Saturday, April 29, 2017

an expat childbirth: why I am electing to have a c-section

A lot of people are very surprised (and rather opinionated) when they find out that I am electing to have my c-section, meaning my doctor is not the one telling me I must do it.

I am a-okay with their surprise (and disapproval) though.

One thing I have learned over my 30 years on this planet is that I am the one who has to live with my choices, and this is most definitely my choice to make -- not my colleague's choice or relative's choice or friend's choice or random stranger's choice. 

Still, the reasons why I am choosing to have a c-section are due to the fact that I am an American expat living in Taiwan, so I am going to share them here on my blog. After all, the whole point of this blog is to share our expat experience both for our future selves and for others who may find themselves in our shoes.

I have already raved about experiencing pregnancy in Taiwan, and while I have nothing to personally compare it to, I know I am being absolutely spoiled in comparison to what many of my girl friends in America experience as pregnant ladies.

For example:

I have received thorough and excellent health care over the past eight months. We have spent less than $100 USD for all of it: the numerous doctor appointments, the numerous blood and urine tests, and the numerous ultrasounds.

Further, I am 37+ weeks pregnant, on my fully paid maternity leave, and have been since the end of my 35th week. I will continue to receive full payment until August. Then, I will receive partial compensation until I return to work in late February 2018.

Further, my employers have to hang on to my position for me for up to two to three years. Between Sean and I, we are entitled to that much parental leave. Even more, Sean has one full week of paid paternity leave to spend with Ruby and me and then the option to use sick and personal leave to extend that time.

However, there is one catch to my experience with pregnancy in Taiwan: it is my opinion (and the opinion of many others too-- just poke around lightly on the Internet and you will see what I mean) that Taiwanese birthing practices are decades behind those of the developed world, which is why I am electing to have a c-section. 

Women essentially have two options for birthing regardless of where they live on this planet: have a vaginal birth or a c-section. The more I learned about what having a vaginal birth here in Taiwan would entail, the more I knew I just couldn't.

First, women in Taiwan (at my hospital) labor in a shared room. It's not the cozy birthing suites I visited after my girl friends gave birth in America. There is a lack of privacy and little room for family. That was the first red flag for me. I am a very private person especially when it comes to certain things like my body or vulnerable moments. Truthfully, even the idea of my mother seeing me breastfeed wigs me out. It's not because I am ashamed of my body or puritanical; it's just the way I have always been, and I accept that. While many people may not understand this, knowing I would not have privacy was a huge deal to me. It stressed me out beyond belief to know that I would be forced to share those hours (or days) with strangers-- and I do not mean the nurses and doctors-- I mean with the other laboring women and their relatives.

Second, there is a shared delivery room. In Taiwan (at my hospital), women labor in one room and deliver in another. That means that during the worst part of labor, you are wheeled through a hallway to get to the delivery room. Again, the whole privacy thing. Further, if more than one woman is delivering, no relatives at all are allowed in the delivery room. Guys, pushing out a baby is not something that happens in five minutes. Sure, it can, but it also can't. The idea that I would be in the delivery room without Sean was the icing on the cake. I knew I could not handle that. Further, I have no interest in being separated by only a curtain from another woman in the midst of pushing out a baby. I know what some of you are thinking: but it's possible no other woman will be delivering at the same time. True. That is true. However, Hsinchu has the highest birth rate in all of Taiwan and that is not a gamble I can live with.

Third, Taiwan has a near 100% rate of performing episiotomies. When I asked my doctor about this, he all but said it was mandatory. However, the definition of the word episiotomty is: "a surgical cut made at the opening of the vagina during childbirth, to aid a difficult delivery and prevent rupture of tissues." Essentially, what my doctor was saying was that they treat every single birth as though it is a difficult one. I have my theories about this, but as they are just theories, I won't share them here. It may sound crazy to someone else, but I am far more comfortable having someone cut my abdomen than my lady bits, especially knowing that regardless of the birthing method I choose, I will be cut.

Fourth, it is still common here for nurses or doctors to apply fundal pressure during labor, which means pushing on a laboring woman's stomach to "aid" the baby in coming out. Um, the only other places that seem to still do this are third world countries in which c-sections and other birthing emergency care is not available.

Fifth, I think it is hard for my American friends and family to understand that in Taiwan, there are not a lot (if any, actually) of choices regarding how one gives birth. Here, there is socialized healthcare. The policy at one hospital tends to be the policy at most, if not all, hospitals. We did copious amounts of research to understand our options in Hsinchu. Really, there were three: my hospital or two others. However, especially after encountering complications in the second trimester, we only felt confident staying with mine because it has the best NICU in Hsinchu, and we were seriously concerned about a premature birth. There is one clinic in all of Taiwan that we could find-- once again, this was after massive amounts of searching -- that does anything close to an American version of a "home birth" with a doula and tub, but it's a birthing clinic in Taipei, which is a two hour drive away -- and we don't even have a car!

All of these factors made it easy for me to come to my conclusion and ask for an elective c-section, which, luckily in Taiwan, is something doctors will perform with minimal shaming and guilt.

While I felt very confident in my decision, I knew I made the right choice last Thursday morning when we ended up at the hospital from 1am - 4am due to some happenings in the night (of which I will spare you the gory details). While everything turned out to be fine in the end and we were eventually sent home, the three hours we experienced on the maternity floor of my hospital reaffirmed everything I know about myself.

I was lying on my back for three hours hooked up to all of these machines stressed out beyond belief. I broke out into a nervous sweat and ended up puking because I was so uncomfortable and nauseous lying in that position for so long (which, by the way, is how hospitals want women to labor here: on their backs-- a friend was told she could not get up and go to the bathroom because how would they leave the monitors strapped to her, so they gave her a bed pan instead). I cannot begin to express how uncomfortable it is to be on your back for that long with a heavy baby pressing on you; for the past two months, the only way I can relax is on my side. I literally feel like I cannot breathe when on my back, and now I know that it also makes me vomit. Sounds like a lovely situation for hours of labor, right?

Further, my high blood pressure is a real concern moving forward regardless of how I choose to give birth. Hypertension in pregnancy is no joke, and I have been grappling with it since 26 weeks of pregnancy when I was diagnosed with mild preeclampsia. When I was just contemplating what a vaginal birth would be like in Taiwan, I could feel my blood pressure rise. However, when I was actually at the hospital lying down on that bed with all those machines and wires strapped to me for just three hours, I could literally see my blood pressure rise-- I am talking readings of 150/115 when normally I hover around 120/95 (which is still quite high).

I can only imagine what would happen during actual labor with all of the factors I mentioned-- likely, my blood pressure would hit such a level that I would end up with an emergency c-section regardless, which is what happens when a woman's blood pressure gets dangerously high in the midst of labor.

To me, all of it sounded way too traumatic and being legitimately traumatized sounded like a really poor way of entering motherhood.

So what does all of this mean?

On May 5th, I will check myself into the hospital so I can have my c-section the next day. Within a 45 minute to 1 hour span of time, I will be wheeled in and out of the OR. I will get a private recovery room afterwards, and Ruby, as long as everything is good, will be with us the whole time afterwards.

Why May 6th and 38 weeks?

All of the literature says it is safer for hypertensive women to deliver once they reach 37 weeks. Due to my family history of severe preeclampsia, which is something that happened to both my aunt and cousin and made both terribly and dangerously ill, I am not willing to take the risk of seizures, coma, permanent kidney or liver damage, or death.

To me, that sounds pretty reasonable.

In the end, being an expat in a foreign country that is remarkably different from your own can make childbirth a more daunting concept than it is to begin with.

For me, there are far too many practices surrounding childbirth in Taiwan that just don't sit well with me at all. In the end, I chose the option I could best live with, even if it's not the option I would have chosen if I was home in America, which would have just been an early induction to deal with my pregnancy induced hypertension.

Many people warned me that having a baby would entitle all kinds of people to offer their unsolicited opinions about my pregnancy and parenting choices, but I cannot think of a more personal choice for a woman to make than how to give birth, which luckily, I was able to do.

And for that, despite the fact that Taiwan and I don't see eye to eye on many matters regarding birth, I am grateful.

Sunday, April 23, 2017


I woke up this morning, and it dawned on me that I do not have to go to work for 10 months. Today -- Sunday -- I do not have to wash my work clothes, go to the grocery store to stock up on ingredients for healthy work lunches and snacks, or ensure that I have everything (prezis, assignments, reading, etc.) in order for tomorrow's lessons. 

Instead, today I can take it easy, and tomorrow I can take it easy, and the day after that I can take it easy.

I am so excited to take it easy for the next few weeks before Ruby's arrival!

While I know some women work right up to their due date, that was just not going to happen for me. I am 36+ weeks pregnant, and for the past few weeks, I have been in downright agony while at school. 

Teachers do not have the kind of job that allows them to sit down for long periods of time. Part of my job is managing 30 teenagers. It's a joke to think that can be done well (or at all in some circumstances) from a chair. Further, my campus is large and spread out. I have to walk a lot to get from the teachers' office to my three different classrooms -- often while carrying heavy bags full of papers and large books-- and there are stairs that I have no choice but to navigate. Throw in Taiwan's heat and humidity and my school's inability to truly climate control its classrooms, and I was a hot mess. 

My back pain left me hobbled by the middle of the day, my feet were purple and swollen, and I was having crazy braxton hicks contractions all day long. I would make it home at the end of the day only to collapse on the couch and not move until bed time. 

Suffice it to say, my maternity leave did not come soon enough, but, but, but: it also came too soon.

Most people, when I tell them that I teach middle school, offer me some sort of condolence. I think most adults are allergic to middle schoolers. They find them loud, obnoxious, annoying, etc. Not me though! 

I find my students wacky, inquisitive, malleable, and far more decent to be around than most adults.

Some of my favorite units are coming up, and I am sad I won't get to be the one to guide my students through them. Further, I actually enjoy going to class and spending time with them. I will miss talking with them and working with them. 

Before I left school on Friday, I was showered with gifts and cards from my kids. My favorite was the Cauldron Cakes (a Harry Potter reference that in reality was just seriously good brownies) some of my 8th grade girls made me along with a handmade card that showed Ruby as a wizard baby. Then there were the huge Taiwanese cards that all of my students signed. Some of the comments made me laugh out loud. I think some of my 8th grade boys think I am going on a 10 month vacation rather than giving birth and then caring for an infant. Boys. Then there were the sweet cards and gifts from my 9th graders who are kids I've worked with for two years in a row. 

I didn't need the gifts and the cards, but truthfully it goes to show how thoughtful many of the kids are.
On Friday, I also cleaned out my desk. I have been working at my current school for five years. At the bottom of my desk drawers, I found curriculum I brought with me from America. I have not looked at it once since I put it in the drawer five years ago. After perusing through the binders and folders, I came to the realization that my current job has allowed me to blossom as a teacher in ways I never could have in America. Here, I have so much freedom to develop curriculum that suits my students and my teaching style. I have the freedom to try (and fail). In America, education is so cookie cuter. I could see how much growth I have made over my time here, and it made me feel even more grateful that I get to return to my job in 10 months to continue progressing on. 

So while I am ecstatic that I get to sleep in tomorrow, I will also miss my kiddos as first period begins without me and they start one of my favorite units of the entire school year. As they begin a poetry unit, I will likely be playing the Harry Potter Lego game my husband bought for me on his PS4 and washing all of Ruby's clothes and bedding. 
We will be heading to the doctor again on Friday. It is very possible that if all is looking well with Ruby's weight, we will schedule my c-section for Saturday May 6th. 

That is only 13 days away! 

I will be very busy over those 13 days organizing all of the stuff we have been given-- the clothes, blankets, bibs, pacifiers, toys, toiletries, artwork, bottles, wipes, books, etc. 

Today, Sean and I realized that the only things we have purchased ourselves for Ruby are six outfits, a car seat, a stroller, a baby carrier, a crib, and a changing table. Everything else piled high in our guest bedroom and our bedroom has been generously gifted to us by friends and family and colleagues, so today I went to the stationary store and bought a million thank you cards to get started on. 

So tomorrow, on top of playing Harry Potter Lego and doing many loads of laundry, I will sit down to pound out the many, many thank you cards that are owed to the wonderful people who have supported us along this journey for the past 36+ weeks. 
And I will definitely wonder how my kids' introduction to poetry went. 

Monday, April 17, 2017

a gathering of friends

Yesterday, I had my second baby shower. This one was planned by my friends instead of my school. There were only 10 of us, but it was perfect. There was bean dip, spinach dip, chocolate cake, blueberry scones, chocolate chip walnut cookies, fruit, popcorn, and so many other delicious things. I had been looking forward to this day for months, literally. It was the day I gave myself permission to just eat what I want and enjoy my friends, so that's exactly what I did.

My friend did such a good job decorating her apartment! Seriously. Just look! I stole all the decorations and brought them home for Ruby's nursery.

My other friends spoiled me with the cutest baby clothes and most delicious smelling body products and even more delicious tasting treats. I felt once again so lucky to be surrounded by such wonderful and generous people who are just as excited as I am about Ruby.

And I just heard back from my husband-- baby shower #3 is planned for next Wednesday. His students' parents are throwing us a party in the middle of the school day.

While I am exhausted from work and have an aching back & feet, it makes me feel a lot better to be part of such an awesome community that is so excited for us and our upcoming adventure!

Wednesday, April 12, 2017

a thankful heart

I am almost done with my pregnancy (thank god) as I only have about five more weeks to go-- that is if I even make it to my due date. 

Last Friday, my school hosted a baby shower for me and two other colleagues who are also expecting their first children (both baby girls) in May.

During the shower, I was unexpectedly asked to say a few words, and at first I stalled because my brain went completely blank.

After a second or two, though, I knew exactly what I wanted and needed to say: thank you.

While we conceived in America over summer break, we had no idea we were expecting until we arrived back in Taiwan. I had a sneaking suspicion for much of early and mid-September that I was pregnant, but we did not confirm it until late September.

From that point on, we have experienced every single facet of our first and what will likely be our only pregnancy abroad.

Let me tell you: it has not been easy, especially due to the serious complications I developed at 26 weeks.

However, a multitude of people have come out of the woodwork and have gone out of their way to make this easier on us, and that is where my grateful heart comes from.

Some were expected-- like my mother.

You guys, I have the best mother in the whole wide world.

In less than a month, she is flying to Taiwan and will spend all of May and June with us.

Beyond that, she has sent us so much stuff over the past few months.

When we had trouble finding reasonably priced baby clothes here in Taiwan, it was mom to the rescue. When I wanted certain products from America because their directions would be in English rather than Mandarin, it was mom to the rescue. When I needed maternity clothes shipped to Taiwan because no stores here sell my size, it was mom to the rescue. When I craved Kraft macaroni and cheese, it was mom to the rescue.

I cannot wait for her to arrive so we can share the last few weeks of my pregnancy together, not to mention the time we will have with Ruby.

And then there were other expected people: friends from back home.

In all likelihood, I will be having a scheduled c-section. I had a ton of questions and knew exactly whom I could turn to: one of my childhood best friends. She gave me so much peace of mind and great advice about recovery and motherhood in general.

And there were more expected people: good friends we have made here in Taiwan.

When you hear really scary and potentially terrible news at the doctors office, what you want and need are people who will just sit with you in the ugliness of the situation. The day after our scary doctors appointment in which the word terminate was used, a dear friend came over and just watched movies with us. That same friend took two maternity photo shoots for me. She is also hosting a baby shower for me this weekend.

But there were also so many people who took the initiative to step into our lives-- people who had no reason to do so-- and they have become great friends too during this process.

There are the expecting ladies at work whom I never spoke much to before this. Now we Facebook each other often. They are both locals, and they have provided me with so much guidance about where to buy certain items and second opinions from their doctors. It has been so helpful to use them as a sounding board because they are going through this alongside me, but at the same time they have a much better grasp of the culture in Taiwan surrounding pregnancy and childbirth.

There is the administrator at work whom I emailed way too many questions to: if I feel sick like I have a cold, should I see my OBGYN or can I go to the clinic down the road? And she kindly responded to every single one. Trust me, I asked a lot.

There are the people who offer time and time again to drive us here or there or pick up this or that for us. They ask how they can help, and they actually mean it. And when they say they are going to do something, they do it.

There are the people who hear me say I am craving Mexican food, so they invite us over for a Mexican feast. We have been invited over to so many people's homes for dinners recently. Dinners made especially for me with my strict dietary guidelines adhered to, and that is no small thing. There are the people who go out of their way to bake me the most delicious and healthy treats (that don't taste healthy and instead just taste delicious)!

There are the expat mothers who also went through what I am going through, just a decade or so ago. They listen to me ramble and offer sage advice. Their experiences and stories are so valuable to me, and I am dying to take them out for coffee when this is all said and done and just chat about something other than babies and hospitals-- mostly for their sake since that is all I can seem to talk about these days.

There are my friends/colleagues who carry my heavy bag full of teaching materials all the way up to my fourth floor classroom just so I don't have to-- and then make sure a student will bring it back down to the office at the end of the period. There are my other friends/colleagues who keep a stash of healthy snacks in their desk and make sure I know exactly where they are in case I get hungry and have no snacks. There are even more friends/colleagues who donated so much money to the school baby shower that we got every single thing we requested and an envelop with $250 USD worth of cash in it because there was so much left over after purchasing the things we asked for like a high chair, baby cutlery, clothes, baby play stations, mobiles, toys, etc.

There are the guys who stepped up to the plate to give Sean fatherly advice and just listen when he needs to express his concerns-- often over a beer sitting down by the lake.

There are people who drove us to baby stores on multiple occasions to help us buy things like a stroller, baby carrier, car seat, etc, and each time was a painful, hours-long ordeal often requiring Google translate.

There are people who offered to come to my doctors appointments (which is no small sacrifice as each one lasts 1.5-3 hours) or be on standby ready for me to call if I need something translated.

There are the people who donated their gently used baby clothes to us.

There are the people who keep asking again and again what we need and how they can help.

There are people who hear great things from other parents about a particularly useful product and then purchase us coveted items like a MamaRoo.

There are the parents of Sean's students who came together and gave us 20 beautiful picture books. They also want to throw us a baby shower! Can you believe that? Three baby showers!

All of these people made a huge difference over the last 35 weeks.

I cannot believe we are almost there.

More so, I cannot believe how lucky we are that so far away from home and family, so many people still rallied around us to take care of us in this special albeit trying time. I partially think this happened because we have been a part of our small school community for half a decade now (which is still hard to believe), but more importantly because the people we are surrounded by are just some seriously amazing, caring, and generous people.

How did we get so lucky?! 

Thursday, April 6, 2017

the 5th birthday without him

April 10th is my dad's birthday.

He would have been 64 years old.

This is the fifth birthday we've marked since his death.

I still find death to be such a bizarre thing.

For me, my dad will always be frozen in time as the 59 year old he was before his death.

When I remember him, I don't recall the days leading up to his unexpected death.

Instead, I recall him from the time right before we left for Taiwan, which was four months before his passing.

I remember going out to lunch with him. I remember walking down the streets of Bainbridge Island with him and talking about what an awesome adventure moving overseas would be. I remember him taking apart our furniture as we packed and him driving loads of our stuff to the Goodwill. I remember riding the ferry with him on the way to the airport. I remember squeezing him goodbye before we went through security. I remember Skyping him once we arrived in Hsinchu.

I remember my dad being my dad: present, interested, and excited for us.

While the sting of his death has faded over time, one thing has not: the sting of new beginnings.

My dad is dead and gone. I know that, and most of the time, I am okay with it.

After all, I understand that we all die, and that death is a natural part of the human experience.

The times I struggle to be okay with it are the times when I feel like I am departing dramatically from the person I was when my dad last knew me-- the times when I think my life would be the life of a stranger if he saw it now.

There have been very, very few times I have felt this way, and they happen whenever I venture down an immensely new fork in the road.

I mean, I kinda figured things out pretty early in my 20s.

Despite the fact that my dad died when I was 26 years old, I had already been with my husband for eight years. I had been teaching for five years. I had been travelling the world for nine.

So even at 30 years old, I feel like much of my current life four years later would be easily recognizable to him-- well, until now that is because I cannot think of a newer, bigger fork in the road than my impending motherhood.

Honestly, I think my dad would have been very surprised that Sean and I decided to have a kid after all, especially while still living in Taiwan. That said, I think my dad would have been surprised that we still live in Taiwan at all. I think he would have been tickled at the prospect of Sean being a 4th grade elementary school teacher.

So much has happened over the past four years that he will never be a part of or know-- all our travels, our decision to remain in Taiwan, Sean's graduation and employment, paying off all of our debt-- but Ruby is so much more than the sum of all those other things.

She is a grandchild he will never meet.

In a way, her impending birth and his impending birthday mark a finality in my perception of my father's death.

Until now, my life felt divided in two: before and after his death.
Now, my life is adjusting.
She will mark my great before and after.

And, sadly, she is something that he could have never even fathomed.

All of the other things-- our adventures and successes-- I like to think my dad knew those were in store for us, but Ruby is altogether something else.

This year, we will mark his birthday with a little extra sadness because we are about to embark on our greatest adventure yet and my dad will not get to witness it or be a part of it-- ever.

Tuesday, April 4, 2017

the baby bump -- 8.5 months pregnant

Spring has arrived in Taiwan (finally). We have had unusually cool weather lately, which I am certainly not complaining about. However, along with the cool weather, we have also been getting a lot of wet and dreary days. I woke up today though to blue skies! We had a four day weekend, so a friend and I decided to take Bubu on a walk around the lake to snap some more baby bump pictures.

We live within a 1-minute walk from a really beautiful (and artificial) lake called-- are you ready for it-- Lake Placid. 

I love the lake mostly due to its beautiful architecture and lotus pond. I walk Bubu around the lake often, and in the past Sean and I would walk around the lake a few time a week while catching up and talking about our days. 

Today, the entire lake smelled so good because of all the vibrant and beautiful blooming flowers. 
I was slightly worried about bringing Bubu on this photo adventure. While Bubu is such a good boy, he is also a complete weirdo. He is super shy and sometimes does not listen very well. However, I am his favorite human and he sticks pretty close by all the time.

We tried something new today: he ventured around the lake off leash.
And you know what?
He totally surpassed my expectations.

He stayed with us the whole time and acted semi-normally around other people and dogs. Trying to take pictures with Bubu around required a little bit of finagling in the form of constant supervision and redirection and treats, but it worked out pretty well in the end.

And we were able to get some adorable shots!
The lake was fairly busy today because everyone had a four day weekend for Children's Day and Tomb Sweeping Day (I am not gonna lie: I have always wondered why these two particular holidays are paired together because it seems a little morbid to me). There were plenty of families riding bikes, having picnics, and taking their own pictures.

Like the last time we did a maternity shoot in Beipu, we drew a few long stares from the locals. I think mostly because I am pregnant and we had a dog with us. Most foreigners who are in Taiwan are ESL teachers-- a more transient and young population-- so they a. are not pregnant and b. do not have a dog. 

We also sat in the dirt and climbed on some ledges, so that also could have been the cause of some of the stares. Plus, I don't really think maternity photos are a thing here. Wedding photos? Yes. Baby bumps pictures? Not so much. I don't think anyone took pictures of us taking pictures this time though, so I will consider it a win. 
In the end, Sean surprised me by coming down to the lake. Despite appearances, neither of us are huge into the idea of getting our pictures taken. As a couple-- meaning in the 13 years we have been together-- we have only had one official photo shoot, and it was for my parents' wedding vow renewal ceremony. 

That's right: we didn't have any professional photos done for our engagement or wedding. We are just not those people. I think the reason I got into the maternity photos is because my awesome friend took them, and I got to take some awesome photos of her in return. 

I was totally shocked that Sean came, but I was so glad that he did! We got some really cute pictures of all four of us-- mom, dad, baby bump, and dog. 
We are getting closer and closer to my due date!
And then I will likely bombard you all with cute pictures of Ruby!