On Sunday September 22nd we welcomed little Ellie Kate, or "Baby Sissy" as she is lovingly referred to most often, via a scheduled c-section at Saad Hospital in Khobar, Saudi Arabia. Since this was my second scheduled c-section (apparently I only carry babies in the frank breech position) it has been fun to compare the two experiences. Again this is a long post, and I don't spare the medical details so if you don't want to know, don't read!
1. OB Appts
I am very thankful that several of the girls on the compound have already had babies here so I could piggyback on their recommendations and not have to go through the process of vetting an OB and a hospital at 30+ weeks pregnant. The
Saad complex is beautiful. Driving up to it is a little intimidating because it looks like a walled fortress. The inside of the clinic part of the complex is unlike any hospital clinic I've ever seen--marble floors, large koi ponds, fish tanks, mosaics, bamboo adornments, I could go on and on! At each appointment I was called back into a "female only" room for a nurse to take my blood pressure and weight (no idea why the husbands can't be privy to this information!) and then we would meet with Dr. Ashour in his office. In the back part of his office was an exam table with an ultrasound machine. While the exam table was covered with the usual sanitary paper they used nice sheets and blankets to cover me during the ultrasound. I had either an ultrasound or non-stress test (NST) at every appointment, as my Doctor specializes in fetal ultrasounds. However the only time I had a urine test was during my lab work, which was quite a change from having them every appointment back home! Another difference is I think they only measured fundal height at one of my last appointments, which back home was also a standard thing for each appointment. Also I was never checked for dilation and effacement. Here scheduled c-sections are simply done at 38 weeks to avoid going into labor on your own.
2. Hospital admissions
My surgery was scheduled for 8 am, so they told us to be at the hospital at 5. We left our compound at 3:15 and arrived at 4:55. Turns out that they expect Saudi's to always be late and we didn't really need to be there until 6:30 or 7:00! We had to enter through the trauma entrance because the main entrance wasn't open yet. In fact they made us wait a few minutes so we wouldn't be admitted before 5 am and charged for an additional day. Once it was time to be admitted, a nice man walked us down a dark alley to the main hospital, past the check-in desk where two security guards were sleeping, and into his office where he then processed my admission. Travis paid extra to accompany me as my 'companion'. One perk (for me) is this did include three meals a day for him, so he didn't have to leave 3 times a day to go to the cafeteria. He may have preferred having an excuse to leave the room though, ha!
3. Surgery Prep
After being admitted I was led to my hospital room in the maternity ward where we were to be for the remainder of our stay. It was nice knowing that we had a room right when we got there and not worry about what to do with our bags during the surgery (in Texas you leave your bag in the car until you've had the baby and you're admitted to your regular room). A nurse soon came in to prep me for surgery and administer my IV. The IV didn't go well and they had do it a second time. Then my hand and arm started swelling around the second IV but the nurse just said "We'll keep an eye on it." This wasn't exactly what I wanted to hear but it didn't seem like they were concerned about it so I tried not be concerned either. Thankfully this was probably the worst part of the surgery prep. At this point we then had over an hour to kill before the surgery so we tried to nap a little. I may have slept a few minutes but it would have been a lot more valuable to sleep at home and arrive an hour later!
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| The point of this picture is not my humongous belly, or the fact I'm overdue for a haircut, but rather the beautiful crown molding above the closet doors and on the ceiling seen in the mirror. It was almost like having a baby in a hotel! |
4. The surgery
A little before 8:00 they came to wheel me to the operating room. Conveniently the operating room was just outside the maternity ward and down the hall. Travis had to change into scrubs in a men's changing room and was to come out through a different door on the operating side than he went in on. It was a little disconcerting waiting for him and hoping he would be allowed through that door! While I was waiting the anesthesiologist came up and introduced himself. He was very nice and asked me a few questions about my previous experience with anesthesia. While everyone had assured me that Saad was a fantastic hospital the anesthesia was by far the part I was most worried about. Specifically the spinal! I had a good experience with the spinal and my c-section at The Women's Hospital in Houston and I was pretty nervous that this hospital wouldn't measure up. He was very reassuring and extremely professional.
Dr. Ashour appeared with Travis through the door a few minutes later and I was relieved to see both of them.
At this point I think Travis had to wait somewhere else again while the surgical team prepped me for getting the spinal. I was very impressed with the surgical team and thought both the nurses and the anesthesiologist did an excellent job. In fact I think the spinal was easier than the IV! Once the spinal took effect and Dr. Ashour was ready for the surgery he came around and said "So I can make the incision a little shorter than the original or I can make it a little longer and give you a small tummy tuck." Why yes I will take the gratis tummy tuck! Now that is something that would never happen in the states!
The c-section itself took a lot longer than Lucy's. I also had a better experience with the anesthesia--with Lucy's I felt like I couldn't breathe very well, and I'm not sure if it was because I was more prepared for it or what but this time I did not have that side effect.
5. The first few minutes and recovery
With the delivery came another 'only in Saudi' experience. My Dr. called Travis to the other side of the curtain so he could take pictures as they were pulling Ellie out! I'll spare you the actual images of my gory guts but part of me think it's pretty cool we have these pictures :)
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| I think it's pretty cool that you can see how Ellie's leg was stuck in the frank breech position--it's still sticking straight up here! |
As soon as they cleaned her up and wrapped her in something warm Travis was able to bring Ellie over for me to see her.
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| She gave me kisses as soon as she saw me! |
They took her back to check her vitals, and then a nurse brought her back to start nursing. I was impressed by this! The surgical team took their time sewing me up and Travis was able to hold and snuggle with Ellie for most of this time.
The anesthesiologist and my doctor kept trying to tell jokes as they were finishing the surgery. One of them was "Dr. Ashour, what happened to your diamond ring?" implying that he lost one inside me. I did not laugh. Then I think they started talking about the price of gold and told me I needed to make Travis buy me some as a present, and I think they were describing the best markets to go to. Sorry docs, I wasn't really in the mood for joking! Dr. Ashour also insisted on adding Travis as a facebook friend at some point during the surgery so he could share pictures he was taking of Lucy with us. I can't see any doctors from my Houston practice doing this either!
Once they were finished (it seriously took at least 45 minutes--I didn't realize my tummy needed that much tucking!) they sprayed what looked like a hair spray all over my wound. I found out later that it was a spray adhesive and therefore they did not have to use any sort of bandage! Then Dr. Ashour told me "I fixed your belly button too". Um, thanks, didn't realize anything was wrong with it! After talking to several other girls here I have learned that Saudi's are very pro-plastic surgery, so this came as no surprise to them. At the end the anesthesiologist told me "The baby weighed 3.1 kg, the placenta was 1 kg, and you lost 1 kg of fluid. Congratulations, you lost 5 kg!"
Next Travis was sent to our postpartum room and I was sent to recovery. Now in general I really don't like recovery rooms. I have been in 5 in the last 3 years and the only one that was pleasant was after the birth of Lucy. At the Women's Hospital in Texas Lucy and Travis were allowed to stay with me while I was in the recovery room. This was the first chance I had to start nursing with her, and I really treasure this time where Travis, Lucy and I first got to know each other. In all the others, and this one was no exception, I was all alone for what felt like 30 minutes (it was probably 5) before anyone came in to say hello or tell me how long I had to lay there. The nurse here did not speak very good english and it was a long, boring wait until they finally let me leave.
6. Postpartum care
Once I was back in my postpartum room and the anesthesia wore off I was a little surprised at how high my pain level was considering I had opted to pay extra for a pain pump. This must have been different than the pain pump they use at the Women's Hospital because it did not really seem to be working! By noon I couldn't sit up to nurse Ellie. I was really thankful I already knew what I was doing with nursing because if this had been my first it would have been really, really hard. It wasn't easy trying to nurse her lying down but I didn't really have a choice. Then we realized that my hand/wrist with the IV was continuing to swell and now my hospital bracelets were tight.
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| Picture of my wrist ~9 hours after they switched my IV out. It was sometime the next day before it went back to normal! |
Once the nurse saw it she immediately took it out and put a new IV in my other hand. Thankfully this one worked and was not painful like the other ones. I think all those expensive pain pump meds were just building up in my wrist! The nurse also gave me a new pain medicine and that one seemed to be much more effective, so by about 4:00 sitting up was bearable again.
Our good friend's the Feimster's had been taking care of Lucy while we were in the hospital and Heather brought Lucy to visit that evening. It was so fun to watch her meet Baby Sissy for the first time! I think she was even more excited to see me and Travis though :)
Later on in the evening, with a LOT of help from the nurses, I was able to walk to the bathroom by myself. This was definitely not a pain free experience, but I was impressed at how mobile I actually was 12 hours after surgery. I think I was on different pain meds in the states because while I don't remember as much acute pain, I know walking the day Lucy was not possible.
As usual the first night was busy with nurses coming in and out to take vitals. At one point I really wanted a light turned off and Travis was hopelessly asleep. The only thing I had to throw at him was a bulb snot sucker but he continued snoring away, so I bravely got myself out of bed and turned the light off myself. This probably isn't recommended, oh well!
By the end of the next day we were getting pretty restless. I had been disconnected from everything and as long as I took my pain meds regularly I was feeling ok enough to walk across the room, sit up, etc. I was relieved that the nurses agreed I could probably go home the next day since the hospital c-section policy stated that a 3-4 day stay was the norm. We attempted to go on a walk around the ward, but we were thwarted. When the nurses saw us they started panicking and whisked Ellie back to our room. I was really confused, but it turns out that as part of their security plan the baby is not allowed to leave the room without a nurse! Oops. They realize they had not explained this to us so we didn't get in further trouble, and we explained that this is a typical postpartum activity in the states so we had no idea it would be a problem.
At some point I realized that no one had been in to talk to me about lactation, or newborn care. In fact no one even came in to check my vitals the second night (which I was totally fine with, but it was unexpected.) I wasn't sure if this was because they knew this was my second baby or what. At my one week follow up appointment with Dr. Ashour he explained that lactation and newborn care services are not covered by the national insurance here. I thought that was really interesting since the insurance covered almost everything else 100%. The only things we had to pay for were the pain pump meds and some other prescriptions (which cost me a grand total of $10). I did see signs with a number to call for lactation help if needed, but I'm guessing that is extra.
By Tuesday we were stir crazy. Thankfully the check out procedure was much more efficient here (possibly the only thing in Saudi that has been more efficient than in the states!), and we were on the road about 1:00 after getting some panini's from the Costa Coffee at the clinic.
We've been blessed that all of us have stayed healthy since the birth. I did venture out about a week after Ellie was born to try and find some spare parts for my pump. Unfortunately I was not successful in finding spare parts, but I did find this amusing display of Medela accessories at a BabiesRUs in Khobar:
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The top row is Medela panties, support briefs, support belts, tank tops and nursing bras. All the women in the pictures have been censored. Apparently the woman modeling the support belt needed her face censored too. You're out of luck if you'd like to see the difference in panties vs support briefs or the cut of the nursing bra before opening the package.
And there you have it. I'm happy to answer any other questions you may have about having a baby in the Kingdom!
