First, the background
- As a doctor with obstetric training and experience, the hospital environment is my workplace and not necessarily my idea of the oasis of calm required during labour
- I know too much of what I feel is arbitrary and unnecessary in what is considered routine obstetric nursing procedure.
- The midwifery model of care does not exist in Singapore
- Episiotomies and suturing is still widespread practice in Singapore. Episiotomies are old news, and may be harmful in most cases. Stitches also may delay healing. However, almost no one gets out of hospital without a courtesy stitch, at the expense of the mother’s healing time and added pain of roughly 3 days.
- Medical intervention at 3rd stage is more practical in a hospital setting and there is no support for late cord clamping or natural delivery of placenta
- I believe in the intelligent design of the human body and can’t imagine God would in his infinite wisdom put a baby inside of us and then make it impossible for us to push it out.
- I’ve seen natural birth and healing occur many times over.
- I’ve seen iatrogenic birth complications caused by over intervention. This includes the consequences of overzealous pain relief.
- I’ve seen mothers being coached (screamed at) to push, ineffectively, out of sync with their natural surges.
- Trying to conceive, pregnancy, labour, birth and postnatal recovery can be a spiritual experience and journey for the mother and the family. It is not purely biological, chemical nor scientific.
- The mother is very vulnerable to outside energies during this time of change. She is never really adequately protected or nurtured in the hospital setting.
It was during my first pregnancy that I had somehow already decided early on that I would birth naturally and without pain killers, and even better, and if possible, birth at home.
I sought out a doula, and her Bradley method prenatal classes, and the rest is history! I sought out Dr Lai Fon Min as he was the only obstetrician who would come to your home to “deliver” the baby.
The Bradley method equips parents for as natural a birth as they desire, and in the 12 week format, you form close relationships with the couples you attend with. This wasn’t something you could crash course, as every week built on the other and each week I remember Angelyn looking through my food diary with new suggestions each time.
Attending the course with a doula who has coached many births before, gave me a knowledge base and rich collection of stories of women who have done it the natural way before, gave me the added confidence that this task was not as unattainable as the medical industry would have you believe.
My first child
Pregnancy was trailblazingly good and filled with positive energy, “I can do it” and I did not entertain any nay saying thoughts.
I ate two eggs a day and achieved 70g protein a day and was religious with my prenatals.
I was aiming to birth him in the caul! Ha ha!
He finally came at 41+3 weeks, 8 hour labour and alot of work! I was so happy, and tore minimally likely due to my use of the epi-no as he was 3.2kg.
My second child
Pregnancy started off with me being a cranky cow, and being all kinds of sensitive and emotional, almost like my emotional mind wanted to clear 2 years of marital issues swept under the carpet from raising a toddler.
And so we did, and are so much better for it.
We had a total of 2 scans with Dr Paul Tseng: the 20 week scan and a bedside one at 36 weeks to give me his blessings for a home birth.
In this pregnancy I had got onto the bone broth wagon, and had it every couple of days, and a chicken essence every couple days too. I also had my iron topped up before conception just for the heck of it and got from ferritin of 50 pre-pregnancy to ferritin 110.
Then in the third trimester my energy plummetted, to the point I would want to take a taxi to cross the road, and had to pause for breath climbing a flight of stairs at home!
Checking my ferritin, it had fallen to 20 by my third trimester, warranting an iron infusion, to the point of complete recovery and actually feeling pretty robust physically.
(In retrospect my first trimester ferritin in the first pregnancy was 50, and I really should have checked it at the third trimester because I had lost a wee bit of blood during labour and experienced pre-syncope afterwards, almost fainting to the ground. In my ignorance I had kept calm and carried on despite being moderately iron deficient by my standards)
Anxiety was abound, from 34 weeks I started counting down and allowing disbelief to creep into my mind. Could I do it? It was bloody painful of course. Would I be able to hack it? Would I get exhausted, and be shipped into hospital?
I bought electrolyte formulas to prepare for labour like it was a marathon.
At 39 weeks I was beside myself with anxiety, and had to calm myself with affirmations, rainbow relaxation tapes, and scripture.
And then, at 39+1 day, I passed a blood stained slither of mucus. Sure, blood spotting is normal during early pregnancy…wait. I’m at term. This is a mucus plug! Google helped me visually verify this.
Lets wait and see! Don’t panic.
Husband says he will stay up to work so he would finish work by the end of the week and be all ready for the birth next week. Next week? Ha ha ha.
Braxton hicks all night from 9pm. Until at 1am they became impossible to sleep through. I suppose that was active labour! 3am, I was moaning away, and finally called the troops in, and carried the toddler in his slumber, down to his Nana’s room.
Indeed! Lets get the water tub prepped, and the towels out, fairy lights, music, the works! It’s happening!
Or not…surges slowed down. Midwife promptly said, you two, go lie down and take a nap, we’re going downstairs to chill.
We managed to catch some zzzs in those 2 hours! Between tiny surges, until a huge one happened at 5am. Troops marched back up to sort the tub out, and it was all systems go.
Each surge now gave me a feeling of needing to push. I went into the birthing tub, and was surrounded with lovely warm water. And I set my spotify playlist to everything The Album Leaf.
Suuuuurge! Rest… Suuuuurge! Rest…
Midwife tells me to feel down there, see if I can feel the head. I say I can feel a bubble! My waters hadn’t broke yet, and I was so excited that I could have a water bag intact until so late!
I think it was the penultimate surge that broke the bag. And I definitely could feel the head then! Next surge and the head was out! And then the body rotated and rotated on its own. And the next surge and shoulders were out, voila!
What! So fast, so efficient? So different from my first birth where each surge didn’t exactly guarantee that baby was any further down the canal. Here, it was purposeful, effective and very sure!
“Let me look between the legs…”
“It’s a girl!”
And she looks around, listens around, and proceeds to find my boobs for a suckle!
She was 2.7kg, smaller than Nat, but I tore more likely due to the fact I didn’t use the Epi-no to prep my tissues beforehand. I had shrunk down there I suppose! However, I opted to heal naturally, even some of the vagina was looking a little shredded, because I could see that as long as I Kegelled, they came together nicely! And of course confining myself to my room for 7 days as advised by my midwife, really was the trick.
What an experience. No stitches meant swelling was down within 6h, but in my last experience with a “courtesy stitch” however good, in itself caused pain and swelling and I couldn’t sit comfortably for 3 days.
The biggest change for me was also how my first baby suddenly seemed a giant, and how much he and I had to adjust to missing each other quite abit in the first week or so. To the point of tears for both of us.
I was too weak to carry him and too engorged to have him bouncing around me.
But the way he looks at his little sister and wants to give her a million kisses melts my heart, and makes me feel that making siblings for your existing kids is a legit thing to do.
These are the current options for having a home birth in Singapore
- Private midwife attends the birth + supportive obstetrician does scans and picks up during change of plans (Dr Paul Tseng is the only one at time of writing)
- Doula + obstetrician to attend the birth at home (Dr Lai Fon Min is the only one who does home births, at time of writing)
- Planned hospital birth but quick labour means birth occurs at home. To head to hospital immediately afterwards for subsequent vaccines, injections, blood tests and birth registration procedures as parents are usually not prepared nor well supported outside the hospital setting in such cases.