We went to the hospital again this week. This was supposed to be our 4th check-up, but since I was away for most of July, it's just the 3rd. I think that's fine, though. Chinese hospitals are far too stressed out about pregnancies and that has everything to do with the single child policy. "Just one child" has to be the perfect child and so they check and double check and triple check. I realize this may be my only child, but I feel more relaxed in comparison. Maybe it's just my Western background showing through.
We were there for just after 8am and left at 11:30 but it felt like an especially long morning because I couldn’t eat beforehand. “Why?” I wondered, but when they fed me two cups of absolutely ridiculously disgusting sugar water after getting a blood test, they told me that they had to test me for gestational diabetes. I burped sugar water for at least an hour. I found out later that I’m all good—perfectly healthy and no diabetes. The baby danced in my gut from the sugar high for at least an hour. I think he or she takes after me in that regard!
This was also the day for the “彩超” or “colour ultrasound.” Guo Jian got to come in with me and we marveled at the image of the baby, all four limbs intact and waving around, Little Spark’s little face turned to the camera as though he or she was perfectly aware that we were peeking in. In fact, at one point, we saw Little Spark’s mouth and it really appeared like a smile. Truly! We were mesmerized.
After the ultrasound, we headed back to the doctor’s office where I had my initial list of concerns ready to go. I have been reading, as you know, and doing a lot of talking to women who have had both positive and negative birth stories. I’ve paid particularly close attention to those who have birthed overseas and extra-particularly good close attention to those who have birthed here in China.
In the office, the doctor checked the baby’s heartbeat herself with a Doppler monitor, checked over all my charts, told me everything was normal and said that we were free to go. She was just about to wave the next couple in when I stopped her and said I had some questions. At that point, our session had been no more than ten minutes.
Of course, she put down her pen and turned from her desk towards me and told me to ask whatever I liked. I had the feeling that not many women do so. I swept that thought aside quickly, though, and launched right in.
“Will you be the one to deliver the baby?” I asked. Turns out the answer is “no.” There is a hospital appointed midwife that will be delivering the baby, accompanied by a doctor on call in the event of any emergency, an assistant midwife and a nurse. Usually, she said, no more than three attendants will be with me at any time.
I was shocked. All this time we have been building a rapport and then it won’t be her between my naked legs? I used rather crude Chinese to express this and my expression of horror probably did the rest. She assured me that she could arrange a “special meeting” for me and the midwife before delivery and I was likewise amazed that this would be a special request. “I know that my labour could be stalled and slowed if I am not comfortable and if I don’t get along with this woman," I said, adding in a panicked staccato: "Of course I want to meet her, maybe more than once!”
She assured me she'd arrange it. I was rattled but Guo Jian nudged me to move on.
“Will I be able to control the environment of the birthing room? Bring special lighting or candles, our own music, have three people in there with me, for instance, like my friend (doula), partner (Guo Jian) and my Mom?”
The response to this one was convoluted. First she rambled about having to control the environment for hygiene and cleanliness. I listened for the first minute but then interrupted her and asked why any of those suggestions would compromise hygiene? She was focused on the candles, it appeared, and I agreed to just bring an electric light that would dampen the hideous fluorescent lighting. She then assured me that we could have the three in the room, but too many would be too confusing so limiting it at three would be ideal. That’s fine with me, actually. Three is probably enough.
Then the music: she knows we are musicians but still proceeded to say that there is an expert on staff who provides music for labouring women. We could bring some of our own music in and give it to this expert but then she would choose which music would be most appropriate for the delivery.
I think my jaw hit the floor at this comment. I picked it up without much grace, surely, because my facial expressions have lost all filters since I got pregnant. I took a deep breath and managed to calmly reply, “Excuse me doctor, but with all due respect to your hospital, I am not seeking your expert’s permission regarding the music that I can listen to while I’m labouring. I want to control the music. I want to decide what I listen to.”
I’m guessing that she hasn’t met a lot of women like me. But, to her credit, she deals with hormonal “Mumma Bears” every day and she smiled gently and said that that would not be a problem. She looked amused by my shocked expressions. I mean, by now, she'd seen at least three of them!
Now, I realized that I would need my list to continue. I had painstakingly prepared it the night before in my messy Chinese writing, the calligraphic poise of a Chinese preschooler. When I took it out of the folder, Guo Jian slipped it from my hands and directly handed it to the doctor. “She wrote this list,” he said, standing and outstretching his arm across the expanse of her desk, “And maybe it would be easier if you just read it first.” As he settled back into the bench beside me, he nudged my shoulder with his in support. My initial embarrassment over what could be illegible written Chinese smoothed out like a cloth finding the table's edges. As she read it, she nodded silently. She took her time.
Here’s what the list says:
1. 除非十分必要，我希望尽量不要剖腹产 Unless absolutely necessary, I truly hope not to require a C-section。 *note on this: Do you know that the rate of C-sections for this hospital is between 50-60%? I am aghast. That's the average rate in China in general, too.
2. 除非十分必要，外阴切开术我不要 Unless absolutely necessary, I don’t want to have an episiotomy.
3. 我想自由， 我不要一直躺着， 想走动，随便改变姿势 I want freedom, I don’t want to be always lying on my back. I want to be able to walk around and to change my position whenever I’d like.
4. 我不要任何痛药 （催产素）I don’t want any pain medication whatsoever (ocytocin/pitocin)。 *note on this: I put these hormone in brackets as well because I also want to avoid taking those. The doctor said that after the baby was born, they advise them to birth the placenta. I would be more agreeable as long as the baby wasn’t going to be affected.
5. 我不要一直有胎心监护在我的身上。 I don’t want to always have an Electronic Fetal Monitor on my body.
6. 我想呼吸和使劲吧孩子生出来，我不要任何方式把他／她拉出来. （产钳 ／ 胎头吸引术）I want to use breathing and my physical strength to birth the baby, I don’t want to you any tools to pull the baby out (forceps/suction).
7. 三分钟以后（不再抖动后）我希望我的丈夫可以剪段断脐带. After 3 minutes (when it’s no longer pulsing) I would like my husband to cut the umbilical cord.
8. 孩子一出生的时候我希望把他抱在我的胸前， 肌肤贴着肌肤。As soon as the baby is born, I would like the baby placed on my chest, skin to skin.
9. 我不要给孩子任何药，包括免疫。 I don’t want to give the baby any medicine, including immunization *note on this: In China, they immediately immunize your baby when it is born as a policy, without even asking the parents for permission!
10. 请在我面前给孩子进行检查和处理 Please do not take the baby away from me for any examination or treatment.
And those are just the initial points. I imagine that my final list may be twice this length and hopefully organized a little more logically into labour, delivery, and special circumstances. If I do require a cesarean, for instance, I'll need to be clear on my desires for that experience. I have more Chinese homework to do!
When the doctor looked up from the list, she again smiled warmly and said that all of these issues were negotiable. She was concerned with not immunizing the child right away, but said she would respect our wishes. She also noted that we should make a copy of this list and keep it in our folder to then distribute to those in attendance so that everyone has the information in advance.
My biggest fear (and I expressed it right then and there in her office) was that all the work that I will have put into organizing, negotiating, making my desires known (etc) will be for naught when new people come into the picture. I'm concerned that, having never met me before and not feeling any attachment to the rationale in these requests, etc., they will undermine my authority. Worse yet, I am worried that my foreignness will be the source of the dismissal. It's not uncommon to encounter prejudice for being a foreigner who "really doesn't understand" [what is best for my child] because I'm not culturally or ethnically Chinese.
The doctor again heard me clearly and just assured me that our "special" meeting with the midwife in advance of the labour would hopefully clear up any issues I might have. My doula, Nan, suggested that I photocopy a few of these lists in advance and then tape them to the outside of the door as well as hand them out in the early stages of labour. I like that plan! And it will be written in both languages, as well, so that everyone around me can understand it and reinforce the requests just by emphatically pointing to the item on the list. Myself included!
I thanked her as respectfully and sincerely as I could and told her how much I appreciated the time she had just taken with me. Her patience and her manner was consistently open and warm. I left the office feeling like a huge step had been taken without any incident. Phew.
And then I ate the banana in my bag with hungry relief.