Mid Term Pregnancy Termination - The Actual Process

When I found out that I had to go through a Mid Term Pregnancy Termination (MTPT) instead of a DnC, I was so down that I burst out crying in front of Prof Biswas because I thought there was no way I could be conscious and yet deliver my 13 week baby girl. After we have gotten home, I went home to ask Google for anyone who could give me an actual description of the process but I could not find any. All of the accounts are of emotions of guilt and depression. The other clinical articles are too brief. I have a close friend who unfortunately, has gone through this process, has shared with me and prepared me. So, I have decided to post an entry while the process is still fresh in my mind.
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As my gynae is now Prof Biswas, the MTPT would be done in NUH. We chose A1 ward because I wanted to ensure that I wanted privacy as the whole process would be carried out in the ward room. For those who want to opt for B1, they do have a special single bedded for B1 but it depends on availability. Otherwise, I cannot imagine delivering behind closed curtains with other patients in the room. On Sunday, I was wishing very hard that A1 would be available because I received an SMS in the morning from NUH not to proceed to the hospital before 4.30pm (we were supposed to check in at 3pm) as they were still sourcing for a bed for us. I replied to an unknown no, (most prob a computer) and ask it to try its best to find because I really wanted the privacy. At 1.30pm, I received another message that our room was ready and we have to check in before 3.30pm. We still had not have our lunch because I was packing. I packed 30 cm sanitary pads and disposable undies because my friend said that I could have diarrhoea from the side effects. I also brought along some cream crackers and milo in case the process was too long and I needed some strength to carry on. I also grabbed a small towel, a toothbrush and toothpaste.

Although we have not taken our lunch, we decided to claim our room first. We reached NUH around 2.30pm, checked into our A1 room and it looked nice and spacious. No regrets paying more. I forgot to mention that we were in the Maternity Ward and most of the rooms were bursting with joy of life and the crying of babies in the air. Photos of babies adorned the notice boards along the corridor. We quickly escaped into our room of refuge. It was too much to bear. A nurse entered the room and we told her that we were very hungry. She told us to eat our lunch first. We went to Burger King to eat because I wanted to eat beef. I knew that I would lose blood later so I need to load on iron. We both ordered Mushroom Swiss burgers and the succulent juices of mushrooms and beef with the melted cheese comforted our tired souls. That few minutes of fast food lunch gave us a brief respite from all the tensions, fears and griefs building up in our hearts.

Finally, we were done. We trudged back to our room. I was feeling very anxious because I was afraid of the contractions. I was feeling sad for the obvious reasons. The main reason of anxiety was that I did not have a strong motivating factor to endure the contractions - usually at the end, a bundle of joy would be placed on the mother's chest after hours of hard work but in my case, obviously, no.

Around 4pm, the same nurse came in. She was always wearing a mask but her eyes shone with empathy and love. "She" would be "Nurse Ruby" - someone who would walk with me during the first league. She explained to me briefly the entire process and I was so shocked when she said that the doctor would be coming in around 4.30pm to examine me and insert the first dose! I did not expect it to be so fast.

Around 4.30pm, a young lady doctor walked in. I chatted with her and realised that she was a houseman who was doing her rotation in the O&G department. She wanted to major in family medicine. She also briefly told me about the whole process. I asked her how long it would take and she said that it all depends. I asked her for patients who are fast, how long that would be. She said that usually it would take 15 hours because they would be inserting one dose every three hours. One full cycle has five doses. Some patients take very long and they require a second cycle of five doses. When I heard that, my heart sank to the floor.

She wanted to set a plug for me in case I lose too much blood later. I told her sometimes nurses have difficult drawing blood - maybe only once or twice. In all, she poked me 6 times and could not set the plug nor draw my blood. Because she was very sorry, I wasn't pissed. I watched many doctor dramas and knew she was truly sorry. She would get her Medical Officers to set the plug and draw the blood instead.

My first dose was inserted at 5.00pm. They were supposed to insert 2 pills but somehow, only 1 pill has been inserted so the second one was inserted around 5.15pm. The young lady house man wore gloves, put some lubricant and inserted the pill into my vagina. It was not very painful but uncomfortable. Soon, I had a burning sensation at my vagina. Nurse Ruby told me I might have an allergic reaction to the lubricant. She told me to try wiping it away. The burning sensation subsided after a while. Both the nurse and doctor told me that for first dose, usually, I would only feel some pulling like menstrual cramps. My friend told me the same thing. For her case, her contractions would come and go and eventually became more intense towards the end after hours later. Both of them also told me that there was an injection of pain killers which would stop the pain but this jab could only be administered once every 8 hours so I have to take it only when I really cannot take it, otherwise, during the climax, I cannot use the jab.

Another two young doctors came in. They poked me another 5 times and still failed to set the plug. At least, they managed to draw some blood. I asked if I could get an experienced nurse to set the plug but they mumbled that it would be difficult to find. Anyway, they left the room and told me that most probably, I would not even need a plug because most patients would not lose so much blood that they would need a blood transfusion. The conclusion was - no need to set plug. I was worried because imagine, if I really lose a lot of blood and they could not set the plug, wouldn't it be dangerous?

Since the doctors, nurses and my friend said that first dose should be nothing much, so I decided to take it easy, read magazines and drank apple carrot juice with no ice. After an hour, I don't feel anything except for a slight pull here and there. During the second hour, when I was reading Her World, I felt some cramps settling in. Not exactly, painful, but like mild cramps. During the last hour before the next dose, the pain was increasing at such a steady rate that I could not concentrate on my magazine anymore. Clutching my stomach, I told hub that it was very painful. We pressed the bell for Nurse Ruby to pass me some oral panadol. The panadols did nothing to ease the pain. The pain continued to escalate. I felt very strange because I thought, during first dose, I was not supposed to feel such pain. I even doubted myself that I have a very low pain threshold. If I really have a low pain threshold, how am I going to make it to dose number 5? The pain did not feel like contractions because contractions are supposed to come and go. This pain is constantly rising and it pulls the back and my tummy downwards and inwards. It resembles a very nasty food poisoning type of diarrhoea except that this has no respite and it escalates.

Out of the blue, I remembered my friend telling me that diarrhoea is a side effect of the pill. Hey, maybe I was not having contractions at all. Maybe I just need to poo! So I pressed the bell for assistance. Another nurse came in and placed a disposable basin made of cupboard on the toilet bowl so that I could pee and shit into it. This is to prevent the tissues and foetus from dropping into the toilet bowl. The disposable basin was so shallow! I clutched my stomach and tried my best. I only managed to poo a small grape. I stumbled out of the toilet and shook my head at my hubby. I sat on the bed, unable to do anything at all. I went back to the toilet and tried again. This time, I bent forward, clutched my stomach and waited. I managed to poo quite a lot and I was relieved - I was still normal and it was only diarrhoea. But strangely, the pain did not subside. I was so worried that the shit might touch my front because the basin was shallow. I laid paper on top of each poop before I tried again. During the last bomb, I shouted,"Oh my gosh!" Water gushed out from my vagina. My vagina looked soft and spongy when I took a look. I better wiped myself clean in case something funny was happening. The basin was too shallow for me to wipe the normal way. I had to squat on the floor and clean myself. While I was doing so, my goodness! Pink water came dripping down from my vagina. Quickly, I returned to the disposable basin. Dark pink water gushed out from my vagina.

Is that my water bag? How could it be? This is only my first dose!

We pressed the bell for the nurse. The nurse did not look very alarm and told me I did not pass out any tissue, just shit. I climbed back onto the bed and continued to ooze out water stained with pink spots on my pad. I told Nurse Ruby that I was in pain and she held my hand and told me very gently that maybe my pain threshold was low and did the pain feel like menstrual cramps. I told her it was more painful than menstrual cramps. Another nurse came in. It was painful enough for me to consider taking the jab. She told me she would give it to me if I really needed it. But who would take jab during first dose? Maybe I am just lousy at managing pain? I asked her if she thought I should take it now. She told me that I looked like I could still manage because I was not sweating yet. Usually, when the baby wants to come out, I would be in great pain and sweating. I nodded and she left.

We were left alone in the room. Somehow, after the water shed, the pain began to ease a little. Nurse Ruby came in and told me that it was time for the second dose. She looked very sorry. She knew that I was allergic to the lubricant so she did not use any of those cream but she used something else. Because there was no lubricant, it was more uncomfortable than the first try.

After the insertion of the second dose, I felt something flow out from my vagina. I pressed the bell again. By this time, I had already removed my panties and lying on a big piece of pad. This time, an unfamiliar nurse came in. I sneezed lightly and shouted out in pain. To my shock, when I sneezed, I felt a sharp pain shoot up my left side and a big gush of blood oozed out. Unfamiliar Nurse quickly took a cushion and gave it to me. She told me to hold something when I sneezed. She did not check on me because she said she was not familiar with my case so she would call my nurse.

Nurse Ruby came in with another nurse. She introduced her as Nurse Yuen. Nurse Yuen looked very motherly. Nurse Yuen checked on the pad and confirmed that it was blood but nothing else. I asked her when I should call her. She told me to call her when I felt great pain because baby would be coming out by then.

All of a sudden, the pain was gone but blood was flowing out intermittently. I have stopped calling the nurses and braced myself for the great pain that was to come. I felt scared so I called hub to sit beside me and hold my hand as we watched TV. I kept telling hub that I was worried because I was already bleeding this early, would I bleed too much by the time baby comes out. I was still worried that they could not set my plug. Nurse Yuen did assure me that they would ask another doctor to try setting again even though I pleaded with her to set for me.

We were watching some Channel 5 Talent show whereby Selena, Tay PH, Bryan W were judges. There was nothing I could do except feel the slow gush of blood every now and then. Suddenly, I felt something slide down to my vagina and I yelped! It was stuck. I thought it could be a big piece of tissue. I pressed the bell and hub went out of the room to get the nurse. Nurse Yuen came in to check on me. When she saw what was stuck there, she mumbled, " I am going to get the trolley." She took some time so hub went out to look for her.

Just when the two of them opened the door, I let out a scream, "Oh my gosh! Something just popped out of me!"

I felt something hard, round, too firm and big to be tissue. Could it be baby? How could it be? It was only two hours after my second dose! Nurse Yuen came over to check what had popped out. My hub asked, "Had it popped out?" She nodded her head and mumble,"yes, it is the foetus." I said loudly, "Hey it is not a it. It is our baby!"

I began to pray softly.

"Dear God, I pray for Baby and thank you for receiving her into heaven peacefully."

"Goodbye Baby," I said softly.

Nurse Yuen pushed her trolley, with a metal basin, to the side of my bed. She fiddled with the foetus and said that the placenta was still inside my body and she would not be pulling the foetus out because the umbilical cord would snap. I felt the cord to be quite long and thin. Nurse Yuen said that I could try pushing like I want to da bian. After a few pushes, I felt something else slide down my vagina. I felt a huge piece of something slimy pushed through my vagina. Nurse Yuen smiled and said, "Very well done, the placenta has come out."

All the while, my hub was hiding behind a curtain. Anyway, I told him not to see since my friend's husband regretted witnessing the horrifying mess.

"Do you want to see?" Nurse Yuen asked.

We had been bracing ourselves for this moment because we already had a few conversations over it. We decided to preserve the memory of our baby as the bundle of joy we felt when we first saw the ultrasound at ten weeks.

"No, we won't be seeing," we replied.

As Nurse Yuen was still cleaning me up, I asked her if I should see. She told me that if I was emotionally ready, I could see. But if I were those type whereby the image would be retained in my mind and haunt me for life, then I should not see.

"Then I think I better not," I replied.

"I will not push the foetus to the mortuary yet, in case you change your mind later," Nurse Yuen said.

She also asked us if we want to claim the foetus or leave it to the hospital. We were not prepared for this question as we did not even know there was an option to claim the foetus so we told her that we would leave it to the hospital. It was after this that I found out online that some parents choose to conduct funeral rites for their babies.

After cleaning me, she told us that a doctor would be coming in to check if everything had been expelled. It was a male doctor who looked young and kind. He used a plastic thingy to open my vagina and it was so uncomfortable that I tensed up. He kept telling me gently not to squeeze the instrument. He decided to do without the instrument and used his finger to feel for any clogs instead. He inserted his finger deep into me, yes, this sounds like something from an erotic novel, but no, it was just disgustingly uncomfortable. He told me that I should be fine and he would report to Prof. Prof would be visiting me the next day.

My hub and I were left alone again.

"Baby, you wouldn't be lonely... Your siblings in heaven would take care of you. You will have so much fun up there," my hub said. (referring to our earlier losses)

From first dose inserted at 5.15pm to 10.30pm, when baby decided to come out peacefully, it was 5 hours. Recalling back, the pain I had endured during the first dose was not menstrual cramps after all. So, I am not such a weakling with super low pain threshold. After young and kind doctor had left, I was being checked for blood pressure and blood flow every three hours. The kind nurses also changed my pad. The next morning, Prof came to see me and pressed my tummy. He said that I could be discharged but there was always a small percentage that not everything had been expelled. If I am soaking my pad every two hours, or having very bad cramps or having fever, I have to return to A&E.  I would be seeing him in three weeks time and I was given a month of hospitalisation leave.

I was surprised that I was not swallowed up with grief as I had expected and feared. I felt very numb. Hub occasionally asked a rhetoric question, "Where is Baby?" and pointed to the hospital ceiling and waved goodbye. When he did it for the third time, I was so irritated that I told him that Baby had left us peacefully and she is definitely in heaven with her siblings. I felt a bit guilty after that because I knew that was his own expression of grief.

By the way, we have names for all of them. But it is too private to share online.

I turned to my husband and said, "we have to stop adding babies in heaven."

Somehow this nightmare has to end. How? I do not know.

Would we ever have a healthy child to raise and grow old with? I do not know.

When I started this blog, I was brimming with hope despite three failures. Now, I am brimming with tears. In the end, we still chose not to see Baby when Nurse Yuen informed us that she would be sending her down to the mortuary. I felt a slight guilt for not seeing. Should I have? I just do not know.

Although this pregnancy has ended in tragedy, I would still be posting flashbacks to the day we found out I was pregnant. I wanted to dedicate those memories to my Baby Girl that although time spent with her was so short, Mummy is still very proud of her and wants to share with everyone her joy.