Sunday, June 26, 2011

Birth story I - c-section I

Many of my male Chinese friends told me that their babies came to this world via elective c-sections. "It's not like we need to get pregnant again in life."  They said.  True, in China one-child policy has been practiced for more than 30 years now, and for >99.9999% of the women, there is no need to worry about the risk of uterine rupture, which is associated with subsequent pregnancies following a c-section any more.  "Plus, c-section preserves the tight vagina, which brings more pleasure to sex life!"  Some of the male doctors said this to me as if I were one of them.

When I was a little girl, my mum did predict that I would have trouble to bear babies, she meant that I had an apple-shaped body figure with small hips.  It was long time ago and I had forgotten about it when I got pregnant with ZhuZhu.  At the end of the third trimester, I had imagined that I could pop out the baby effortlessly like every other Chinese woman, although I had no concrete birth plan.  The birth class instructor, a very nice midwife who has 4 children herself, was not pushy enough to make me to come up with one.  So, my first birth story ended up being written by my medical caregivers and it goes like this: at 4 days prior to her due day, ZhuZhu was born via an emergency c-section on Tuesday 20th of February 2007.

A longer version, however, is much more interesting. 

It began with one night when I was showering sitting down.  What, you don't know how it's done?  When one is heavily pregnant, standing under the shower could be a challenge, you see.  So, at the last few weeks of my pregnancy, say from 32 weeks on, I was doing "sit inside the tub" showers to avoid falling - I was huge!  On Sunday evening 18th February, 2007, I decided to take a hot tub bath to reward myself for the hard work over the weekend, I had finished a small research grant and a slide presentation that was scheduled on Tuesday, 20th of Feb, at which I would need to report our work progress to a group of big shots in our research field.  After the warm and relaxed bath, I went straight to bed.  

In the middle of that night, however, I jumped out of the bed because a gush of fluid coming out of my vagina.  Soon I found the fluid was pinkish and the flow become constant, so I suspected that the bag of my water was broken. "I must have lost my mucus plug while taking the bath."  I told my husband who was not too happy to be awake at this time.  He mumbled something like, "How do you feel?"  "Nothing, no contraction, no hurting.  But should we call the doctor?"  I was nervous.  "Remember what the birth class teacher said?  You now need to time your contractions, if they are 5 minutes apart, we go to the hospital."  Then he turned round and went back to sleep. 

"You too, need rest because you will need to work very hard tomorrow!"  He threw this sentence to me when I woke him up again a few minutes later.  I could not believe this was the man that I married to.  How could he continue to sleep leaving me alone with my leaky vagina was beyond me.  The baby could be dying inside!  At that point, I became a nervous wreck.  However, I did not feel like waking him again since my gut feeling told me that the man was right, we would have a big day ahead and we needed that night’s sleep.  Yet it was hard for me to stay in lying position as the amniotic fluid leaked faster that way.  So started to walk around the house after putting on a pair of heavy duty protective underpants.  2 hours passed, no obvious contractions; another 2 hours passed still no painful contractions.  At that point, my protective underpants became heavy and I began to be really worried about the baby to be in distress.  It was 4 am, so I could no longer stay calm.  I then dialed the phone number given by my birth class instructor.  The receiving nurse was unimpressed by my report, "Since you are still able to speak calmly, most likely you are not in an active labor."  I, a biologist having >15 years of working experience in medical school together with having just completed a birth class, did not understand why I was told to stay put.  "Call us back when you feel like screaming."  She told me.

Being a good patient, I then decided to wake the soundly sleeping husband at that time so that he could drive me to the office.  I'd better submit the research grant prior to the baby's birth, I'd thought.  He did not complain this time and even helped print few hard copies of color figures, bound them neatly, and then packed into a FedEx box.  

It's now 6 am on Monday 19th of Feb; I still did not feel like screaming, even a regular contraction pattern was still not developed.  What should we do now?  I asked the brain.  The husband then felt it might be necessary to show up in the hospital to at least make sure the baby was okay.  

Bonus to us is that the hospital is right across the street from my office.

"So, you said that your water was broke last night and your contractions are 10 min apart?"  The receiving nurse saw that I was walking confidently towards her and clearly in doubt about what I reported earlier over the phone.  She led us to the triage room and said, "Get on the bed and let's check it out.  Most likely we will send you home to wait."

Acting as a good patient, I followed her instructions: took off my cloth and put on a gown as quickly as I could so that the nurse could see with her own eyes how full my protective underpants had become.  She left the room and came back immediately with another nurse.  The new one wiped my bottom with an indicative paper said instantly, "Yep, your water is broke and wait here for the doctor!"  She sort of showed me the blue indicator and left the room.

"I knew it!" I said to them in my inner voice.

Few minutes later, the ob came in and stuck his fingers in my private part and said, "You are at 2 cm opening and let's give it another few hours."  He then left quickly to attend my howling neighbor.  She was just wheeled in few seconds ago but it felt like forever as she never stopped cursing and wailing!  I turned to Fabrice (the hubby) and found him looking impatient.  "I would never cry and curse like her."  I said and truly was embarrassed.  The hospital is where we both work and those nurses and doctors share the same cafeteria with me.  I would not like to see them following such "indecent behaviors", you see.  Feeling quite safe in the hospital, I told Fabrice to get to work - I intended to allow him to free his schedule so that he could be with me at the time when I needed him the most.  His office and mine are in the same building anyways.

By the time Fabrice came back to the hospital from work, I was already wheeled into a private birth room, hooked to several electronic machines that monitored my contraction, blood pressure, and pulse, and the baby heart beat.  However, I was told that my cervix opening was still stayed at 2 cm. "The doctor instructed them (nurses) to prep me for the pitocin to induce labor.  The hospital's policy is to have the baby out by 24 hours after water breaks to prevent infections."  I updated him briefly.  "Boy, what a luxurious birth room that you have!"  Fabrice looked around curiously and excitingly.   There was a big TV, office table, two guest chairs, one rocking chair with pull-out bed, toilet, and a small shower room!  "Wow, a shower!" he then disappeared in it.  Right, the man had not had his morning shower yet.  

Well, so hadn't I!  

Not only that, I even had not had any food and I was hungry! 

Few hours after the induction, I started to feel cramps but it was bearable.  The ob came back to check on me every 2 hours or so, but after few hours, the cervix only opened another 2 cm more, although I felt the cramps hurt me more and more as if I was having my most painful periods... It did not take long past that point for me to ask for epidural - I clearly felt uneasy to make any moaning noise in public.  Little did I expect as soon as the epidural was used, the contraction was also slowed down.  At 2 am next day, Tuesday, my cervix opening was only progressed to 6 cm.  It went over the 24-hour mark.  The ob explained to me that it was okay for me to wait a bit longer since I was tested negative for GBS (Group B streptococcus).  Unfortunately, the cervix dilation never passed 7 cm.  At 4 am's check, my ob informed us that the baby's heart rate dropped, "The baby is in distress and we need to get her out immediately."  He announced and left the room.  Letting us worried in the birth room for a long 30 minutes later, the ob showed up in our room with an anesthesiologist (I was told later that he was delivering another baby by c-section during that 30 minutes.)  

At 4:45 am, I was all prepped and wheeled into operation room (OR).

The OR was very cold.  Seeing me shivering, the nurses covered my arms with few warm blankets. The anesthesiologist gave me more drugs to numb me from chest down and poked me everywhere on my belly to make sure that I could not feel anything.  Then he stood beside me.  The room became quiet.  The ob must have been cutting me open at that point.  I really wanted to see what they were doing to me, could not.  They put an annoying curtain between me and them.  Fabrice was instructed to sit beside me so he was also unable to see anything below my chest.  Then I heard my ob said to someone, "Push!"..."Again!"..."Harder!"...I guess that he was telling a nurse to press my belly to push the baby down so that he could engage the baby's head with a extractor probe.  Each push made me nauseated and I began to gag!

"I cannot breath!" I said to the operating ob.  He said sternly, “You are breathing fine!”  Then he asked another male nurse to replace the girl nurse. "Push!” he ordered loudly this time.  Boy, that nearly killed me and my stomach started to contract, uncontrollably.  Poor me, after 26 hours without eating anything, I vomited only unproductively.  "Blood pressure!" the ob asked.  His assistance said 83 or something.  "More fluid." the ob ordered, "Push!"  He shouted again.  Only a second later, I heard this, “Oh you are so tall!”  Then a muffled wet baby cry started from the other end of the room.  Soon the cry became clear, loud, and high pitched, "Lah, lah, lah..."  Someone must have aspirated the fluid out of her mouth then.

"5:19, 7 lb 11 oz..." my ob announced ZhuZhu's birth.

What an eventful 35 minutes! We welcomed a miracle to the world! She was alive! I felt so relieved, but my dizziness did not go away and I was lying on the operation table shivering, gagging, and dying. My blood pressure did not come back to normal, it was still dangerously low and I began to fear seriously that I could not leave the operation bed alive. Then I heard that my ob asked the anesthesiologist to make me stop gagging angrily since he could not close my belly. The anesthesiologist bent over and to my ears, he whispered, "Relax, take a deep breath, good, you are doing very well…" Suddenly, I magically stopped gagging. "Ka Ca Ka Ca Ka Ca..." I heard these horrible staple sounds. The ob was sealing me up quickly, with a staple, just like I do to my poor animal subjects in the lab! At that time, he was also joking around. They were talking about something completely unrelated to my labor and baby. "Great job, thank you!" I heard my ob told that to his operation team. I then knew I could get out the room alive.

"Look what we got!" the proud daddy was holding ZhuZhu who was cleaned and tightly wrapped in a receiving blanket like a peanut. She was sleeping soundly. That was from the excess amount of epidural in her blood, I found that out later. At that point, I was too nauseated to keep my eyes on her for long. I just remembered her beautifully curved eyebrows above her tightly shut eyes and a red mark at the corner of her mouth. I passed out soon after that. It took me another few hours to wake up to meet ZhuZhu again. She was the most wonderful creature that I have ever seen: her eyes were still shut but I noticed the double-fold eyelids that every Chinese loves, her nose was perfectly supported by high and distinct bridge (see what my Dad did to me?), her mouth was perfect with full and clear-edged lips. She definitely inherited the best feature of a Chinese and French. The sound of her baby cries, boy, that was absolutely to die for. It was the most beautiful music to my ears. Until today, I still like to imitate her baby cries to her.

At 12:13 pm, the Daddy could not wait to send out this email announcement with a photo of our beautiful ZhuZhu attached, "Hello, my name is Mia. Mummy and I are doing well and we will be happy to meet you tomorrow when mummy will be rested. By the way, I was born at 5:19 this morning by c-section. I am 7 pounds 11 ounces (3.4 kg for the ones using international unit measures...) and 20 inches. See you tomorrow!"

I had been quite disappointed that ZhuZhu did not come to this world through the natural canal. I should have stayed home to wait for the active labor to be established; I should not have used pitocin to induce active labor; I should have waited a bit longer to ask for the epidural...The self blame game had not stopped until I had my do-over in 2009. But this will be a story for next time. Stay tuned.

Sunday, June 19, 2011

Naming your baby - Imperfect father, part II

We Chinese give babies small names (XiaoMing, )" or milk names (NaiMing, 奶) at birth, which is used at home by parents and close relatives.  In the past, a formal name sometimes was not given to a baby until months even years after birth at the time when the parents felt the need, such as enrolling a child to school.  Therefore, a small name could associate with a person for life and even be better known than the formal name by the family.  A baby's name was often an animal, especially a bad and ugly one, since it is believed that ugly names could make a baby strong enough to survive to fight the high rate of infant mortality.  Nowadays however, every infant is required to be registered at birth so a formal name is usually picked early in one's life.  Accordingly, the last character of a formal name becomes a small name for the baby and this character is often called twice.  You may know of some common ones: Lingling (bell sound), Maomao (hairy), Doudou (little bean), Zhuzhu (pearl or little pig), Niuniu (cow), Xiaohu (little tiger), Datou (big head)... I remember that I loved it when the first and only small name of mine was once called Lili by one of my father's female friends.  Unfortunately, no one else followed her, not even my parents.  Modern Chinese also prefer to pick a small name matching a baby's look, personality, or what the parents wish it to be.  Also, like in the Western world, a name also comes in fashion, you often can guess at which time-period someone was born by his/her name.

Regardless small or formal names, old or modern times, naming a baby in China is nothing trivial.  We believe that one's name influences everything that happens in life, therefore, the baby's name, especially the formal one, is often picked carefully by grandparents or other knowledgeable and wise people, such as fortune-tellers.

Like Westerners, we also have nicknames for kids. We call it a flower name (Huaming, 花名). The difference is that nickname in China is more like name-calling in the Western world.  Look what my nicknames once were:

"African" - to make fun of my dark skin; we Chinese consider a fair-skinned woman beautiful;
"Lai Ku Mao, 赖哭猫" - crying cat; Mia, you may get this from your mama, sorry;
"Da Shuan Bi, 大蒜鼻" - garlic nose; to laugh at my flat nasal bridge
"Mouse eyes, 老鼠眼" - mouse eyes to ridicule my small Chinese eyes;
"Ma Da Ha, 马大哈" - to describe my taitailielie (dadalielie) or careless personality;
"Guangxi Lao, 广西老" - to mock the lovely persona that resembles the locals (my parents are from Hunan province but I was born and brought up in Guangxi.)

Do you have an image of what I was/am like now knowing these "nick" names?  Can you believe all those names were called exclusively by my loving father or evil older brother Bing?

Little girls are dumb.  I did not figure out it was I who encouraged those name-calling games until years later.  I had/have no sense of humor and could not know why they were laughing when I was so mad each time hearing one of those names, yet the madder I got, the more it was called.  It also didn't seem strange to me that Bing beat other kids to death if they dared to call me any names at school.

Now when I have become a parent, I find it funny too when I see my lovely kids inherited some of our features, and spontaneously I have the urge to call them funny names.

"Your nose looks funny," and "You have elephant ears," I said those to Mia when I first noticed that she has gotten his father's square nose and big ears.  After hearing that few times, the daddy rolled eyes at me so I stopped.

"You got your daddy's teeth," I shouted out loud one day when I suddenly noticed Remy's two front teeth tilted to the right. "They both did." the daddy added.  I guess this is not considered to be name-calling, although I find it equally funny to Mia's square nose and big ears.

It might not be too late now to give small names to Mia and Remy.  I used to call Mia Xiaozhu (little pig) or Zhuzhu since she was born in the year of pig and Remy Niuniu as he was born in the year of cow.  Can I still call them these names now, you think?  Starting from tomorrow, I'll insist to call Mia Zhuzhu and Remy Niuniu.  I hope they stick.

What about you, do you have funny nicknames?  Dare to share some?


Sunday, June 12, 2011

Boys value more than girls - imperfect father part I

"Daddy did not even congratulate me when I told him that he had another granddaughter!"  My younger brother Yanghe told me sadly on the phone a few weeks ago.  He was upset also because this baby meant a lot to him and our father knew his struggles - it took 11 years' marriage and 2 wives.  "He does not like the baby because it's a girl."  My bro continued.  He probably thought I would have agreed with him since I had the first-hand experience with being a "girl".  The real story here is not because my father does not like his little granddaughter, it is that he did not approve of his new wife.  Nevertheless, my little brother's crying reminded me of some of my father's imperfections.

It is not a secret that my father has a strong preference for boys, here are the pieces of evidence.

Story 1:

My parents have 3 children, 2 boys, and 1 girl.  Bing is the oldest son who is 2 years older than I and 12 years older than Yanghe, so my father had always expected Bing to have a son so that the family name could be passed on.  At the time when Bing married, the one-child policy had already been reinforced in China.  The pressure was on.  Knowing his duty as the oldest child of the family, Bing did not wait for long to impregnate my sister-in-law.  According to the shape of her belly, everyone predicted that she was having a boy (we rely on such Old Wifes Tales to predict the baby's sex since it is illegal to determine (disclose) the gender of babies by modern technologies in China.)  My father had lived for months with the belief that he was having a grandson.  On the day that he came to know that Bing took his wife to the hospital to give birth, my father went to the market to buy a live chicken.  After spending all his day killing, cleaning, and finally cooking a delicious fresh chicken soup for my sister-in-law, my father heard Bing's birth announcement, "It's a girl!"  Bing had inherited the evilest sense of humor from my father and couldn't pass the opportunity to play a joke on his old man.  Bing rushed back home as soon as he could just to see the look on his old man's face.  Our poor father, immediately stopped what he was doing (cooking) and said, "A girl?  How?  That's not possible?!"  Seeing Bing was looking at him without any emotion, he believed Bing and said, "A girl is fine too."  Our father responded with such a deep disappointment showing on his face.  After he realized the seriousness of the possible impact, he told Bing, "Why don't you take the soup to the hospital yourself when it's done."  Our father left Bing alone with the halfway-cooked chicken soup.  He had planned to go to the hospital himself with the soup so that he could meet his little grandson sooner, but a "girl" just wasn't worthy of his time.

Until today, this story remains to be a classic joke of the family. "Had he (the nephew) been a girl," we always tease him, "would you ever plan to greet her at her first birthday?" 

Story 2:

I am the middle child and a girl, obviously, who is not supposed to be better than any of the boys. However, I was the one with the highest motivation to excel and to become independent ASAP.  At 16, I left home for college, and at 20, I graduated and became a high school teacher.  However, after few years of teaching, I decided to go to graduate school.  While I was busy studying for the admission tests, he said to me in a most sincere and caring tone, "haven't you had enough education?  Men are already afraid of asking you out now.  If you had a higher degree, where would you find a husband?!"

5 years after that, I left China for the U.S., and 17 years after that, I married a French.  See, there is a solution for every problem, father! 

Story 3:

When I was pregnant with Mia, I told my father that we were expecting a girl.  He said, "Let's see when it will be born."  And then he was holding to the hope that the ultrasound could fail sometimes.  When he confirmed the modern technology is pretty reliable, he said, "Girl is good too."  But I knew that he wished for a boy since my husband is the only son in his family.  My parents-in-law (PILs) came from France on the very day when Mia was born to visit us and help out for the beginning weeks.  When I was on the phone with my father, he asked, "How did they (my PILs) take it?"  He was imagining that my PILs would be so disappointed that they would not take good care of me.  He had not met Mia until I brought her to China when she was 13 months old.  However, when I became pregnant with Remy, I told my father the news and he did not stay in China to wait to meet him.  At age of 77, he took his young wife and spent a 20-hour painful plane ride to come to the U.S. one month prior to the birth of Remy to make sure he could personally welcome his second grandchild to this world.  He stayed additional 4 months to be my personal chef while his young wife nannied Remy.

My father never admits that his coming to the U.S. to meet Remy was because he was a boy though.  He said it's only because of perfect timing - his young wife had to quit her job in order to accompany him on this international travel.

Do you believe him? 


Tuesday, June 7, 2011

IVF, 好, and scored 100!

好 (hao) means good and is a compound Chinese character of girl (女) and boy (子). If you have a girl and then a boy, mainland Chinese would congratulate you with a saying "You wrote a 好 character!" Taiwanese would say, "You scored 100 (out of 100)!" If you have boy and then a girl, you score 90, two boys, 80, and two girls, 70, and so on. This just to introduce to you about what the most common wish is for typical Chinese family.  I am one of these who has always wished for an 好 in my family planning.  I even have wished for their age gap to be two years apart so they could grow together without fighting with each other.  I got it all planned out, you see.
W
hen I entered early fertile age, I believed that a girl could be knocked up if she would swim in the same pool with men and I was watchful for any usual suspects whenever I went swimming in a pool.  Like many girls of my age in China, I had my menarche at 14.  But after that, the period would only show up every two to three months and most of the times when it came, it was so unbearably painful that I had to curl up in the fetal position in the bed wishing to become a man.  Since all the books that I could find mentioned my symptoms were normal, it was just oligomenorrhea, which were expected for young girls, I had not been overly concerned about my menses.  But when I reached 20, I became a bit sensitive to my woman issues.  At that time, I just got out of college.  A Biology Bachelor's degree might have alerted me that I should attend my female parts.  So I made my first visit to an Ob/Gyn.  She pressed my belly a bit, probed my lower half with something called B ultrasound scanner, and then announced, "Your female organs are under developed and you'd better take some hormones from now on to help them to catch up."

Did I listen to her? Of course not, I didn't have to because I did not even have a particular someone with whom I wished to have kids.  As a biology newbie, I decided to challenge the doctor and let the nature take care of my fertility.  Deep in my mind, I must have wished the Ob/Gyn to be wrong.  Regardless what my subconscious mind was telling me at that time, I had find that out by the most economical and natural way.  Lo and behold, after only ONE unprotected sex I became pregnant, at age of 24 or may be 25.  I was as fertile as any most fertile woman can be!  I was happy even though I had to endure the shameful D&C to terminate the pregnancy (it was/is illegal to have a child without a marriage in China.)

(BTW, given this particular case, I do not believe "accidental pregnancy" anymore.  Do you believe that almost all the so-called knock ups are in fact the results of intentional (mis)conducts?  Admit it, don't we all know that unprotected sex can lead to pregnancies?  Don't we all want to find out whether we could be knocked up or impregnate others? Sure we all do!)

...

Fast forward to 14 years later, I was now in the U.S. graduating and facing a transition from poor foreign student to still poor but semi-independent researcher.  Keenly knowing that my fertility was slipping away, I started to toy with the idea of becoming a mother.  "Next handsome guy comes around, I would totally prostitute myself."  I announced determinedly to my best friend, Zee, who often encouraged me to take the advantage of the U.S. freedom.

However, many good-looking guys later, I was still not pregnant.

Few years later, my lovers were concentrated from few to one who soon moved in with me, which by the way miraculously cured the oligomenorrhea that I lived for more than 30 years.  Now it should not be long before I would became a mother, I'd predicted.  Yet after 2 years of random trying, that didn't happen.  Eventually I tricked my French Xishi to believe that marrying me was the best decision that he could have ever made in his entire 32 years of life.  Following an official marriage at 43, we began the timed mating journey.  Boy, wasn't that fun.  I was religiously monitoring my ovulation month after month, and in the mean time, carefully trying not to tell him in order not to spoil the mood.  I even arranged several romantic trips in order to keep the activities alive.  Never in my life time had I ever been so looking forward to a delayed or better yet no-show period!  Yet it had never failed to show, month after month and after month.

I did not just want one child, remember, I wanted to write a 好!  When the nature did support it, I took Fabrice to seek for the help of modern technology.  My first U.S. Ob/Gyn patiently finished listening my stories and then turned to my baby-looking husband who was obviously quite annoyed by being there.  He questioned, "Have you seen a urologist?" "No?" he possibly feeling stupid then after answering the obvious question since he is also a biologist who should have known he could be the part of all these ordeal too.  "We thought that I am the likely infertile one since my previous oligomenorrhea and advanced age." I tried to defend him.  I am in fact 10 years older, plus men usually do never lose their fertility, lucky bastards!

Then he had few visits to his urologist and one small surgery to remove his varicoceles, which boosted the viability of his little swimmers from 35% to 75%. "Lo and behold, he IS the one to blame and I was pregnant soon after that" - no, scretch that, that is just what I wished what I could tell you.  The reality was 9 months after that, my belly was still as flat as the earth surface.

Finally, my Ob/Gyn gave up and decided that I was infertile, although secondary.  So, she sent us to a local fertility center, where the reproductive endocrinologist put us on the most powerful ART - IVF. $30,000 dollars, 5 cycles (one full IVF cycle, 4 frozen cycles), and 19 embryos later, at 44.5 and 46.5, I became a proud mother of Mia/Zhuzhu and Remy/Niuniu.  The IVF worked to its perfection.

We wrote "好". Life is good with these buggers in it.