Deciding Dates

The evening of the baby-cot shopping, we also went to see the gynecologist, both for a final check-up and to fix a date for the Cesarian section. Fixing dates is no easy task. The stars, the auspicious hour charts, convenience and the gynecologist's operating days, all have to match. As it turned out, the most auspicious day was the weekend after next, but the gynecologist was not going to be in town then. We finally agreed on a date two weeks down the line, on a Monday. The other alternative was the Friday before, but I believe in not getting operated electively on a Friday, since support services over a weekend are always sluggish and this can turn out to be a major problem in case there is a complication. The best days for a surgery are Tuesday to Thursday, but since we did not have a choice we agreed to the Monday date.
 

Rupture

The next day was a Sunday and WFM felt a strange wetness early in the morning. Not sure about its significance, she kept quiet for a couple of hours. During that period, for the first time in six months, I went to office on a Sunday morning, to finish some pending work. For also the first time in months, don't ask me why, I did not take my mobile with me. The moment I reached office, I found a message from WFM waiting for me. When I called back, she told me in a quavering voice that she thought she had ruptured. For a moment I thought she was joking, but when I realized that she was deadly serious I rushed back home.

Once the membranes have ruptured you cannot wait beyond a few hours, because of the increased risk of infection and fetal distress. WFM had already contacted our gynecologist's assistant and an immediate C-section had been scheduled.

When I reached home, everything was ready; the bags had been packed, the servants and cook had been given instructions and the driver had been located. On the way to the hospital, I was told that our gynecologist would not be around as she was attending a conference in Nashik. WFM was going to be operated by her locum, another senior gynecologist from the same hospital. I insisted on the assistant's presence, despite it being a Sunday and the locum was kind enough to let him assist her. It took some time getting the admission formalities done - this is a major headache in virtually all hospitals in Mumbai - but thankfully, it did not result in a medically significant delay.
 

Epidurals

During C-sections, you have a choice between general and epidural anesthesia. Epidural anesthesia is a terrific alternative wherein the anesthetic agent is given in the space outside the spinal nerve roots of the lower spinal column; this completely anesthetizes the abdomen, while keeping the patient conscious so that she can participate in the delivery process. Post-operative recovery is also obviously much faster since the patient has not been knocked out or made unconscious. A lot of gynecologists now advice their patients to go in for epidural analgesia even during normal labor, since it reduces the pain, but allows the rest of the delivery to proceed normally.

We decided on epidural anesthesia and an obstetric anesthetist specializing in epidurals was contacted. By 2.00PM, the whole team was ready and WFM was wheeled into the OT for the Cesarian section. The anesthetist was great; he took the trouble to make WFM feel calm and comfortable and was responsible for creating a very nice and warm atmosphere. A little before 3.00PM, the abdominal incision was made. By this time, the neonatologist and her assistant had also arrived.
 

Delivery

In less than 10 minutes, the uterus was in view. A small nick, fingers inside the uterus and the gynecologist had placed her hand around the head of the first baby. With a clean jerk, it was out and immediately handed over to the neonatologist who after a little cleaning and suction, placed it on WFM's cheek for her to see. In the next minute, the other one was out. It took a little while for the first cry, causing a slightly tense situation for a few seconds, but this was taken care of immediately. This baby too was placed next to WFM for a short while.

There were happy faces all around. Sunday afternoon, the rest of the OTs all empty and only a few of us around, celebrating and rejoicing. The twins were four weeks premature, but otherwise fine, one weighing 2.1 kg, the other 1.9kg.
 

The Sexes

Oh, all right! We had one boy and one girl.
 
 

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