Sunday, October 10, 2010

Third child

Some animals mark their territory by pissing. We playfully tossed around the idea of marking the countries we've lived in by having a baby in each one. (Or perhaps more accurately, making each birth a souvenir of each place, and folding those countries into our family, at least symbolically.) I wasn't sure we would actually go through with it, but now we have. The U.S.: Aiden. Korea: Max. And now China: Felix. All boys, all born in May, but each in a different country. 

Pregnancy and childbirth are transformational experiences on the individual level (both physically and emotionally), but they also provide a kind of up-the-skirt glimpse at the values and prejudices of the society one lives in. When you're walking around with a big belly people feel free -- compelled, in some cases -- to give you advice. To warn you of the dangers of X and Y. To implore you to raise your kid This Way or That Way. Same thing when you're carrying around a newly-minted human being. I suppose that people see pregnant women and babies as a tabula rasa, a blank and forgiving slate, available for imprinting and for correcting previous wrongs. Pregnant women and babies represent a place for redemption, for individuals and societies. If you can just nip that problem in the bud and change someone else's life... the reasoning goes. So it's hard for people to keep their thoughts to themselves. 

Maybe because being pregnant draws people's comments so well, I feel like going through pregnancy and childbirth in each country gave me a chance to get to know each country better. In the case of China, it was my first real encounter with the medical system here. (Up to that point we had taken care of all of our medical needs in Korea, and just tried to stay healthy in China, where we have no medical insurance.) I don't think one can really feel comfortable living in a country unless one can comfortably bank, go to the doctor, and send one's kids to school. Now I have some experience with each of these, and it makes me feel more settled here.  

Anyway, sleep deprivation is no easier the third time around but I'll try to slap myself into semi-consciousness long enough to write some notes on this last pregnancy and childbirth. Not only am I tired and scatterbrained, but it's also been a long time since I did any writing. Starting blogging again is like starting exercising again: painful and clumsy. 

Third. In the U.S., having a third child is pretty ho-hum, but in China and Korea where birth rates are low, being a mom of three is much more unusual. Reactions upon discovering I was pregnant were interesting. In Korea, several people commented, ""육심이 많네요"; a case in a which I had trouble reading tone/nuance. [I'm having a hard time translating this: something like "you have a lot of desire/greed," but that doesn't really capture the meaning in Korean.] Was that meant to be a veiled criticism? Can't decide. In China, I got, "太多了!" (Too many!) Which just made me laugh. Many people speculated that I must be trying for a daughter, and several asked me if this baby was planned, which I felt was an overly personal question, but answered it anyway (yes, it was planned). In the early days, whatever I ate was scrutinized: my grapefruit cravings were a sure sign of a boy, but ice cream was a girl. My complexion was remarked upon many times (if your skin is good, it must be a girl). Later, the shape of my belly was commented on by almost everybody I walked by; I felt like a tourist attraction. The pointy belly meant a son for the Chinese, but for the Koreans it is the opposite. (In this case the Chinese were right.) I also got scolded for walking around so much, and after the baby was born, for being out and about so soon after giving birth, and for not putting socks and a hat on my newborn. Nobody asked me why I wasn't wearing one of those radiation garments, probably because I'm a laowai, but all the pregnant Chinese women were wearing them (an ugly smock that is supposed to block electromagnetic radiation). 

Hospital. We decided to have the birth at International Peace Maternity, a Chinese hospital specializing in women and children's health, in the VIP section. There's really no qualification to become a "VIP" except willingness to pay about ten times more than what the regular people pay, and for that you have fewer lines, better facilities, and doctors who have some international experience/training. I chose a Chinese hospital for two reasons: first, as a hospital that deals with so many births every day, it is well-equipped to deal with all sorts of emergencies, and it has an in-house NICU. The international hospitals provide an atmosphere that may be more like an American hospital, but the care is not necessarily as good. The second reason was financial; we don't have health insurance in China and delivering in a Chinese hospital, even in the VIP ward, is two or three times cheaper than in an international hospital. 

Peace is a pretty popular place for expats to deliver. I know a lot of women who have had their babies there. And for that reason it's hard to get an appointment, even at normal times, and it may have been more crowded than usual when I was pregnant because people were trying to have an "Expo baby." I called soon after I found out I was expecting and the first available time slot was not until my 19th week. So I ended up doing the first half of my pre-natal visits in Korea. 

Going back to Korea (to 차병원, which is also a well-known women and children's hospital) for half of my prenatals was nice and familiar, and my old doctor seemed very blase about this pregnancy, except for the maternal age factor. When the Triple Screen results came in, he said, "나이가 그렇고, 그래도 괜찮을것같아요." (something like: you're old but it'll probably be ok.)

Boy or girl? For the first time, I really wanted to know the sex of this child beforehand. But both Korea and China have policies prohibiting the disclosure of the child's sex, to prevent selective abortion of girl babies. In Korea the policy is changing, and in most local hospitals you can find out, but the larger hospitals  are still quite strict. I did my best to find out, pulling out the "I'm a foreigner!" card and the "I already have two boys!" card. I tried the subtler routes: asked what color clothes I should buy and whether the baby takes after me or my husband, but the ultrasound tech wouldn't even give me a hint. She told me to ask my doctor. Finally he told me, "아빠 닮았어요" (the baby takes after its father). In other words, another boy. At Peace, in the ultrasound room, they have a sign saying something along the lines of "don't even ask because we won't tell." 

First appointment at Peace. We were running late for our first appointment at Peace, so we rushed through the door without really thinking about what we would find. KC stopped in his tracks and said, "Oh my god, I've never seen so many pregnant women in my life!" It was a large room with tons of people standing in line, sitting in rows of uncomfortable chairs, and milling around. We headed towards the back where the VIP elevators are manned by a security guard, who looked us up and down and extended his hand towards the elevators, letting us through.

We took the elevator up to the 13th floor, where the scene was more peaceful. A large room with sofas, with a circular nurse's station in the middle topped by a chandelier. An espresso machine in the corner. Free bottles of juice and water plus packs of crackers and candies in bowls around the room. Most of the sofas were full but it was nothing like the cattle driving going on downstairs. 

Procedure-wise, it was much like Korea: check in, stand in line at the cashier, provide urine sample, get weighed, wait. Later: make appointment, pay for any remaining tests or medicine. Like Korea, there's a production-line structure to hospitals that enables clinics like this to see many many people in a short time. 

We met the doctor in a very large room, larger than our largest bedroom, but empty except for the desk, two chairs, and an examining table. After we talked for a bit the doctor asked me to take off my pants and lie down, but there was no sheet, no curtain, no barrier between me and the very large room. It felt odd. I mean, there's a chandelier outside but you can't give me a modesty sheet? The sheet, if you think about it, doesn't really do anything, it's just something extra to wash, the doctor and husband are going to see everything anyway in a moment, and there's nothing really to hide, it's just psychologically comforting, like a security blanket. 

This (what Americans would consider) lack of privacy was the main thing I noticed in the medical arena. When waiting in line for the cashier one day, a doctor and patient standing a foot away were immersed in a conversation which I think was about the patient's miscarriage. (Could be a misunderstanding, since it was in Chinese and I missed the beginning, but it was about how there was no heartbeat, how there is usually no way to know the reason, how the patient should try again, and get prenatal care earlier.) 

Check me out. The sizing up of patients is the same, or similar, no matter where you go. When I was admitted to give birth to my first baby, in the University of Michigan Hospital in Ann Arbor, I remember the nurse watching me for a while and then proclaiming, with a decided air, "You're going to do just fine." In Korea, while I was in early labor (3cm or so) there were two nurses hanging out in my room just waiting for things to get exciting, I guess, and we were all listening to the screams from the woman in the room next to mine. They commented, "She's having a hard time." And then looked at me and said, "You don't seem to be in any pain at all." You're weird, seemed to be the unspoken question. Then they gave me pitocin and I think I made enough noise to satisfy them after that.

It would be fascinating to do an enthnographic study of Labor and Delivery nurses, who have to deal with all manner of laboring woman, probably learning to diffuse each one like a different type of ticking time bomb. They seem to have their own codes and theories about what makes a woman easy or hard, or even what makes us go into labor. I arrived in the hospital in Ann Arbor for my first delivery after a tornado had gone past town, and was informed that the hospital was full. "When the barometer drops, everybody goes into labor," the nurse told me. In labor for the third time, when I approached the nurses station and announced that I was having contractions, the nurses gave each other a look. "A lot of people today?" I asked. "Four already," the nurse said, and gave a little chuckle. 

Anyway, perhaps (probably) because it was my third, the nurses and doctors here seemed relaxed about this pregnancy. They kept telling me, "No problem. It's going to go fast." And during labor, they for the most part left us alone, which was wonderful. We had a button to push if we needed anything, and got to labor the way we wanted. And after the birth, we were also left to enjoy our baby without much intervention, especially at night. In Michigan and Seoul people were coming in every hour, day and night, and I couldn't get any rest at all. Because of that, this last birth was the most relaxing. 

Show me the money. Since we didn't have insurance, we needed to deposit 30,000RMB before giving birth; this would be about the cost of a C-section should I need one. On the day we checked out of the hospital, an administrator came around with a large bag and a bunch of papers showing how much we had actually spent (less than half that amount, since it was an unmedicated natural birth), and then reached into her bag and started pulling out large wads of cash. "Count it to make sure it's correct," she told us. Ha! Someone should have told us we'd be taking home two important bundles: one with a baby and one with a lot of cash. Take note, Chinese robbers! The administrator remarked that she was returning a lot of cash that day because so many people had had natural deliveries. 

Baby Swimming. Another unusual experience in China was the baby swimming. I had seen advertisements for this in the subway stations and thought it looked really strange. Basically, they put little inner tubes around the baby's neck and let the baby swim in a small, tall tub of warm water. On Felix's second day of life the nurses asked us if we were interested in having him try this plus an infant massage for 100 RMB (less than 15 dollars). Sure, why not? The nurse woke him up, which he was not happy about, stripped him and put a piece of tape over his belly button stub, and put the tube around his head, all of which made him cry. But the minute he entered the tub he grew calm. He wiggled his little legs looked around very quietly. We were amazed. I suppose that being immersed in warm water must have felt familiar and comfortable for him, despite the big tube around his neck. I later ordered a tube on the internet and have been letting him "swim" every few days in our bathtub. It takes a lot of water so I don't do it every day, but he continues to love it. Our tub is not quite deep enough, so his feet touch, and he can push himself from one end of the tub to the other, and flip so he's somewhat stomach-down or back-down. 

Breast Massage.Another option in the hospital was to have a breast massage. I had just watched a good friend of mine here in Shanghai go through a terrible bout of mastitis, having to be put on IV antibiotics and finally having to have surgery to drain the infection. One of the things she ended up doing to help was having a breast massager come to her house and unclog the blocked ducts manually. Apparently there’s a branch of Chinese medicine that does breast massage. I got to watch once, as the masseuse rubbed and pulled at the breasts, spraying milk all over the place, and getting small back and white things to come out, which I guess were what was blocking the ducts. Pretty gross.

So when given the option to have a massage at the hospital I took it. I imagined it would be done by a person and that it would be painful, like my friend’s had been, especially since my milk had already come in and I was quite engorged, especially on the left since Felix seemed to prefer the right. But in the hospital it was done by a machine. A nurse came in with the big machine, and put two flat, round, black rubber pad-type things on my breasts, which emitted some sort of pulse. It was actually quite nice and not painful at all. Afterwards the nurse helped me express some of the milk from my rock hard left side. She got about an espresso shot amount out of it, still orange from the colostrum. “Drink it,” she said. “Don’t let it go to waste, this is good stuff.” It was far sweeter than I had imagined.

The small plastic cup she expressed the milk in (like an espresso shot size) was what they use to feed the babies in the nursery. I’m not sure why they don’t use bottles. Interesting.

Head or Tail? I was curious, this time around, to see how the midwife would hand the baby to me upon birth. In the U.S., I received Aiden head-first, so my first view of him was his face. In Korea the nurse handed me the baby butt first, so I got a good glimpse of his balls and penis, as if the nurse was allowing me to confirm that yes, this is indeed another boy. I don't know what to make of that, is it a cultural thing or just an accident of that particular hospital or nurse? 

Anyway, in China I again received the baby butt first. Hmm. 

Naming. Each of our kids has a Western first name and a Korean middle name on their American passports (their Korean passports just have their Korean names). It takes us a long time to come up with the first name, but we have total control over that process. The Korean name is more logistically complicated. The second part of the name is generational, so each kid has the same character. My in-laws have employed a name-maker to come up with options for the first part of the name. The name maker is someone who specializes in coming up with a good name for the child, based on the parents' and the child's birth dates and times. For Aiden, we knew we would only have a few days  to prepare a name, so we asked the name maker to come up with some suggestions despite not knowing exactly when he would be born. He gave us 5 options and we chose one of those. When Max was born, we had more time to employ a name maker, since the Korean hospitals give you more time to come up with a name. Still, the process was quick; it only took a day or two if I remember correctly.

This time around we called KC's parents soon after the birth and asked them to get on the name-making process. But they didn't understand, and it didn't occur to us to explain, that we needed the name within the next 3 days in order to put it on the birth certificate. They had decided to employ a high-end name-maker who needed a week. After some back and forth the name-maker agreed to give us a name on the third day but we would have to call him to get it. 

I was surprised how nervous we both were, waiting for this name. We called the name-maker from the hospital room (via skype) and he gave us three names. We chose one of those right away, and then ran into problems right away, since the character we chose, (빛날혁), is kind of an older character, not really used in modern Chinese. Would they be able to put it on the birth certificate?

It turns out that they were able to. So Felix's birth certificate has both his American and Chinese names. Pretty cool. 

42-day checkup. At Peace, mothers and babies come for a joint 42-day post-partum checkup. All the moms and babies are taken to the waiting area where the babies are weighed, one by one, and then sent one by one to see the pediatrician and the Ob/gyn. The weighing was quite funny to me: all these moms and grandmas and ayis crowded around their little baobaos, but watching all the other babies, sizing them up. Felix was the first to be weighed, since we arrived first (I finally learned to be the first one there in order to get out in a reasonable amount of time). He was quite small still, having been born 3 weeks early and exclusively breastfed (he is not small now, he is quite a porker). One mom abandoned her baby to grandma to stand by the scale and comment on all the other babies' weights. She asked the nurse, "Is that baby also 42 days? He is so small! He's only half the size of my baby!" Then after her baby was weighed, she crowed happily to him (and the whole room) "你是第一名!" (You're in first place!) He was a really big baby, must have been 5kg. The women were all busy exchanging information about whether they were doing breast or bottle, how much their babies were sleeping, etc. I listened to them, exhausted, remembering what it was like to have my first child, back in the days when I had no idea what I was doing, when I was hyper-conscious of what other parents were doing. Back when I gained a sense that I was doing ok as a parent by constantly comparing myself and my child to other moms and their children. Imagine a whole room of first time parents, all vying for some sense that they have a handle on things, trying to fight off that sense of panic that comes with being a parent for the first time and having your life changed completely as quickly as someone pulling the rug out from under you. Now imagine a society where almost all parents are like that, because they only have one child.

On that note, the Korean ajumas say that moms of three boys are 깡패, gangsters. I've got to go knock some heads, but will try to keep up the blogging now that I've started again.  

Note: Thanks for the comments, everybody! I have figured out how to email my posts, but I have not yet figured out how to approve comments from behind the Great Firewall. So keep the comments coming, but be patient with them appearing on the site. I still get a lot of spam so I don't want to set it to automatically post comments. I will figure it out soon. 

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