked how much weight I should gain over the whole pregnancy and the doctor said 9 kg/ 19.8 lbs. It wasn’t until after the appointment that we were able to calculate and realize that 9 kilos over 9 months is one kilo per month. At the 16-week appointment I was up four kilos from the very start, which is in line with one kilo per month. This did ease our minds a bit but I wouldn’t soon forget the weight and fat criticism from the doctor.

Four weeks until our next appointment…

-Mrs T

Having a baby in China: Prenatal vitamins

So far each visit to the Dr had included a prescription and purchase of prenatal vitamins. I had enough to get me through to our next appointment and thought I would take a look whilst in the UK and see if I could get them at a good price. I hadn’t remembered to look at what I was paying at AmCare but was quite certain that they would be cheaper in England.

I was pleasantly surprised when I visited Boots pharmacy and found their brand of vitamins at a great price.

Boots Pregnancy Support 30 tablets

I was able to stock up with enough through to this summer (12 boxes of 30-day supply) for £27.92 ($42.98/269 rmb). This amount was even more appealing when I arrived back in Tianjin and looked back at my receipts and found we had been paying 135.5 rmb (£14/$21) for each 30-day supply. In total we saved 1357 rmb (£140/$216) by stocking up.

The moral of the story here, stock up on prenatal vitamins, and any other medications, from home if you have the opportunity to do so!

-Mrs T

Having a baby in China: 12-week appointment

This was our first official appointment within our package and we couldn’t have been more excited. Due to our anticipation and the fact that I was required to fast we made a very early start with an eight o’clock appointment on a Saturday morning.

We were greeted with the usual cheery welcome, despite our translator not being in sight. We were checked in and I received my hospital issue wristband which they use to scan me into each area of the hospital. Vital signs were taken right away, as well as a urine sample and we were left to wait in the cafe area. We could sense a bit of worry amongst the staff members, and it looked as if they were typing away into their phone translators. I was impressed when someone came over with a preprinted form with Mandarin and English and pointed to the line that said, “May I take a blood sample?”

The nurse taking my blood worked quickly and steadily as they took more blood than I had imagined they could take at one time. I believe about seven different vials! Next to even out my blood sugar I was given a boiled egg, a piece of cake and some warm milk.

Our translator arrived just in time to join us for the ultra sound, this was the bit we were most excited for and it met our expectations fully. It was an amazing moment to see the actual shape of a baby on the big screen and to hear the heart beat for the first time. Any worries were washed away and I enjoyed watching Mr T’s excitement and our translator’s amazement of a husband so eager and interested.

We met with our Dr who examined me and took a pap smear for a few tests. She did have a go at using the doppler to hear the baby’s heart beat but she couldn’t get it. We didn’t worry much as we had just heard it in the ultra sound.

She gave a few instructions to eat healthily and take pre-natal vitamins and that was it! We scheduled our next appointment four weeks from then and left the hospital feeling so pleased and excited about the future.

-Mrs T