Wednesday 28 December 2016

39w7d Baby is Here: Emergency C-section at Pyeongtaek St. Mary's

Updated 17 September 2017

My first birth was at Agitanseun Natural Birth Center (김옥진조산원) Kim Ok Jin (Rosa) at her old location in Ansan. Since then I had gotten involved in the natural birthing community and become a childbirth educator, postpartum doula, breastfeeding counselor, Dunstan Baby Language Educator, and La Leche League Leader. I felt confident in my abilities to give birth naturally and had planned on a home birth.

Unfortunately, it ended up with an emergency C-section. For those who say I shouldn't have attempted a home birth, I totally disgree. Had I been in the hospital during labor, I'm sure I would have had a much shorter labor before they did major abdominal surgery that left me with a 5.5 inch scar from the C-section. Labor is beneficial for both the mom and the baby.

I had a lot of difficulties coming to terms with it, especially since I 100% believe that the interventions led to the C-section, with pitocin most likely being the cause of it. It turned into a horrific nightmare. Yes, the baby's heart rate was at 90 when I was transferred to the hospital, but it then dropped to 60 while there. My midwife refused to give me pitocin because it can increase or decrease a baby's heart rate. I believe that had they not given me pitocin, I could have had a vaginal birth.

Labouring at Home with Danica and Jinny from Mama's Birth Center
I mentioned before that I was having a home birth. My midwife came to check out my house a few weeks before and I showed her my birthing box that I had prepared. Then she dropped off a bag full of supplies as well as oxygen.

I'd been having contractions for the past two nights. My husband and I had just gone to the pharmacy to get some cough medicine. I was having minor contractions but thought nothing of it. He went back to work and about 20 minutes later my water broke. I called him and told him and he asked if I was kidding since I had just told him to go to work. I then cancelled my doctor's appointment that I was supposed to go to. While on the phone I had sent kakao messages to my Jinny my doula and Danica my midwife. I texted my neighbor and asked her to pick up my daughter from daycare.

The midwife and doula arrived around noon and I was only 2cm dilated but it felt like I was further along. The contractions picked up in intensive pretty quickly and all I wanted to do was stay in the bathtub. It was comfortable and I didn't have to worry about peeing myself. The baby was sunny-side up so labor was much more intense than my first. Being in labor with a sunny side up baby is a lot more intense than being on pitocin with no painkillers. I spent a lot of the labor straddling the toilet in reverse and in the tub.

My husband was not that helpful to be honest. He went in the bedroom and was watching The Simpsons. My doula did pull him out of the bedroom and got him to help while I was on the birthing ball. She took photos so he does have proof that he helped. However, he said he didn't think he was needed since I had a midwife and doula. I don't think he really knew what to do. (He should have paid more attention in the birthing class).

We tried to flip the baby by side lying and hanging my leg off the couch. It just wasn't working. My midwife kept checking the station, dilation, and heart rate and things weren't looking good.

Transferred to Pyeongtaek St. Mary's
Around 7pm her heart rate dropped to 90 (the norm is 120-180) so they transferred me to Pyeongtaek St. Mary's. I was only 4cm dilated but it felt like I was in transition.To make it worse the baby had just gone up a station. I had asked if I could wait an hour, but they said no. My neighbor came over and helped frantically pack a bag to go to the hospital.

I think going in they wanted me to get a C-section. I was given an epidural, oxygen, pitocin, antibiotics (since I had a cough and runny nose), fluids, and a catheter. I had an EKG test and multiple NSTs. I was not allowed to eat or drink anything. I was allowed to move but with IVs in both my arms plus a catheter, movement was very limited.

My doula and midwife came with, but the doctor quickly kicked them out. Luckily, Mary the nurse was on call that night and she was familiar with my case. My doctor, Dr. Lee was also there, but he didn't perform the C-section. 

I am fully convinced that them hooking me up to pitocin caused her heart rate to drop. My midwife had pitocin and refused to give it to my. Why? Because it can cause a baby's heart rate to drop or go up dramatically. Had I not been given pitocin, I probably would have been able to have a vaginal birth.

They bullied my husband into signing the papers by saying the baby could end up dead. The reason the baby's heart rate was dropping was due to pitocin and all the stress they were putting me through. They should have taken me off pitocin. I wish I had had advocates for me there, but they had kicked my midwife and doula out. This was my second birth and I had planned it well, yet all the interventions got out of hand, as they usually do.

Frantic Birth Plan
When I realised the baby was going to be born soon, I started telling them what I wanted and didn't want. I didn't have a birth plan because I hadn't planned on giving birth in a hospital. I was told that immediately after the birth I would be able to hold her and breastfeed her, so I said no formula. True to their word, they did not give her formula: they gave her sugar water. I wasn't able to hold her for 13 hours, not because she wasn't ok, but because I was unconscious and had IVs in my arm. I said delayed cord clamping, but that didn't happen either. They didn't bath her, but they sure scrubbed all the vernix off her.

Emergency C-section
Her heart rate dropped to 60 (the norm is 120-180) and then they gave me a spinal and took me to the OR. In the OR they gave me something in my IV that made me unconscious. My husband was not allowed in. She was born on her due date at 11:39pm. They briefly stopped the drip that kept me unconscious. I remember seeing the coiled cord in the bucket before I saw her. They didn't do delayed cord clamping like I had asked. Her APGARs were 8 and 9. She had a flat head on top which makes me think she was brow presenting which would explain the small measurements and failure to progress.

Recovery
Afterwards I was unable to move or open my eyes for about 5 hours. I could hear what was going on around me though. I was flat on my back for 8 hours in order to prevent a spinal headache. When I woke up I had short-term amnesia. I thought I was in Peru with my ex. I left Peru almost 6 years ago. 13 hours after the C-section they took the catheter out and I was able to walk. Contrast that to my first birth where I walked out of the birthing center 8 hours after giving birth.

I was given antacids, antibiotics, and pain killer pills three times a day. I really don't think they helped. I ended up with 2 ketoralac shots 8 hours apart on the second day because the pain was so bad.

I was alone so I had to do everything myself, like bus my food trays four times a day and walk to the nursery. The food was decent. I got three meals plus a snack. I was able to choose between Korean food and Western food. I decided to go with Korean food since I knew that the cooks could cook Korean food. I certainly didn't eat everything. I didn't really like the food, so my daughter and husband got some. There wasn't much fruit. I think I got fruit once or twice, so my husband brought me some.

Amazing Nurses
I really didn't enjoy my recovery time at Pyeongtaek St. Mary's. However, the nurses and international clinic were amazing. Mary and Luna helped me fight against some of the policies and worked with me even though they might not have agreed with what I wanted. They helped me breastfeed without taking the class, breastfeed on demand, got the baby into my room, got me discharged early, and allowed visitors outside of visiting hours. 


Not Being Allowed to Hold the Baby
I still hadn't held my daughter. I was told that it was hospital policy that while I had an IV in my arm I couldn't hold her. They wanted to keep me on morphine, fluids, and antiobiotics for 1 day and then do 2 more days of antibiotics for my upper respiratory infection (aka the common cold).

Meaning that if I followed what they wanted, I would be able to hold her on the 4th day. I'd be free to look at her through the windows though. I told them to stop the morphine and fluids and that I didn't want antibiotics. I'm not sure if you've ever been suddenly taken off IV painkillers and given Motrin instead, but let me save you the trouble about imagining what it's like and tell you that headache medicine does not help when they've put a 5.5 inch incision into your lower stomach. It just doesn't work. They took all the IVs and catheter out and then I was taken to the nursery.

Being Told I Wasn't Allowed to Breastfeed
I was shown the baby through the glass and when I asked to breastfeed her, remember, it's been a little over 13 hours and all she's had was sugar water, I was told no. Why? I'm glad you asked! I had to take a class before I was allowed to breastfeed. Thankfully, Mary was there and told them that this was my second child, I'd breastfed my first until she was 4, I actually teach breastfeeding classes, and I was one of two La Leche League Leaders in Korea. After about 10 minutes of arguing how I was able to breastfeed, they finally "permitted" me to hold her.

Let me just tell you that the "class" they teach must be pretty crappy. All women were given nipple shields and they all used them, they "cut" their breasts instead of used C or U holds, and they were leaning forward.

Where Babies Can Stay
You had two choices about where the baby would stay: the nursery or your room. You couldn't take the baby to your room and then put them back in the nursery. Since it took me about 15 minutes to walk 10 feet (remember Motrin to recover from a C-section), I could barely take care of myself, so she stayed in the nursery. The first night she was in the nursery and my husband spent the night with me. The second night she was in the nursery and my husband was at home. The third night, we finally got her in my room and my husband spent the night with me.

If they're in the nursery, you're "allowed" to feed them 5 times a day for 30 minutes each. Five. They actually listed 6 times on the information sheet in the nursery, but I was told it's really 5. This is only for breastfeeding moms. So if you breastfeed, you get to spend a total of 2.5 hours a day with your baby. Yeah, that's healthy. If you aren't breastfeeding and would like to hold your baby, you either take your baby to your room or wait until you get home. Lovely.

Now, in order for a baby to be healthy and a mom not to lose her milk supply, a baby should eat a minimum of 8-12 times a day. Let's do the math. . . 12 divided by 5 means they're letting you feed the baby less than half of what is required for a baby to thrive. Thriving isn't just about nutrition, it's about touch. 2.5 hours a day with their moms, definitely not a healthy environment. Now let me just explain that all these rules are for normal, healthy babies. They're not in the NICU, they're not sick, they're totally health.

Of course, they could supplement the baby with formula or breast milk in the bottle, but if you're trying to breastfeed, bottle feeding just isn't helping. Yet another reason why their breastfeeding "class" is crap.

I was pumping. My husband brought my pump since their pump "wasn't working" Fantastic, right? On Friday, I decided that I'd had enough and told them I wanted to be called every time she was hungry. They called me about every hour. It was horrible. It was hard enough walking to the bathroom, now I had to go downstairs (in the elevator, but still) about every hour. Thankfully, I knew my husband was coming that night and we were going to get her into our room. 

Having the Baby in Your Room
The third night (Friday) we finally got the baby to our room. No easy task. We had to sign a few papers, all in Korean, no idea what we signed. And even then they didn't want to hand our own child over to us.

We had to keep the room at a minimum of 26 degrees (78.8 F), but they preferred 28 degrees (82.4 F). We had to fill out a paper saying how often she peed, pooped, and ate. That paper was checked by a nurse at night and in the morning.

My Husband's Accommodations
No pillows or blankets are given for dads. Just a gym mat. We asked and again were told that it was against hospital policy. I was sweating so I gave him my blanket.

Dads are only allowed 30 minutes a day with their babies and that's from 8-8:30pm. Moms aren't allowed in during that time. There are no exceptions. My husband decided to keep working while I was in the hospital because then he could get 14 days off in a row. Plus, why waste days when I was in the hospital? And someone had to take care of my first child.

He missed the birth, but saw her through the glass before I got to see her because they knocked me unconscious. I got to hold her, but he didn't. He never got to bond with her during those first two days. He was about ten feet away, looking at me when I breastfed, but was told it was "against hospital policy" for him to hold his own child.

Trying to Leave the Hospital
When went in on a Wednesday night and were told 5 days, which meant that we were supposed to leave on Sunday since they counted Wednesday as day 1. Then we were told if we left on a Sunday, we would be charge 50% more since the accounting staff wasn't working and they weren't sure of the exact charges. What they'd do is overcharge us and then on Monday we would come back and sort everything out.

I'd had quite enough of the hospital policies, so decided to try to leave early. On Thursday, we asked to leave early. They said no. Imagine that. Even though both of us were perfectly healthy. On Friday, in the morning, after we got the baby into our room, we then informed them that we were leaving the next day. They tried to talk us out of it. Got a nurse, a doctor, acted very concerned. We politely insisted.

Saturday morning around 7am, I was given the ok. It took them about 4 hours to finally discharge us. We had to pay and get meds, which consisted of antacid, pain killers (yea Motrin, totally not enough), and antibiotics for my upper respiratory infection (common cold). But we finally left 2.5 days after arriving.

Interventions
A c-section is major abdominal surgery. They are necessary at times, but when 33% of women given birth are given them, you know they're taking advantage of the situation. Interventions are the #1 reason why I tell people to pick a good place to give birth. Here's what was done to us in the 2.5 days we stayed. There might have been more, but this is what I can think of now.

In Labor
  • Epidural
  • Oxygen
  • Pitocin
  • Antibiotics
  • Fluids
  • Catheter
  • EKG test
  • Multiple NSTs
  • Not allowed to eat or drink anything
The Birth
  • Being knocked unconscious for the C-section
  • Immediate cord clamping
  • Rubbing off the vernix
After the Birth
  • 5 hours being unconscious
  • Amnesia
  • 13 hours flat on my back
  • Baby being given sugar water 
  • Baby in the nursery
  • Being told I wasn't allowed to breastfeed
  • Only being able to hold the baby five times a day for 30 minute at a time 
  • Antacids, antibiotics, and pain killer pills twice a day 
  • 2 ketoralac shots
  • Husband not allowed to hold the baby until day 3
Complications Afterwards
11 days after the baby was born, my left breast was super hot and painful. I had no energy, just wanted to sleep and had a slight fever. I went to the ER at Osan AB and was told my WBC (white blood cell count) was 19,000 and the norm is supposed to be about  4,500-11,000. They did loads of tests: blood, urine, breast milk, nose mucus, ultrasound on my breasts, temperature checks, blood pressure, and possibly more but I can't remember.

I was diagnosed with mastitis, which I fully believe was due to Pyeongtaek St. Mary's only allowing me to breastfeed 5 times a day.

The doctor originally wanted me to put me on meds, but I was allergic. His number two choice was to stop breastfeeding for 2-3 days while they dripped antibiotics into me. No thanks. Stopping is the worst thing you can do. They admitted me and the baby overnight and gave me antibiotics. My husband stayed with me the first night because I was still recovering from my C-section. They decided on day 2 that I should stay another night. We hadn't wanted to since that would mean missing the baby's appointment to get her passport, but my WBC was still high, so the baby and I stayed another night. My husband wasn't able to stay because we didn't have anyone to take care of my daughter. I left on the 3rd day. The next day they called me and told me I had a mild case of MRSA that I had caught while at the hospital (since I didn't have it when I went in) but that I wouldn't need treatment.

Final Thoughts
Although I loved the prenatal care I got there I would not recommend birthing there. Here's a list of places around Korea and here are 6 birthing centers in and around Seoul.

I know some people say that all that matters is that you have a healthy baby, but I don't believe that at all so please don't say that to me. I planned for a peaceful home birth and ended up with everything I didn't want plus complications afterwards. With all the difficulties we had with miscarriages, this complicated pregnancy, and a nightmare birth, we have decided that we are done with having kids.

More info
For more info, you can see how much this has cost, I also have a summary of dates, as well as my Rx protocol.

Wednesday 21 December 2016

38w7d BPD still small

I can't believe I'm still pregnant. Tomorrow will be 39 weeks on the dot. They didn't talk about induction now, but said I should have the baby within 2 weeks. My husband says they can't make me go to any appointments. I'm supposed to go next Wednesday to another one. Measurements are still not good.

31w7d everything was fine: 
  • BPD was 8.01 cm (32w2d).
  • AC was 28.03 cm (32w3d).
  • FL was 6.52 (33w5d).
  • FHR was 142 bpm.
  • EFW was 2052 gr.

At 34w7d the head was small: 
  • BPD was 33 weeks.
  • AC was 34 weeks.
  • FL was 35w6d. 
  • EFW was 2400 gr.
This meant that in 3 weeks, the head had only grown about 6d, the abdomen 1w6d, and the leg 2w2d.

At 36w7d the measurements were a bit better:
  • BPD was 8.77 cm (35w4d).
  • AC was 31.39 cm (35w3d).
  • FL was 7.14 cm (36w4d). 
  • EFW was 2776 gr.
The head was 1w3d behind, the abdomen was 1w4d behind, and the FL was 3d behind. However, the head had grown 2w4d, the abdomen had grown 1w3d, and the leg had grown 5d.

At 38w7d things are small again:
BPD is 8.72 cm (35w2d).
AC is 32.87 cm (36w6d).
FL is 7.44 cm (38w1d).
EFW is 3081 gr.

My due date was pushed back to the 6th of January and is now pushed back another week to the 13th of January. The doctor said I need to have the baby within 2 weeks though. What this means is that from my last appointment 2 weeks ago, the head has shrunk 2 days. The abdomen has grown 1w3d. The leg has grown 1w4d. I don't understand what's going on. The baby is head down. I know in breach babies the BPD can be off.

Money
  • Today I paid 195,830.
  • Doctor's visit: 32,260. 
  • Ultrasound 100,000. 
  • NST 63,570. 
  • Tricare (my insurance) paid 195,830. Out of pocket was 0.
More info
For more info, you can see how much this has cost, I also have a summary of dates, as well as my Rx protocol.

Sunday 18 December 2016

38w4d in denial about being pregnant

I found out I was pregnant at 3w2d and went to the doctor straight away. My betas were 11 and they did my first round of IVIG but were hesitant to offer any congratulations, saying that I needed at least a 50 on the betas. I knew that 11 was low, but I also knew that I found out I was pregnant pretty early. Three days later my betas were 80 and I was officially declared pregnant and told my due date was 28 December 2016. For the first 12 weeks I was scared of miscarrying even though I was on IVIG, baby aspirin, and progesterone cream. They say 1 in 3 women miscarry and with high NK cells I'm sure my odds of miscarrying were higher.

After 12 weeks I was feeling better and just hoped to make it to 24 weeks, which is considered viability. Then at 20w7d I started leaking fluid. After a few stressful hours in the early morning in the ER I found out that everything was ok.

I made it passed my second trimester and was smack dab in the middle of my third when I found out at 34w7d that the baby, who had always been at or ahead of dates, was now a few weeks behind. I know that at that point measurements can vary by as many as 4 weeks. However, it's not very comforting when everything was measuring fine before then. Two weeks later, the measurements were better, but still didn't match up so they pushed the due date back until 6 January 2017. The doctor seemed not to worry and induction was never mentioned. I know in the US they seem to induce by 39 weeks at the latest when there are immune issues involved. I guess Korea is different. I'm honestly surprised I got this far. My water broke with my daughter early in the morning at 37w2d and she was born at 37w4d. Now I'm 38w4d and I have a feeling I will be late.

I think due to the miscarriages I had before I don't want to get my hopes up. I know I'm pregnant, but I'm in denial. It's hard for me to connect to the baby. It feels weird to think that there's a little human inside of me. I definitely don't feel as excited as I did when I was pregnant with my daughter. I just want to get this all over with and have a healthy baby. I only got sick once in the first trimester and started wearing maternity clothes in my first trimester. I had some bad leg cramps in the second trimester. I've also been having Braxton Hicks throughout the third trimester. I haven't gained much weight. In fact, I haven't gained any weight since 21 weeks, but my belly keeps getting bigger.

I've finally started taking some photos of me being pregnant, but nothing like when I was pregnant with my daughter and took weekly photos. I feel more cold and objective. I file all the paperwork and organise the ultrasounds so that I can make a claim with my insurance. I have all the paperwork we need to get the baby's American passport, CRBA, and SSN as well the the Peruvian passport, DNI, and birth certificate. But the excitement's not there. I'm just holding my breath hoping that everything will be ok. My doctor is supportive. Surprisingly they haven't said anything about me having a home birth.

I also feel like a part of my freedom is being taken away. My daughter just turned 5 a few months ago. She was breastfed until she was 4 and we co-slept until she was nearly 4.5 years old. She still sneaks into my bed in the morning. But now she's independent. She can get dressed, get herself food, I can leave her alone in the bath, she picks up her toys. I can have some me time. Once the baby comes, all that will go away. I'll be starting over for the next 5 years. This baby was very much planned and wanted, but I still have mixed feelings about the whole thing. Soon, this pregnancy will come to an end and we will have another little human in the house.

For more info, you can see how much this has cost, I also have a summary of dates, as well as my Rx protocol

Friday 16 December 2016

38w2d midwife dropped off supplies

I'm surprised I'm still pregnant. Everyone thought I would go early. I think I'll go late. We are still waiting for some paperwork from the US that we need in order to register the baby with the embassy and I feel like I still have a lot of personal stuff I want to do. I know with a baby I won't have much time. I feel like I just now finally got my 5 year old daughter to be independent and I'll be starting over again for another 5 years.

The midwife came and dropped of a small carry-on suitcase with supplies as well as a tank of medical oxygen. She came quickly and then left. She will be going to Kunsan for the weekend and won't be back until Sunday. I should be glad I didn't go early. My doula was out of town from the 1-10th and the midwife and doula had a conference from the 14-15. So now I'm in the clear and any time the baby's ready should be good.

This visit is included in the midwife's fee and since it is not a part of staying pregnant, I'm not including it in my fee breakdown. For more info, you can see how much this has cost, I also have a summary of dates, as well as my Rx protocol.

Wednesday 7 December 2016

36w7d better measurements

Last time the measurements were small and they didn't give me a print out of them.

31w7d everything was fine: 
  • BPD was 8.01 cm (32w2d).
  • AC was 28.03 cm (32w3d).
  • FL was 6.52 (33w5d).
  • FHR was 142 bpm.
  • EFW was 2052 gr.

At 34w7d the head was small: 
  • BPD was 33 weeks.
  • AC was 34 weeks.
  • FL was 35w6d. 
  • EFW was 2400 gr.
This meant that in 3 weeks, the head had only grown about 6d, the abdomen 1w6d, and the leg 2w2d.

Now at 36w7d the measurements are a bit better:
  • BPD is 8.77 cm (35w4d).
  • AC is 31.39 cm (35w3d).
  • FL is 7.14 cm (36w4d). 
  • EFW is 2776 gr.
The head is 1w3d behind, the abdomen is 1w4d behind, and the FL is 3d behind. However, the head has grown 2w4d, the abdomen has grown 1w3d, and the leg has grown 5d. I'm glad that head has grown what it should have grown, which is 2 weeks.

This appointment
I had called nurse Mary to ask about my blood and urine results, because they hadn't texted me so that meant bad news. She said all my numbers were a bit off. My cholesterol was a bit high. I had a bit of protein in my urine. My sodium was a bit low (I'm really not sure how. I thought it would be high). I'm also a bit anemic (despite taking iron pills). But they were only one or two points off and didn't seem to worry, so that was good. Today they gave me my results and the only thing they mentioned was that I was a bit anemic. So I'm in the clear.

They did a NST (non-stress test) and that was normal. They said I had one minor contraction and the baby was moving fine. I've been feeling lots of Braxton Hicks this time around. I didn't have any with my daughter.

Surprisingly, they told me to come back in 2 weeks. Usually after 36 weeks you have weekly visits. But I'm not complaining. As long as the baby is moving, everything should be ok. No need for me to go more often.

Money
  • Today I paid 195,830 
  • Doctor's visit: 32,260. 
  • Ultrasound 100,000. 
  • NST 63,570.
  • Tricare (my insurance) paid 195,830. Out of pocket was 0.
More info
For more info, you can see how much this has cost, I also have a summary of dates, as well as my Rx protocol.
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