Surviving confinement alone

l feel persuaded to write on this. My latest postpartum experience differed remarkably from the former two.  Previously I had  full time carers to look after my needs and my newborns'. but this time I had to do it solo. Not to mention I have another two kids to look after.  both my mom and mom in laws are still working. My gran is already too old to care for us. My maid was due for her  3 months term  break around that time. Therefore I pre planned my confinement arrangement 2 - 3 months prior.

1 ) the elder kids

I didn't think I could handle three kids at the same time when i was supposed to recuperate from the delivery aftermath. ( but I have proven I  actually could haha)
So 2 weeks prior to my due date I began my maternity leave.  We enrolled Harris to a nearby preschool 1 week before delivery (on our 7th engagement anniversary to be exact) . we initially planned to send Sarah to a babysitter house who lives opposite ours. but the plan was scrapped off eventually  as Sarah seemed not ready to be sent away  plus (after testing for a day or two post partum)  I was able to look after her after all. hehe. though not easy, but manageable.

2) the part time domestic helper

I did look around for a confinement lady. and didn't find one that tailored to my need and budget. ( RM 3k for a 2 weeks service seemed too much)  but there were still  plan b which I think is better. after all, me being me ,who never condone to the traditional confinement rules, getting a proper confinement lady is quite a waste of money. haha. a helper is what i need. we were lucky to be able to convince a day time maid to stay with  us for 3 nights a week to help us with the house chores. otherwise tongkang pecah la rumah hihi..
she mainly look after the house and sarah. and she was only available after week 3 post delivery.  so prior to that ( except for the  first 2 3 days  when my husband was still around) I was totally on my own.
During these days, mr hubby had abruptly changed to be a very effective housemaid/ chauffeur/ shopper and many other domestic posts. I was both thankful and impressed.  lolz.  but I ve got to say his working efficacy and performance was inversely proportional to mine over time.  mentang2 la bini ni mobile n x brp berpantang. lolz. gradually he left the house chores back to me except for the shopping and the chauffeuring part . lolz. my mom also did come by for a while after work ( if she didnt have any other programmes/duties) helping me tending to the baby, particularly during the first few weeks. alhamdulillah.

3) post partum friendly baby equipments

these are rather important and very very very helpful when you have to care for your baby yourself during the delicate days. General rules post delivery mom shouldn't be bending down or squatting too much ( in fact I believe the pantang hardcore people prohibit this all together until certain period of time)
so we bought these :

a bathtub stand. we had had that white baby support since Harris' time.previously, most of the time my older newborns were bathed by my maid/mom/gran. I would only bathe them myself once in a while and a stool would suffice as an extra helping tool. but  this time, since it s gonna be a twice daily routine, i need the bathtub stand.  so i bought it online   (much cheaper than the ones sold in the local baby outlets)

changing table . bought this during my impromptu solo visit to ikea at 9 months preggie age! everone was concerned and offered to help me with the trolley ,queuing and all (except for the ikea staffs themselves, ironically. at least not until i asked them to help with the loading and unloading) good to see there are still many noble-hearted Malaysians!

the nursing pillow. really a great help too for a more comfortable posture during nursing.

4. confinement gadgets

i may not observe all the malay confinement rules but i did follow some which i think is practical in reshaping your body and skin contour as long as it doesn't involve oral jamu /herbs. 

i used leesa's girdles and body contour gel for postpartum body shaping. the packet with the chinese writing is a mix of chinese herbs i used for a more refreshing hot shower. bought it from my masseuse.  

this is my 'batu tungku'. an electric water pillow that can be heated ( given by my grandma).  during previous confinements i did use the real batu tungku wrapped in some sort of leaves. but that would be a bit too tedious for me to do by myself daily. 

All in all, it was a very challenging but no less wonderful experience for me. i was tired for sure, but it makes me value motherhood more. and allowed me to spend more time with my kids as a mother should be. I owed them this because of work commitment, and  I'm going to have to leave them again for the very same reason. I hope my children would understand.

soon babies.  we'll be chillaxing more. for now, mommy have to strive to become paediatrician first, muah muahx.

The arrival of Hannah

Praise be to Allah. The birth of Hannah is like a dawning sunrise to my life. Alhamdulillah. I am a happy mother today.

I believe this is the first time I wrote about my 3rd pregnancy. I first discovered I was pregnant encore for the 3rd time  on november 17th 2013. My feeling? Honestly it was a cocktail. Surprised, scared, why too soon? What would they think? Two is already a headache are we capable of three, now? I hugged my husband, took a deep breath and told him the news. He was much calmer and said he's happy about it and welcomed a third child all the same. Even at that moment. A pillar that I really needed then. And he was one. Still is.

So life went on.  I kept the news to myself (apart from my husband) for quite a while. I had the worst URTI in my life during the early days. For good three weeks I tried to avoid taking any form of medicine as I was still in the first trimester.  but it just got worse over time.   I took a course of cefuroxime eventually. I also suffered from a very bad rhinitis almost throughout the pregnancy, especially during the first half .with a farfetched wide  jobscope and hectic, stressful on-calls,  It was, in a way, physically challenging. But alhamdulillah,  I was free from morning sickness and emesis gravidarum. ( though there was another kind of 'morning sickness' occured on most of the working days of which had nothing to do with my gravid uterus. Huh!)
I didn't make it public till I was over 4 months pregnant.  Bump had started to show up a little and I think I should at that point tell my colleagues. So they knew. And many congratulated sincerely. Alhamdulillah.

My first scan  was around 9 week+ . Parametres were corresponding well with gestational age. Just  like the previous pregnancies, I did not encounter any major problems while bearing little hannah inside. My kk follow ups went smooth sailing all the way.

Except for 1 thing. She was a little bit small. We first noticed it when I booked my obstetrician around 24 weeks ( dr suraya of ksh again :))) ) a scan at that time revealed that her parametres were about 2-3 weeks lagged from her supposed age. However  based on the repeated scan two weeks later  she seemed to have caught up.  So, apart from the bad daily sneezing and annoying superior,  all went well again.

Then during my 3rd trimester scan  at 34 week poa by a colleague, she was found to be small again. Parametres was just about 30-31 weeks weighing about 1.7 kg. A scan by an obstetrician 3 days later confirmed this findings.  But other things were good. The fluid seemed adequate, placenta looked healthy, and blood flow through the placenta were excellent.  Eversince, I was given  2 weekly appointment with obsterician. Despite being a lil bit small for her age, she's  growing steadily, following the centile chart. She s otherwise fine all the way. As one of the  specialists ( dr melati) put it, may be she's just petite. Nothing wrong with that. She was estimated to be 2.1 kg by 36th week, 2.5 kg by 38th, and 2.85 kg 2 days before delivery at 39week6 days.

I took maternity leave 2 weeks earlier than my edd. We were in the process of shifting places too at that  time plus my maid was about to go back  for a long end of term break . I needed to settle a few things before the baby popped out, like enrolling my first born to pre school.

I had irregular painful contraction since 39 weeks but it merely came and go in paroxysmal pattern. Within that seven days or so, I woke up with the tinge of butterfly in my stomach wondering could this be the day ? At this point I had almost zero sadness and things were  pleasurable . I remember feeling this pleasant anticipation each day and closed my eye at the end of the day thinking may be she d come out tomorrow.

I was a bit confused when I should go to hospital initially. At what frequency and intensity of pain should I packed up for hospital ? The irregular bouts of contraction was playing trick on me. Sometime it was as frequent as every 3 to 4 minutes lasting like 20seconds , before gradually dissappearing for like 3-4 hours. This kept giving me false alarms, that I ended up in the hospital 2 days before edd. I was reassured and went back again.
I went again on my due date as I was advised not to allow post date. I was lying on the hospital bed by 12 noon and was induced with prostin by 12.30.  Pain began to be more consistent,  more frequent and more intense gradually. I had my loving husband by my side all the way and was joined by an ex primary school mate a while later. He was warded at that point of time too. I have to say, these two men helped taking my mind off the pain by chitchatting away. He was with us for more than 3 hours and eventually left ( for iftar - at home! ). So it was me and my husband again with nothing much left to say. My mind started to refocus on the pain and after 15 minutes I asked for a nubain.  Nubain was good. I felt light headed, drowsy, calm,  more clingy to hubby and much less in pain. This lasted for a good 4  hours before the contraction became agonisingly painful again. Hub was in the bathroom when it first came, to the point i shed tears. And when he came out, he called out for the nurse to have a look. I asked for another dose of nubain but the nurse was reluctant to give as it should be at 6 hour interval. She  offered to bring me to the labour room instead,  so that I could inhale the laughing gas ( nitrous oxide). I immediately agreed to this. 

We were in labour room by 10 30 pm. Contraction was searing and tearing my stomach apart. The initial os was about 4-5 cm effaced. By the next hour I was crying hopelessly in the labour room. All the time reciting zikir like the simple 'Allah' and the one that was recited by prophet  yunus 'lailaha illa anta subhanaka inna kuntu mina zoolimin'. Continuous head and back massage from the husband , tummy massage and soothing voice of guidance from the midwife was a big  -huge- help at that moment.  people always told me that the entanox was just a waste of time. For a long time, even with two previous labours, I believed this.  But this time i realised you have to do it right to make it work. It was all about timing when to inhale and when to hold your breath. I wouldnt have been able to do it without the midwife guidance ( when you were in such pain it was hard to take control of everything, even yourself!)
You see, this labour experience was rather different from the previous two. 

1) previous pregnancies, I had water break first before contraction pain. This time, I needed to be induced to go  into labour and even up the point that written above ,the amniotic sac was still intact!

2) I received epidural analgesia for the  former labours.  Though there were mishaps in both occasions ( harris - epidural jab was a bit too late. I went into 2nd stage right after. So I felt the strong painful contraction but not the bearing down pain. As with sarah, I had epidural from the beginning but it got blocked right before 2nd stage so I felt the bearing down pain but not the maximally intensified contraction pain.

This time I chose to try to do it without epidural analgesia. Hahaha kinda bad choice but I didn't regret it. It gave me a new level of confidence and I know I can bear such pain.

After 12 midnight the pain was so excruciating I was screaming  ( within tolerable range I think , lolz. This is one of the reason I chose to deliver in private centre. I couldn't bear hearing the ladies in adjacent cubicles screaming and all the supposedly encouraging shoutings from the doctors/midwives. I need the quiet and calm ambience.  So if there s anyone need to  scream it would be only me. Just me. Hehe). The doctor was called immediately.  Os was already 8-9 cm. Membrane was bulging  but  for goodness sake it just  wouldnt burst by itself!
Dr suraya attended calmly and ruptured the membrane with a hook. There was sudden temporary relief of pain while the liquour gushed as if coming out from a water hose . But not for long. I then knew the baby was about to come out. I could feel her head down within my pelvic cavity and crowned with each push.  The pain was indescribable.  I was among the luckiest not to have to experience it too long. Though it felt like forever,  it was just a less than 10 minutes deal. And there,   My 3rd baby was delivered and was put on my belly at 0025 on july 17th 2014. 25 minutes  exceeding her due date ;)  alhamdulillah , she was a beautiful perfect baby girl with excellent APGAR score. She weighed 2.86 kg. So the estimation was almost accurate! I was so tired post delivery that all I wanted to do was to sleep. I didn't have any tear . Just received 1 lap  of suture to catch a bleeder.

The ambience was just as I dreamt of. Calm, surreal and filled with tons of love. Everytime I delivered there would be this feeling of enormous gratitude to Allah and also as if our marital bond was tightened and upgraded to a new level. I didnt just say it. But  by God,  I can feel it does.

Our little baby was nursed under radiant warmer initially, as she was slightly and transiently tachypnoiec. Her initial blood glucose was also quite low. It was 1.5 mmol/l . I consented for formula milk enteral feed as a rescue measure, and since it was significantly low, we decided for  immediate intravenous dextrose bolus  too ( though the reading just prior to bolus was actually 3mmol/l) followed by maintenance infusion. She was fed via ryles tube as they were worried she might aspirate from the rapid breathing. But I breast fed her anyway ( the  breast milk was very scarce in amount at this point and she wasn't too tachypnoiec afterall ,  hence I felt it would be safe to do so ).  I let them continued enteral feeding via ryle's tube throughout the night as I didn't want to risk another episode of hypoglycaemia.

She was  perfectly well the next morning. We took off all the 'wires'  from her, put her in a cot and roomed her in with me. Yeay!

Her haematological investigations came back normal. Full blood count and film, crp ( though I dont see the point of performing this before 12 hours of life,
G6pd and cord tsh test : all were perfecto.

We were allowed home by noon.

it was a wonderful  journey bearing and giving birth to this lil baby. It s even more wonderful to have her in my arm , so tender and pure.

We name her  after one of the greatest women in  history, the mother of Maryam / mary : Hannah

Mommy loves you dearly little Hannah ..

The birth of Sarah

Our second angel has landed on earth. Praises be to God.

I was admitted at 35 week 6 days for premature contraction which turned out to be a false labour. ever since, my Braxton Hicks became more frequent though still irregular. This went on uneventful  until the night of 19/09/2012 .

At around 9.30 p.m , I felt a sudden unprovoked leak. couldn't be urinary incontinence as i just came out from the bathroom. Then it hit me ; has the time come? is it now? By the time the second surge came out, it was enough to convince me. My water just broke.

I told my husband. He then quickly packed our stuff to go to the hospital. we have packed most of the stuff, just needed a final add-ons  here and there. by 10.15 p.m., we arrived in KSH.  I came here as I have booked my obstetrician, Dr Suraya ( the same doctor who delivered Harris). When we arrived at the registration counter, they brought us to the labour room. Only then they told us there were no more room left. I was quite surprised and disappointed at that time as I had called earlier before reaching there to inform them that I was on my way and was in labour .If I were to deliver there, the labour room itself would be my room.  Abrupt decision had to be made then.

i told the nurse to proceed with the CTG and to check my cervical dilatation. The CTG was fine and os was about 3 cm effaced but station was still high. After discussion with my husband and my parents, We decided to find another centre, and the choice was Darul Makmur Medical Centre.

It was about 10 to 15 minutes drive between the two hospitals, and it was raining heavily. Alhamdulillah we managed to arrive there safely. We were also joined by my parents and the co-owner of the hospital later ( I sometimes do locum at his other clinic).  By 11 pm, I was in  their labour room . Contraction had become more regular but still very mild.

My attending obstetrician was there within 5 minutes, It was Dr Roziah. The initial CTG was reactive. Liquour was gushing out like water hose every time i felt stronger contraction. I requested for epidural again this time. it was successful after two attempts. I received a spinal bolus too. Immediately after the procedure , my body was itching all over.  When the anaesthetist saw me scratching, he immediately told me that it was a common side effect of the fentanyl - the opioid used in the epidural cocktail - apparently if you happen to have it you just have to bear with it as anti histamine won't work to stop the pruritus. Pitocin was initiated right after the epidural procedure.

Things were fine until 3.30 a.m. (  i could pose for pictures,chatting with hubby, the doctors and nurses casually, reciting surah Maryam (Mary) via iQuran Pro on my phone almost pain free) . The fentanyl infusion kept on beeping signifying there was interruption with the flow.  Pitocin concentration was increased gradually every hour.  At that point, My baby's CTG  began to look less desirable.initially it showed good baseline variability  but with no obvious acceleration within 20 minutes, then it slowly got worse. there were a few type 1 decelerations  which became more apparent overtime.The last few decelarations even had saw-toothed appearance  with significant bradycardia each time (saw toothed or sinusoidal decelaration as i remember from my O&G days, might signify abruptio placenta). Only God knows how terrified I was then, though outwardly i tried to look as composed as i could manage. my pitocin concentration was reduced back to half and i tried changing my position from supine to right lateral  position, and alhamdulillah it worked. The CTG became reactive again and i was able to avoid surgery :) It could be the hyperstimulation from the pitocin or it could also be due to significantly reduced venous return as the CTG change was almost immediate by changing position.

By this time, I am pretty sure that the epidural infusion had failed. i felt the contraction pain which was already strong. i cringed silently, my fingers gripped my husband's so firmly each time. through out the labour, i recited prophet Yunus' (Jonah) doa' while he was inside the whale repeatedly ( my grandma kept on reminding me to do this  since the false labour ).

By 4.55 a.m. I had the urge to bear down. the doctor checked my opening and told me I was all set to push my baby out. tears suddenly streamed down. it's not the pain that triggered it I swear - but mixed feeling of  fear, joy, hopelessness, and doubts  over my own self confidence.

I gathered all energy left within, held my two legs without being told, breathed long and deep, and began to push. it was really agonising when the baby's head had crowned but you couldn't push at that time as there was no contraction.It was not easy. I needed all the moral support i could get  from the people around me and i was very lucky as they were really encouraging and soft spoken.  Husband was at my head, hugging, kissing my forehead and wiping my tears. Retrospectively, I  feel sorry for some moms who had traumatising experiences in the labour room, being scolded by the staffs for not pushing properly or for feeling hopeless. It would be the last thing you need to hear at that time. personally, i fell that positive encouragement was really vital and it does help.After 10 minutes battling, with one final push ( which was accompanied by a scream - but only during that last push :p)  , My second baby was born (at 5.05 am 20th of September  2012 ).

They put her on my chest. I dried and stimulated her myself with minimal help. My first thought when I saw her - she looks like a newborn Harris, only bigger.  It was so surreal. I was so mesmerised by her that I forgot that my placenta was still inside. haha. but they didn't need me to push that hard to bring it out :P
I reluctantly handed her to the staff for further nursing care. She experienced mild transient tachypnoea due to hypothermia ( the labour room was chilly cold at  5 o clock in the morning).She was put  under the radiant warmer and was given headbox oxygen for a while as a supportive care. She was fine after five minutes.

We were discharged home the same day. I was a bit anxious to go home as I wasn't sure of Harris' acceptance towards this new addition to our family. But Alhamdulillah, he adjusted himself to this new environment rather immediately. he was very welcoming and loving towards his little sister, and he doesn't mind me nursing or holding her, though once in a while when the baby was not on my lap, he'd come to me, hugging, cuddling and kissing me as if he's been longing to that the whole day. thank you Harris for being considerate and understanding.  I love you just as much.

We name our little baby, Sarah :)

Insyaallah, you'll be a well nurtured and honourable woman both in this world and hereafter. May both of you - my children - be  among the solehiin (the pious) . amiin.

je t'aime mes petits bonheur

Sarah's little foot

Day 10 of life

The arrival of Harris

ENFIN !! Our petit angel is here!!

Our baby was born on August 21st 2010 ( 21 / 08 / 2010 ) at 37 week and 6 days of POA. everything seems to happen timely. mama planned to start taking pre delivery leave on saturday, and there you were ! showing the sign of getting out from my womb as early as 630 a.m in the morning of saturday 21st.

I was about to perform my subuh prayer when i felt something dribbling down my legs. initially i thought it was the incontinence which i sometimes experienced when i cough or sneeze ( or any manouvre that increases intra abdominal pressure in that matter ). however, this one came unprovoked. I hesitated and sat for a while. it had gone. I then continued with my prayer. halfway performing it, the dribbling became more prominent.. it was more like streaming then. My prayer was halted. There and then I was pretty sure it was not urine. It was something else coming from a different tunnel. My heart skipped a beat or two. ' is it gonna be today?' 'for real?' and i kept asking myself the same thing over and over.
mama told papa of what happened. there were both happy and nervous expression on his face ( so did mine). we already pre planned to travel back to kuantan that morning as papa was supposed to work and my leave began that day. i did not feel any contraction pain nor having show at that moment, therefore we were not rushing and took our sweet time to prepare for the voyage to the hospital:)

we arrived at the Kuantan Specialist Hospital around 1015 am ( after stopping by wan and aki's house to pick up some essentials) and checked in. The liquor kept on gushing out that the back of my cloth was quite significantly soaked. mama was initially placed in 4-beds- room. it was ok but not condusive enough. lack of privacy i guess. The nurses were nice. as i lay on the bed, the midwife nurse began to set up the CTG probe on my belly. well, my dear boy your CTG was reactive :)

Dr suraya came to check on you and mama around 1215 pm ( as she had an OT case to run earlier). She's a very lovely consultant specialist. She advised me to have Prostin inserted (a per vaginal medication to induce labour) as i still did not feel any contraction pain even after 6 hours plus post leaking liquor. i reluctantly agreed as i knew she was right but also had heard the less favourable story about prostin induction ( especially about its hyperstimulated pain ).

I was right too. mama began to have a moderate contraction straight away right after 5 minutes or so post prostin. my cervical opening was only 1 cm prior to the prostaglandin insertion. After 1 hour, the pain was becoming more and more frequent and stronger. i was no longer able to smile or laugh at papa's jokes. Dr Suraya came to my bed again. my os was on ly 2 cm at that time. she then prescribed me with intramuscular pethidine to ease the pain. the drug did make me sedated but failed to do its main job : pain relief. i suffered for another hour or so with contractions frequency of every 15 seconds!!

i could not take it much longer ( with os that small n pain like you are almost ready to push!) hence requested for epidural analgesia. they then pushed me to labour room for the procedure. i was lucky to be pain-free while on the wheelchair. however the ultimate pain came while i was about to underwent the procedure. i couldn't describe how excruciating it was. the midwife checked my os once again before the procedure. it was 3 cm but cervix was already effaced, she said. my epidural was administered by Dr Nordin, an anaesthesiologist. i was crying, citing 'Allah' ' lailahaillallah' and the syahadah. i didnt know what else to do. Papa was there all the while from the beginning, holding me, massaging, kissing my forehead and stuff. He too was worried and sad, seeing his wife in agony.. the pain was soo strong that i bearly felt the epidural needle being poked at my back, luckilly i did not move. Dr Nordin gave mama a bolus spinal analgesia as well for immediate pain relief ( as epidural's will take 5 to 10 minutes to work). My whole body felt numb for a while after the drug was introduced. i was almost immediately pain free after the procedure. Then Dr Suraya did a VE on me once again. i couldn't believe her when she said my cervix had already fully dilated! what?? 3cm to 10 in 10 minutes????? - Yes it was a superfast precipitated labour..

they then hurriedly prepared me for second stage labour and arranged my legs in lithotomy position. because of the newly introduced spinal analgesia, i barely felt like bearing down. however the midwife was monitoring my contraction hence helping me to know when to push. the second stage was very brief, with papa, dr suraya and the midwife encouraging me rather ..casually i'd say ( as i was no longer in severe pain :D ) . Being a doctor was a plus at that time i guess. though i didn't really have the bearing down feeling, but i technically know the correct way to 'push' and it did help!! Papa got to see your temporal head for a while( and he was really amazed it seemed) before your head crowned. I initially refused for episiotomy ( KSH still applies the 'rule' - epi for all primid) but after contemplating about my baby well being ( estimated weight of 2.8 Kg , no continuous ctg monitoring at that time, prostin induced + precipitated labour which were all prone to cause fetal distress) I finally agreed. Dr Suraya performed the episiotomy when your head was crowning. and in a matter of seconds, you were already on top of me my dear.. no longer inside.

I was speechless and mesmerized. hearing your first cry and saw you moving your limbs actively gave me a relief : i knew straight away my baby had a very good APGAR score ( indeed it was excellent. your APGAR was 9 at 1 minute and 10 at 10 minutes!) . they put a linen separating you from my belly which i slowly removed so that your skin would touch mine. it was so surreal. both papa and mama were in awe. we are finally.. parents - To a lovely baby boy.

The bonding time was very brief. they then brought you to an open care to put you under warmer ( as well as to have you cleaned). papa went to see you and had you 'azan-ed' while the doctor and nurses were nursing me. I can't help smiling, feeling fully tranquil. i have delivered our very own child...

After half an hour or so, the nurse returned you to us. you are soooo cute and adorable and tiny. you weighed 2.41 Kg, with length 43 cm and head circumference of 31 cm. your sugar level was 3.4 mMol/L according to the glucometre. Dr Siti was your attending consultant paediatrician. the first thing papa told me after he saw you was ' comel nye baby, mata die kelabu'. indeed you are very cute and your eyes are beautiful as well as the whole of you.

by 530 pm. we are transferred to a single room which was waaay better than the previous one. you were visited by many of our loved ones that night. wan and aki, nenek and tok, your great-uncles and great-aunties. everyone was in a very cheery mood just because of you :)

i think i have written long enough. there were still alot of things to tell you. but i will do so in future entries.

we named you, our petit ange : Harris - a protector, the guardian of heaven :)