Prenatal / Labour & Delivery / Maternity Ward Tour & Giving Birth @ Royal Columbian Hospital

**EDIT August 2013**

Baby girl is 8 months old now! :D We had an ideal labour and delivery at RCH. My water broke at 2:20pm on November 25th, 2012. I laboured at home until 6:20pm until contractions were 3 minutes apart. Checked in at RCH at 6:45pm. Examined 4cm dilated, fully effaced. There was a traffic jam in L&D that night, so I laboured in the exam room for another hour or so, then got transferred to a proper delivery suite down the hall. Couldn’t manage to breathe in the gas without gagging, so we did the warm shower thing, and in the shower I got this major urge to push…panicked because it felt like the kiddo was going to fall out right then and there. Hubby pulled the help cord, and the nurses got me onto the bed. Examined again…fully dilated and ready to push! Didn’t get to do any fancy pushing positions – it was seriously all I could manage to just lie down. No drugs. It hurt. Coached pushing felt stupid…eventually body took over with some big contractions and the pushing Doc arrived just in time to catch the baby with a few pushes left. Awesome little girl born at 9:07pm. Put to the breast immediately after getting stitched up.

Had to ring the nurses a lot to help me with breastfeeding and the crying and refusal to be put in bassinet etc. Seems like they sometimes give conflicting advice…but I guess they’re trying all different methods to help you solve a problem so that’s probably why. Baby had a rough second night (we got a 10 pounder with a set of operatic lungs for roommate, sigh) and I had to hold her skin to skin the whole night…which majorly freaked me out that I was going to drop her when I fell asleep (the back to sleep campaign put the fear of the Lord in me) but you do what you have to do to get through. Anyway, we got off to a good start with breastfeeding and that still remains one of my greatest joys.

And yes, I did get to keep my placenta. Go back to the L&D floor afterwards and ask the desk for it. Just don’t leave it too long otherwise I guess they send it away for disposal or whatever.

I wish you, dear reader, the best of birth experiences.
Post in the comments if you want to share your experience!

*ORIGINAL POST FOLLOWS*

I’m pretty darn pregnant with my first baby (35 weeks) at present. Went to the prenatal tour offered at Royal Columbian Hospital (RCH) today in New Westminster, BC. Great experience, so I want to share with you the details in case you’re looking to give birth at RCH as well.

Here’s the booking information I got from my doctor:

PRENATAL TOURS & PRE-REGISTRATION: Prenatal tours/Information sessions are available for you and your partner, usually when you are approximately 30-34 weeks. Space is limited, so please call to book when you are approximately 25 weeks. Please call 604-520-4956 between 9:00am and 4:00pm Monday to Friday. The hospital fee for tours is $25.00 per couple

The tour met today (Thursday) at 5:30 pm on the main floor lobby of RCH by the lottery stand. There were about 10 couples on the tour. The nurse who does the tours is named Jeanine (or maybe Jeanne?)…and she is GREAT. She has worked the labour/delivery unit at RCH for 35 years, and is now a lactation consultant in the maternity ward there. Her tour was very thorough, and she was clear and concise in all her explanations. Made my other 4 week prenatal class seem like a waste of time!

First, she explained that first, you call your doctor or midwife to let them know that you’re in labour. Then, when you come to the hospital in active labour, you go to patient admitting and register. The person driving you to the hospital can drop you off right outside admitting (by the emergency entrance) and go park the car. The best parking lot with no time restrictions (unlike the staff parking lot and street parking) is just west of the hospital where the daily maximum is $8.75. THEN you head up to Labour & Delivery. So we went up to the 2nd floor to visit the Labour & Delivery unit. We passed by the neonatal intensive care unit on our way to the assessment and birthing rooms.

In L&D, the first thing in the hallway is the ice/water machine, toaster and microwave, and the placenta fridge! The food fridge is further down the hall – no food in the placenta fridge! Yes, I am planning on getting my placenta encapsulated, so I will be making use of this fridge. The food fridge is for food you bring for yourself and your partner. They don’t feed any of your labour support team – delivering moms get fed 3x per day, but no one else – so it is imperative that you bring food so your husband or support person doesn’t get cranky.

Next, we went past the assessment room where they bring you after you have been admitted. They do an exam to check the progress of your labour and dilation etc. If you’re not in active labour, they’ll send you home for a while. Otherwise, they set you up in a birthing room. Note: if you have a midwife, you might skip the assessment room because your midwife will probably have assessed you at home before you decided to head to the hospital.

Then we all went into one of the birthing rooms. It’s not a terribly cozy scenario, but functional and clean. They have a variety of birth accessories there – birthing stools, birthing bars, birth balls, mirrors, and really encourage changing positions to help labour progress. Each room is also equipped with a shower (some rooms have bathtubs – request one upon admission and they will do their best to get you into a room with a tub if one is available). Labour partner should bring a swimsuit. She advised moms to stick with wearing the hospital gowns (they give you one for the front and one for the back so you’re all covered up if you need to walk around). If you bring your own gowns, make sure they’re really ratty – apparently they’ll get totally destroyed in the birthing process. There is a full sized (like high school) locker in this room – you need to bring your own padlock.

Then came the talk about pain control procedures. At RCH, the nurses will work with you to try to manage your pain first with acupressure, massage, breathing, showers, etc., but if you do need more, they will be there to help you make informed decisions. They offer nitrous oxide, morphine, fentanyl, and epidurals, and apparently each of them can only be applied during a certain window of your labour. I’m personally hoping that I don’t have to get an epidural, because I just don’t like the idea of not being able to stand up and walk around. But it’s nice to know it’s available if I need it.

If you need a cesarean section, one interesting thing is that in the last few years, they’ve changed their procedures so that after the surgery, instead of whisking mom off to the recovery room and baby and labour partner to another room, they try to regroup everyone back in one delivery room to recover if possible, and apparently, they are now able to do this in 75% of their cases. Sounds much nicer.

Then when the baby is born, they encourage immediate skin to skin contact on the mom’s chest and breastfeeding right away. They’ll dry off baby with a warm towel placed on mom’s chest. Interestingly, they don’t dry baby’s hands! Apparently amniotic fluid smells like colostrum, and the smell on their hands helps them find their first meal. Also, it was nice to find out that not all babies latch right away, so a couple hours before the first feed is normal as well. Labour partners are welcome to cut the baby’s umbilical cord if they so wish.

There’s a heat lamp and some fancy looking equipment on the other side of the birthing room so they can take care of baby in case he/she is in distress of any kind after the birth. They must also do a thorough assessment of baby before you are released from L&D.

Then we went up to the postpartum/maternity unit on the 3rd floor and visited the kitchen and one of the semi-private recovery rooms. They do 24 hour rooming in for baby and mom – they don’t whisk baby away to the nursery like they used to! There are cots available for semi-private and private rooms for your significant other to sleep on, but they have to bring their own sleeping bag. No cots are permitted in the 4-bed wards and SO has to sleep in a chair. Private rooms are $195 per night, semi-private $165, and is worth it if you have extended medical coverage (or don’t mind paying). The basic 4-bed ward is covered under your basic BC medical insurance. There are also lockers in these recovery rooms.

So the average stay for moms after vaginal birth is 24-48 hours, and 2-3 days after a c-section (not counting day of surgery). Again, they’ll feed mom 3x per day, but bring your own snacks! During this time, there are daily lactation classes at 10am, and a nurse will come in to your room to teach you how to bathe the baby. A hearing specialist will also come in to check baby’s hearing. They’ll make sure baby is properly secured in a CANADIAN certified car seat before you are discharged from the hospital.

And then finally Jeanine discussed all the procedures for SAM (self-administered medication), and wristbands for mom, significant other, and baby (x2), the little starter pack you get with 6 newborn diapers (ie. bring your own stash), some maxi pads (again, bring your own stash), a squirt bottle, and fun stuff like that. She also talked about the BC published Baby’s Best Chance guide as the one thing that you should definitely read during pregnancy that you should have picked up from the public health unit (mine actually got mailed to me!) as it is chock full of up to date and easy to understand info that is relevant to giving birth in BC.

Finally, she collects your $25 per couple fee (cash preferred, I paid by cheque payable to Fraser Health), and helps you complete your hospital pre-registration if you haven’t already registered.

So in summary, if you are considering giving birth at Royal Columbian Hospital, I’d HIGHLY recommend signing up for the prenatal tour. It was really a great tour. I feel much more confident now that I know the lay of the land a bit more so I won’t be anxiously wandering around the hospital wondering where to go when I’m in labour. Also, they seem to be well balanced with all the latest labour and postpartum and breastfeeding practices, which I like. Also, I’ve known two other families who have given birth at RCH, who have nothing but the highest praise for the care they received during labour/delivery/postpartum and recommended birthing there without hesitation. 

I’m not really into the whole homebirth-with-midwife scenario because I’m not comfortable with being even 10 minutes’ drive away from RCH if I happen to have sudden life-threatening complications. But that’s just me. I know plenty of people have had really pleasant and safe homebirth experiences but for this birth, it’s just not something I want to do.

So yes. Less than 5 weeks to go before baby girl arrives! I’m excited to face the whole challenge of labour and delivery. In some odd, perhaps sadomasochistic way, I really enjoy pushing my limits to see what I can physically accomplish. I used to row, and know what it feels like to push myself through muscles screaming 3/4 through a race or a time trial, still push through tunnel vision where everything else fades, you think you’re probably about to faint, and it’s just you and your goal. I’ve run a marathon without giving in to the temptation of walking, so I know what it feels like to be at mile 20, completely exhausted with aching joints, and break down crying over the thought at how brave Terry Fox must’ve been to do a marathon every single day, then keep going. It’s really neat to feel like you’re on the edge, that you’re really living. So in the same way, I hope to be able to experience a natural vaginal birth with baby girl, even though I know it’s probably going to…um…hurt.

My Favourite Things. Warning: Mostly Food – February 2011

Once in a while I like to write down a list of things with which I have recently become totally obsessed/enamoured.

1.) Ambrosia Apples. Bastard love child accident between a Golden Delicious and a Jonagold born in BC’s Okanagan Valley, these are especially delicious when in season (summer in British Columbia). In season, the large ones with more green than red on them are excellent. Because of their low acidity, the greener ones just have a better firm, crisp texture instead of being more sour than the ripe ones. Out of season (like right now, February), the big ones can be found but they tend to get overripe. If you see yellow-red ambrosia apples, DO NOT BUY THEM. They will be mushy and you will hate me for recommending these stupid apples to you. BUT wait! I have a solution. Go and search out the little ones (I’ve found Safeway to be a good source). Buy the greenest, firmest ones you can find. They will be 3/4 the size of the good summer ones, and are still grown in BC (look for the BC brand sticker with the little tree). These little Ambrosias seem to have a longer shelf life, and retain their crispness for a good 2 weeks after you buy them from the supermarket. Yes, they will look shiny and waxed as most big chain supermarket apples do, but a good out of season apple is worth eating a bit of wax for, in my opinion.

2.) Tempeh. Tried tempeh for the first time this week, and have wanted to eat nothing else since. Tempeh is a pressed, fermented soybean patty looking thing, without the nasty feet smell of Japanese natto, without the uniform texture (or textureless texture) of tofu. Originated in Indonesian cuisine. Mostly odourless and tastes pleasantly mushroomy, with a good beany texture. It is truly one of the only veggie things so far that would make me not miss meat in a meal (the only other thing being bocconcini cheese, oddly.) The brand I tried is Green Cuisine’s “Tempeh Burgers”, found at Donald’s Market in New West. I’m going to hit up an asian store and see if I can find something cheaper.

3.) Thai Basil Pesto. Okay. I’ve blogged about this one before, but really. In lieu of flowers, I would like chopped thai basil sprinkled on my grave on a regular basis, please. So garlicky, so cheesy, so satisfying. This is orgasmically powerful pesto, not for the faint of heart (or breath), but will most likely leave you wanting more.

4.) Shirataki Noodles. The pesto goes really well with those awesome shirataki noodles that you can buy at asian grocery stores. Yes, they have between 0-20 calories per serving (depending on the brand). Yes, they’re all soluble fibre so they’re good for your digestion and blood sugar. Yes, it will help you lose weight. Yes, it’s the same stuff in PGX weight loss granules/pills except that you get to EAT THEM (muahahahaha) and have soluble fibre be DELICIOUS. Yes, you don’t have to cook them (just drain and rinse). Find them at asian grocery stores (T&T, H-Mart) in one of the refrigerated aisles – they come prepacked in water. Add some pan fried tempeh to the noodles and pesto and boy you’ve got one hell of a low calorie vegetarian heaven. *UPDATE: MARCH 2, 2011 – just saw shirataki tofu noodles (made from konnyaku and tofu) at my local Safeway, which is new…they didn’t used to carry it. Cool.*

5.) Circus. I haven’t run away, but I have joined the circus. I’m finishing up my 4th month of Aerial Silks classes at Vancouver Circus School (New Westminster location), and I am loving it. Huge workout for your upper body, core, and flexibility. I don’t know exactly how to describe it, but go and YouTube Aerial Silks. A couple of my favourite videos: http://www.youtube.com/watch?v=c8aeQO-M7kM and http://www.youtube.com/watch?v=szd4xnI30Ng. Yes, those people are really strong and bendy. I’m neither particularly strong nor bendy. But the class at VCS is still awesomesauce and highly unboring.

6.) The Dog Whisperer. Cesar Millan is fricking magic. *Tsch!* I’m going to raise my future children the way he raises dogs. Every episode is like watching a hypnotist do his work. He’s really got a way with them dogs, and I am really thinking that his strategy of “Exercise, Discipline, and Affection, in that order” would probably work really well with children too. (I know it works on me…so…)

7, 8, & 9… Oh and I’m also obsessed with oranges (the big navel ones #4012 are so sweet right now), bananas, and kimchi but those seemed so ordinary that I didn’t feel like making a big fuss about them but yes also good for you and they make life delicious and happy.

February 2011. Aerial Silk at VCS

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