Sunday, May 15, 2011

How it all Happened Part II: Preparing for our Preemie

Continued from Part I here...

...as our flight proceeded southbound to Darwin, I was still trying to find some answers for the why, and most importantly, any positives on a prognosis for a baby born at this early of a gestation.  Unfortunately my natural birthing books emphasize the 'normal' in birthing (which is what I loved about it) and less so the 'what can go wrong' bits - so we were stuck worrying and wondering.  Midway through the flight Chris thought it a good idea to request we be let off the plane first when arriving, I quickly grabbed him and told him not to say anything until we were on short-final for fear the pilot might be mandated to turn the plane around if someone was in labor (which of course, we were still praying we weren't).

At the Darwin airport Chris and I disembarked the plane along with an elderly lady with a short connection.  We tried patiently to stay with her and the ground staffer, until we reached the gangplank into the terminal when we sped up our pace.  Armed with nothing but hand luggage and a freshly adhered visa in our passport we stood sheepishly in front of the passport control agent who asked for our arrivals cards.  Of course, we completely forgot to fill them in.  He was about to tell us to step aside and come back when they were complete when I suddenly blurted out "I might be in labor" - I have never seen an immigration officer complete two arrivals cards on behalf of passengers so quickly - within 15 seconds we were stamped and on our way to customs.  Again, they looked at us, I pointed to my belly, and they waved us right through (which is unusual for Australian customs agents!)

In the arrivals hall Chris grabbed cash, I hailed a taxi.  "Darwin hospital please" and off we went...

Sitting in the back of the taxi watching the sites of a foreign city we had only visited once before, go by as the last of the sun starts to dip, I was still praying and tearful, yet survival mode was starting to kick in.  "When should we call our parents, which ones do we wake up?"  I wondered out loud which entrance it was again that my doctor in Dili told me to go to when we pulled up outside the Emergency Entrance of the Royal Darwin Hospital.  At this time my courage sank into my shoes.  Having planned a tranquil all-natural HypnoBirth at my lovely home in Scarborough overlooking the Atlantic ocean, arriving at a state hospital in a strange place, where most of the visitors sat cross-legged on the pavement smoking a variety of legal and illegal substances under the no-smoking signs while drinking beverages from brown paper bags, was not my idea of a good compromise.

We rushed in the door to the window where we were immediately directed to go to the 6th floor.  Ascending the elevator to the 'pink' floor, how could I have known that I would be riding the same elevator for the next six-plus weeks, every single day.  We were slightly surprised that the wards were all behind strict security gates with cameras and buzzers, rather resembling a prison than a hospital.  We proceeded to the 'maternity' ward, where we were sent immediately over to the 'birthing center' to which I objected profusely explaining that 'no one is actually in labor here!'   At the birthing side of things were were shown to a room and interviewed by a young man in slacks and a white shirt with no identification.  He could have been a vacuum salesman for all I know, apart from the stethoscope around his neck.  The conversation centered largely around our family health histories.  We went through the drill of how I felt, what had happened, and what my symptoms were.  He said he would return with the doctor in charge, a young female named Dr. Koh, a more-efficient-than-bed-side-manner-oriented type.   This time the conversation went more along the lines of 'hm, interesting' from her side, to 'excuse me, how bad is it' from mine.

Things quickly progressed to include a vaginal examination and other vital signs being checked.  My world started spinning when she said that I was in fact 1cm dilated and that my cervix had started effacing (or thinning).  To confuse matters more, two separate tests for amniotic fluid came back with conflicting results, so we were still not sure whether or not I was leaking.  She had to leave to attend to another woman in labor and I was left trying to keep things together and remain calm, until we met Dr. Andreas. The nice German  had actually participated in the Tour de Timor the year before and we made some small-talk about the island we lived on. It was when he introduced himself as the pediatrician on duty that I panicked and realized that yes, there is a high possibility now that there is a baby in our very near future.  He was also the first one to explain to us not only the risks involved, but also that should it be the case that we have the baby in the coming hours/days, it is very likely that he/she will have to remain in hospital until the due date - that was almost ten weeks away!

When he left, Chris and I had a few minutes to try and grapple with the reality we were possibly about to become parents.  I started crying again, Chris tried to comfort me and we started making a list of all the questions we needed to ask.  Then we turned our attention to the first matter at hand, birthing this baby, if it turned out to be the case that the Bun was in such a hurry.

As it turns out, Australia, much like the UK, has a very strong midwife culture therefore all the nurses on staff in the birthing center, are also midwives.  Having planned a midwife-only assisted birth in Cape Town, we quickly turned our attention to the young midwife assigned to take care of me after admission.  Not only did she bring us dinner (which, at the RDH at 1900 on a Monday evening consisted of a vending machine sandwich), she also tried to make us as comfortable as possible (which, in a birthing room with a single bed and one chair was not easy).  We immediately started talking to her about the perfect pregnancy we had experienced up until 24-hours before, and the equally perfect birth we had been training and hoping for, and whether or not, in the event I did go into labor, I would be able to have the baby naturally.  She comforted us and said that unless something was wrong (cord, breech, low vitals etc) there should be no reason I could not.

Next up was the small matter of logistics.  Here we were, in a hospital at the far northern side of a town where all the hotels were located in the southern end of town.  We had no friends or family, no reservation, no local phone, no internet access, no car, no place to go.  It was nearly 9pm and I may or may not be in labor.  The most important thing for us was to be together and I could not even bare the thought of staying behind in hospital alone, which is exactly where they wanted to keep me for observation overnight.  So we did what every insured person would do -  inquired about a 'private room'.  (Note: At this point, we did not even know whether my insurance would cover any of this, I mean - does one get pre-approval for this sort of thing? who knew?)  Unfortunately we were told, the maternity ward is completely full, so there was no way Chris could stay.  The midwife must have seen the panic on my face because she promised to try one more thing.  When she returned she informed us that we could spend the night in Birthing Room 6 down the hall, unless at some point, someone actually needed to birth in it.  We thanked her and watched them drag a mattress in for Chris to sleep on the floor. Looking over at the bed, I thought to myself there is no way I am sleeping on a hospital bed, since in my mind, I was not exactly 'sick'.  Instead, we removed the couch cushions and created a makeshift bed on the floor for both of us.

In my haste to pack and make the flight, I managed to pack every book on labor and child birth I could carry, as well as a number of other items like my iPod, camera, and a handful of Balance bars.  What I did not pack, were hospital necessities like pajamas, so in addition to the t-shirt I wore over on the flight, I changed into a pair of Chris' boxer shorts.  At this point we knew we had to let our families know what was going on. Due to the timezones we decided not to wake Chris' family at this time until we knew what was going to happen, but opted to call Susan's dad in South Africa - who, months later, told us that when he saw the phone ring from my Timor number so early on that Tuesday morning, he knew that something was wrong.  We explained to him what was going on and promised to keep them updated along the way, explaining that we were going to spend the night in hospital, but that the midwives were still hopeful that the labor would be delayed thanks to the nifidapine I was receiving.  

The midwives who took care of us that night were in a word, angels.  They dragged a lamp into the room so that they could turn the lights off, encouraging us to get some sleep between the two-hourly vitals checks I was receiving.  So once we had brushed our teeth (I did manage to pack toothbrushes), we curled up in each others arms on the floor of a cold birthing room at the end of the corridor in a hospital in a strange city in a strange country far away from anyone we knew, and everything familiar, and we prayed together that this baby please remain inside of me for a few more weeks, or even days.  Tears ran down my face pretty much permanently at this point as we vowed to each other that we would try and get some sleep because whatever tomorrow might bring, it was bound to be exhausting.  I listened as Chris drifted off to sleep and then turned on my back and resumed praying, the constant stream of tears soaking the pillow behind my ears...

Stay tuned for Part III, our birth. 

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