Having a baby in China: 38-week appointment

This would be our 12th and most likely final appointment. It was a Sunday afternoon, the sun was shining and Mr T and I were enjoying a lovely day together. We thought it was funny when our translator greeted us by saying; “You’re in a great mood today!” I just laughed out loud, amused by what she must think of me.

It was a simple appointment, vitals, urinalysis and fetal heart monitoring. We did have a bit of a scare when the monitor stopped recording, the nurse had to come in and replace the cord but all was fine from there, though the new cord only recorded heart beat but not fetal movement. I could still feel the baby moving so I wasn’t concerned, we were just hoping we wouldn’t have to sit through another 20-minute session of monitoring.

In with the doctor she said my stats were good and she did a physical exam, not surprised to find baby still in breech position. The doctor said she would like to preform a cesarean birth between the 9th and the 16th of June (39-40 weeks). We expected this and said we would schedule for the 16th, still leaving some time for birth to start naturally but accepting the doctor’s wishes not to go past 40 weeks. It was amazing how quickly they were ready to process us in for the surgery, forms were filled out in no time and I had confirmation text messages before we had even left the building!

Although we had succumbed to scheduling the cesarean, I still came with two lists of points that are important to us whether it is a cesarean or natural birth and as much as they were probably annoyed with me, I took the time to go through each one. It was a kind exchange this time and Mr T and I feel that we understand what the hospitals procedures are and that they understand our wishes. I have since typed up my own birth plan and had a friend translate each point so we can have a clear quick reference on hand, just in case.

So that’s it, next installment should be about the birth of our baby!!

-Mrs T

Having a baby in China: 37-week appointment

As it often happens in the small world of expat living we by chance met a couple that had recently (one year ago) had their baby at AmCare. It was just after our last appointment and we were still feeling a bit negative. They had had a great experience at the hospital, I think this was because of two factors: the woman was Chinese, so there was less of a dependency on the translators and the man was very up front and asked for (and got) what he wanted. Before committing to the hospital he wanted to meet with the president of the hospital and would settle only for the lead doctor in the hospital to care for his wife. It was nice to speak to another couple who had used our hospital and hear some positive things. The woman has continued a personal relationship with her doctor and made a few calls and got us an appointment with her. We were unsure what this appointment would be like. Our translator canceled with our original doctor and scheduled us with the new doctor. We didn’t know what type of dialogue (if any) had occurred between the doctors or the translator about us. Had she been warned to watch out for the moody, demanding westerners or were we just another patient to her… This appointment was a very simple one with just vitals, urinalysis, fetal heart monitoring and then a visit with the doctor. It did seem as though the translator was being a bit kinder toward us, and I as well had vowed to come in and stay calm and accepting. The new doctor took great care to explain everything to us, starting with the fetal heart monitoring report, describing what each line meant (contractions, heart rate, and fetal activity) and told us all was normal. Upon her examination she found the baby to still be in breech position and she took the same stance as our previous doctor, but with a bit more sensitivity in her delivery of information. She also did not recommend acupuncture to attempt to turn the baby. She is willing for us to wait to go into natural labor, but would not feel comfortable going past the 40 week mark. We made it clear that we were not expecting anyone to try to vaginally deliver a breech baby, because we think that they think that is what we want, (from what we can tell it is just not done in China), but we would like to give the baby as much chance as possible to turn or let us know it is ready to be born by labour beginning. She explained how the hospital would define cesarean and emergency cesarean and the costs that accompany it. We asked how many days in advance did they need to schedule a cesarean (they can do it the next day). We left the appointment feeling secure in the care we were being given. We know we have done what we can to help the baby move and if it sticks in breech there is a reason for it. What is most important is not how the baby is born but that the baby and mum are safe and healthy. -Mrs T

Having a baby in China: 36-week appointment

Another intense appointment…

We were squeezing in our appointment around what is called a birth rehearsal class. We arrived to first have a fair amount of blood taken for several different tests, which I had to be fasting for. And for the first time we remembered to bring our own breakfast as boiled egg and prepackaged cake is not my favourite thing to eat. We then had our 20 minutes of fetal heart monitoring, heartbeat was strong and steady, though the monitor itself seemed to jump from very low to very high and there was nothing being recorded on the sheet. At this point we had to go for our class so we would return for more monitoring later.

Birth rehearsal class consisted of about 8 other couples, all Chinese. We of course had our translator with us, though I am sure I did not get all the info. Luckily I do feel quite prepared for birth based on my own reading and support of our doula. The important bits of the class were to know when to call the hospital (when contractions are 5-1-1, or when your water breaks), what phone number to call and whether or not to go in the main entrance or into the emergency entrance. We had another tour of the room we will labour in and stay in after the birth and then we were brought up to see the delivery room. We were pleasantly surprised to see the room looking very similar to the labour room, wood paneled walls, and soft colours. The difference from the labour room was the size (a bit smaller), and the bed (designed specifically for delivery). The teacher spent a lot of time talking here about the stages of labour. We were also informed that the operating rooms are just across the hall in case of any emergency.

At one point in the delivery room they asked all the men to go stand in either the bathroom or the closet so each of us women could have a go at sitting in the pushing position. It was quite funny seeing Mr T ushered into a tiny room with a bunch of men he wouldn’t even be able to talk to! I gave the teacher a bit of a scare when I asked if I could push in any other position, and demonstrated by turning around, getting on my knees and facing the back of the bed. I thought she would have a heart attack. The answer to my question was that I would have to speak to my own doctor.

That was the end of the class and we were back down stairs to finish the rest of our appointment. We had 20 more minutes of fetal heart monitoring, which was more successful this time. We were a bit confused about this as the nurse said they couldn’t get an accurate read if the baby was not active, but surely we thought the baby should have a heart rate whether active or not… just another thing we had to trust them on without understanding exactly the meaning. I then went in for an ultra sound as doctor wanted to check the baby’s position. Mr T stayed with me for a few minutes and then our doula joined me in the room (she had come along for the class and wanted to have a look at the baby’s position as well). The most important bit was that the baby is healthy and has a strong heartbeat, but seeing the confirmation of the baby’s head cuddled up against my upper right ribs, really hit me emotionally. I tried my best to not let anyone see, but I couldn’t stop the tears from flowing. Coming out of the ultrasound room I had to sit for a minute and have a good cry. It is just that I know my body was built to give birth naturally and I felt upset that I might not be able to do it. This compounded with having no support or encouragement from the doctor. I knew in a few minutes we would walk into her office and she would be ready to schedule my cesarean.

The visit with the doctor was quite grim. All the same comments about the baby’s position and the way forward remained the same. I asked if I could get acupuncture as I have read and spoke to several women who it has helped to turn the baby and the doctor flat out said no, don’t do it. We continued to hold our position of wanting to go into labour naturally and then proceed to cesarean if necessary, she seemed to accept this though not agree with us. In the midst of this my pulse was rising due to the fact that the translator in the room was proving to be very weak. She could not articulate acupuncture, and had to be corrected by a doctor’s assistant in the room when reporting results of our blood tests (she said your kidney results are normal, when actually it was liver, not the biggest concern of mine however it made us wonder about other inaccuracies she may be reporting back to us). At this point I was adamant that the other translator return to help us.

So there we were sitting with four stone faced Chinese women in front of us and things turned even worse when I returned to the questions from last week’s birth plan discussion. The first point was Could our doula be with us for labour and delivery? flat out answer: no. This completely devastated us, it is something we had been clear about since the very beginning, she had attended an appointment with us and never had the doctor said she wouldn’t be allowed. At this point we both just felt so disappointed and felt there was no sense of trust. The only sympathy we received was a tissue passed to me by the doctor’s assistant (who we had only seen for the first time today) to dry my crying eyes. Our translator went through the remainder of the questions though I don’t really recall what she said as I was so upset. I had asked last week for her to prepare a list of procedures that are normally carried out on the newborn baby and she had not prepared it, so the doctor sat and wrote it as we watched, and the translator begin to rewrite it in English but I said don’t bother and took the doctors notes.

We arrived home that afternoon feeling the gravity of the choice we have made to have our baby overseas. I found myself thinking maybe having an optimistic, adventurous outlook may not suit all of life’s important decisions. It took a few days and many discussions and explorations of our options for us to calm down and accept our situation. I did clarify that our doula could be with us in the labour room and must wait outside the door of the delivery room, which did mean something, albeit it would have been nice for someone to say that in the appointment.

We will be sticking with our hospital, but with a very clear view that we need clear communication and know that what we want or expect may not be what they will do.

-Mrs T