The Delivery

Premature in Hong Kong: My Twins Born at 31 Weeks

Leila and Rahul were born 2 months early, at 31 weeks in Hong Kong, where I temporarily moved a month before the birth, to access better NICU facilities.

At 29 weeks my contractions became more frequent, every 5 minutes. I was immediately hospitalized, for the 4th time during the pregnancy, given another round of steroid shots to speed up the babies lung development and put on a magnesium drip. The contractions were controlled at this fancy private hospital that didn’t have an NICU. So at 8am on Sunday morning, exactly 31 weeks gestation the doctor announced that I was in labour and had to be taken to the Queen Mary, a public hospital with an excellent NICU facility.

Rahul was low in the womb so a Cesarean section was risky. Leila was under my rib- cage and in a transverse position. A natural vaginal birth carried the risk that she might not turn head-down and an emergency C-section would then be needed.

Until then, my doctors had all been men who said I would need a C-section. That morning though, my husband Maher and I had to decide what to do on the spur of the moment, while I was contracting and in an emergency delivery setting.

The doctor on call was refreshingly a young woman who was insinuating that I opt for the natural birth. We didn’t have my blood-type on paper, so they couldn’t operate until they got the results. They drew blood soon after I arrived, late morning. They could not administer an epidural for the same reason. I secretly wanted to give birth naturally, and for the first time in the entire pregnancy I realized that it was possible, with risk of course, but we were accustomed to that by then. I felt I was in good hands. The efficient and natural way in which my case was being handled made me realise they did this often.

A sweet nurse called Angel held my hand through many of the growing contractions and Maher was by my side. I breathed in a gas mask, which would ease pain from the contractions. I remember frantically asking for Maher as I was being transferred from the ambulance stretcher that brought me in from the ambulance. I was wheeled through blue hallways, metallic elevators and ended up in the little delivery room. He wasn’t with me and I had no idea if he’d found his way.

He doesn’t speak a word of Mandarin, forget about Cantonese. The contractions were getting stronger, and longer and I didn’t realise that it wouldn’t be until 5pm that the babies would arrive. He made it. I relaxed a bit when as I saw him.

It was lunch time. The nurses insisted that he grab something to eat. There would be a wait before the delivery. My parents were waiting outside by then too. He took them down to the Starbucks that I would get to know very well over the next 6 weeks.

Between contractions Maher drew my attention to the view from a window next to my bed. It was beautiful. The afternoon sun was shining, the blue sea was glistening, and there was an island. The gas relieved some pain, but as the contractions became stronger I started to do bhramari (humming bee sound), and sheetali (sucking air in through a rolled tongue) breath work. It all came back to yoga, during the pregnancy and now. It was spontaneous. It kept me calm, grounded, and connected to a familiar practice. I used ujjayibreath all the time, contractions or not.

Just before 5 pm, I had fully dilated. The room suddenly filled up with nurses, doctors and two teams of paediatric specialists, one for each baby. Maher caught a glance of Rahul when he came out, right before he was rushed to the NICU. In the meantime a doctor was pushing on my belly to help baby 2 turn around. Another doctor had already given me an episiotomy and was ready to enter and manually turn Leila if needed. She turned on her own and was born 7 minutes after Rahul. She didn’t cry. There was some quick movement and maneuvering around her incubator for a few moments. They resuscitated and rushed her to the NICU.

A few minutes after all the delivery procedures ended Maher went up to the NICU to see our babies and to get some information about them. Only parents were allowed in during the visiting hours, 9am to 8pm. In the span of a few minutes, the room I was in went from being full of shouting nurses and doctors, to empty. I found myself alone, eating a bowl of rice and Cantonese beef or pork. I don’t remember which. There were two attendants who came in to ask which I didn’t eat – beef or pork. To them my brown skin automatically meant that I was either Hindu or Muslim. I asked for chicken.

The women then wheeled me to a room with thirty little cubicles separated by green plastic curtains. Each space fit a single, tiny bed and a little cupboard. I was to spend the next 3 days and nights there.

It was almost 8- o’clock, the end of visiting hours. My parents and brother-in-law who had just flown from Chengdu, made it in for a few minutes. They put my clothes, mobile phone, and whatever food they had on them in my little cupboard. I could reach for it from my bed. Maher came by for a minute with no news of L and R yet. The doctors were still preparing and assessing them and he hadn’t been allowed in. He rushed back to catch the 8pm deadline.

The attendant on duty who was changing sheets, cleaning the cubicles, handing over babies to their mums for feeds, and bed pans to others was not in a good mood, obviously bored and exhausted from her day in and out of dealing with new mums and their crying babies, and especially lacking patience for one who doesn’t speak Cantonese. I was exhausted but the adrenaline was pumping through my veins. My husband had seen the babies and sent me photos by SMS but they didn’t open on my phone. I spoke to family and friends. They were all upbeat and congratulating me. Maher was worried and I was reassuring him.

The room I was in was always awake, day and night, with the 30 mums trying to feed their babies, sleep, use the toilets and showers, and contain their excitement and pain.

A nurse came by to check my blood pressure. It was high as it had been for the last few weeks. I was not to leave the bed until early the next day. She also handed me a syringe and showed me how to express milk by massaging down on my breast, and then pushing in and down, but not squeezing. I slept for a few hours before I had to pump again, and then again. In the future I was to wash my hands thoroughly before expressing, clean the nipple and make sure the syringe was always in its wrapper. This I did every 3 hours that night, and for many months after. The nurse was surprised by how much colostrum I managed to express. Each syringe had to be labeled clearly and precisely with the date, time, and babies names, and then kept frozen until I could take them to the NICU in the morning.