Tuesday, January 08, 2013

Delivery experience for my 2nd baby in Accra, Ghana

(This might be the longest blog post I've ever written and posted... Started 2 1/2 weeks after delivery and finally finished it 2 months and 1 day after the baby was born...)

It's been about 2 1/2 weeks since the birth of our second baby. I've been trying to rest and take good care of myself and the baby. It's been very different since Kweku has been so sleepy that I often have to wake him up to nurse. It's also been stressful because I was afraid that he's not taking in enough breast milk for his growth. Unlike An2 who was almost 10lbs when he was born, having a 8lb baby (even though that's also a pretty normal weight for babies, and maybe on the heavier side) is just different. All that is to say I've not really had much time to really sit and reflect on this adventure/process of having a baby in a foreign country.  There were so many different (good and bad) things I've experienced this time around. I guess because I had a baby in the U.S., there are definitely many contrasts of how things are done there and here in Ghana. I'm not sure if I'll be able to record down the things I noticed in an organized fashion, but at least I do want to write it down for my own benefit, just to remember all the things that I went through.

Delivery process 
Through out this pregnancy, I prayed and asked many others to pray for a normal delivery. I had a C-section last time around because after being in labor for hours, I wasn't fully dilated. When An2 came out, the doctor said the umbilical cord was around his neck and that's why he couldn't come out through vaginal delivery... With Kweku, I had expected that he would be born around 39 weeks just like his older brother but 39 weeks came and went. His due date came and went (40 weeks). I was growing anxious and impatient (it was very uncomfortable since I had contractions on and off during those last weeks). I went to see the doc on Nov 6 and he said if the baby didn't come by the following Monday, we'll have another C-section.

By early morning of Nov 7 (around 2am), I started to have intense and more regular contractions. Just to make sure that this time it's for real, I time it with an app (because I know hubby would not want to take me to the hospital if I wasn't sure). Thank God real labor started during that time because we left our house around 4am and there was no traffic. (I was also very anxious about Accra traffic if we needed to go to the hospital during the day.) With traffic, it might have taken us 1 1/2 hours to 2 hours. But without traffic, we were there in about 45 minutes. When we got to the hospital, it was very quiet and hubby told the nurse that I'm in labor. The nurse didn't believe him because I seemed very calm (I saw no point to have loud screams or feel like I'm passing out... I just tried to breath through the contractions...) Sure enough, when she finally check to see how dilated I was, I was already 5cm (half way through).

When we first reached the hospital, the nurse even told us that they have no more rooms available and that we needed to go to another hospital. (The nurse said that they have women sitting on wheelchairs waiting to deliver their babies...if I heard her correctly...) But because of our GHAFES connection (a doc with lots of powers and influences), they had to take us in. We still needed to wait to be checked in properly (a young doctor had to go through all my medical history) before I could go to the delivery room. Once they were ready for me, nobody except for the hospital staff can go into the delivery room (not even your family members... and they don't allow men/husbands to be in the delivery room anyway).

By the time I went in, hubby had to rush back because he was having classes those few weeks. (I suppose it didn't do him or me any good if he had stayed since he couldn't be in there with me. There wasn't any waiting areas there either.) The contractions were intense but still bearable. It was weird hearing other women groaning and moaning in the other rooms but not long after that, I had joined them. When I went in, they were just about to change shift for the staff so it was quiet for a while. Then it seemed like different groups of nurses came in and out (since it was a teaching hospital so some were still going through their training). The doc came periodically to check how I was doing and it seemed like hours had gone by from intense contractions to this feeling that I needed to poop. The nurses were around but they weren't coaching me like I would expect in the U.S.. All I remember now is that they'd ask "how are you doing? do you need anything for your pain?" Last time around I didn't want to take anything for my pain but finally gave in to epidural because I was just too tired and not making any progress. I really wish I didn't need it because I could feel where they poked me months after An2 was born. This time around, I also didn't think I need anything although it was painful, it was bearable (my stubbornness and pride keep me from taking anything for pain).

What seemed like hours in the delivery room till baby came out was only from 8am to about 12:50pm (almost 5 hours).  I only remember the doc came in to check my cervix and breaking the sac. I was sweating till my glasses were foggy (Oh, and I was wearing my own dress the whole time... I didn't change into a hospital gown at all). I was there "pooping" the baby out with groans that An2 makes when he wants to go the bathroom... At different points I thought "why didn't I just have another C-section?" because I was so ready for the baby to pop out. Since the nurses didn't coach me, I kept wondering if I was doing the right thing (they told me to lie on my left side and that's about all). I was so ready for the baby to come out. When it was almost time, I asked the nurse (or mid-wife) if it's possible for me to squat because I really wanted the baby to come out by then. Thankfully a doc came and declared that I was fully dilated. From that point on, everything moved very quickly (except that I needed to move from this bed to the delivery table and it was very painful for me to try to get up and move over). Once I was on that delivery table, the mid-wife asked me to push hard. The first couple of times I was pushing but not "pushing" where I needed to. I think by the 4th of 5th push, I was finally able to push the baby out. I was so happy to hear the baby's cry (I was expecting that cry the whole time I was in labor). I asked if it's a girl (because that's what the ultrasound had indicated) and the nurse giggled and asked me to see for myself... of course the baby turned out to be a boy and for which I'm not a bit upset (somehow I really wanted another boy and if God willing, the third child will be a girl if we have a third child). After they sew me up because of some tearing and cleaned up the baby, we were left alone in the delivery room.

Essential thing to bring to the hospital
When I was going to the Legon university hospital for my ante-natal check ups, I received a check list of things to bring with me to the hospital. The list includes (from my memory since I don't have that piece of paper anymore): for mom--2 old cloth, macintosh rubber, night gown, 2 pairs of surgical gloves, 1 large bottle of savlon, 1 small bottle of savlon, 1 large enema pump, 2 packets of feminine towels, 1 packet of cotton, toiletries (soap, toothbrush, etc.) cup, plate, bowl, spoon; for baby--10 cot sheets, 2 safety pins, milo & milk powder, 1 small enema pump, soap for baby, baby gown (for going home), 10 old cloth, etc... (I can't quite remember the rest)

In preparation to the delivery, I asked our house help (a local girl) to go out and buy these things. since she's young and hasn't helped anyone with their deliveries, she was confused as to what some of these things are and why would we need these things for delivery. But she tried her best and bought most of the stuff. We packed them into the suitcase that we brought to the hospital. It was only after we checked in for delivery, then I started to understand why they need some of these things...

I guess in contrast to how hospitals operate in the U.S., most things are provided for you. Of course most things are probably charged to your insurance or the government (in case someone can't pay for it on their own). Here... the hospital do provide some things but in comparison, very minimal. As you can tell from the next part regarding to checking out from the hospital, bringing things like our own bowl and soap or antiseptic solutions, it definitely cuts down costs.

Besides the list of things to bring, one interesting cross-cultural experience occurred when they were going to give the baby his first bath. About 2-4 nurses came into the room at different points of time because I didn't have all that they required to bathe the baby. They asked for baby oil (which I wouldn't think about using), a new baby gown, sponge (it's a sheet of unfolded body wash sponge), soft towel... I had a normal adult sized bath towel, small wash cloth, Johnson & Johnson baby soap with baby oil. I told the nurses just put him back into the shirt he was in and they looked at me with a lot of uneasiness. They also were discussing in Twi for a while as to what to do with me and my limited "stuff". Finally, they told me to just pay for a set of these things that they sell downstairs so they can wash the baby properly... I'm still curious as to why they really absolutely needed some of these things. I need to ask some people to find out...

Checking out of the hospital
One of the scary thing about checking out of the hospital in the U.S. was that nobody provided me with an itemized bill.  Although we have insurance and I know that most of it will be paid for, I wasn't sure how would we be able to trust the hospital to bill exactly the things that I used or needed during my stay at the hospital. (or do they just have some kind of standard way of charging different types of patients?)

Here in Ghana, since we are not on the National Health Insurance Scheme (NHIS), we paid everything out of pocket. The hospital makes it very clear when we are there of this fact. We were told prior to delivery that if it was a normal delivery, it might cost us about GH$300 (which is about US$150) and if I had a c-section, it might be about GH$1,000 (US$500). And the nice room at the hospital would cost us GH$40 a night (including three meals). At the time of check-out, a man brought the itemized bill. It was very clear as to what was used for the different parts of the delivery (things like gloves, IV drips, etc.). Everything was reasonable (a little bit like paying at a restaurant looking at exactly what you ordered). With the normal delivery, we had to pay about the amount estimated. Nothing fancy like the U.S.... probably why our health care in the U.S. costs so much more...

Sense of community (receiving help from others at the hospital)
I've experienced this ever since I started to go to the ante-natal clinic for regular check ups. Obviously I stick out as a sore thumb since i'm not local and I'm "white". I don't speak Twi (the common local language, which they use in a lot of the communication to these pregnant women). I often seem clueless when I went for the check ups (which I was). There often was a leader type woman who would help me with some instructions as to where to go or what to do next.

When I was staying at the hospital after delivery, I was in a nice room (with air-con and television) that accommodated three people. For that night we stayed in the hospital, there was only one other woman in the room with us (baby and me). Around 4am (the time most people get up), I saw that she seems to be getting ready for bath. Not long after, a nurse came in with some water for her and asked me if I wanted to bath. Right away the nurse asked, where is your bucket. I said I didn't bring one (I didn't know that I needed one). She also asked if I have other things I need to bathe. So the woman staying in the same room was very nice and offered me to borrow her bucket to bathe. That is just one example of the help this woman provided. She also lent me her cloth (so it's easier to get in and out of the common shower rooms without carrying too many things). When her mother came to visit her with some local maize porridge, she offered me a bowl. My cellphone battery was low. She borrowed a charger to help me charge my battery. When I wasn't sure where to take my bowl to get it washed after lunch, she asked a friend from the hospital to wash it for me. Prior to the delivery, I had prayed along with our house help that I will encounter angels at the hospital. Sure enough, God sent a wonderful roommate for a day to provide all the help that I needed that day.

Well, so here you are... my first hand experience of giving birth to a baby in Accra, Ghana as an Asian American woman who already had one baby in the U.S.. I wish I can make it more concise or vivid but this will do for now...

4 comments:

Unknown said...

Thanks so much for sharing.I will be giving birth in Accra later this year.

USA -my firsy child was born here in the States

snalgh said...

Hahaha most welcome to Ghana. A country of peace and good hospitality. Thank you for sharing. I Thank God for your life .

Anonymous said...

Wow, this is some experience. Thanks for sharing. Had both my kids in the USA and its quiet a different process. All u need to bring to the hospital are change of cloths for u and the baby when you are leaving the hospital and your car seat. Everything else is given at the hospital. Thanks for sharing. Might serve for future use

Unknown said...

Really helpful, needed some information, thanks