Our birth story uncut: about the time we had a baby at Al Nada hospital in Cairo, Egypt

Because I had two previous c-sections, combined with high blood pressure and cholestasis, this our third baby was to be delivered by a planned c-section, 10 days before the estimated due date. Because it was a scheduled birth, my mom, who has come after each of our two older boys were born, was able to plan her trip early so that she could be here before and after the birth. This made the transition a lot easier for the boys, and it was quite a relief to know that she would be here with them while I was in the hospital. In the end, as we decided after our initial visit to the hospital, Courtney was also able to stay with me the whole time, all the while my mom stayed home with the boys.

On the morning of the day Karl-Abraham was about to enter the world, our building had no water, and I had to help Courtney wash his hair under a nice, cold bottle of Nestle mineral water. Our bags were packed, I was hungry (I had to fast before the surgery), and it was hard to understand that this was finally it. A very kind and generous friend had lent me her car and driver, who picked us up at 9 am. We got to the hospital on Al Manyal Island about ½ hour later and were checked in and taken to our room just a couple of easy forms to fill out and a 3000LE deposit later.

The room was big, or rather the two rooms. The front room was a living room with a small kitchenette, three pull out couches, a table and a large flat screen television. The back room had another pull out sofa, a small table, a closet, and a hospital bed with a bedside table. Adjacent to this room was a spacious bathroom with an open shower, a toilet and a sink.

I got the baby’s clothes ready, unpacked a couple of things, the boys checked out the TV and opened the special presents we had bought for them, one of which was to be used during the delivery (which for them meant waiting in the room); Alvin and the Chipmunks on DVD. Courtney concluded that the internet was unreliable and extremely slow at best.

After a short while and a chat with Dr. May as well as the anesthesiologist, Dr. Sherry, the nurses came and took my vitals, and gave me one of those robes with the back bare to put on instead of my clothes, as well as a cap for my hair. I was then given an IV in my hand, said good bye to the boys, and was taken down to the OR in a wheelchair, through corridors filled with people, mind you. Courtney came with me, and he had to put on roughly the same outfit plus a face mask (he however got to keep his clothes on) before entering the OR with me. After this, the procedure was pretty much the same as in Belgium, only a bit less sterile and strict. The anesthesiologist had me sit with my chin down exposing my back as she washed it with iodine and first numbed the part of my back where she was working, and then inserted the epidural catheter. After this she gave me a light sedative, and as I felt like I was going to vomit (I actually gagged) something against that. I lay down on the stretcher, which as it turned out was the actual surgical table, and cloths where put up in front of me. My arms were placed on special extensions to the surgical table, but I could still move them freely (in Belgium my arms were always strapped down). Courtney was by my side the whole time. After a short while, Dr. May made sure the epidural was working and started the procedure. She offered to talk me through exactly what she was doing, but as I already know the procedure quite well, I opted to enjoy my light sedative in peace instead. Besides, even though I don’t feel any pain, I can feel what’s going on, i.e. if she cutting or pulling, etc., so I knew what she was doing at all times anyways. After a short while she pulled the baby out, and although I heard him whimpering and was assured that he was fine, I could hear that he wasn’t as strong in his cries as the others had been. The assistant brought him to me and I got to kiss his face and touch him a bit before he and Courtney left the OR with the pediatrician. I wasn’t worried, and this is where the sedative really comes in - to keep me half asleep and calm through the rest of the procedure; the stitching and putting back together (which takes a lot longer than the opening up).

When I got back to the room, the baby wasn’t there. As it turned out, his breathing was too fast, which meant his lungs were having trouble absorbing oxygen, and he had to be placed on oxygen for a while. At first they told us they would keep him on there for two hours and then, if he did all right without the tubes during half an hour, we could have him back. This was repeated three times, and he was still having trouble, so our pediatrician, who was leaving for the night, ordered that he’d be put on oxygen until the next morning, and asked if I could pump some colostrum for him to be given by syringe. I was nearly in shock; this was not the way to have a baby in my attachment parenting world; he needed bonding, love and my breast these his first hours outside the womb, and not tubes in his nose, naked, in a plastic box with sterile lights around it. The doctor agreed to let me hold our baby for a brief moment between sessions, and I knew when I saw him that he was going to be all right – I let him have a bit of milk even though we were told not to, and he did fine - but understood that he still needed to go back. Yet it was hard to let go. Add to the frustration that I was stuck in bed, unable to even go see him through the glass windows, and that we were not getting frequent updates on what was going on. Our pediatrician had left for the night, and the pediatrician on call was not reporting back to us as promised. Courtney spent a lot of time looking at Abraham through the window, and went over and filmed our baby for me. Then he went to the pharmacy across the street and bought a breast pump, and I, by now almost going crazy, watched the short movie and produced two ounces of nutrients. By morning, finally, we were told that he was doing much better. Dr. Omar, the pediatrician, came back, gave our baby a final check-up and brought him to our room, just as the boys and my mom came back from having spent the night at home. It was a very happy reunion!

I still think it’s best for everybody if baby can be placed on the mother’s belly immediately after birth, breastfed within the hour, and not physically separated from family members at all during the first few hours or days following birth. I know now however, that if circumstances don’t allow for this, everything can still be fine. I don’t think our baby suffered any major trauma, and he didn’t cry in the oxygen room; he lay there, drifting in and out of sleep for about 18 hours, getting better, and then, everything was fine; he has been held by someone – me, Courtney, the boys, grandma - since the moment we were able, he’s already interacting when you talk to him, he nurses well, and he seems very happy and… attached.

As for me, you might wonder (or not); how did I feel after this my third c-section? This one was different in that it was planned, so I had been able to mentally go through the procedure and prepare myself. In a way I got through it more mechanically, because I knew what I had to do, but I also was able to reflect more; the other two times where so chaotic per se, that I didn’t have time to focus on the pain, but this time, especially since I didn’t have the baby to keep me busy, the first 24 hours were extremely difficult. I kept the epidural throughout the night, but by morning it wasn’t hitting the right spot any more. I had this happen in Belgium as well, where at a certain point it seems like the focus of the epidural has shifted, so instead of relieving sensation in your lower abdomen, the epidural makes you lose your entire left leg – or some other part of your body, leaving you still in pain and unable to move. Early in the morning I had a nurse remove my urinary catheter, and the anesthesiologist the epidural catheter. This is where the hard part starts. A sturdy nurse came in and offered me a hand, indicating that I needed to go to the bathroom and that she would help me wash myself. Sitting up in that bed was terrible, walking over to the bathroom was awful, sitting down on the toilet was an act of sheer will, and going pee was probably the most painful moment of my life – and I’ve gone through 24 hours of labor before, mind you. The nurse washed me all over and then helped me get dressed. When I got back in bed I remember thinking that I would never, ever be able to do all that again. But then Karl-Abraham came, I endured the extremely painful contractions his nursing caused, I went to the bathroom several times (not without tears and faces of terror though), and the next morning, I got up myself, washed my hair, my body and got redressed. For a moment there I actually thought that I wouldn’t get through it this time, but somehow I still did; it’s all for something, right?

I’m not sure exactly when, but at some point the headaches started. As long as I remained laying down I was fine, or as long as I didn’t raise my head above my waist, rather, but if I tried to sit or worse stand up, I felt like my head was going to explode. When I mentioned this to my OBGYN, she indicated that it was probably my high blood pressure. The fact that I’ve had high blood pressure for as long as I can remember and never headaches, did not seem to raise any flags (just like the fact that high blood pressure and headaches in general have nothing to do with each other). Another doctor suggested that it had something to do with the epidural, but my doctor quickly dismissed this. In terrible agony, somehow I still managed to leave the hospital after two nights. When we came home, Courtney & I, as we do with anything, did our own research, and concluded that indeed, it seemed pretty obvious it was Post Dural Puncture Headache. I spent another few days lying down in bed, keeping Abraham with me. If I had to go to the bathroom or something else, I had to walk with my head at waist level or I felt as if my head was going to split open. On the Wednesday, to everybody’s relief, one day before my mother was leaving, the headaches went away.

During my one week check-up when my OBGYN removed the stitches, we mentioned the headaches, and our diagnosis guess, which was based on the progress and outcome of the whole thing, but again, she dismissed it as unlikely, once more blaming my high blood pressure. When I tried to start a discussion quoting sources and research we’ve done, she gave me a very stern lecture on self-diagnosis and how I should respect the authority of a medical specialist. It was really quite annoying, and I realized the futility of a discussion on possibilities, and just let it go. When Courtney & I talked about it later, we both concluded that the mentality and perception of a doctor is different here; in Egypt, it seems (or maybe this only applies to the doctors we’ve happened to have met; it may be a coincidence), a doctor is an authority not to question or discuss with. If you have a problem, you see a specialist, and you don’t question his/her abilities, but leave the diagnosis and treatment up to him/her. Courtney & I though, not only are we by nature going to question anything and everything as the academics that we are – especially when our and our children’s lives are at stake, but if we had completely trusted everything a medical doctor told us in the past, we would not be walking around upright today. It’s possible that Courtney & I were wrong, but it’s also very likely we were right. When it comes to anything that has to do with immediate gynecological matters, Dr. May was one of the most professional OBGYNs I’ve ever met, and for these purposes, I will keep seeing her. For everything else though, we will find someone else.

In general, I would say the hospital was pretty much what we had expected. The doctors we had chosen; the pediatrician and the OBGYN were good, but as soon as we were left to deal with the hospital staff, it was hard to find anyone who spoke reasonable English and/or understood our strange western approach to childbirh and childcare. Some of the nurses were very nice, the food was terrible but there’s a McDonalds downstairs, and I still think it’s weird that you have to bring your own drink s (or use the over-priced room service) and towels (we didn’t know this; I ended up using a sheet) but that we had a flat screen TV!