Thomson Medical - 4 days 3 nights maternity stay

due to caesarian section, i had to be warded for a standard period of at least 3 nights. was bedridden right after delivery till 26th morning and had to continue fasting while on IV drip. green light was given to consume milo on 25th evening and soft solid diet is recommended for my 26th breakfast. the best part of this bed confinement is i did not have the need to pee as they had inserted a catheter without my knowledge. both the IV drip and catheter were removed after dr claudine's 26th morning in-room visit and approved me getting out of bed. she advised to move around slowly in order for my body to adapt and to prevent affecting the wound.

my virgin IV drip nicely done by dr chong

despite stories of the uncaring staff at thomson and their slow response, i did not want to pass judgement till i see it for myself. at the end of the stay, i have to commend and thank the team at the ward for helping with the following.

• wiped down and changed for me while i was confined in bed 
• changed drip bag and cleared catheter bag on regular basis
• served meals on time and ensured the correct diet was provided
• great sanitary service
• timely medical provision, especially for issuing piriton 4mg when i complained of itch on the 1st day

and also to the nurses at the nursery for

• bringing baby to me 3 hourly to latch
• assisting to feed expressed breast milk after i decided to pump on the 3rd day
• clear explanation on care for baby (eg. cleaning umbilical area), items provided and details stated in the health booklet on the day of discharge

the overall experience was good, staff/nurses are attentive and responded to our requests promptly. however, i personally feel there is room for improvement.

• lactation consultant came in on the 2nd day for about half an hour. taught the different ways to latch and correct massage technique for the boobs prior to latching. seems to be only fulfilling her duty but lack a personal touch.
• during admission, we were informed of the on-going renovation works which would be carried out for stipulated timings on weekdays only. i was glad as it would affect us only for a day. they dropped a memo to us on friday itself to inform that there will be renovation over the weekend. dear spoke to the in-charge and she mentioned this was communicated upon arrival which was not. she then offered to convert a 2-bedded room to single-bedded for us as that area would have minimal disturbance. we decided to stay put as it would be too much trouble to pack our things and to inform relatives/friends on the change in location. 
• we were asked to settle the bill at level 1 counter as they were shorthanded. dear went down and found out there was only 1 cashier available. requested for them to reach us at the room since we needed to wait for baby to be fed as well. finally managed to sign off at 12 noon, an hour past official discharge timing. 

thank you all relatives and friends who took time off to visit and for the gifts, your generosity and thoughtfulness is appreciated.

gifts from relatives and friends

flowers from cousin jennifer and family

goodie bags from thomson medical

My Delivery Journal

the day is finally here. think i was tired out by the last minute checking and the fasting since 12 midnight that i slept till 0645hrs. wanted to wake up at 6am to play facebook games for one last time since i had no idea when will i be well enough to log in after delivery. dear on the contrary woke up earlier than the alarm and switched it off, which explained why i overslept. he was drinking coffee and playing games on his ipad in the kitchen when i went to wash up. had to remind him of the time and chased him to the shower. after which he packed the very last items on the checklist, photo/video taking equipment, and we were ready to set off.

really appreciate the smooth traffic during holiday, wonder how long the journey would have taken on a normal workday had we been rushing to the hospital due to contractions. we left bedok at 0738hrs and reached thomson medical at 0756hrs, awesome isn't it?

took a number for admission, queue 2004. there was only one other couple at the counter, but there was also only 1 staff serving at the moment. while waiting for our turn, we did what most people would have done, selfie!

我们去生孩子了！Merry Christmas everyone!

we were so engrossed with photo-taking and browsing of brochures that the staff had to call out to us if it was our number. the wait was approximately 5 minutes and it took 20 minutes to settle the paperwork, which included the following.

1. Registration
2. Hospital rules & regulations
3. Estimated bill for hospital/professional fees
4. Medisave/medishield claims
5. Renovation notification
6. 3 complimentary parking coupons ($3 per exit) were provided, 1 additional coupon can be obtained from ward nurse daily for companion
7. Paid deposit of $4000

the concierge then led us to the ward where the nurse took over and showed us the way to room 313. after putting down our "luggage", the nurse went ahead with the procedures.

1. Took urine sample for tests
2. Brief procedures
3. Measure blood pressure
4. Measure baby's heartbeat, still in breech position
5. Shave private area
6. Insert poo softener, felt like air sprayed into anus and i needed to clear bowels within a minute
7. Change into operating gown

thomson medical centre - single-bedded room 313

self-orientated around the room for 15 minutes and the nurse came to check if i was ready. put on the socks provided and off she pushed me to the waiting area. mobile phones were not allowed and had to be separated from dear for a short while. he was asked to proceed to delivery suite 10 minutes before 1000hrs, the scheduled caesarian timing.

final photo before delivery while waiting for the lift

the nurse came to confirm my particulars and was told to fill in my name and NRIC on the consent for operation. she then offered magazines for my reading pleasure while waiting. after what seems like 10 minutes, dr chong jin long, the requested anesthetist appeared from behind. he briefed me on the epidural procedures and the effects that i would experience. shortly after, dr claudine, my gynae arrived, said hi and checked on how i was doing before i was pushed to the delivery suite.

after being transferred to the operating table, dr chong informed that he would start administering the epidural. the whole process was almost painless, the only pain was similar to that of an ant bite. from insertion of the IV cannula to local anesthetic to epidural injection, dr chong explained clearly what he would do and how i would feel. have to thank fellow mummies for recommending such a good anesthetist. as we opted to donate baby's cord blood, blood samples were drawn through the IV line before epidural was given.

in less than 5 minutes, there were pins and needles in my legs and i gradually lost the feel of them, like they aren't there anymore. dr chong performed 2-3 tests to check if the caesarian area is numbed and is confirmed that i could no longer feel pain nor cold. dr claudine then pinched me real hard as what they described and all i could feel was tugging at the tummy. the epidural administration was a success. dr claudine told me that they would summon dear to come in once baby is ready to be delivered.

much as i would want to peep through the green cloth that was draped above my chest to see what they were doing, i was not sure if i would be able to take the bloody scene. the anticipation was killing me and was really glad when dr claudine asked the nurses to get dear to standby.

dear geared up in protective suit with surgical mask

dear and i chatted for a while but i could not remember what our conversation was about. i was very much distracted by the movements around the tummy area and was paying attention to dr claudine's comments. dear and i giggled when she complained that baby pooed on her. shortly after, she announced that the baby was here before we heard his 1st cry. the nurse showed baby to me for the 1st time and carried him away for cleaning with dear watching by the side. she also counted baby's fingers and toes to ensure baby is perfect and requested for dear's confirmation.

bonding with baby

baby was crying while lying on my chest. no matter how i patted him or what we said to him, he just kept wailing. this lasted for 5 minutes before they brought baby for various measurements and dear had to follow through.

the next half hour seemed to last forever. wonder why but i suddenly felt sleepy and dozed off on and off. it was pretty annoying to feel the tugging and pulling while dr claudine and the nurses worked on sewing me up. dr chong checked on me a couple of times to maintain the steroid level. it was a relief for me when they were finally done, time check 1110hrs. i was then pushed to the recovery area for 15 minutes observation before being sent back to the room where i was finally reunited with dear and of course, our newborn baby.

a very big thank you to all the personnel who helped to deliver our lovely and healthy baby boy.

My Pregnancy Journey - 38 Weeks

dear and i had mcdonald's breakfast this morning before his only appointment prior to the scheduled gynae visit at 12 noon. time check at 0930am and we were wondering if baby would have arrived should we have gone for the previously planned caesarian on christmas eve morning. this was in place due to baby shifting back to breech position a few weeks back. we went on to discuss plans for tomorrow, christmas day. options were to go window shopping at newly opened shopping malls, one km or seletar, or we could spend a day at jurong bird park. what helped made the decision for the latter was when we saw the newspaper ad for sintex warehouse sale at jalan ahmad ibrahim. since the sale location is near bird park, we could conveniently do both. little did we expect a huge surprise awaits us.

since i was not having any contraction symptoms, thought we would be ending this 2nd last pre-natal visit with "see you next week!". as we proceed with the usual OBS scan, dr claudine exclaimed "aiyo! you know what this boy do?". both dear and i froze for that second. "alamak! you tell me how?" she asked as she moved the scanner nearer my ribcage - we saw baby's head. she then provided the 2 available options, to arrange for caesarian tomorrow or to wait and hope baby turns down by 29 Dec. after much discussion on the pros and cons and also the possibilities of ending up with an emergency caesarian, dear and i decided to welcome our baby boy on christmas day. 2 of the main concerns were my water bag may break while baby is breech, his limbs might fall out or if baby fortunately heads down, and we induce the birth, there is a higher chance of ending up with an emergency caesarian.

as we trudged home trying to digest the fact that baby will be here tomorrow, there are last minute preparation to be done, eg. installation of the car seat and informing parents and close friends of the news. mixed feelings of excitement and anxiety, excited to finally meet our baby and at the same time worried of the new challenges ahead. nevertheless, i pray for a smooth delivery, a healthy and strong baby.

Christmas Eve Dinner - last meal before welcoming our Christmas baby

There are many gifts under the Christmas tree. But the best one is the gift of your friendship.

15 Dec - high tea at l'espresso, goodwood park hotel, with loves

20 Dec - potluck at wen ting's house - salad with japanese sesame salad dressing, portobello mushroom with cheese, pork ribs, roast chicken, army stew, bakerzin log cake and udders icecream

20 Dec - uniquely ours tropical christmas tree - with compliments from wen ting's dad

thank you Jia Le, Chu Kok Loong and Nicky for the much appreciated thoughts

My Pregnancy Journey - 37 Weeks

Admission Letter from Gynae

finally received the legendary blue letter from dr claudine, she has not been able to pass a verdict on which form to issue me due to our mischievous baby. he turned down at 32 weeks and went into breech again during 34 weeks, which we then scheduled a caesarian section on christmas eve morning, the latest date the surgery can be performed. wonder if our boy was pulling a fast one on us or that our daily counseling worked, he was back in the head-down position at 35 weeks. dr claudine decided to go through the consent form and delivery charges with us after she comes back from her 2 weeks break.

Addendum to Consent Form - Normal Labour

the form consists of 3 parts :

• labour risks
• labour care and possible other procedures
• acknowledgement section

Estimation of Doctor's Fees - amount before GST

1. doctor's professional fees

• normal vaginal delivery $2100 - $2700
• vacuum / forceps $2700 - $3300
• lower segment caesarian section $3300 - $4000

2. doctor's daily attendance fees $200 - $240 per trip, usually 2-3 trips
3. anaesthetist $600 - $800 per trip, caesarian section 25% surgeon's fee
4. paediatrician $600 - $800

Low Vaginal Swab

went through the microbiological examination for group B strep and results would only be available the following week. a vaginal swab is taken and sent to the laboratory. the cells from the swab are transferred onto a dish or ‘plate’ containing agar (a growth medium) and after 24 and 48 hours incubation, the plate is examined to see if GBS has grown.

whatever the result of a group B strep specific test, it is good news. if test result is negative, that is great. if test result is positive, that is also good news – although it means the baby is at a raised risk of developing group B strep infection, it also means the risk is known so steps can be considered that have been proven to be hugely effective at minimizing that risk.

Nesting Instinct

much as i have been packing, cleaning, washing and putting baby stuff in place consistently since 31 weeks, something seems to need to be done everyday.

duckie - 1st toy from mummy & daddy

mini cot 23"x42" at my in-laws'

luxury cot 130x70cm at my parents'

recycling a cupboard that mum wanted to discard for storing of baby's daily necessities

Singapore Cord Blood Bank - SCBB

Cord Blood Donation Process

1. Speak with the delivering doctor on the intention to donate cord blood.
2. Call SCBB at 63945011 for a pre-screening and appointment after 32 weeks of gestation.
3. Meet the SCBB nurse coordinator to sign the volunteer information and informed consent form and complete the maternal risk questionnaire.  
4. Affirm the volunteer information and informed consent form in delivery suite/labour room.
5. Collection of maternal samples - approximately 30ml of blood.
6. After the baby is delivered, the umbilical cord is clamped and cut, the cord blood is then collected before the placenta is delivered.
7. The collected cord blood and the mother’s blood samples will be brought to SCBB laboratory for evaluation and processing.

For more information, please visit http://www.scbb.com.sg/Pages/Home.aspx

whether to store or donate our baby's cord blood has been on my mind since 1st trimester. read up on the benefits of storage with private banks and always wondered if our child would need it. finally reached a decision during early 3rd trimester when both dear and myself find it unnecessary since it would not be helpful if there is unfortunately a genetic issue.

procrastinated the donation registration due to the seemingly troublesome pre-screening. upon confirmation from 2-3 friends that it was a relatively short and fuss-free process, i skipped the discussion with gynae portion as she was not in town till coming friday and called SCBB line on tuesday afternoon. the phone conversation took about 15 minutes, had to answer some background/health related questions and made appointment to sign necessary documents.

the face-to-face meeting is usually fixed in conjunction with gynae appointment. however, mine was done near home this afternoon as they do not work weekends and my upcoming gynae visit happens to be on saturday. doreen, nurse coordinator for SCBB, was friendly and helpful. though i have to mention that she rushed through the pretty lengthy questionnaire and shorten the meeting to only 20 minutes, she had all areas covered. managed to also find out that if in case immediate family (eg. parents/siblings) needs a transplant, we can check if the donated cord blood is still available, using either of the parent's IC no. to track.

hope the donation will be a success and save another person's life.

Old School Delights

OSD - http://www.oldschooldelights.com/

Lime Juice Ice - $3.90, Mochaccino - $4.90

Pulut - $4.80

Otak - $2.50

Mee Siam - $5.80

Mee Rebus - $5.80

Sticky Chewy Chocolate Fudge - complimentary

finally got down to bringing xiao bai for almost due servicing and also, to fix the wheel bearing problem before baby's arrival. while waiting, we decided to take a walk from xin ming to upper thomson for our brunch. dear was torn between prata, his all-time favourite and old school delights, for the mee siam. he chose the latter in the end as it has been eons since he last visited this old friend's shop. it was a pity that we did not see olivia in person. thank you for the call and we will arrange for a meet-up when baby is here.

My Pregnancy Journey - Part 12

Birth Plan

there are occasions when i popped random questions at my gynae when they come to my mind, such as "can episiotomy be performed if i opt for natural delivery without epidural?", but never gotten down to write my birth plan till now at 36 weeks. will discuss with her during my next visit at 37 weeks to ensure that we are on the same page and make necessary changes if needed.

What Is A Birth Plan?

A birth plan is a sheet communicating your concerns and wishes for the nurses, midwives and doctors caring for you in labour and birth. It describes how you would like labour and birth to be managed, the kind of support you would like, such as a doula, and your preferences for comfort measures and interventions. It also includes your wishes if things do not go as expected, and for breastfeeding and postpartum care.

Why Write A Birth Plan?

You may feel that you do not really know what to expect in labour. Even so, there is value in creating your birth preference sheet.

• When crafting your birth plan in pregnancy, you find out about options for labour and birth. This reflection and information gathering prepares you to make considered decisions in labour and birth. You also feel more confident as birth approaches!
• A birth plan is more than a checklist; it is a vehicle of discussion with your doctor. As you and your doctor go over the draft, you are able to discuss specific wishes; your doctor gains insight into your concerns and gives feedback.
• Your birth plan allows you to communicate with the labour ward staff, enabling them to support you in the way you want.
• In labour, you would not want to be answering questions. Having a birth plan ensures that those around you know your preferences.
• This is especially true if you have less common wishes for your birth such as allowing your baby to descend gently without prolonged periods of pushing or ‘cheerleader-style’ coaching from those caring for you in the crowning stage. Other requests may include your desire to give birth in an upright position or skin-to-skin contact with your baby immediately after a C-section.

How Do You Create A Birth Plan?

① Research & Reflect - Become informed about all available forms of comfort measures and pain relief. Find out about the benefits and drawbacks of each alternative. Read about routine procedures and when these are medically necessary. Take independent childbirth classes, learn new skills. Use your new found knowledge to work out your philosophy towards your birth. All the requests in your birth plan need to be consistent with the kind of birth you want. For instance, if you would like minimal interventions, think about how this can be achieved and what you would need to do to reach this outcome.

② Draft - Write a draft.

③ Dialogue With Your Doctor - Discuss the draft with your doctor. During these discussions, you will learn how compatible your wishes are with your doctor’s and hospital’s practices. Stay flexible, but aware of your goals for your birth.

④ Your Final Birth Plan - Towards the end of your pregnancy, you will arrive at a final version, a product of your research, reflection, and dialogue with your doctor.

Consider these dos and don’ts

① Layout - Organise your plan as a chart or using bullet points. Use short paragraphs and clear sub-headings.

② Language & Choice of words - A long list of demands for your doctor and his staff may be frustrating for them. Opt for an easy-to-read style and use words that are neither passive (“if it is possible, could I have…”) nor aggressive (“do not perform unnecessary vaginal exams…”). Go for a friendly, respectful tone. Keep a copy in your patient file, pass one to labour staff, and keep a copy handy for yourself.

③ Sample Birth Plan - Point-Form Birth Plan

• Introduction about you and your partner, your feelings, your background – state strong feelings for example, about having an unmedicated birth.
• Your goals, wishes and other concerns – mention any fears or past experiences.
• Your preferences for managing labour pain – think of your preferences as being on a scale, with one end being ‘feeling no discomfort at all’ and the other end being ‘no medical pain relief, only comfort measures such as using a birth ball’.
• Interventions – when labour progresses normally, are interventions necessary for safety? What are your views on monitoring the baby/contractions, using drugs to speed up labour, intravenous fluids, having an episiotomy, vacuum or forceps birth or coached pushing as the baby emerges?
• Preferences for unexpected events – consider how you can still meet many of your goals for example, in a C-section or with kangaroo care.
• Postpartum care – mention rooming-in or dietary needs.
• Newborn care & breastfeeding – mention your wishes for skin-to-skin contact after birth, plans for newborn procedures and breastfeeding.

Show your birth plan to your gynae and ask her to go through it with you during one of your antenatal appointments, ideally before you are 36 weeks pregnant. Discussing your plan with your gynae will give you the chance to ask questions and find out more about what will happen when you go into labour. Also, by listening to your preferences, your gynae will get to know you better and understand what is important to you

Though a birth plan is helpful, labour and birth are unpredictable. Your midwife may need to recommend a course of action at any time which is not what you had originally hoped for. But this will always be in the best interests of you and your baby.

You may choose not to write a birth plan or defer birth decisions to your doctor. Even so, you already have some beliefs and expectations regarding your birth and writing your birth plan on paper is merely a way of communicating those goals to your birth team. The information-gathering, self-awareness and reflection you go through in creating your birth plan are all as vital to having a fulfilling birth as the birth plan itself!