Pregnancy Diaries
Preconception – Where do babies come from?

For many years when I did not get pregnant I just assumed fate thought we were simply not worthy or deserving to be parents. Or that there was a list in heaven of who gets babies. By some error our names were skipped over and no one checked back to make sure that the right person from the list got a baby. God would read a name off the list, then throw a lightening bolt down to earth towards this person and they would get a baby. Only the list was rather non-specific and God’s aim was bad. So if the list said ‘that American woman living on the Bolwerk(our street in Holland)’ then the American woman down the street got pregnant. This happened a lot. One of my friends conceived while we were on vacation together. Their room was directly below ours so the lightening bolt intended for us must have missed me by one floor. The five previous treasurer’s before me for the American Women’s Club in Amsterdam got pregnant. I took on the job and didn’t.

My GP referred me to an infertility specialist just starting his practice with no waiting list. The GP said that that waiting list at other places was 2 years. After all the humiliating and degrading tests he couldn’t find anything wrong with me or my husband. I didn’t know it then but when they don’t know what else to do and you’re getting up there in years they put you on a drug called Clomid. I asked if there was a risk of multiple births. He said yes, twins. I did the math, my paternal grandmother is a twin and my mother has sisters who are twins. I didn’t want to have a litter and so I refused. He’d never done a hormonal investigation on me because there were no indications of problems but I didn’t want to start ‘extraordinary measures’ until we’d exhausted all the other possibilities. So I blackmailed the infertility specialist. I said if he would do a hormonal study I would consider taking the Clomid. Remember this guy has statistics to support. If he fails with me, it will go on his records. Well he muttered as he wrote out the referral letter to the endocrinologist that this was a waste of time and money and then gave me the letter.

The study took several months. And they did find something minor wrong with my thyroid. This was corrected with medication. After a few months of monitoring it was determined that I was taking the correct dose of medication. By then the infertility specialist had kicked me out of the program because I still wouldn’t agree to the Clomid. Seems he’d accumulated a waiting list himself and wanted to replace me with someone else who he had better odds with.

My husband supported me in all this. He didn’t much like me being cut up, poked and prodded. And he agreed with me wholeheartedly about not taking the fertility drugs. I am not a very nice person to begin with and when I am on hormones I become downright unpleasant. No wonder he didn’t want to put up with that. He said, ‘a baby would be wonderful. But we have a very nice life without children already. So let’s just enjoy ourselves and our freedom.’ So we did. Sure I wanted a baby. My husband’s baby. But I also have always wanted to be tall enough to be a supermodel. It just wasn’t going to happen.

Some female problems a few years later made me examine my desire to still have children. I wasn’t ready to give up yet. I wanted to keep all my parts just in case a miracle (or lighting bolt) happened. So I went on some hormones for a few months. It was awful. The drugs were supposed to fool my body into thinking that it was pregnant. So I gained weight and became truly miserable. My mood could only be described as fit for an abattoir. I went off the drugs and started looking for more lifestyle/herbal ways to deal with my illness.

About three years later, we were living in Thailand by now, what started as a simple UTI ended up with me in the hospital with a mysterious cyst pressing against my spine. It was very scary. Thai Doctors are revered and not used to explaining what they are doing. Language is a problem but it was pretty clear that the lady Doctor surgeon wanted that cyst out! Taking things on trust isn’t my style at all. I was dreading surgery – were they just trying to extract money out of me? Was it really necessary to cut? There was really no way to know but I was in pain and the surgeon was anxious to remove the cyst. At this point I didn’t know if I would end up with a complete hysterectomy or what. Since my 40th birthday wasn’t far away I thought it was time to completely give up on babies. So I thought, ‘Okay. Take it all out. It never worked right anyway.”

I went under thinking the Thai word for good health sabai and woke up 45 minutes later repeating sabai sabai. It must have worked because I was allowed to go home then. They’d only had to remove the cyst which also happened to be my left ovary. Enough of my baby making factory was intact to still work. But we really did not hold out much hope. After 11 years of no baby what difference would a little surgery make?

I had a sneaking suspicious that a little surgery could make a world of difference but I didn’t dare to hope. I didn’t dare tell my husband either. Even though now I think I should have told him that a baby was a possibility. I lived in a kind of elated fear that I would/would not get pregnant. But I had no confidence that I could ever get pregnant. For heaven’s sake, I would be 40 shortly.

Well, about this time I had started a little business to amuse myself. I only wanted to work 1 week per month. It was ridiculously easy and I felt so guilty for all the trailing spouses who were unable to find meaningful work. My husband was right we DID have a nice life. He’d travel. I’d travel. We’d meet for a long weekend at a Thai island. Life was good. It was just too easy. Work started to pour in fast and I realized it would be difficult to keep to just part time.

After only my second three day contract I came home and had to sleep for another three days. My period was a little bit late for the first time in years. I put it down to the operation. I honest to god did not put 2 + 2 together at this point. How clueless can you be? I thought, maybe having only one ovary makes you skip every other month? Maybe it was early menopause – I’d be 40 in about 2 months. The Doctor hadn’t explained anything. She made me feel like I was challenging her authority by asking any questions. So I certainly wasn’t going back to her about this.

It was three weeks before I could get a pregnancy test at another hospital with a different Doctor. Even then I told myself this was just a precaution before I got my immunity booster shots. Well, surprise! The test results were positive. My lightening bolt had finally struck ME! This sure took the sting out of turning 40.

FIRST TRIMESTER – Blissful Stupor
I immediately turned into someone who eats to live instead of lives to eat.

I felt like the first woman in the world to ever get pregnant. Wasn’t I clever? Finally doing what a lot of teenagers can do effortlessly, unintentionally? I told myself that I lived in a city of 10 million people and realized, ‘Everybody was a baby!’ Ten million babies! How can the world contain so much joy?

Back to my ‘who gets a baby list fantasy’. I embellished this now. My father died about a year before I got pregnant. So the first thing he must have done is inquire about his baby’s baby. Maybe they checked back on the list 11 years ago and found their BIG mistake. After they apologized, things were put to right and I was given the consolation prize of no morning sickness. Or Daddy looked up my baby who had just been waiting around and said, ‘What gives? You’d better get down there soon.’ Thank you, Daddy, you must have given quite a persuasive argument to finally make baby come.

With all my problems I had no confidence that I could stay pregnant. So I tried to cherish each day. And I read. And read. The books said the 2nd trimester is better, but how could mine be? I was already feeling terrific, but not really pregnant. I let my business crash and burn. Which was an extremely difficult decision. I know how lucky I had been to find anything, much less the wonderful situation I had simply fallen into. But the miscarriage statistics were so scary for the first trimester that I didn’t want to risk anything. This lead to a rather nasty incident for me at the airport. While the plane was boarding (I’d managed to land a 3rd contract) I started to hyperventilate and decided not to go. I asked the baby (I kept up a continuous dialog with him in my head) what he wanted to do and got a very clear, ‘I want to go home!’ Probably wishful thinking but I already knew who was boss.

I’d already fainted once, probably from heat, excitement and low blood-sugar. So my maternity leave began very early. Can I go in the Guiness Book of World records for the earliest maternity leave?

Second Trimester – Good News
I felt the baby move for the first time during an airport layover on our way to home leave. There was a definite ‘log roll’ in there. I shifted to give him more room and couldn’t feel him anymore.

I couldn’t wait to go maternity clothes shopping in the states. But after just a few minutes at the mall I began feeling unwell. Oh no! I knew it wasn’t the baby just gas but boy! was I in pain. So much so that I finally laid down in front of B Dalton’s. The cool tile floor felt so good! A nice lady stopped and asked how I was. Then she started ordering everybody around, ‘Call 911! Get me some ice!’ She said. Well, turned out she was an ex-EMT with six kids. When mall security heard that I was 3 months pregnant they wouldn’t take no for an answer and insisted that I go to the hospital. My husband came out of the bookstore and stopped to see what the commotion was. Poor guy, he must of thought, ‘Not again!’ He’s gotten used to my fainting and takes it in stride. I knew all I really needed was a toilet but they were all one floor up so instead I got to ride in an ambulance with the siren wailing.. Maybe that is fun for a six year old but I felt ridiculous. A wonderful young lady gynecologist listened to the baby’s heartbeat, all was fine with him other than his mother embarrassing him. And once the enteritis (an $800 word for indigestion) ran its course I felt good enough to leave.

After that, Christmas in Skokie was lovely as usual. We wasted much time during Christmas eve dinner making the family guess the names we had chosen. By the way, boy children really have a knack at this. We had decided to tell everyone a fake name because we didn’t want to know if they had a negative opinion of the real names we had picked out. Our fake name was ‘Elvis Napolean’.

Because of my age we’d scheduled an amniocentesis for when I would be in the States. The procedure was nothing. The interview with the genetic counselor, who thought we were SO interesting (not!) was a bit uncomfortable with the full bladder I needed for the ultrasound. She just went on and on. We’d been warned to bring a VCR tape and it had been put in the machine before the technician started but the machine didn’t work. So after the needle part the technician performed yet another interminable ultrasound after we’d made sure the VCR was on.

I didn’t realize that an amniocentesis was just taking a urine sample from the baby. From that they can extract and culture cells. The baby’s chromosomes can then be counted and analyzed from this culture.

Part of the preliminary ultrasound is to measure parts of the baby. When the technician was measuring the femur it became very obvious that we were having a boy. My husband and I were stunned. We didn’t care what we got but we really didn’t expect this. So our baby would be ‘Andreas’.

I felt very vulnerable and protective of the baby the next few days. Secretly, as soon as I could, I got out the still picture that captured his hand and counted the joints in his little finger. I’d read somewhere that Downs babies sometimes only have two joints. My baby had three. What a relief. We still had a two week wait for the official results. It would be a race to get them before I left the states to return to Thailand. On the last possible day I called the clinic. They said they would do their best to get back to me. All day I tried to figure out how I could cope if we got bad news. The only thing I could come up with was if we were the unlucky 1 in 100 that meant that 99 other couples would get good news. The very short call came in the late afternoon. The first thing she said was, ‘I’ve got good news.’ I guess she’d done this lots and KNEW how to start the conversation. That is really all I needed to hear. The tests confirmed that we were having a boy.

I hung up and immediately called my husband. He’d returned a week earlier and it was the middle of the night there. I could hardly get the words out through my happy tears. Since he was half asleep he read me all wrong so I kept shouting, ‘he’s okay!’

I laid on the couch cradling my stomach and tried to figure out the difference between faith and intuition. I’d always sensed that the baby was a boy, but I didn’t dare dream it was. We truly had no preference but felt that if the gender was written in a file somewhere why not find out? I’d also always had faith that the baby was okay. But of course did not dare dream/wish that it was so.

When my mother returned I told her ‘I’ve just successfully navigated a statistical obstacle course.’

Now all we had to do was figure out which continent we would have the baby on. I calculated that I spent somewhere around 3 1/2 days in the air over the next few months. My baby wasn’t even born yet and so far he had been to: Phuket, Hong Kong, Singapore, Chiang Mai, Tokyo, Chicago, Indianapolis, California and Amsterdam! Literally around the world. We flew to Holland and to San Francisco chasing a job that my husband eventually turned down. I do not advise this. We took a short holiday to Koh Samui where we basically tried to get over out jet-lag and the ‘the cough’ we had caught on our world tour.

Back home in Bangkok I now started on my quest to find the perfect Doctor and hospital to deliver our precious baby. The appointments with the OB/GYN I had been seeing were becoming more and more strained. And I just could not imagine him delivering my baby. Plus he kept mentioning that a caesarian was a real possibility because my baby was so ‘precious’. Am I stupid? Or aren’t ALL babies precious? So once I realized that I REALLY WAS having a baby I decided to try and find someone else. I made a short list of four possibilities.

First, I went back to Mongkutwattana where I had been admitted twice previously. They have a communal labor room with four beds. Once you are ready to deliver you are transferred to a small soundproof room where there have a state of the art delivery bed. I spoke to a different Doctor than had done my surgery. Dr. Anon speaks very good English & has a certificate in reproductive endocrinology from an American University, so he was able to answer questions everyone else had shrugged off. He has experience in alternative birth positions, but is very persuasive in defending the traditional ‘lithotomy’ position. He understood my desire to wait to cut the baby’s cord until the pulse stopped spontaneously. I felt comfortable enough with him to ask if Thai’s routinely circumcise their little boys. He crossed his legs and screwed up his face and said, ‘no’. This was certainly the warmest and fuzziest hospital of the four I visited. But I did not like that the baby would be taken from me to be put in a ‘cooling down’ incubator for a few hours.

The second hospital was Bangkok Nursing Home. It’s a smallish, clean & new facility. They also had separate labor & delivery rooms. The lady Doctor and I did not get along at all. I guess two headstrong women in the delivery room is one too many. We were both older women who were used to being in charge so the search continued. Again there was no choice in giving the baby up to a cooling incubator.

Sametivej hospital, which I saw next, has a good reputation in Bangkok for natural childbirth. Brochures from the World Health Organization are found in the waiting room. FYI point #13 states:

The healthy newborn must remain with the mother, whenever both their conditions permit it. No process of observation of the healthy newborn justifies a separation from the mother.

First I toured their labor and delivery facility. They have one beautiful room where I could imagine myself giving birth. The room had a mattress on the floor, dim lights and a Jacuzzi. I took an immediate liking to the midwife who showed me around. She was one of the first people who I felt I would like to have calling the shots at the birth of my baby. They have a three day delivery package, epidural not included. It took me forever to get home. If there was an acceptable hospital closer to home, that still would be preferable.

The last Doctor I met was at the same hospital I was already going to. Each OB/GYN at Bumrungrad has pretty much complete leeway in how they conduct labor & delivery. There is a new labor/delivery wing with six L-D-R (Labor-Delivery-Recovery) rooms, with four operating theaters across the hall. This connects to the NICU. They boast one of only two neo-natologists in all of Bangkok. The L-D-R rooms have a TV, recliner, and a private shower. Once the baby is born I would have a choice of a suite, deluxe or single room – all private. There is a royal suite as well but chances are it is ALWAYS already occupied. And I would never be able to talk my husband into the expense, even if I wanted to. They also have a three day delivery package which is about US$100 cheaper than Sametivej, epidural included.

Well, after a short discussion I decided Dr. Nopadol was my man. He had all the right answers. I think I would feel confident enough to let him use his judgment. Dr. Nopadol has a very low personal caesarian rate and trusts nature enough to let it run its course (until there is a problem and then he is confident enough to step in and use his medical knowledge) and was educated in Europe (UK-so the best English I’ve encountered yet). He thinks a woman should give birth in the position that feels right at the time. I was very relieved not to have to face the long drive back and forth to Sametivej. Bumrungrad is right off the highway and now that the new stretch is open it only takes about 35 minutes to reach.

I was dismayed to find the labor & delivery world divided into two mutually exclusive groups; 1) the natural childbirth advocates and 2) the ‘childbirth doesn’t have to be painful anymore’ school. These two groups often hold diametrically opposing opinions about the same issue. I abhor extremes and was hoping to find a middle ground Doctor and hospital. Sametivej has declared itself to be on the side of natural childbirth while Bumrungrad, by not taking sides is assumed to be of the other school. Both hospital run prenatal classes. Bumrungrad offers a series of five classes in English currently held on Thursday night. Sametivej runs a series on Sundays and also has a class on Friday once a month for each trimester.

It was frustrating that I couldn’t call a hospital and just ask to talk to the head of Obstetrics. If I could’ve done that then I would’ve discussed the various styles of the Doctors on staff to see which one best matched my preferences. All the hospitals wanted a name of an OB/GYN before they’d commit to an appointment. So where I didn’t have a name I just asked for their youngest lady OB Doctor who had experience in natural childbirth.

Third Trimester – Under Construction
My due date is June 10th so I am still in the 3rd trimester. Remember all a due date IS JUST AN ESTIMATE, it could be two weeks either way. So please no one call me until June 25th to say, ‘Where is our baby’?

I sent the following to a male friend who asked me what it’s like to be pregnant.

What it is like to be 7 months pregnant. To get an idea this is what you should do. First, turn the heat up in your apartment about 5 degrees F higher than where you are comfortable. Then fill a balloon with 16 pounds of water, get a 4 pound baby sea-otter. Give the baby sea-otter about 10 cups of coffee & then put it in the water balloon. Strap the water balloon securely to your stomach. Now you can’t take the water balloon off for anything. You have to sleep, eat work & exercise wearing this extra 20 pounds. No sleeping on your stomach or back. Side sleeping only. Now go to a costume store and get the most hideous clown costume you can find. Wear it all the time. And you have to go on a very healthy diet, no white sugar, flour, caffeine or alcohol. And you have to avoid raw eggs, meat & fish (no sushi!) & unpasturized cheese. Enjoy. Oh over the next 4 weeks replace the baby sea-otter with one that is 1 pound heavier. Don’t forget to give it the 10 cups of coffee first. You need that for the movement effect. Everyone who sees that you have a sea-otter filled water balloon will have some unwelcome comment for you. Like, ‘gosh my sea-otter filled balloon was that size right before I delivered!’ Or ‘do you need a special zoning permit for that thing?’ or my favorite (not!) ‘Are you sure there aren’t two sea otters in there?’ Yeah. Right. This is 1999 and you’re 7 months along. I think you would know if there were 2 sea-otters already. I don’t really know how the sea-otter comes out in month nine. There seems to be some kind of gag order for everyone else who gets their sea-otter to come out, so I will just have to wait until I have to do it myself to find out what it’s like.

My third trimester (what an arbitrary demarcation!) was fairly short. First of all because I didn’t notice that I was in it until a whole month had passed. I attribute this to taking care of myself. Walking on the treadmill at the gym, floating in the pool, eating right and napping as much as possible.

So my DR says I’ll go into labor within the next 4 weeks. I probably won’t recognize it. I’ll be in and indefinite amount of pain for an uncertain amount of time and my huge belly will eventually become a baby. Sounds pretty unbelievable to me.

I feel like a damsel in distress tied to the railroad tracks with the labor and delivery train whistling in the not to far distance. Even with the huge belly the feel-good pregnancy hormones have allowed me to feel beautiful until about the 32nd week. At that point I started to feel enormous. Secretly I was hoping that my father’s deal included a painless delivery- but how was fate going to pull that off?

There’s a theory that pregnancy hormones make you feel good so that you won’t panic and become hysterical about all the hard work that is ahead of you once the baby is born. Another part of this theory is that the baby won’t be born until you become uncomfortable enough to prefer labor to carrying the baby anymore. This didn’t happen to me until the last ten days or so.

Have been in the foulest mood lately. Maybe that’s because I’ve gained 28 pounds, all in my belly which is sticking out like a horizontal watermelon from my navel which gives me the profile of Alfred Hitchcock. Ick. And I can feel that not so little head trying to squeeze through my pelvis. Ouch. If it weren’t a natural occurrence…I would call it torture.

What they don’t tell you about ‘dropping’ – 1) your clothes will fit funny. The ones you can still fit into. 2) Your torso skin will fit funny too, you can’t rub enough anti-stretch mark cream on it. Are we having fun yet? No.

At my 37 week appointment I felt like someone was trying to jack my hips apart. My Doctor was going away during the upcoming holiday weekend so my next appointment wouldn’t be for another ten days. TEN DAYS! He didn’t think anything was going to happen for an agonizing additional TEN DAYS! I was distraught. I distracted myself with shopping. One of my friends, a nurse told me to look up when the next full moon would be. Because that is when I would deliver. The Sunday before my 37 week checkup on Monday I was able to time my Braxton Hicks contractions every five minutes so I laid down for a nap. A friend dropped by. I was so glad to see her because she had three kids. She said it was false labor and I would deliver in a week. They were both right.

When I did not go into labor at 38 weeks and one day as I had hoped, I put myself to sleep that night thinking up reasons why it would be good to stay pregnant another 2-3 weeks.

The next morning I thought, this is strange, there was no false labor the whole night long and then my water broke.

Birth Story
My water broke when I was 38 weeks 2 days at 7:30 am on Saturday the 29th of May.

I wanted to eat breakfast before I called the Doctor because he doesn’t allow you to eat during labor. Had devil of a time figuring out how to beep him. Was too excited to finish my food. Finally spoke to the Doctor at 8 o’clock He was 3 hours away. I asked if we should bring everything & he said yes. I thought we had plenty of time so was calm, but Allan was testy and we bickered all the way to the hospital.

Unbeknownst to me the Doctor hopped in his car for the drive from the beach. At the hospital they made Allan wait outside while I was put in a kimono like gown and hooked up to the fetal monitor. Baby was fine but there were NO contractions. The nurse examined me and then talked to the Doc on his cell phone. He asked to speak to me and said ‘we need to consider the real possibility of a cesarean’. I was floored! I said I’d try to go into labor in the next 45 minutes. I was barely 1 cm and not effaced & Andy’s head was not engaged. I kept asking to see my husband- he’d not been allowed in the prep room.

Finally I was moved to a birthing suit and got to be with my husband. I told him what the Doc said. We knew all along that I might need a cesarean but I still was hysterical over the idea. I was hooked to the monitor again. Doctor arrived and confirmed the nurses assessment that I was not in labor and said we could induce but it didn’t look good and we’d most likely end up with an abdominal delivery anyway. I asked Doctor if I was his sister what would he recommend?

Doctor left Allan & me alone to decide. A sweet little nurse came in and asked what kind of room I wanted & did I want the package or a la carte? I wanted to kill her. I asked for a VIP suit. I think my husband wanted to argue with me but didn’t dare since I was crying inconsolably at the time.

The decision was a no-brainer we weren’t about to risk our baby to infection. Nor did I want to start down the induction, epidural, episiotomy, assisted birth path that often begins with an induction. I said I never had my heart set on a natural birth anyway.

They brought in a wheelchair for my short trip across the hall to the operating theater. The anesthetist poked my back expertly once. The epidural began to take effect, but not enough so she put me out for a very short time and just a few minutes later at 12:02 I heard the most beautiful sound in the world, Andy’s cry! Uh-leh! Uh-leh! I ached to see him. So as soon as they could the pediatrician let me cuddle the little guy.

They brought the baby to me in recovery. He was awake for a little while and then he slept for the next two days! I went up to my room at 4:00. I was allowed 24 hr rooming in the whole time. All I had to do was ring for someone to give me my baby or change him. 24 hrs after the surgery my IV and catheter were removed and I was allowed to get up and move about. I felt like a million bucks.