Monday, August 20, 2018

My Labor Experience

It has been 20 days since I gave birth, and I finally found time to write about my experience. Since I am a doctor, I know the signs of labor already and know when to go to the hospital and when to stay put in the house. Should know anyway.

On the friday before I gave birth, I thought I had an episode of leaking bag of water but my contractions weren't regular. But upon check up, everything was fine and I was sent home, my IE or internal exam showed my cervix to be 1 cm, high which means it's a long way to go yet.

So in the meantime, I tried eating dates, walking around a lot, doing acupuncture and electroacupuncture on myself, and even tried to get some massage (and eyelash perming but not related to inducing labor) but wasn't allowed because they don't want to risk me going into labor (which is what I wanted anyway). I also tried the evening primrose oil, which I inserted vaginally.

On July 31, I had an episode of bloody show and knew this is one of the signs but my contractions still weren't regular. So I went for an ultrasound, a non stress test with amniotic fluid index. There was no problem with the NST but my amniotic fluid showed decrease amounts, also known as oligohydramnios. Complications of that include mecomium stained birth and fetal demise. So I went to Cardinal Santos Medical Hospital to be admitted.

My internal exam showed me to be still at 1 cm, good results in fetal monitoring via NST.  Since I wasn't in active labor yet, they just put me in my room, had my vital signs and fetal heart beat monitored, and inserted 6 caps initially then 4 caps of evening primrose oil intravaginally every 4 hrs, with internal examination monitoring also done.

In the morning, my IE was still 1 cm but it was soft and doesn't hurt as much as the previous. I was brought to the labor room after breakfast at around 8 to 9 am where I could be monitored via NST continuously.
I was given oxytocin at 10 am when they saw that my contractions weren't regular. Eventually I could feel the contractions closer every 2-3 minutes. And I could feel myself bleeding and gushing out during and after contractions.

At 2 pm, IE was done, where I was at 5 cm but my cervix was paper thin already. My doctor said I could suddenly fully dilate anytime. At this point where my previous IE were just 1-2 or 4 cm, I was thinking if I may eventually end up with a cesarean section. But that gave me hope. Anesthesia was then given because I was officially in active labor... And that the labor would progress quickly so I better have the anesthesia already in.

At this time, contractions were getting intense with my hip pain eventually at 7/10. At first, I can describe the hip pain as numb, which doesn't really hurt at all. Then it became tingling or feeling of "nangangawit." Eventually, it felt like I was being grounded (as in a small electric current). So I was a bit glad that the anesthesia is being prepped already.

I was put in a fetal position for the spinal anesthesia. They might had a bit hard time putting the needle in because I felt several pricks before it was successful. Yes, imagine doing a fetal position to extend the back, but I have a huge uterus in front that is contracting and giving me electric shocks to my hips! It was sooo hard to kept still but I had to because I also know the consequences if the needle hit anything else.

Eventually, it was inserted successfully and, I can feel the pain going away. I was even able to take a nap. But the medicine only lasted for 2 hours. So I may have to be given more if needed.

At 4 pm, IE was repeated and showed I was fully dilated. Yes! But... My doctor wasn't around yet. I was given anesthesia again 2x before I gave birth.

At 6 pm, I was wheeled to the delivery room. My legs were a bit like jelly and numb from the anesthesia. My hips were also numb. I couldn't feel the contraction anymore. I was a bit scared but anxious thinking, "this is it!" my whole 9 months has been preparing me for this ultimate moment!

My husband was called in because he was going to cut the umbilical cord hehe I was  bit anxious for him because he's scared of blood but well atleast he didn't faint hehe I cannot feel my contractions so I was just coached when should I take a deep breath etc. The anesthesiologist also did a fundal push. I felt like I was either going to vomit or cough. And I did. My OB suggested vacuum assisted so it would also be easier also. After 4 tries, at 6:11 pm, Maple was out and crying even though I have yet to see her it my abdomen yet.

When Maple was put in my abdomen, she had her eyes open and was looking at me, but she didn't want to breastfeed or atleast suck. She was just staring at me.

Honestly, I didn't feel like a mother at that instant. But it did feel weird and kind of incredible still that a little baby came out of me. It was a surreal experience, that's for sure!

Monday, July 30, 2018

Inducing Labor Naturally

So I've been ready to give birth for the last 2 weeks, and still... waiting.
I don't want to wait beyond August 1 that's for sure because of the complications that may arise when the baby stays too long in the womb. So I tried to find and did some research on natural induction methods. Some of which, I do wish I started earlier.

This are generally the requirements for a successful vaginal delivery: 1. regular labor contractions, 2. cervical dilatation and effacement, and for the 3. descent of the fetus to the vaginal canal. To induce labor contractions, one needs oxytocin while cervical softening requires prostaglandins. Descent of the baby usually is not a problem when there is no problem with the pelvic area (which causes cephalopelvic disproportion); this part cannot be helped much.

1. Exercise
There are a lots of exercises out there for pregnancy. Mind you, I did my "normal" walking (applicable with commuting) through out pregnancy. I even incorporated some yoga mornings and stretches to "open my hips" more (though those poses I already did prior to getting pregnant).

In pregnancy, the hormone elastin allows the pelvic bones to move in preparation for birth, enabling it to become wider... and supposedly this stretches are supposed to help.

What I should probably do is climb lots of stairs...

2. Dates
There's a research journal saying that this is effective if taken in 4 weeks before your estimated time of birth, taking a daily dose of 6-7 dates/day. My OB friend who is also working in the middle east, also swears by this based from the patients she'd seen. Eating dates are supposed to shorten the labor time and soften the cervix effectively.

3. Acupuncture and acupressure
Because I'm an acupuncturist, of course I would do this to induce myself into labor. The most effective points is LI4 and SP6, but I am also doing GB21 (just because I also love my shoulder massages), BL32 (back massage), BL 28 and BL 48 (butt massage), KI1, KI3 and BL 60 (foot massage).

I read that some are effective without the need for electrical stimulation, but if it doesn't work, I am going to apply TENS also to my needles.

4. Sex
Nipple stimulation causes oxytocin to be released (which is similar process to producing breast milk), prostaglandins from the semen, and reaching orgasm to stimulate contraction of the uterus are all said to help induce labor... but really, it's a bit of a challenge to do this when you're so big and you easily get shortness of breath with certain positions.

5. Evening primrose oil
My friend took this orally for several weeks before giving birth, and it wasn't very effective.  I tried to look it up in journals also but oral intake doesn't seem to be much effective.

My OB told me that on the day of induction, she will use 6 caps of evening primrose oil 4 hours before IE. Apparently, she was one of the authors in a study in PGH, where it was said to improve Bishop scoring (and cervical dilatation) to more than 4... Though in that study, only about 31% had successful vaginal deliveries and the rest had cesarean sections due to fetal distress (46%), intraamniotic infection (1%), and arrest in cervical dilatation (15%).

Because almost half the reason for cesarean section was due to fetal distress, I am contemplating on doing that the night before we get admitted, or just doing it in the hospital.

6. Malunggay capsules
One OB in a prenatal class I attended said that Malunggay capsules can also start contractions, that's why she recommends giving it when the patient is already term. When I asked my OB about it as a supplement in preparation for breastfeeding, she just told me that it's a supplement, so you have to establish breast milk first. And it may have constipation as a side effect.

Anyway, I started drinking 1 cap 500 mg since I was in 37 wks old, but I don't think it's very helpful.

7. Pray
Probably the best thing to do is also to pray. Pray for a safe and successful delivery to a healthy baby. I am constantly in anxiety over the possibilities of stillbirth and postnatal infection and complications, especially now that I'm getting past my ideal 38-39 weeks AOG.

Every night, I listed to my fetal heart tone... sometimes, twice! Especially if I don't feel her move as much. I noticed that there is less tendency for movement in my last month of pregnancy as compared to the 2nd and early 3rd trimesters. The reason for this is because the baby is accumulating fat and getting bigger, and the uterus is getting cramped.


Anyway, I will update on how my labor goes. I don't know else what to do when there's only less than 48 hours before my scheduled admission!

Tuesday, July 17, 2018

Where to give birth? Cardinal Medical Center VS St. Luke's QC

Yes, we are now officially term at 37 weeks AOG, and I can finally have my massage and whatnot! Hehe Anyway, just when the time is about to come, we realize that we better check out St. Luke's QC too as an option for giving birth, since our OB-Gyne is also affiliated here too. I will also post their recent packages and room price list if anyone is interested as of July 2018.

St. Luke's QC

Room Rates and Packages


Room Rates in SLMC QC



SLMC OB Packages
In case that the above picture is too small or can't be read, we just want to emphasize on the following rooms (price is per day):
Private Rooms
Executive private - 6,400
Deluxe private - 4,400
Regular private - 3,700
Small private - 2,800

Two-Bed Private rooms
Two-bed private with TV & Ref - 2,400
Two-bed private w/o TV & Ref - 2,000
Ward - 1,200

Birthing Room - 13,100
Birthing Room Rooming in charges (single baby) - 14,100
High Risk Pregnancy Unit (HRPU) - 5,400 (for 24 hrs)
Labor Room - 1000+

Rooming-in charges:
Suite Room/HRPU - 1000
Executive Private - 700
Deluxe/Regular/Small Private - 600
Two-Bed Private - 500
Ward - 400

I have highlighted our possible room choices.

Pros:

Location is nearer (about 1 km from our home)
I can call my acupuncture friends to do that technique with me, right? Because they aside from acupuncture, they also practice as Pedia, OB, and a medical acupuncturist in St. Luke's (though there might be a conflict because I haven't really told my OB-Gyne about this part)
More HRPU units as compared to 1 Lamaze room in Cardinal (where the husband can stay during labor)
Admissions staff was very friendly and even offered us an admission papers already

Cons:

Rooms are way smaller as compared to Cardinal
More expensive than Cardinal (?)

Others:

Admitting kit is already provided in the room, containing toothbrush, toothpaste, medicinal cup, kidney basin, etc
Newborn kit contains EVERYTHING daw according to the nurse, including 2 swaddles, 1 set of clothes and bonnet/socks/mittens, 2 pcs baby diaper, alcohol, etc



Cardinal Medical Center

Room Rates and Packages



Room Rates in Cardinal




OB Package in Cardinal

In case that the above picture is too small or can't be read, we just want to emphasize on the following rooms (price is per day):
Big private - 3,690
Regular private - 3,480
Small private - 3,160
Semi-Private - 1,930

Lamaze room - est. 2,200 (first 2 hours) + 229/every 30 min
Labor Room - free for first 8 hrs + 250/hr

Pros:

Rooms are bigger as compared to SLMC
May be cheaper than Cardinal (?)
My friend Karen gets to be my Pedia
NICU nurse, DR nurse, and admitting section were very prompt in replying to my email

Cons:

Only 1 Lamaze room (and they will give priority daw for those with certificates)
Location is farther... especially if school resumes for Xavier and ICA
Admission papers weren't given yet (a relative will come down for me to be admitted)

Others:

Admitting kit contains toothbrush, toothpaste, face towel, soap, spoon and fork, medicine cup and glass, 1 roll of bathroom tissue, 1 500 mL water, 1 pillow.
Newborn kit contains EVERYTHING I will need like white basin for bathing, kidney basic, cotton buds, cotton applicator, alcohol 70%, J&J top to to wash, diapers, digital thermometer, cotton, and 1 box of gloves. I will provide the swaddle and clothes when the baby is roomed in.
(Since I already have the swaddle, I am leaning towards Cardinal instead.)

*Not sure if all medications and supplies are required to be from the hospital, but from Mariel's inquiry with her chemo drugs, Cardinal is not as strict as SLMC.

Though I have posted their OB packages, a lot of nurses and staff don't think that they are economical because a lot of doctors prescribed medications and supplies that is not included in the package, so this would be a waste, and you have to pay extra for the excess. So one still has to consult with their OB-Gyne.

Conclusion

Our preference would still be for Cardinal Santos Medical Center mostly because of the bigger rooms... But if I feel that I can't make it because of traffic, etc.... Well, I guess St Luke's would still do because it's nearer. Or I was thinking, I should just have my IE in St. Luke's first and decide from there if I could still transfer to Cardinal Santos.

We weren't also sure about the Lamaze room. Though I did told myself, maybe depending on the IE? If I was dilated already, like more than 8cm dilated, perhaps I will just choose the Lamaze room. But if the contractions aren't closed enough yet, or I am less than 8 cm dilated, I know that it will take several hours of labor so I would just have to do with the labor room.

Regarding my anesthesia, I was wondering if I could have an epidural without having sedation? Or if I could only be administered once my VAS is more than 7 or 8?

Tuesday, June 19, 2018

Hospital List

Hooray, we are in the 8th month already! 6 more weeks to go before I popped out! Hehe
So now, it's time to prepare our hospital bag :) The goal is to have them ready and waiting in the car by 36 weeks AOG (or for some, 34 weeks).

I have read a lot of blogs and forums on what to prepare, but of course it really depends on the patient, right? Actually, I also think it depends on the hospital because their rules and package inclusions also vary.

So this is our hospital list. We are going to give birth on Cardinal Medical Santos, under the service of Dr. Angela Aguilar, and so far, NSD is still the plan. We have a prenatal check up scheduled on Monday, and we're going to try to go to the nursery, and ask if they have a list of things to buy or prepare for giving birth... or whatever is included if we're going to take the package? Like, for certain hospitals, they will charge you for the diapers, maternity pads, cotton, thermometer, wound cleaning solution, abdominal binder, etc. I am going to ask if we can prepare them in advance so they don't have to charge us.


Labor Bag

o   Paperwork:

o   Birth Plan

o   Admitting Order

o   Maternal Information Sheet

o   Philhealth contributions, MDR

o   Marriage contract

o   Government IDs

o   Medical Records/Lab Work-up

o   Apparel:

o   Socks

o   Slippers

o   Things to do:

o   Cellphone

o   Charger

o   Labor:*

o   Massage oil or lotion?

o   Heat pad

o   Gym ball?

o   TENS machine

o   Toiletries:

o   Eye glasses

o   Petroleum Jelly

o   Hair tie

o   Betadine vaginal wash

o   Cordlife Kit


*I know that Cardinal offers a Lamaze room for a really expensive price (more expensive than a suite) for those who plan to give birth naturally (meaning without epidural). I myself thought about it and wanted to try natural birth... but I also want to have the reassurance of an anesthesiologist because they say giving birth REALLY hurts. Second, we didn't really officially go to  Lamaze class and don't have a certificate (because I'm already a doctor, and my OB told me it's not necessary for me because I have already seen and birth other mothers).


So I am thinking if their Labor room would allow this stuff? And would allow me to attempt for natural pain relief? I myself know acupuncture, so I am planning to use the TENS machine when the time comes (actually, I am planning to induce myself with acupuncture haha)... Though I wonder if I could do it myself if I am in soooo much pain. I did wonder if I could give birth in St. Luke's QC (because my current OB also have visiting rights there), because I know another OB who also practices acupuncture, and I could call on him when I am in labor, right? He did help me with my morning sickness and my constipation back on my first trimester...


Recovery Bag

o   Postpartum recovery:

o   Adult diapers or maternity pads

o   Abdominal binder

o   Cutasept would cleaning solution? (I read in another blog from someone who gave birth on St. Lukes... I also know this was given to my sister in UST post-surgery)

o   Apparel:

o   Going-home outfit

o   Front-opening pajamas

o   Bathrobe

o   Bath towel

o   Disposable undies

o   Nursing:

o   Nursing bras

o   Nursing pads

o   Nursing cover? Or use the bathrobe?

o   Nipple cream?

o   Nursing pillow?

o   Breast pump

o   Toiletries – toothbrush, deodorant, contact lens


Partner’s Bag

o   Change of clothes

o   Toiletries - include tissue

o   Pillow and blanket

o   Things to do

o   Cash, credit card

Babies Bag

o   Health

o   Thermometer?

o   Cotton/Baby wipes

o   Alcohol?

o   Powder?

o   Toiletries

o   Hooded towel

o   Small cetaphil?

o   Diapers

o   Receiving blanket

o   Lampin

o   Clothes

o   Tie-sides

o   Swaddle

o   Going-home outfit

o   Bonnet, mittens, booties/socks

o   Baby book

o   Feeding bottle?


 So there... but I will update this list especially after our prenatal check up on Monday.

Update (7/7/18):

I sent an email to Cardinal Medical Center. The admitting section replied promptly, indicating the following in their admission kit (so i don't have to bring) :


1. Toothpaste (small)


2. Toothbrush


3. Face towel


4. Soap


5. Spoon and fork


6. Medicine cup and glass


7. 1 roll of bathroom tissue (one time charge only)


8. 1 500ml of bottled water (one time charge only)


9. 1 pillow 



For the nursery, they will provide everything in the kit such as: white basin for bathing, kidney basin where we place the cotton mix  with soft in there, cotton buds, cotton applicator, alcohol 70%, J & J top to toe wash, diaper, digital thermometer, cotton and 1 box of gloves. Other inclusions are Bcg, hepa b, vit.k, erythromycin, bld typing, newborn kit, newborn hearing, and baby diploma. They will just ask for the clothes and swaddle when the baby is roomed in.

When I asked about the DR rules, they told me that I cannot bring supplies or machines including cellphones in the Labor room and delivery room complex.

So I guess, I can remove a lot of the things I have on the list... Though the basis of this list is actually based on US websites. Though I am wondering how am I going to manage labor in the labor room without my ball, warm compress, cellphone to monitor my contractions. Will they let me do labor in my room? Haha

I remember the Labor room as a boring place to wait for the contractions and for the labor to progress.

I know that they have a Lamaze room but I find it expensive. It's like a birthing suite. And for practical reasons, I don't want to have to get that. Maybe i should just monitor my contractions at home then when they're like 3 to 4 minutes apart, I will go to the hospital then haha I don't know yet... A part of me wants an unmedicated chilbirth but I know that it's not a popular thought in the Philippines. And I am a doctor haha


Tuesday, May 22, 2018

My Ideas on How to Save on Baby Stuff

So... I have been going through these baby stuff for more than a month now, and I just want to share my thoughts on something. Once they add the word "Baby" to a regular item, it becomes more expensive. So... if you could, you can actually buy the normal/adult version because it can do the same process. I am going to share tips on what I think to save on baby stuff.

1. Feeding
They say this is one of the biggest expenses for babies. So the lesson: Breastfeed!
Aside that the milk is free, it also has more nutrients for the baby (and immunoglobulin), less side effects and constipation from the milk, good for the mommy who can lose weight and get back to their post-partum bodies faster, etc.

The equipment that you might need:
  • Nursing Bra - well, your breasts are going to get bigger anyway, so why not buy the nursing kinds directly? I bought these online for less than 200 pesos only. But I am planning to invest on a really good pair after the baby is born. (I read about Marks and Spencer, and checked the price from Mothercare which cost less than 2000 for 2 pairs of nursing bra).
  • Silicon manual breast pump - I bought a manual silicon pump, Haakaa style, because (1) the electric ones are too expensive (and I'm not yet sure if I might need them), (2) the manual ones have a less suction on them than the Hakaa-style manual pump, and (3) the Hakaa style is simpler and easier to clean because it only has 1 essential part and its lid. You can try the suctions themselves if you just go to an SM Department store (they don't have the Hakaa brand, but a cheaper similar silicon pump from Mom and Me was there only cost 300 pesos, which I compared with the Looney Tunes manual pump). If you want the original Hakaa brand, it's 950 pesos in Rustan's and The Parent Emporium (the lid is sold separately), but since I wasn't sure of a lot of things yet, I bought it online in Shoppee for only 100 pesos! It also comes with a lid, where I can even choose my preferred color :)
  • Breast pads - actually, I just bought 1 or 2 washable pairs online because I wasn't sure yet  if I would have enough breast milk
Optional:
  • Breast milk storage bottles/bag - optional actually especially if you're with your baby 24/7
  • Nursing cover - actually, I didn't buy this because... I had a lot of sarongs and this wraparound multipurpose blanket from Headware, which I used during my camping and traveling days which I think would serve the same purpose
  • Nipple cream - I haven't bought this actually since I wasn't sure yet if I will need it. They say to prevent those nursing pains, make sure I breastfeed correctly... And that I should just leave the residual milk which will be the ones to heal any nipple wounds.

My pediatrician friend told me that production of breast feeding is also about the mind and willpower of the mother. She told me to make sure to feed (or try) every 2 to 3 hours so the milk will just continue flowing. Don't wait until the baby is hungry but I should try and pump even while the baby is asleep just to keep the stimulation of breast milk continuous. (That and I was planning to take one of those seemingly-delicious lactation brownies and cookies that I've read about, and maybe those malunggay capsules which should be started on the 3rd trimester.)

But if I really can't.... then for bottle feeding, the essentials are:

  • Bottles! - I have read about babies selecting their bottles and nipples, though I am not sure how common is that in the Philippines. Anyway, after reading a looooot of blogs, I decided on Philips Avent bottles. It's waaaay cheaper to buy them from the US (10 USD for 3 bottles as compared with 1800 per bottle here in SM) and fortunately, I had a friend who came from the US so I saved a fortune with those. Aside from Philips Avent, I also bought Tommee Tippee (because we liked how the nipple resembles a natural breast and Comotomo was still too expensive) and we were also thinking about Playtex (because it was just soooo cheap from the US but decided against it because I think we think we already have 10 haha). So if you could, do it like me, buy online from amazon, ship to someone you know in the US, and bring it back when your friend comes home hehe
  • Bottle cleaner - this is actually pretty cheap since it's just basically sponge that can reach the bottoms of the bottle. We bought this online, though we also saw this available even in Daiso stores.
  • Milk - now this is the expensive part. But I didn't buy any because well, sometimes the pediatrician is the one who will advise on the kind of milk. And... I am really pushing for breastfeeding.
Optional:
  • Milk storage container - I wrote this under optional because you may just need this while traveling
  • Bottle sterilizer - we weren't actually sure if we're gonna buy this because we think the old habit of "boil and dry" method works
Now, regardless if you're breastfeeding or bottle feeding, the baby will need this:
  • Burp cloth - one of the most useful things for a baby, they say that you might need as many as 15! Good thing, a burp cloth can actually be a receiving blanket, a lampin, a towel, etc. They even say that the bigger the size, the better because sometimes the original burp cloth is not enough to catch all that spit. --> Personally, what we plan was use several lampin or microfiber towels to be used as burp cloth since they are bigger, more absorbent, and versatile
  • Bib - we got the cute waterproof ones, and obviously this is to protect your baby's clothes from the spit and the milk so you won't have to keep changing their clothes. Though... what we did was bought a "Bib/Clip Holder", which means we can use any cloth actually as a bib as long as it was absorbent... so we bought wash cloth and microfiber towels instead which was cheaper. (Of course, these are also more versatile.)
Optional:
  • Nursing pillow - we bought the U-shaped one which was what my friend advised me from PC Supermarket in Shaw for only 400 pesos (it was the only one left, not sure if they will restock)! Next to that, cheapest we've found was in Shopwise Cubao. Online and in baby stores, you can buy it for a whopping 1000 to 2000 pesos! So even though we weren't sure if we're gonna buy these, we bought one because it was really cheap compared to the baby stores haha
2. Diapers
Next of the bigger expenses are the diapers that a newborn baby can consume 12-15 per day because they say that a newborn has to be changed every 2-3 hours (about the same time frame that the breast needs to be stimulated for breastfeeding).

For me, in order to save bucks (and save the environment, plus also decrease the risk of diaper rash), I am going for cloth diaper. I already had a previous post on this topic, so I will just summarize my essentials:

  • Lampin - they say gauze is more absorbent than bird's eye, though bird's eye is more durable and can be used as a burp cloth, bib, towel, cloth wipes, etc. Very much available in department stores, but cheaper in Baclaran (if you have the time and patience), and also available online.
  • Cover-Type Cloth Diapers - our fave because if the baby only urinates, we can just change the insert and reuse the diaper. Unfortunately, I can only find this online in Shoppee and in Facebook
  • Pocket-type Cloth Diapers - for night time use, so we can stack up inserts and increase absorbability. I found this cheaper online, but can also be found in department stores (usually with brands like Charlie Banana, Hush Tush, Next9, etc) 
  • Microfiber diaper insert - actually, I wasn't a big fan of microfiber after reading that they will only last for a year and after which they lose their absorbancy. So... what we were planning to do (which I followed from certain blogs) was just use the regular microfiber towels, wrap them in lampin/cotton, and use them as inserts, which was cheaper and more versatile.
  • Hemp diaper insert - my favorite so far because it's so thin! And it's one of the best in absorbing. However, it's a bit expensive, though there are only several online shops that sell this. I was thinking of making my own diaper insert, but the fabric seems to be not available in the Philippines.
  • Cloth wipes - I was thinking about using disposable wipes (at least when we travel), but if we're doing cloth diaper, basically it's logical to also use cloth wipes because they can just be washed together. I've also read about several mixtures of oil or water to keep the baby's bum free from rash. I read that you can use just about anything (but preferably cotton) like old t-shirts, but we were also thinking of using the wash cloth or microfiber towels since we also bought them.
  • Changing mat - for me... this is more essential than a changing table (which is more common in the US) because it's more portable. Also... I think this has the same purpose as a waterproof protector used in cribs.
Optional:
  • Bamboo charcoal diaper insert - also not a fan, because I find them soooo thick and bulky, but we have them because they say this is better than microfiber inserts in absorbancy
  • Bamboo cotton diaper insert - this is also a bit thick, but someone advised me that she would rather use this than microfiber for the absorbancy and duration of use
  • Diaper clamps - if we're going to use lampin as is, without any cover, we would still need this
  • Wet bag - used for traveling to store and separate clean and dirty diapers
  • Diaper pail - common in the US, but for me... this is just similar to a hamper specifically for diapers, correct?
  • Changing table - in the Philippines, this is not really common because you can just change the baby on the bed, right? Well, what we did to make it more convenient was just to buy the diaper caddy organizer (which can be stuffed with a changing mat, clean diaper, cloth wipes, powder, etc) which is also very portable.
3. Sleeping/Nursery

Essential:
  • A place to sleep with a stiff and safe mattress - I didn't say crib or playpen because a lot of Filipinos co-sleep with their babies on the bed, and what we planned was use Baby Cuddle (which was a gift) on the bed with us. From what I read in several forums, cribs can be hardly used if the baby refused to sleep by themselves once they're co-slept. (We were thinking to just transfer the Baby Cuddle in the crib once the baby is asleep if we're not co-sleeping).
  • Waterproof protector - protects the mattress from baby's accidents while sleeping
  • Blanket/Swaddle - depends on the baby if she likes to be swaddled (because some swears on a wearable swaddle to keep the baby asleep), but my friend recommended Halo. Though I think a regular blanket for swaddling is also essentially the same thing.
Optional:
  • Wooden crib - we were still deciding between a playpen and a wooden crib, when this was bought for us. Advantage would be a crib feels sturdier, but disadvantage with wood is that it's heavier. We were thinking of a playpen because we like its portability and multi-function use with the reversible napper and changer. Graco is so expensive here in the Philippines, and what we originally thought was to buy it online in Amazon (only 4000 pesos), then have it shipped here via sea (additional 2000 pesos) which is soooo much cheaper than the ones in bought in SM (14000 pesos). Anyway, the wooden crib was a gift and so... we will just save our money for future vaccines hehe
  • Crib mattress - we had this customized in Mandaue Foam for only 900 pesos (Uratex costs more). Inquire about their mattress particularly for cribs, which was stiffer than the softer and more comfortable ones for adults. Their crib mattress has a warranty for 5 years (which is more than enough for a baby).
  • Crib sheet set - since we had a crib size smaller than the usual size, we will just use one of the blankets as crib sheet (we bought 4 from Shopee just because it was so cheap, the equivalent of 1 muslin blanket from the mall)
  • Baby monitor - common in the US because the parents room is usually separated from the nursery
  • Night light - usually helpful at night for diaper changes. We already have two actually even before we got pregnant.
  • Bassinet - Actually this is a gift... Though from the reviews of rocker napper, it can be used up to toddler months. This is actually one of the reasons why we weren't in a hurry to buy a crib or playpen because we know that the baby can sleep in this for at least 3 months. 
  • Wooden Rocking Chair - We actually bought one because of my reflux during my third trimester, and I can hardly sleep sometimes because of that. And well, I realized we could use this while feeding the baby and rocking him to sleep. Online, there's ofix (physical shop was also located in Gilmore) selling it for 3000 pesos, but we wanted the old rocking chair type that our grandparents used because it feels more sturdy. It can be bought in Caloocan from 3500 to 5000 pesos.
Not really recommended
  • Crib toys, pillows, bolsters, mobiles - they say this can promote SIDS. So... let's just minimize what's on the crib
4. Bathing and Health

This is one of the departments where putting "Baby" in front of the item becomes more expensive than their adult/ordinary counterparts.

Essentials:
  • Wash Cloth - an alternate cheaper version to the baby version would be to just look for normal face towels
  • Towel - I don't think it has to be hooded... but the hooded ones can be soooo cute!
  • Shampoo and body wash - got a lot of free samples already
  • Thermometer - I'm pretty sure the adult digital thermometer is similar to the pediatric one
  • Nail filer/cutter - They say that the newborn nail cutter is different from the adult one...
  • Nasal aspirator - imagine how hard it is to sleep with a stuffy nose as an adult, what more for a child who cannot express anything?
Optional:
  • Bath tub - according to some american blogs, this is one of the things that you don't really have to invest in because you can just bathe the baby in your sink. Because... what happens when your baby outgrows your bath tub? It's just something bulky that can occupy space. So...  I had this idea to just use one of those big plastic storage boxes like the Megabox? They are made out of plastic just like the bath tub, but at least they can still be used when the baby is already big. But this is just in theory... We didn't really bought one, because apparently, my sister already bought us an inflatable baby bath tub! Hehe
  • Bath net - my friend recommended this especially for newborns, who have no head support yet. The baby can just sit with his neck supported while you can easily bathe him even if you're by yourself... Though I was thinking that you can also use your arm (or maybe prop up some towels) to recline him? Anyway, after 3 months, the baby is supposed to have neck support already.
  • Bath hat - honestly, I just bought these because I want to have free shipping on Shopee hehe but this is optional, though I guess could be helpful as I remember getting irritated as a child when the water would flow to my eyes and ears. What more for a baby who doesn't understand to close her eyes?
  • Bath toys
5. Clothing

I reserved this last because personally, we haven't bought this since we were thinking if there was a baby shower, we would get a lot of this.

But personally, babies are small and they outgrow clothes very fast so I wouldn't really recommended the really expensive or branded ones. My friend even told me that I should just get second-hand ones because babies outgrow them very fast anyway.

Anyway, this is my list:
  • Newborn set (3 sets of tie side sleeveless, short sleeves, long sleeves, shorts, and pajamas with 5 sets of bonnets, mittens and booties) - only 400 pesos from Shopee! Though I must admit I am not sure of the quality (because it's not Lucky CJ as they say)... but on the other hand, the baby will just use it for 3 months, so... Actually we weren't sure about the shorts and pajamas as well, because the baby will be in cloth diaper anyway, isn't that a cuter and better bottom for the baby? :) There are also blogs about bonnets not really that useful, and keeps on falling so they are also not a priority for me, but I've read that mittens will keep the baby from scratching themselves.
  • Socks - I think socks are better than booties at keeping the feet warm and more secure
  • Hooded long sleeves - we will also buy this hooded long sleeves just in case the bonnet keeps on falling off our baby's head (and also to reach the PhP 500 minimum for free shipping from Shopee hehe)
  • Onesies - we are looking for those onesies with snap-ons on the side, and it was actually hard to find these in SM. If we do found one, they are usually long sleeves or long pants or frog suits, instead of the romper kind. Instead, we found 2 in Uniqlo for only 300 pesos! Haha
6. Travel

Optional: (until the baby is born because some say that you have to try these with the baby's approval)
  • Carrier/Baby Sling - actually, they say that I should buy this when the baby is born because the baby may not want to be carried in a certain way. Anyway, we got this as a gift.
  • Stroller - Did you know that there are many Japan Surplus selling strollers from Japan? While Aprica strollers are being sold online and in SM Department stores for more than PhP 17000, Japan Surplus stores like Mumsavers in FB sold them at only PhP 4500-5500 (depends on the model, but we are aiming for Aprica Karoon Plus High Seat because it's lightweight, one-hand operation, reversible handle). Actually Mumsavers also sells cribs, playpens, etc which are also cheap as compared to mall prices. Their physical shop is just in Gilmore area, so it's pretty near our place too.
  • Car seat - actually, this is supposed to be required before bringing the baby home from the hospital, but is not very commonly done here in the Philippines. We are still thinking if we're going to buy this or not. Though if w did buy it, we will probably get it from Mumsavers too.
  • Diaper bag - We prefer the backpack type because my back hurts if carrying heavy objects using only one shoulder. We got one from Shopee for only 300+ thanks to its coins and vouchers and promos haha 

Hmmm... I guess, that's all for now. This is what I think... as an expectant mother (but no experience yet) so I'm not sure what will hold true or not haha