Yes, we’ve only put this together a week later than most would have expected. We obviously overestimated our abilities to “keep up” with our regular lives (including updating this website / various social media platforms about Ruth’s birth) after Ruth was born. It has taken us more than a week to pen our labour story down and yes, you didn’t read the title of this post wrongly. Labour lasted for a total of 52 hours (excluding the time that my doctors took to patch me up) and we were cooped up in the hospital for close to a week.
The main takeaway from Ruth’s birth story is that we are so incredibly grateful that we made it out alive. There were so many moments (okay to be frank, at least 80% of labour) where I felt so weak and exhausted from the pain to the point that I would forget to breathe. Then, it seemed so much easier to cave into the pain and give up on life. And trust me, it was very tempting to do so. There were also quite a few complications arising from the delivery process that we could not have foreseen, and at the same time, there’s so much to be thankful for. If you’re reading this, we just want to put out a disclaimer that we don’t wish to “scare you” about the labour process because everybody’s body is different and each labour story is unique. We just want to leave behind a record of our experience with Ruth, so that we can look back on this story in the time to come with joy and thanksgiving, whilst being reminded of God’s faithfulness to us through the years.
So hello there. We’re extremely proud and happy to introduce you to our daughter, Ruth Jedidah Lee Xuan (李萱). Born on 25 August 2020 (38 weeks + 3 days) at 2:43am to the music of Harry Potter and the Prisoner of Azkaban’s Apparition on the Train (oops) and clocking in a weight of 2.735kg and measuring a height of 48cm.
A. Our decision to induce Ruth’s birth
During our visit to the gynaecologist on 22 August 2020 (at exactly 38 weeks of pregnancy), we were told that Ruth was still extremely comfortable in my womb which somehow also still had an extremely good level of “water”. However, by that time, I was already so tired from being pregnant. Over the past few weeks, we had previous Braxton Hicks “scares”, but nothing too major that warranted a visit to the hospital. Also, due to the stress that I experienced from our OSCAR test, I just wanted Ruth to come out as soon as possible so that her physical presence would reassure me that she was doing okay, and most importantly, that she was alive. Whilst many would advocate for having the baby stay in utero for as long as possible, the fear that I could not tell whether she was alright or not was something that I struggled with. And I didn’t know that I held this fear in my heart until Dr Chi asked me if I was willing to wait another week following which we would explore induction, to which I responded with tears much to Marc and Dr Chi’s surprise.
As previously mulled over with Mel, having a baby that didn’t reach full-term wasn’t something to be embarrassed about. Induction also does not make me any less a mother than those who waited until full-term. If anything, Ruth was our baby and we should retain the full prerogative to make decisions that were the best for our family and importantly, my mental well-being. There was no guarantee that I’d still be mentally strong to have Ruth past 40 weeks especially if those were the fears that were hidden in my heart. That being said, I made the decision to induce Ruth knowing that this decision could be criticised by others. But to me, the fact that I continued to cry during brunch at PS Cafe only demonstrated that induction was necessary and since medically, baby was ready, what was holding us back? We were prepared to spend a little more on induction, bearing in mind the main principle that money can always be earned, but somethings cannot return.
B. The initial stages of induction
We “checked into” Mount Elizabeth Hospital (Orchard)’s delivery suite at 9:30pm on Saturday so that I could be induced that same evening. When we first stepped into the suite, we were extremely impressed by the size of the suite, and the nurses on the night shift were just so so sweet. I felt relatively comfortable and positive about the whole process because I truly did not expect my body to react negatively to the induction medication. Also, being young and having made it a point to exercise rather frequently during the pregnancy, I assumed that I’d have a relatively easy labour and that at best, labour would take 24 hours or so (similar to what my mother experienced with me).
After settling in, Dr Chi arrived at the delivery suite at about 10pm or so and we started the induction process with the Prostaglandin pill. From what I gathered, the Prostaglandin pill was supposed to assist with the softening of my cervix and would be inserted into my cervix once every 6 hours. We also understood that I would experience contractions once every 5 or 10 minutes, but that this was the method by which my cervix was softened. 5 to 10 minutes per contraction? I was prepared, in fact, both of us were relatively prepared for any pain that may come. Following the insertion of the Prostaglandin pill, we were sent up to the maternity ward to rest as the pill would take approximately 3-4 hours to take effect.
Ah now, this is what I regret the most – not resting during this 3-4 hour respite when I had the opportunity to do so. Really, the optimism I had was so unreal. I couldn’t fall asleep until say about 2am and by 2:45am when the contractions kicked in. They were slightly different from what I had experienced with Braxton Hicks and of course, of an intensity far greater. However, what I found really odd was the frequency of which the contractions came; they were about a minute or two apart which I thought would only occur when I was just about to “push”. After about half an hour of resisting the pain (oh yes, still had plenty of energy then to “act hero”), we eventually updated the nurses of the development. Then, they put me on the CTG machine which was able to monitor both the frequency and intensity of my contractions. At that point, the nurses were able to confirm that my contractions were coming between 1 to 3 minutes, and as such, I should be moved down to the delivery suite again.
Hello there again, delivery suite. Obviously, due to the intensity and frequency of the contractions, I expected there to be some sort of development to the softening of my cervix. I mean, how could it not be soft enough after all that pain? Unfortunately, the worst was truly yet to come. After going back to the delivery suite, the contractions became twice more intense in pain than they were in the maternity ward. Being a person who prides herself on having a high pain threshold, the pain I felt from these contractions (which continued to come every minute or so, essentially leaving you no time to “rest”) left me in tears along with clenched fists. No distractions helped, it was just pain, pain, and pain from 2:45am to 10am on Sunday. Due to the amount of pain that I experienced and how tired my body was getting, I was given a Pethidine injection at around 10am which would provide some pain relief. And alas, sweet relief. With the injection, I managed to get in some sleep until about 2pm when the next dosage of Prostaglandin was given to me. As both of us managed to catch some sleep after the first wave of pain, I thought that I’d be able to tolerate the second wave of pain. Anyway, I was desperate to give birth as soon as possible but then, my cervix was still extremely uncooperative. I don’t think I’ve ever hated the measurement “1cm” more than now.
As it was with the earlier pill, the contractions from the Prostaglandin pill took about 3 or so hours to take effect. But this time round, the pain DOUBLED that of the earlier Prostaglandin pill. Again, I broke down in tears from the pain from the contractions that came every minute or so, although the medication wasn’t supposed to work that “effectively”. Thankfully, the night nurses, Audrey and Abigail, were there to support Marc and me through the process. They were extremely encouraging and walked us through the pain and for that, we’ll always be grateful. We felt so safe in their hands. Given the tire of my body, they gave me another Pethidine injection for some temporary pain relief. Unfortunately, it did not work its magic as well as it did the first time. I could still feel a good measure of the contractions (after we were sent up to the maternity ward at just after midnight) but they were still more tolerable than feeling them at full force.
The next morning (Monday), we were sent down to the delivery suite to check on the status of my cervix again. Finally, we hit 2cm and Dr Chi was even able to manually expand my cervix to 2.5cm (of course I dahan a bit because any progress is still progress). As such, we agreed to hit me with one final Prostaglandin pill just to aid the dilation process, following which Dr Chi would burst my water bag at 3pm that same afternoon. Admittedly, I was quite reluctant to even have another pill given the pain that I had already suffered twice. But bearing in mind that the pill was only going to be given to me at around 10am, I clung on to the hope that the effects would only kick in when epidural was being administered. Within those pain-free hours, I ate lunch and took a warm hot bath which would take me through the next few days after delivery. Better sort that out whilst I could!
C. Commencement of Active Labour
Dr Chi attended at the delivery ward at about 3:30pm to burst my water bag, At first, I was presented the option of bursting my water bag after epidural or to do it without an epidural. Of course, who would want to have their water bag burst without pain relief especially when pain relief was available? But since Dr Chi arrived at the ward before my anaesthetist did, and we didn’t want her to make another trip to attend at the ward again, we just burst the water bag without the epidural (so brave, hor?) To break the water bag, Dr Chi inserted a very thin hook-like contraption that would nick the side of the water bag. But after the first uncomfortable nick, she realised that my water bag was double-membraned so yes, another uncomfortable prick I received.
I’ve always wondered what it would feel like to have your water bag burst at home, or wherever else. And I honestly didn’t expect it to feel that way. It’s akin to a whole gush of water flowing out of your legs sporadically, and you have absolutely no control over the same. I wouldn’t say it’s an uncomfortable feeling, but I did feel rather embarrassed from “leaking” so much and making a big mess on the bed. Thereafter, the epidural was administered by Dr Tiong Ing Hwa (the best anaesthetist ever, by the way), who was Dr Chi’s ex-colleague from NUH and also, my cousins Irene and Jonathan’s senior in the speciality. I recall him coming into the suite and proclaiming that he is very “OCD” because of the nature of his work, but I told him that I welcomed an anaesthetist who pays attention to detail because honestly if the epidural was administered wrongly, I’d be the one who pays the price. Better safe than sorry.
The administration of the epidural was rather simple (on my part), save for the aspect where they needed me to curl up my spine like a cat and I simply couldn’t (lol). I even imitated the “meoooww” posture to invite the correct form but it was tough due to the belly. Perhaps all those years of sitting up straight at the piano / whilst playing the cello really took its toll. And if you’re wondering about the size of the needle for the epidural, it really isn’t that frightening and in fact much thinner than what is used at blood donation centres. The only thing odd was that I kept feeling my water bag “release” itself whilst the epidural was performed and the contractions from the Prostaglandin were still ongoing. So we had to be quite careful to meander the insertion of the epidural around the contractions lest the occurrence of any complications associated with the epidural.
After the epidural was administered, I felt the wave of relief that you’d often hear people talk about. The catheter was then inserted and the nurses started me on an IV drip of Oxytocin, which serves to stimulate strong and regular contractions that would assist with the dilation of the cervix and the delivery process in general. As the epidural still had effect and I couldn’t feel any of the pain from the contractions brought on by the Oxytocin, I assumed all was well. Or so I hoped.
D. The prolonged active labour
The pain set in proper at around 5 to 6pm, barely a few hours after the epidural was administered. Obviously, this was quite concerning for us because we had assumed that the epidural would just last me through the entire process of labour. Alas, it did not. The contractions from the oxytocin were also hitting me every half a minute or so, thereby leaving me with no relief/break to recover or catch my breath from the excruciating pain. The only saving grace was that I was dilating even further and was close to 4cm then. To counter the pain that I felt, the nurses gave me a bolus or rather an extra shot of epidural (which started from an initial dosage of 7ml/hour). Again, slight relief for a short period of time. The pain from these contractions was similar to the annoying wasp that won’t leave your living room no matter how hard you tried to chase it out. Or the person in your life who keeps on spouting toxicity no matter how much you try to block the entry point.
By 8pm, I had dilated to 6cm; rather good progress I’d say. But this was not without me screaming my head off with every single contraction. I wept with all my heart and was so emotionally and physically broken from the pain that the contractions brought me. Nothing could distract me from the pain and all I thought about was wishing that time would pass quicker, and hoping that my cervix would dilate even faster so that I could evict Ruth out as soon as possible. At this point, I think Marc was also quite broken by the sight of me weeping and moaning. And we soldiered on.
By 10pm, I had dilated to 8cm. Again, this was good progress and I continued to cling onto the hope that I’d dilate even further to 10cm within the course of the next hour. Between 8pm to 10pm, I had problems breathing, I couldn’t focus and I was screaming my heart out, partly because my body was just unable to cope with the extended duration of the pain. Do bear in mind that as labour progresses, the amount of Oxytocin that is put into my system increases. Earlier, I had already displayed an extreme sensitivity to Oxytocin but yet the medication was continued and the epidural “couldn’t catch up” though additional doses were shot into my system. I became so frustrated with everyone telling me to breathe. It got to a point where I howled “What makes you think I’m not breathing? Can’t you hear me breathing?! I am trying so hard, I’m not sure how long more I can do this for.” I really felt like dying, and that I was so close to death. Given my struggles to “hold on”, I was put on laughing gas to ease the pain.
Honestly, I thought laughing gas would be my best friend. I assumed that it would be an excellent pain relief but no leh, it did not help at all. Instead, it made me more drowsy and unable to focus on the contractions, but yet still feeling the full force of the contractions. When I performed the breathing exercises into the mask, I would even forget to breathe after removing the mask, because I was just so flipping exhausted and the laughing gas made me so drowsy. I would just lie there and not move (because not breathing felt so much more comfortable than breathing) and Marc had to pinch my face and yell at me to wake up and breathe. And right after I woke up to Marc’s pinching and yells, another wave of contractions would hit and the cycle repeats. During those turns when I didn’t use the laughing gas, I would be rolling around in excruciating pain and hollering my heart out. And it’s not even that I’m in labour, but it already felt like I was, and that was pretty scary.
And Claire was just so blessed to have the luck of Bad Luck Brian. At 11pm, I was still 8cm dilated despite the increase in Oxytocin, and the pain was killing me so badly. In tears, I told Marc that we must treasure this child and do our best to take care of her (especially since I felt that my body was being torn apart whilst birthing her), protect her and bring her up well. We also agreed to not argue about trivial matters and to really focus on what matters: our family and our future together. Everything else was secondary. Then, I noticed that I was getting an increased pressure on my butthole (to be blunt). It felt as if there was a wedge up my asshole and I couldn’t figure out why. So I told the nurses to contact my gynaecologist and ask her whether this was part and parcel of the delivery process, especially since the pain was coming from a part of my body which was not normally associated with labour.
At 11:30pm, the nurses returned to a devastated, exceedingly tired, and bloody-eyed Claire, and told me that they had been in contact with Dr Tiong and he was heading over to the ward first. I was so so confused. I thought I had asked the nurses to be in touch with Dr Chi, so why weren’t they reaching out to her? When I asked them if they had called Dr Chi at all, they admitted that they hadn’t and I burst, “Could you call Dr Chi, please? I’m dying and I need to know what she thinks about this situation.” Again, they looked at my cervix for good measure, and no surprises there, I was still at 8cm. The nurses then shuffled out of the room to say that they’d be in contact with Dr Chi and I went back to screaming / crying murder. I also recall the nurses telling me not to push the baby out, to which I yelled back “I’m not pushing, how could I be pushing? The baby is pushing, not me so stop asking me to push!”
Just before midnight or after midnight, Dr Tiong arrived at my ward with a face full of worry and concern. I couldn’t help but continue to scream and yell per contraction and by that point of time, I had already maxed out on the amount of epidural my body could take (19ml/h). I told him about the pain that I felt in my anus and he performed the “ice” test on my body. I was already numb from my uterus up to just above my breasts i.e. dangerously close to my heart. There was no way that my body could take any more epidural if not there would be potentially damaging consequences. He then pointed out that there could be a chance that Ruth was in the Occiput Posterior Foetal Position (the “OP Position”) i.e. Ruth was moving down into my cervix facing up instead of facing downwards (the normal way babies are delivered) and hence, the pressure on my anus. Later, he explained to us that he derived this suspicion from the fact that I was experiencing extreme pain in the area of my anus, which was an area that the epidural did not cover. But he suggested waiting for Dr Chi to arrive to confirm the position. Meanwhile, he continued to hold my hand (alongside Marc) as I navigated the pain in a rather unglamorous and loud manner.
Dr Chi arrived shortly thereafter and when Dr Tiong shared his suspicions with her, she performed an ultrasound and confirmed that Ruth was indeed in the OP position. We then had two options – go with an emergency c-section, or give natural labour another few hours to see if Ruth would turn over. Obviously, Marc and I opted for the former given that my body was already over-exhausted from the dragged out labour and really, I don’t think I’d have been mentally sane if I was made to tolerate the immense and crazy pain for another few hours, with no guarantee that she would turn over. That would mean that we still had to go with an emergency c-section, so why hesitate to just do it then?
Everything moved so quickly after that. They wheeled me into the Operating Theatre and Dr Tiong and Dr Chi were already changed and “ready to go”. Dr Tiong then explained to me that there may be side effects from the medication such as nausea, but in a typical Claire fashion, I vomited before the medication was even administered (lol) and apologised for being messy which Dr Tiong found so odd. I was given an additional shot of Fentanyl to just make sure that all relevant spots were covered. Dr Tiong then asked me if I had any music preference and whilst I’d have opted for Christian songs, somehow I still had some sense in me to exercise some religious sensitivity. So, I asked for a movie soundtrack and when probed further, I suggested Harry Potter. Unknown to me, Dr Tiong decided to play music from the Prisoner of Azkaban (arguably one of the darker movies of the entire series). I heard from Marc that the music got darker and darker as they progressed further into surgery and quite a few people commented about the music of choice. Oops.
When they cut into me, I thought it was strange that I could feel a slight pain from the incisions. Gradually, the pain became more intense and I began to exclaim in pain (which surprised Dr Chi and Dr Tiong). They then decided to put me under laughing gas, which then led to a downward spiral in my mental state. The laughing gas did not remove the pain that I felt from the procedure. In fact, all it did was prevent me from voicing out the pain that I felt, which left me feeling extremely hopeless as no matter how hard I yelled, there was no way to communicate my pain. I then fell into even darker visions (which I’ll refrain from sharing) to the extent that I believed that I died and felt so guilty for bringing Ruth into this world. Overall, it was not the most pleasant experience and there’s a lot for me to work through from this experience.
At 2:43am, Ruth was born. I didn’t hear her first cries because the laughing gas was only removed subsequent to her eviction from my womb. They immediately passed her to me for skin-to-skin and all I remember saying when they were preparing her for skin-to-skin was “打屁股！How heavy is she ah? Oh no, we all lost the bet!” I know my friends and family keep commenting that it was incredible that I still looked “so fresh” despite being in labour since Saturday. But really, all I remember when taking the photo was trying to not be crossed eyed (which I was pretty sure that I was). I think I was also in shock that my body managed to house this large baby, especially when my baby bump was not particularly big.
I also remember turning to Dr Tiong and Marc saying “I remember everything that you guys were saying whilst I was under, including y’all talking about whether I was in sports or not.” After skin-to-skin, Ruth was whisked off for post-operation observation accompanied by Marc. I was then put under laughing gas again (unfortunately with the same experience of pain i.e. that I could feel but not voice out my opinions) and thereafter sewn up.
Following surgery, Dr Tiong took the extra time to speak to me to make sure that I was emotionally stable. He impressed upon me that an emergency c-section did not in any way mean that I had failed as a mother and in fact, I had done exceedingly well given that I had been in labour since Saturday evening. He also told me that through this entire experience, what remained clear was the strength of a mother’s love (世界上，妈妈的爱最伟大). And I echoed his thoughts completely. I did my best to have a natural birth and at the end of the day, Ruth was just in the wrong position and there was nothing that anybody could do to foresee/prepare for that. It is what it is and we’re just thankful that she is safe and healthy.
Although labour took 52 hours, we don’t regret what had happened. In any event, these 9.5 months haven’t been easy. We’ve been through extremely turbulent storms and heck, we survived. Labour is just but a few days of suffering and we have so many more brighter days to look forward to with Ruth and Ichiro. Everything happens for a reason and I do believe that we’ll be able to see the beauty of / lessons to be learnt from this experience in His time.
To all our loved ones and friends who prayed for us, encouraged us and supported us during the turbulent labour process, we love you so very much and cannot be more thankful to have you in our lives. Again, people who don’t matter, mind and those who matter, don’t mind. We truly need to be intentional about the people we love and care for, with the view of forging meaningful relationships that will only serve to bring out the best in each other. We’re so thankful that you chose us, and we will always choose you.