Pregnancy and Childbirth

Changed

Nothing, absolutely nothing, in my obnoxiously-easy and sheltered life has prepared me for that early morning of Sunday, April 26 when, covered in sweat, consumed by grief, and shaking from the rivulets of pain wounding around various parts of my body, I delivered my dead baby. Alone. Well, not alone, if you count the lone nurse tending to a ten-bed hospital ward whose face underneath the mask and goggles I never saw. Not alone, if you count the other women in the other beds — either bringing new life in, or, like me, saying goodbye to eternally-sleeping children. But more alone than I’ve ever been, or ever felt.

Like most wards around the world at this time, the delivery room ward was extremely understaffed. I told myself I wouldn’t call for help unless absolutely necessary. It had been a few hours of contractions, with the time intervals  getting shorter and shorter. I tried to summon the breathing exercises from a birthing class three years ago, but couldn’t remember anything. When the pain became unbearable, I begged the nurse for some painkillers, a request she gently declined. The resident doctor came to check on me and perform an internal exam. I was told it would not be long anymore, and she would call my OB-gynecologist. Suddenly, a searing bolt of pain came and I felt something slip out of me. “Nurse, nurse,” I screamed at 5:00am. I could not recognize my own voice.

 The nurse was at my bedside quickly and took a look under the thin hospital blanket. The changed expression on her face confirmed what I already knew. “Let me just get the doctor,” she said. It took a few minutes before the resident doctor came, and I lay there waiting with my legs spread, tasting my tears and sweat, struggling to reconcile the gelatinous mass on the sheets with the baby in my tummy I sang tender lullabies to just a few days before. “The products of conception have come out,” the resident doctor calmly said to me when she arrived at my bedside, uttering a phrase that sounded as alien as her protective gear made her look. My husband Jan was in our home, sleepless and waiting, prohibited from being by my side. I would soon realize this was only the first of multiple cruelties that COVID-19 would visit upon my family.

Only sixteen hours before, I was happily pregnant and watching Netflix with Jan while chomping on chocolate chip cookies I had baked. Lockdown in Manila, where we live with our two-year-old son, is severe and militarized. On the one hand, I was – like many people in this country – alarmed at the disproportionate impact of this lockdown on the poor; on the other hand, I was admittedly grateful for the time to rest and protect my pregnancy from a rampaging virus. We were overjoyed to learn that we had managed to conceive a child during our holiday in Venice to celebrate our 5th anniversary, and two successive ultrasounds confirmed the heartbeat. “Your baby is so cute and hyperactive”, cooed the radiologist during the last ultrasound before lockdown. We had passed the ten-week mark and the statistical risk of miscarriage was nearly-negligible. COVID-19 caused me stress, but for the most part, we were happy and eager. New life was on its way. My two-year-old would be having a sibling.

I knew something was wrong when I woke up early in the morning of April 25, Saturday, to go to the bathroom, and there was blood on the tissue paper after wiping. I had miscarried in 2016, and déjà vu swept over me. My gynecologist told me to go to the delivery room of the hospital immediately. It was my first time out of the house since March 12 and it was a hospital that had recently announced it would no longer accept COVID-19 patients because of overcapacity. I pushed the thought of miscarriage out of my head and worried about exposure to infection. When I got there, the nurse got a fetal doppler to look for the heartbeat. “I can’t find it, but let’s wait for the resident doctor.” Then resident doctor then came. “I can’t find it, but sometimes at this stage, it’s still hard to find the heartbeat.” They recommended me for an ultrasound. Finally, certainty came. “I am sorry, there is no heartbeat,” the radiologist said. I was told that they would induce labor and when my cervix was ready, the extraction would be performed. I had given birth to my first child via caesarian and my first miscarriage was a blighted ovum at five weeks, so I knew nothing about labor.

“Do you have any questions?” my doctor prodded. “Will it hurt?” I asked, choosing the dumbest, easiest question from the universe of questions in my head. “Yes, it will,” she replied softly through her mask, looking into my eyes.

First though, I needed to take a COVID-19 PCR test and a chest x-ray. Routine protocol, the nurse told me, preparing the long stick to be used to swab my nose. “I probably don’t have it,” I told her, sharing that I had never left the house since mid-March. I also had no cough, no fever, no shortness of breath. I was told that the result of the PCR test would come in a few days, but the chest x-ray took only minutes. If the chest X-ray came out clear, I can be placed in the delivery room with the general population. The X-ray did come out clear, which was how I found myself in a bed at the ward until I got discharged on Sunday afternoon. All I wanted was to go home, hug my son and lie next to my husband in our own bed.

Three days later, I got the call from the hospital informing me that my test results came in and I had, in fact, tested positive for COVID-19. I was asked if I had symptoms – none – and then was told I immediately needed to isolate in a room and have no further contact with anyone. My household was required to get tested too.

We’ve seen how COVID has changed the contours of our world and our modern life in big ways: transportation, work arrangements, health systems. But I did not know how COVID also changes how we grieve and how we comfort the broken — until I was one of the grieving and the broken. When I had my first miscarriage, I asked Jan to take me to a sushi restaurant and I marked the end of a pregnancy with raw fish and wine. When we went home that time, I curled myself in a ball and breathed out my sorrows onto his chest. My mother rushed to my side and held me while I cried like a child. My colleagues came for a visit bearing flowers. My best friends and I met up for coffee. This time, I found myself alone in a room, recovering from the emotional toll of a sudden, painful, late-term miscarriage away from my husband and son and everyone else.

I now understand when people in some form of isolation say that the hours blur into each other and each day melts into the next. I busied myself with social media in the daytime and feared the silence the night brings. I started, but could not finish books. I explored foreign films and series on Netflix, but I’ve found it to be difficult to read subtitles through one’s tears. Yoga has been recommended, but it reminds me too much of the prenatal yoga I used to do right before I miscarried. Grief is a virus; physical isolation incubates it. I wanted to grieve as I have grieved in the past: physically enveloped in love, with the cultural rituals designed to remind the grieving of the temporal nature of pain and the constancy of family and community. COVID19 said, not yet.

I tested negative almost two weeks to the day that I received my positive results. Each day after that was a step closer to the “normal” I remembered. I could fold myself into my husband’s chest again. I could hug my two-year-old again and feel his tender and sticky fingers on my face. It was a relief to putter around in the kitchen once more. I was grateful to stand outside in the balcony and get just a little bit of fresh air on my face.

But I was not pregnant anymore, and normal was back but at the same time, normal could never be back. I thought nothing could be more emotionally heart-wrenching than feeling my lifeless child slip out of me like the end of a whisper  — it turns out that watching my other child toddle up with a big smile, carrying the home fetal doppler and demanding excitedly, “I want to listen to the baby” comes very close. While I was in the hospital, Jan busied himself by hiding all the small accompaniments and accoutrements of pregnancy. But there would always be that one random thing. That bottle of prenatal vitamins hidden in the far corners of the medicine cabinet that comes up in one’s search for eye drops. That pamphlet for blood cord banking stuck in the pocket of a bag you accidentally see while looking for someone’s business card. Yesterday, while replying to some work messages on a Telegram group, a message pops in. “Hello pregnant mommies, discounts on so and so, if you do so and so.” And the grief that you thought you’ve done a fairly good job of keeping at bay comes hurtling back, like a battering ram.

When Jan and I were talking to each other in tears after the ultrasound, we both agreed that we did not want to know the sex of our baby. At eighteen weeks, the sex would be discernible already. It seemed the right decision at that moment,  we clung to any way that might be able mute the grief and loss we were feeling with so much intensity. “Please don’t tell me,” I whispered a reminder to my OB-gynecologist again, right before I was put under sedation.  I wonder now though if it would have been any different if we knew. If we would have grieved differently. And on some particularly difficult days, I wonder if we had been disloyal to the memory of our youngest child – making them less human just to make ourselves less sad. And on those days grief and guilt and regret swirl like a toxic cocktail in my head.

“It gets better,” I’ve been told the past weeks, hundreds of times. “You’re getting better”, “you’re back”, I’ve also been told, diagnosed by well-meaning people who see the side of me that functions, the side that bakes and brags, the side that writes policy briefs for work, the side that comes up with social media posts on this or that political shitstorm of the day. “COVID didn’t get you, lucky girl” they also would say.

And maybe they are right, maybe I am. Lucky. Getting better. Back. But I wake up each day still knowing that longing and memory will color my mornings, and I go to bed feeling the weight of loss on my heart, the emptiness bearing down on a belly that is no longer growing. Grief on some days, is a battering ram, you don’t need to do anything, it charges fast and furiously, and there is no escape. On other days, it is a landmine, one misstep triggers it by accident. Yet other days, it is Pied Piper, and sadness is a seductive song you follow and follow and follow, as all other paths seem to be invisible or illogical. But all days and all the time, it is a gray mass hanging over you, changing you forever.

Pregnancy and Childbirth

What to pack in your hospital bag: A guide for new lazy happy Mamas

Let’s get this out of the way immediately. I was NOT a lazy mama when it came to packing for my hospital stay on D-day. For over two weeks, my husband would make clucking noises while walking past the three bags and one suitcase at the foot of our bed. “Are we staying in the hospital for a month?” he teased me. I spent the last weeks of my pregnancy feverishly researching on what to bring for my hospital stay, and as a first-time mom, didn’t want to leave any stone unturned. Essential oil diffuser with different blend combinations of essential oils for labor, post-labor, and breastfeeding? Check, check and check. As it turned out, of course, we had way more than we needed — and then some. You do NOT want to spend the last few hours in the hospital just before discharge putting things back in suitcases and making sure nothing is left behind.

So here is my ultimate hospital bag packing checklist, a product of personal experience. This is ALL you will need, promise. No need to go crazy.

  1. A plastic envelope containing money and important documents. This includes your identification documents, Philhealth documents, HMO card (if applicable), and the documents/clearances from your OB-gynecologist and other doctors. Take time to show your partner or companion what the plastic envelope looks like and which part of the suitcase you will put it in, so he or she knows where to retrieve it from. Make sure it is in a secure place.
  2. Comfortable presentable clothes to slip into after childbirth and when the visitors start to come. If you plan to breastfeed, easy-access open front blouses are best. No need to buy new clothes. Honestly, it might just get ruined. Also, bring underwear. The big grannie-type panties that go until just below your breasts are what you will be needing.
  3. Toiletries — shampoo, deodorant, toothbrush, toothpaste, facial wash, vaginal wash. Very important whether you deliver by C-section or vaginal: maternity or heavy-duty sanitary napkins. I strongly recommend Charmee menstrual pants. They are the only menstrual pants that I’ve seen in the local market. You wear them like diaper pants and it sops up the blood. Trust me, you will bleed.
  4. Chargers and powerbanks – I don’t want to state the obvious, but these are the stuff very easy to forget. Powerbanks are particularly important, so you can have access to your phone even from the bed.
  5. Baby clothes – bring three sets of baby clothes per day that you expect to be at the hospital. Many moms prefer side-tie or kimono style shirts but if you prefer onesies, that’s fine too. Mittens, socks and bonnets are also necessary. While it is tempting to go full-on OOTD, white is still the best color to go with. It makes it easier to spot insects or random things that can get close to baby.
  6. Baby towels, swaddles, wipecloths and blankets – Bring around 3 towels, 3 swaddles, a dozen wipecloths (bird’s eye lampin) and a few cozy blankets. Don’t pick a furry-type of blanket, as it might cause allergies. Make sure the clothes and items are properly washed.
  7. Baby wash – You are expected to give your baby a bath on the second or third day. I suggest just bringing small sachets of different brands so you get a sense of what you like first, or what baby is hiyang to. Sample packs should be available in baby fairs for free. Sachets can be bought in Watson’s or supermarkets.
  8. Breastfeeding and nursing supplies – there is a tendency to go crazy on breastfeeding supplies. These can come later, when you get home. All you will need at the moment is a breastfeeding cover (if you feel more comfortable breastfeeding with a cover in front of visiting relatives and friends). Some of my friends had use for a breastfeeding pillow (the one shaped like half a donut) but I found normal pillows sufficient. You can bring a nipple salve already, but I’ve found that the soreness sets in after the first week. At which point, you’re already (hopefully) home.
  9. Partner’s personal effects – Hopefully, your husband and partner can join you for the entire duration of your hospital stay. In which case, he will then need his own personal effects. Clothes, socks, underwear, toiletries and gadgets should be good. Funny side story: my husband was really excited to wear his shirt that says “Over My Dad Body” in front during delivery day. We bought it specially for the occasion. In the waiting area for daddies, three of them had the same shirt.
  10. Things that make you feel good! You are entitled to one or two (okay, or three or ten) things that make you feel good — whether that be chocolates, a bluetooth speaker to play your songlist, an essential oil diffuser. Maybe not a book, because to be honest, you won’t really be having much time for leisure reading for the next, uh, 10 years.
Pregnancy and Childbirth

The oneupMOMship in childbirth

I don’t know if you all felt it, but there seems to be intense pressure these days for pregnant women to deliver without any form of painkillers. I remember a conversation with a friend when I was on my 8th month. I told her matter-of-factly that I wanted an epidural from the get-go, and she judgily said, “Oh I guess you also plan to formula-feed your child from birth.” Umm, first of all, that doesn’t compute, and second of all, putting formula moms in the ‘bad mom’ category does not really do anything to increase breastfeeding prevalence rates. The reason I wanted an epidural is a reason known to my dentist, my brazilian wax attendant and my eyebrow threader: I have a VERY low pain threshold. Physical pain is not a minor irritation for me that I can conquer through, I don’t know, meditation or thinking happy thoughts. It engulfs my entire being. And because I had waited so long and tried so hard to have a child (another story for another post), I did not want to risk having my childbirth experience colored by the trauma of pain. I realize that not all people are the same, and that for some moms, pain is a mountain to be conquered. Or pain only makes childbirth even more magical. Or pain makes you feel like a #supermama. More power, ladies, you do you, but that’s not me. As soon as I finished my research on the effects of epidurals on babies (#geekymama) and was satisfied that the risks are low — not zero, admittedly, but low enough — I told myself, as well as my husband, that there was no compelling reason to subject myself to pain I might not be able to handle.

But wow, I realized at that point that intense, competitive, I’m-better-than-you parenting really does begin even before the child is born. Google is a master-enabler at this of course. I’ve spent many a hormonally-charged morning reading about how this mom gave birth in a pool of water surrounded by tealight candles and a doulah singing calming songs. Or how this mom didn’t cut the umbilical cord for weeks after delivery, using essential oils to “annoint” the sacred connection (and if you ask me, probably also to mask the smell). Or how this mom makes placenta smoothies to help postpartum recovery. And somehow, the subtext is, all these moms are better at motherhood.

In the end, I delivered via emergency C-section. My OB-Gyne made the call. There wasn’t even a question of epidural or no epidural. Jan Andres was out of me in 20 minutes, and while they were extracting him out of his nine-month cave, the anesthesiologist — bless her heart — was applying lipstick on me so I would look good in the photos. My son is as healthy as the kid who was delivered via lotus birth or water birth, I only have fond memories of the operating room with my husband there to hold my hand and my baby made to latch on my chest, and I think I’m ok with doing it all over again.