Wednesday, December 12, 2018

Grangettes Hospital

I have not written in a long time because I've been tired and busy.

When I arrived in Geneva, pregnant, I heard many positive things about the birth facilities here. Most of the people in my office gave birth in either HUG (the Geneva University Hospital), Clinique Beaulieu, or Clinique de Grangettes. When I spoke to my doctor, she told me that she only had affiliation with Grangettes and Beaulieu, my husband and I went to tour the facilities to choose. She did mention that if I gave birth before 37 week I automatically would have to go to HUG, since the clinics do not have all the resources that HUG does.

When I was pregnant, I really liked reading other people's birth stories, so I will tell mine here. I actually look back very positively on it, even though it was a painful experience.

Like many women today, I read and watched a lot of videos that promoted natural birth--no pain relief, no interventions, etc. I read many empowering birth stories, and even tried birth hypnosis. The hypnosis videos were great because they helped me sleep--sleeping when pregnant is not easy because you are heavy and uncomfortable. At one point, I was using five pillows--one to support my head, one between the knees to help my back, one against my back, one between my arms, and one under my enormous belly. The hypnosis tapes lulled me to sleep within 10 minutes, but maybe that's why they didn't end up working for pain management because I was always sleeping through them. I'd still recommend them and use them again though, since the sleep help was worth it.

Some women told me awful birth stories--labors that lasted two days and ended with cesareans, persistent chronic pain after delivery, being in so much pain they couldn't breastfeed their babies...several women told me that they would just elect for a cesarean next time instead of going through labor at all. I was trying to keep positive by reading positive birth stories, and it helped me feel less afraid about giving birth. I read Ina May Gaskin's Guide to Childbirth, and JuJu Sundin's birth skills book. Ina May works on a place called The Farm, in Tennessee. Women from all over the US, and some internationally, went to the Farm to have their children the unmedicated way. Had I been in the US, I probably would have tried to go there too. I'm glad I didn't! My birth ended up being more complicated, but I suppose even at the Farm I might have been sent to the hospital since my water broke and then my labor did not start.

Recently there are many articles and news stories about the high cesarean rate in a lot of countries, including the US. Supposedly doctors either get lazy, fear litigation, or are over prudent, and will resort to cesareans even though they are not really necessary. Many women also prefer cesareans if they have an option, even though it actually is a major surgery. Thus, in many hospitals and clinics the cesarean rate is 30% or more. I was worried about this as well--since I don't have medical expertise, it would be hard for me to tell whether I was being bullied or duped into getting a cesarean, or whether it was really necessary. After all, I would feel really awful if I insisted against a cesarean and something bad happened to my baby or myself.

Had I been in the US, I most likely would have had to have a cesarean. I had a condition called placenta previa, which means the placenta is close to the cervix. There is a risk that during labor, the placenta will come out before the baby, which means the baby risks suffocation and the mother risks hemorrhage. My case was actually marginal, so it wasn't so bad, and I did not have any complications during my pregnancy. However, the risks really scared me. My doctor told me I would have to have a cesarean, and would have to have it around 38 weeks because they could not risk having me go into labor. I asked her if there was any possibility I could avoid the cesarean, and she told me that she was willing to attempt a vaginal delivery if the placenta moved to at least 2 cm from the cervix.

For most women, placenta previa resolves as the pregnancy progresses. For me, it stayed at around 1 cm for my entire pregnancy. At 38 weeks however, I measured at 1.9. This was enough for my doctor to tell me that I could try to have a vaginal delivery if I wanted to. I spent hours researching people with similar cases as mine, and there weren't many. This is partially why I wanted to share my story. A few women delivered without complications, but there were also two who had horrible experiences and almost died. The risk of hemorrhage is higher because the placenta supplies blood to the baby--after the baby is delivered, the uterus contracts which signals that the blood flow needs to stop (sorry, I'm not a doctor or a scientist and it's been a while and I can't exactly remember the terms and am too lazy to look it up). If the placenta comes out first, then the blood keeps flowing out.

I wavered back and forth. Some articles that I read said that a delivery with placenta previa would require having a supply of blood on hand, in case you start hemorrhaging. My doctor said that we were close enough to the hospital that they would have blood delivered by ambulance if something bad happened, and warned me that there would be a higher risk of an emergency cesarean. In this case, she told me that I would just see a lot of people running around, and nobody would have time to explain anything to me. I decided to try to deliver vaginally, partially because I wanted to avoid having cesarean for my first pregnancy since it may mean that I would have to have cesarean for the rest, and partially because I think I might have always wondered if I could have done it or not.

Had I chosen the cesarean, my son would have been born 15 days earlier. He ended up arriving 5 days after my predicted due date, which is normal, but was an agonizing wait. Towards the end I was so heavy that it was hard to stand up. My hips and back hurt, and I was not sleeping well. I had a lot of false alarms. I complained to my friends, and one friend of mine told me that two of her friends had their water break while hanging out with her. I joked that we should meet up, because I wanted the baby to get going! I met her for a drink, and my water actually did break. At first I had actually thought I just peed myself, and was annoyed (as this happened quite often during my third trimester). It was completely unexpected because at my appointment earlier my doctor had told me that I was not dialated at all. My husband had drunk four beers because we were so certain that it would not happen.

As amniotic fluid continued to leak, we left the restaurant and took the bus home. I have great friends here, and someone immediately agreed to look after our dogs while we went to the hospital. Most women do not have their water break before labor starts, contrary to what we see on TV. I had my bag packed since week 35, so I grabbed that and we headed out. Unfortunately, if your water breaks you need to be at the hospital sooner because there is a risk of infection.

My labor did not start, so they had to induce me. I entered the clinic Wednesday night, and my son was born on Friday morning. I was exhausted because I was not sleeping at all due to the pain and discomfort. The pain intensified on Thursday night, and it felt like my baby was head butting me. I had pain management tips, which definitely helped, but eventually I asked for an epidural. Prior to that, I had been really regretting that I did not opt for the cesarean (though now that it's all over I'm really happy about it). After I got the epidural, I fell asleep. In five hours or so I woke up to horrible pain again, and they had to give me another dose. Grangettes has a walking epidural, so I was able to get up and move around. When the nurse checked me however, she said that my baby had descended and I was ready to push!

I pushed for about 45 minutes, but it didn't feel like that long. The epidural had worn off, and the doctor told me that pushing during contractions would make it less painful. I did not want an episiotomy, but unfortunately I got one. However, I was in so much pain from the pushing and the contractions that I did not even feel the cut.

My son came out crying loudly, and that sound was, at the time, the most wonderful sound that I had ever heard. One, because it meant that he was alive and breathing. Two, because it meant my pain and suffering was over. They put this warm, sticky little thing on my chest, and as I held him he stopped crying. I was worried before that I might not love my son right away, but when he arrived I was overwhelmed by the love that I felt for him. It was, and is, a love beyond what I could have imagined. I am grateful that I did not have post partum depression during the months after his birth, since I know women who did and it seems like an incredibly difficult experience.

I got to have my son in my room with me, although that meant that I got no sleep. I was woken up by shrieking every two or three hours. My mom came to take care of me, and made me food that is supposed to help with recovery and promote lactation. Apparently babies get really angry around day 3 because your milk typically isn't there yet, and they are very hungry. I had a bit of difficulty at first, since my milk came in late--my son lost a lot of weight, and had to have a bit of formula. However, by day 5 my milk starting coming in, probably thanks to all of my mom's good cooking. Then, my son transformed like the very hungry caterpillar--from a small thing to a big, plump baby with sausage roll arms and three chins. At one point her was in the 97th percentile for weight!

He's a bit less fat now, since he has grown longer. 

Anyway, it took me a while to write this, so I'm glad I'm finally done!

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