Welcome

I started this post with the title “Fatherhood Files: The First One Month”. It then became the “The First 6 Weeks” without a single extra word being added. And even though today is the 51st day (and I’ll probably only finish writing this by the 56th), I am sticking to the present title.

This is going to be a very disjointed post. I will ramble and go off on complete tangents with extreme regularity. Seekers of coherence – tread carefully. For here be dragons.

I became a father on the 29th of August – five weeks before I expected to become one. Our son decided that he wanted to land up a little early and surprise us (good job, boyo).

I have never liked hospitals. Since childhood, my grey cells have associated disease, pain and suffering with these institutions. On a conceptual level I understood that a maternity hospital would be different – after all this is where parents welcome small bundles of joy. But the irrational side of my brain viewed Cloudnine (a superbly well run institution – where my wife and I regularly met her obstetrician and where our son was eventually delivered) with great distrust. And I completely understand the irony given that I work for a healthcare startup.

Throughout my wife’s pregnancy I had a constant fear: I would be at work or I would be travelling to a different city or I would be stuck in the utterly ridiculous Bangalore traffic – but I wouldn’t be next to her when she’d go into labour. She’d have to haul herself to the dreaded (in my mind) hospital on her own. This terrified me. As much as I hated hospitals, the thought of her admitting herself into one on her own gave me many a sleepless nights. This was a private fear – one that I have never shared with her or others (hi, honey!).

So on the night of the 27th of August, when my wife’s water broke, I was oddly relieved. I was with her. And even though this was not supposed to happen for another 5-6 weeks (expected due dates aren’t exact and can be spread across a fairly large time bracket), I wasn’t too alarmed. Not yet.

Science break: the human gestational period is typically 9 months/ 39 weeks long. Babies are considered full term after the 37th week as most of their development inside the womb is complete by this point. In rare cases babies are born between the 40th and 42nd week as well.

Any baby born before the 37th week is considered a preterm baby. With advances in neonatology, the survival rate of babies born after the 32nd week has drastically gone up. Neonatology wards in good hospitals have even done miraculous work with babies born after the 26th week (90%+ survival rates).

Breaking of waters – also called premature rupturing of membranes – is when the amniotic sac surrounding a foetus breaks, releasing the amniotic fluid surrounding the foetus. The fluid is critical for maintaining buoyancy and movement and as a protective layer for the foetus. The sac also prevents external infections.

At a critical juncture in many comedy films, the pregnant protagonist launches into a diatribe. She is done taking shit from the world in general and is assertively taking back control. Promptly, her water breaks. At this point she is either rushed to the hospital, has a healthy kid and lives happily ever after or gives birth in a car/ on a sidewalk/ in her office and is often aided by an unlikely hero/ passerby. [If memory serves, a Doogie Howser, MD episode revolved around a school teacher giving birth in an elevator and Doogie’s best friend coming to her rescue – assisted by Doogie, obviously, through the elevator phone.]

The point I am trying to make is that we have all heard the phrase – “her water just broke” in movies. [Was it Men in Black II where Will Smith helps an alien female deliver her baby in a car? The water breaking scene was particularly memorable in that movie.] But real life is different.

It’s past midnight. My wife and I have been in bed for about an hour. The weekend is fast approaching. I am in my second month at a new job. Thoughts of hiring, building a content engine based on a relevancy algorithm, the merits of Neo4j, the upcoming Sequoia Hackathon are swirling in my head as I am slowly drifting into sleep.

What happened next is still a bit of a speed blur in my memory. It’s like one of those movie trailers which shows every important scene in the movie and leaves nothing for the main full-length movie. What you remember after sitting through the entire movie is just the movie trailer. It’s disconcerting when your memories play out like a trailer.

My wife wakes me up – panic in her voice. I turn on the lights and see the last remnants of a gush of clear fluid. I see a pool of fluid forming on the edge of the bed and the floor. I check with my wife. She is not in any pain. While she cleans herself, I place a call to Cloudnine’s emergency number. They connect me to our doctor at her home. She sounds groggy at first (it is past midnight) but on learning about the situation she instructs me to head to the hospital in a clear voice. The ambulance will take about 15 minutes to reach us – I am told by the hospital emergency number operator. I check my phone. An Uber is 3 minutes away. I book it. We quickly change and prepare a bag of whatever maternity supplies we had purchased so far (and we hadn’t purchased much; we still had 5 weeks to go for crying out loud!).

The Uber arrives. We get in. The conversation is limited. My wife and I are holding hands. My voice is steady when I speak. I smile convincingly at her. I tell her that women regularly confuse pee and amniotic fluids. But we both know that is not the case here. In my head I am marveling at how good our driver is. He can make out that we are in a panicked state. He can see my pregnant wife. He knows we are heading to a hospital at 12:24 AM. But he drives steadily and still makes it to the hospital at 12:31 AM (I have archived that Uber receipt – sappy sentimentalist that I am).

We are admitted and kept in one of the Induction Rooms (I realized later that this was a temporary room where women were kept while they were in labour, before being taken to the operation/ delivery room).

The attending doctor arrives. After questioning us she performs an examination (intrusive and a little painful, but necessary). No fluid is being ejected at the moment. We must be mistaken. This has been a very normal pregnancy so far. No indications of a premature birth. It was probably pee – she tells us. But they will keep us for observation overnight. The thin veneer of composure I had cocooned myself in is beginning to crack at this point. I want to wring the doctor’s neck. My kid is in that amniotic sac, surrounded by no amniotic fluid. He/ she (at this point we did not know if we were having a boy – Indian law prohibits identifying the sex of a foetus – thank god for small mercies) could be in danger.

Time slows down to a crawl. Another 20 minutes or so pass by. More fluid is ejected in a slow trickle. The doctor confirms – it is amniotic fluid. Things begin to move rapidly again.

I deal with stress by making myself comfortable within the confines of the situation that is causing all the stress. And comfort comes from familiarity. So I proceeded to familiarize myself with every aspect of my surroundings at Cloudnine in the six days we were there. It started with the room we were in. I read the instructions on every medicine and every piece of medical supply. I figured out a pillow I favoured. I chatted with the nurses. I walked around the emergency area. The people running the hospital canteen became friends. I worked out backstories for the doctors working the night shifts.

But in the first 32 hours at the hospital before our son was born, it was the GE Corometrics 170 Series Fetal Monitor – an incredible piece of human ingenuity – that was the greatest source of comfort to me.

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There was barely any amniotic fluid around the baby at this point (as a scan showed us the next day morning). The chances of catching an external infection were increasing with every passing hour. But the doctors wanted to administer two doses of steroids to my wife – which would act upon the baby through her bloodstream and aid in the development of the baby’s lungs (which go through their final phase of development in the last few weeks of gestation). The steroids had to be administered at gaps of 12 hours and would take a minimum of 12 hours to take effect.

The Corometrics 170 was our primary means of keeping track of the baby’s health inside the womb. The sensors from the monitor are placed on the mother’s abdomen and can accurately measure the baby’s heart rate and movement. The fact that he was doing well – strong heart rate and good movement – comforted us.

By 28th night/ early 29th morning we were even beginning to feel a little bored and claustrophobic inside the hospital room. Many pregnant women had come and gone from the neighbouring rooms. Labour pains are nothing to joke about. They are loud and intense. And the wooden walls of our room didn’t help.

At one point we heard an older lady (we were not sure if she was the mother or the mother-in-law) exclaim in a very matter of fact way: “Why are you moaning and screaming so much? Keep your mouth closed when it hurts.” She had the “kids these days” tone of voice. I couldn’t imagine my mother or mother-in-law saying this to my wife.

My parents were arriving on the 29th morning. My brother-in-law was on the phone with me regularly. No other visitors were allowed in the emergency area. It didn’t make sense to call up friends – why create unnecessary panic.

We passed the time by playing Settlers of Catan on our iPad. My wife was not in any physical pain. The breaking of waters had not triggered any labour pains. We were just waiting for the steroids to take effect. After which getting the baby out safely was the doctor’s top priority. This meant a C-section.

C-sections have become very commonplace these days. One out of three children in the US are born through a C-section. But it is still a major surgery. We had hoped for a natural birth, but the situation was now out of our control. The jury is out on the long term benefits/ repercussions of such a procedure on the mother and child.

My uneasiness around hospitals was magnified multi-fold by the impending surgery. I have never been queasy about blood or pain when it comes to my own body. But I wasn’t sure how I would take a major surgery being performed on a loved one.

My wife had been prepped for surgery and had met my parents and brother-in-law while she was being wheeled into the operation theatre. I was asked to change into scrubs – which had the words “Super Dad” printed on the side. The doctors would let me in once the baby had been taken out. I really wanted to cut the umbilical cord.

So I waited in the lobby outside the OT. C-sections are incredibly fast. A seasoned doctor can finish the procedure in a matter of minutes. [The stitching up takes time and is usually performed by junior doctors.] But these few minutes were the longest and most difficult of my life. A whiteboard in front me had my wife’s name. Under it were the words: Primigravida (a woman who is pregnant for the first time), 34+ Weeks (the gestation stage of our baby) and PPROM (preterm premature rupturing of membranes). I like abstractions. But seeing my wife and child reduced to a few symbols played havoc on my already frayed nerves.

And then it happened. A nurse ushered me into the OT.

“An army of doctors and nurses on a battlefield. So much blood.” That was my first impression as I walked into the incredibly large OT. The baby was out. The doctors were moving to the next stage of the operation – clearing out the placenta, etc. A screen ensured that my wife could not see the actual operation. She looked groggy but had a smile on her face. Another set of doctors were carrying over a screaming purple bundle towards a neonatal incubator on my side of the room. It was a boy. We had just had a boy!

I was holding back tears. I looked at my wife and showed her two thumbs up. “All fingers and toes accounted for”, I reported to her. She closed her eyes and zoned out. I called to the doctor standing next to her head, “Is she alright?” It was the anesthesia. I looked down at the baby. He was getting a few shots and the remaining umbilical cord was being cut. “Wasn’t I supposed to cut it?”, a part of my brain protested but no actual words came out. “They have everything under control. Things will be alright.” I told myself. My wife suddenly opened her eyes and shouted at me, “Why didn’t you cut the cord?”

Things were going to be alright.

I was ushered out of the room. I changed out of my scrubs and walked out into the waiting area. I was engulfed by my family. I could finally cry.

I am changing the title of this post again! 2300+ words in and there is still a lot of ground to cover. We will need a Part II and perhaps a Part III. Up next: Babies and Product Design.

Fatherhood Files: The First 50 Days – Part I: The Birth
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