Becoming a Dad in South East Asia

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Cutting the umbilical cord as part of the VIP package I didn’t know I’d bought yet

I came home from work last June and my wife was having some cramps.  In hindsight, it was probably Braxton-Hicks cramps.   Pregnant women get these cramps near the end of their pregnancy.  My wife said it was time, that the baby was coming tonight.  I did not agree that it was time, but I wasn’t pregnant, so her opinion naturally counted for a lot more than mine.  So I did my part and drove her to the hospital.

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Hospital #1

I’m American, but I live in East Java Indonesia with my Indonesian wife.  We’d been married about 8 months at the time.  It was too early for the baby.  I’d talked to some other guys about what to expect.  How would I know when to take her to the hospital?  This was kind of important because we lived anywhere from 45 minutes to three hours’ drive to the hospital, depending on the time of day and traffic conditions.  I was given some solid advice.  I was told that there would be no doubt when it was time.  They said if I feel any doubt, it’s not time.  So as I was driving my wife to the hospital that night, with considerable doubt that it was time, I knew that it really wasn’t time yet.  I had complete confidence in the doctor to check her out and send her home.  I figured this happens all the time, especially with first time moms.  Since we’re uninsured and living in another country, I was paying for all this out-of-pocket and my wife had chosen a popular hospital that approached American/European standards of obstetrics.  I figured they’d check her out and tell her it wasn’t time yet and we’d go back home to wait.  I was sure that’s what would happen.  I thought we were getting close, but it was still too early.  We might wait weeks longer.

And I was right, at least right about it not being time yet.  What I was wrong about was that the doctor would send her home.  My wife wanted to have the baby naturally, if at all possible.  So she picked a well-known doctor who was supposedly the man to use if you wanted a natural birth.  When I first met him, he invited me to play golf in Bali.  That should have been a clue.  I’d imagine it’s hard to be a golf enthusiast on the natural schedules of childbirth, but I didn’t think twice about it since it’s common that doctors enjoy playing golf.

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Arriving at the hospital, Facebook photo.

They said the baby was coming, so we were pretty excited.  I posted a picture on Facebook of my wife being rolled to the elevator in a wheelchair.  They parked her on a wheeled hospital bed by the nurse’s station to keep a close eye on her.  We were there about 36 hours, give or take.  It was just miserable.  There was no need to be there.  There was nothing to do.  The doctor checked on her once or twice during that time while he was making his rounds.  He said if the baby didn’t come a little faster, he’d have to induce her with a drug called Pitocin (sounds like pah-toe-sin when they say it).  We objected for a while, but the doctor eventually wore us down and my wife accepted the Pitocin.  They gave it to her on an IV drip.  The doctor said the dilation was taking too long.  My wife was one centimeter dilated and the doctor felt she should have been four or five centimeters dilated by then.  He told us that this was bad for the baby and stressful.  The way he said it was that it was if the baby was being hit each time there was a contraction and that we were prolonging his beating and we should move the labor along with this drug, which is apparently the same exact hormone that women’s body produce.  The doctor described it as a love drug that would have pleasant side-effects and make my wife feel happy.  That was not her experience, but that’s what he said at the time.  We should have said no and gone home, but this was our first rodeo.

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Hanging out by the nurses station, waiting on something to happen.

So the Pitocin worked.  My wife definitely started having cramps and things changed a bit.  I think it was then that she realized she probably should have stayed at home in bed, but that ship had sailed.  We felt less and less trusting of this doctor and since I’d posted that picture on Facebook of my wife arriving at the hospital and being moved in a wheel chair, advice from  American, Australian, and English moms, doctors, nurses, and midwives began to roll in that reinforced our resolve.

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Looking at the newborn babies while on a Pitocin IV drip. Every baby that turned up in the viewing gallery was delivered by cesarean at this hospital.

After a while, the cramps kind of eased up some, so they gave her another dose of Pitocin.  After a while longer, they wanted to give her a 3rd dose of Pitocin. The doctor said it had been long enough and that my wife should have a cesarean.  He told us this was dangerous for the baby and described again how the contractions of the muscles causing the cramps were sort of like punching the baby.  He gave us a deadline and told us it was derived from a UNICEF standard timeline.  My wife had been in labor too long and now it was necessary to perform a cesarean. We weren’t convinced at all.  Nothing seemed wrong.

Another factor I began to suspect at this stage was religious in nature.  It was around the 10th day of Ramadan, the Muslim fasting month.  Indonesia is the world’s largest Muslim country and most or all of the hospital staff were fasting.  During the fasting month, everyone wakes up around 3 am and eats breakfast, followed by prayer.  Then they don’t eat or drink again until the sun sets.  This lasts for 30 days.  People become very lethargic.  Sometimes people faint.  It’s very difficult to focus at work, especially later in the day.  I’ll never know for sure, but this seemed like more incentive for pushing moms to agree to a cesarean. Not only are cesareans more predictable, they are more profitable, so that too.

The decision to leave the hospital was one of the most difficult in my life.  By then, my wife was relying on me to help her make the right calls.  I didn’t trust this doctor at all, but he was a doctor with considerable experience delivering babies.  I had none, but I had some facebook friends with considerable experience too.  They were sending us articles to read and videos to watch.  There was one documentary in particular called “The Business of Being Born” that really impacted us the most.  Everyone who’s never had a baby before should watch this on YouTube.  Another key piece of evidence was the ratio of natural births to cesareans for the babies being born over the 40 hours we were there waiting by the nurses station.  Nearly 2 days had passed and every time a new baby appeared out by the viewing window, we’d ask about the delivery.  Every single baby out there was delivered by a cesarean.  There were 7 or 8 in a row by the time we left the hospital, all cesareans.  I know cesareans are sometimes needed, but it was clear to me that the staff in this hospital believed that cesareans were always necessary, so paying attention to that metric gave us a bit more confidence in ourselves to make the decision to leave against the doctor’s advice.  He wasn’t suggesting we stay and get a cesarean, he was very adamant that we were making a big mistake.  Being nearly 40 years old when this happened definitely helped.  I don’t think I would have had the confidence to override a doctor’s orders if I was much younger or if I’d have been in a western country where I unquestioningly trust doctors.

My wife wasn’t in great condition, but she could walk around and she was so sick and tired of that stretcher bed by the nursing station.  I paid $800, mostly for the Pitocin IV’s, and we left the hospital with the plan that we’d return when she was nearer to delivering.  We wanted to get away from the high pressure for a cesarean.  My wife signed a paper that released the hospital of liability for the decision and we left.

At the time we had a house outside of the city near where I worked that I described in the beginning of this story, but we also had a small apartment in the city.  It wasn’t much bigger than a hotel room, but it was new and comfortable.  Since the house was an hour away, at best, and my wife was definitely in labor now, our plan was to sit there in the apartment until she progressed a bit farther along.  We didn’t want to go back to the hospital until all they had left to do was catch the baby.  We figured they could manage catching a baby.  We were worried that if we went any earlier, they’d do an unnecessary cesarean.

I definitely didn’t have 100% confidence in our decision to leave the hospital, but it wasn’t a good time to doubt and second guess.  It was becoming apparent that husbands sometimes do more than drive their wife to the hospital.  She was relying on me to help her make good decisions.  She only trusted me.  She didn’t even want her mother around, just me.  Being in a conservative, Muslim country, I husbands weren’t welcome at the breathing classes my wife attended to prepare for her labor, so I was doing what I could to catch-up by watching YouTube videos and asking questions on Facebook.

Nothing really happened for another 10 hours, except that we kept further educating ourselves.  I remembered that my sister-in-law in Utah tried to walk her second baby out.  Near the end of her pregnancy, she walked around the neighborhood often.  The apartment was right next to a shopping mall, so we went to the mall and walked around.  When my wife had contractions, she’d just squat down there on the shiny, waxed floor of the shopping mall.  Nobody stared or even seemed to notice.  It was a weekday, during working hours and the mall wasn’t so crowded.

After a while, we went back to the apartment and the contractions started getting more intense and closer together.  I’m not a real private person and I share most everything on Facebook, so people were following along from Chicago to Sydney and trying to help as best as they could.  We were in somewhat unusual and unique circumstances, so I think people found it interesting and worried about us.  Someone suggested that we download a contraction timer app for our phones.  That’s another key point if you’re a dad-to-be.  Download a contraction timer app, there are many to choose from and probably most of them are about the same.  It’s essential for accurate data collection and the frequency of the contractions is the real clue about how close a woman is to giving birth. I suppose you could just use your watch too, but this makes it easier.

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Contraction Timer App.  Looks like I timed the last one around 1 am.  The baby arrived a little over an hour later.

My brother and his wife used a doula (another word for mid-wife) when they had their second baby in Salt Lake City, Utah and they were following along on Facebook.  My sister-in-law got in touch with the doula and explained that I was in South East Asia in a Muslim country during the fasting month with a first time mom-to-be doing my best to avoid hospital billing and scheduling scams while trying to figure out how to deliver a baby myself if that’s what was necessary.  I didn’t really think I’d have to deliver the baby, but I figured there was a higher probability of that scenario given the circumstances I found myself in at the moment.

We got the doula on the phone and in summary she was awesome.  Here’s a link to her if you’re in Salt Lake City and interested in doulas.  I’d highly recommend a doula, even before a doctor now that we’ve been through it.  A pregnant woman isn’t sick, but she needs experienced help and these doulas seem like the best option.  We still feel fortunate that we connected with her halfway around the world in our time of need. She told me some things I could do to make my wife feel better.  She said my wife should get on the floor on all fours and whenever she had a contraction, I should press her hips together.  My hands went on each side of her hips and I just squeezed her hips back together as hard as I could.  My wife said this felt really good.  I don’t know if it felt really good or just made it feel less bad, but I did this as often as she wanted.  For a woman in labor, it must feel like her hips are exploding outward, so pressing them back together must give her some temporary relief.  The other move that helped was pressing down on her tailbone while she was in a squatting position.  The doula told my wife to growl like a bear.  She said to make an “aaaaarghhh” sound to help release the pressure.  It was kind of weird, but it must have helped because she kept making that bear sound during her contractions from then until the baby was born later that night.

The doula was pretty calm and didn’t think we needed to worry.  She said that when the contractions were 3 minutes apart, 1 minute in length, for 2 hours, that’s when we should go to the hospital (remember that ratio, 3-1-2).  My wife hadn’t lost her mind and wasn’t crazy, but she’d definitely gone into some sort of primal mindset.  She stayed down on the floor on the new shag carpet we’d gotten as a wedding gift and was on all-fours, growling like a bear.  I remember the advice the experienced father’s told me and I shared earlier in this story, if you have any doubt, it’s not time.  As I was watching her there on the carpet on all fours, growling like a bear, I no longer had any doubt.  I knew the time was near.

The miserable experience of sitting by the nurse’s station on an uncomfortable mobile bed for 2 days on Pitocin IV drips must have affected my wife.  She wasn’t in a hurry at all to go to the hospital now.  The hospital she picked was across town, but there was another one less than 5 minutes away.  I liked the close hospital better and she’d been to all of her OBGYN appointments at this hospital because it was close to the apartment.  It was very new and is the most popular hospital for expats in this city.  It’s also the most expensive hospital in East Java.  The same doctor would deliver the baby at either hospital, so my wife felt that we should save the money and go to the cheaper hospital.  Her choice was definitely a more popular choice among the moms in town.  I didn’t question her decision, but now I was starting to wonder if I’d have time to drive across town.  I didn’t want to end up delivering a baby while trying to save a few hundred dollars.

Contractions were 3 minutes apart and 1 minute in length for 2 hours.  We crossed that milestone.  I kind of changed too, maybe not in the primal way that my wife did, but I was unusually calm.  I felt like a quarterback driving down the field, down by a touchdown, and the clock was running out.  There was plenty of reason to be stressed out and to freak out, but I knew that wouldn’t help my wife and more than anything, I wanted to help her however I could, so I stayed cool as ice.  My tone of voice was relaxing.  I stroked her hair.  I told her everything was just fine and she was doing great.  I really wasn’t sure that was all true, but I made sure that there was not a hint of doubt in my voice.  For the 2 minutes between every contraction, it was pretty chill.  I tried to emphasize that this was most of the time and during the intensity of the contractions, I’d countdown how close she was to that calm period every time.  “Already half way.  Nearly done.  Keep breathing.  I’m proud of you.  You’re doing so good!”

We’d kept my wife’s parents in the dark until then, but I didn’t have any confidence that I could find my way around this big city through the lawless and congested streets back to the hospital at midnight, so I called my wife’s mom and dad and asked them to come help us get to the hospital.  I said not to worry, we have plenty of time, but I was hoping they would hurry.

They came over straight away and walked into the room to see my wife on the floor on all fours, growling like a bear and completely flipped out, especially her mom.  I guess I kind of get it, but they weren’t being calm and telling my wife she was doing a good job and not to worry.  They were very distressed and frightened. My wife told me later that she’d decided she’d have the baby there on the floor before she went back to that terrible hospital, so her mom’s hysteria proved useful.  My wife finally agreed it was time to go to the hospital and I went down and moved the car to the door.

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My wife’s water broke right there on this rug where the baby plays now.  He’s 11 months old this week.

Then her water broke, there in the apartment on the new carpet we got for our wedding.  She immediately thought the baby was coming out.  The pain must have been immense.  It went from loud moaning and screaming every few minutes to just constant crying and pain.  She couldn’t think straight and could barely walk, even with assistance.  There was no way I was going to attempt to drive her across town, so I drove her straight to the hospital I could see from the apartment.  It took about 3 or 4 minutes and I think I caught some air on a speed bump. I pulled up to the emergency door and dropped her off with her mom and dad and I pulled around and parked the car.

I was gone 2 or 3 minutes parking the car and when I walked through the door, I went almost immediately to the delivery room after waving off a guy who wanted to shuffle papers with me.  The delivery room was very spacious and nice.  I was pleased that we were at this hospital and not the first one.  It seemed so much nicer.  My wife was up in a chair/bed sort of thing that was clearly designed for childbirth.  A nurse was between her legs.  I only found this out later, but she had her finger pressing on some muscle to keep my wife from pushing.  The doctor was on the way and they didn’t want the baby coming out until he arrived.  The baby was ready to come out, but maybe they weren’t confident delivering the baby or maybe they thought they couldn’t charge us the full fee if the doctor wasn’t there?  I don’t know for sure, but to his credit, he turned up pretty fast.  My wife had sent him a message that we were leaving and going to the hospital, so I assume that he was already en-route when we arrived.

We arrived at 1:51 am and the baby was born at 02:19, so it didn’t take the doctor long and as soon as he arrived, the baby came out.  It was a Friday, the best day of the week.  I stayed up near my wife’s head and never looked down to see what was happening.  I didn’t really want to see.  I smelled poop at one point, so I stand by my decision.  I’m pretty sure there was poop, but it’s plausibly deniable that there was not and I didn’t look at it directly.  There was a garbage can right beside here where the collected all the blood and guts and probably the poop.

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This white baby came out of this brown woman. She dreamed of him before and told me that he looked like this in the dream and I told her it was impossible because of the laws of genetics.  I was wrong.

My wife is brown, so I expected a brown baby to come out, but he was as white as snow, like me…maybe slightly grayish.  He cried almost straight away, but for about half a second, I held my breath but he didn’t keep me in suspense for long.  When he cried, I knew everything was ok.  I was just really happy and relieved.  Maybe the happiest I’ve ever been, but I don’t want to get too mushy about it.  The doctor handed me some scissors and directed me to cut the umbilical cord.  I hadn’t planned on doing that and wasn’t excited to do it, but he was really insistent, so I cut the cord and assisted with the removal of some of the afterbirth still inside my wife.  I remember laughing to myself, what am I paying this clown for if I’m even removing the afterbirth?   Someone was there taking pictures of all of this.  Turns out I was the clown.  I was paying extra for this part of the experience!

IMG-20160611-WA0003My father-in-law came in the room and started praying over the baby in Arabic.  Within about 10 minutes they took the baby away and the nurse motioned for me to follow.  They didn’t need to ask me twice.  I’d resolved to keep my eyes on him because I didn’t know what happens next and I didn’t trust anybody.  They gave him a vaccination in his leg for Hepatitis B.  He didn’t seem to notice at all.  They asked me how to spell his name.   I caused an error that probably will haunt him for the rest of his life at that point.  His name is spelled just like mine, he has the same name as me, with a “II” on the end.  I insisted that they put “II” and they seemed hesitant.  I thought he can’t have the same name as me, it needs to have “II” on the end to denote that he’s the second.  I’m senior and he’s junior.  I’m a dual national citizen of Australia and America, so a few months later that caused some drama when I was working on getting his Australian passport.  It seems that Australia doesn’t recognize suffixes on names.  It’s a very minor issue, but I wouldn’t put that “II” on that form if I had to do it again.

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The recovery room we planned to use at the first hospital, but things didn’t go to plan. It had a bed for the dad and a couch too.  I think it was $250 a night with no insurance.

Then they moved my wife to a big fancy room.  I wondered what was happening because this hospital was significantly more expensive than the other hospital where we’d planned to deliver the baby (pictured above).  It turns out that in the 2 or 3 minutes it took me to park the car, my in-laws had signed us up for the “VIP Delivery.”  The nurse asked does she want the VIP delivery and they said yes.  I walked in and signed some 20 page form at the bottom and went straight to my wife.  I got annoyed with the man because my wife’s water was already broke and he wanted to sit in the office downstairs and fill out forms?  So at around 3 am, when our baby was about 1 hour old, I got angry with the billing guy for tricking us like that.  All the photography and the big, fancy delivery room were part of the VIP package, so we’d already consumed part of it.  My wife didn’t want it either so they moved her to a shared room, which was empty except for her, so it was just fine.  I had to pay for what we’d already used, but not the fancy recovery room.  I wasn’t too mad about it, but it was annoying that we were taken advantage of like that in those moments.  I was a little disappointed in her parents for approving the VIP delivery too.  I mean really?  It was 2 am and her water was already broke.  There’s no VIP in that situation.  We were getting whoever was on night shift.

Twelve other babies were born during the time my wife was in labor, between the first hospital and the second.  All twelve of them were cesareans.  My wife was the only mom to deliver naturally.  The next morning she was walking around and in good spirits.  Not a single one of the other moms could get out of bed because they were healing from surgery.  Most of the other moms were Chinese and they prefer cesareans.  My wife was kind of the rock star of the new moms, the only one who’d pushed.  She wasn’t in the hospital even a whole day for recovery.  She checked out the following evening and took the baby home.  It might be harder and more painful to have a natural birth, but after it’s over, the recovery for many women is mostly instantaneous, like it was for my wife.  She didn’t miss a beat when we left the hospital.  She was out walking around with the baby, no bed rest at all.  Within a month, she was back in the gym.  That was worth all the trouble she went through.  We were both very happy that both my wife and the baby were healthy.  I remain proud of her for managing to have the baby mostly naturally in these very unnatural circumstances where everyone was trying to talk her out of it.  It was definitely our greatest bonding experience as a couple.

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Walking around the hospital a few hours after delivering the baby, maybe the greatest benefit of natural delivery.

The doctor told me we were very lucky before I shook his hand and he left the hospital.  I wasn’t even mad at him, just happy my wife and baby were doing so well.  I think he’s kind of an idiot, but I don’t know that he did anything on purpose.  I think it could just be the system.  I was much more impressed with the doula on the phone than the doctor.  We agreed that if we were in America, we’d just use her or someone like her for the whole pregnancy and deliver the baby at home.

The second hospital charged me $2,500 (that included the VIP stuff), and I paid $800 at the first hospital.  We anticipated that the cost would be less than $2,000 if nothing went wrong and maybe $4,000 if there was a problem and she needed a cesarean.  So in the end, nothing went wrong and I used most of the money allocated anyway.  I was still reasonably happy that it was within the budget and since it was our first experience, I was forgiving.

In Javanese culture, the placenta is buried or thrown in the river.  My wife’s family buried her brother’s placenta in the yard and they threw my wife’s in the river.  The hospital puts the placenta in a clay pot that looks like a flower pot so the family can take it home.  It’s really common here.  The superstition is that what you do with the placenta affects what becomes of the babies life.  Since my wife’s brother’s placenta was buried in the yard, he would stay home all of his life.  He’s 32 years old and still at home, so maybe it’s true.  Throwing the placenta in the river, like they did when my wife was born, means that the baby will travel places.  She married an American, so maybe that’s true too.  I’d climbed a mountain an hour outside of the city a few times and I had a spot picked out on the top, near the grave of an ancient Hindu king.  After a day or two, I hadn’t gotten away to climb a mountain and we got worried the placenta would start to smell, so I changed the plan and went down and threw in in the river.  My father-in-law went with me and we threw in approximately the same place where my wife’s placenta was tossed off a bridge by her uncle 28 years earlier.  There was a tall fence, probably designed to keep people from throwing things into the river, but I was able to do a basketball move and sort of launch it over the top.  The placenta filled clay pot made a satisfying splash when it landed right in the fast current in the dirty brown river.  It was kind of cool, a Javanese cultural experience.  Something different, something to talk about.

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Junior and Senior taking our first nap together.

Author: Aaron Hamilton

I'm a naturalized Australian who was born and raised in America. I've lived and worked in three US states and four countries over the last 2 decades. I married a Javanese flight attendant in Indonesia a couple of years back and we have two babies.

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