We got there in the end

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Birth is a journey.  Always. Sometimes in more ways than one.  

This birth journey took many twists and turns.

We got there in the end.

Manitoba is a rural province, with so many communities close, but not close to the ‘big city’.  This can be complicated for times when you need medical support, like when you are having a baby in a hospital.

For this couple, the closest hospital is Selkirk, unless extra helps are needed.  To avoid a possible mid labour transfer they chose a well regarded Doctor in Winnipeg, which meant they had more than an hour of driving to factor into their choices.  Not an uncommon situation, but not without its challenges.

The day after their baby’s “guesstimate” birth date she was feeling pretty rough.  She went to the local clinic and her blood pressure was high, which matched those symptoms of dizziness, weakness and general not great feeling.  So under medical advice, and because it made good sense, they headed to Winnipeg to check in with their Care provider.

That blood pressure reading stayed high, so everyone agreed it was time to nudge this baby to the outside.  She was given something to help with the blood pressure, and a slow, gentle induction was started.

Induction usually sounds, and let’s be honest, feels kind of scary. This was definitely not the path they had been looking to walk down. Because they have an awesome Doctor, the induction was managed in a careful way, so they both tried to rest while the cervidil hopefully worked its magic.

He got some sleep, she did not. Triage is just about the last place you can expect to get any sleep.

BUT, 13 hours later at the next assessment her cervix had responded.  It may not have seemed like much (1 cm) but that’s pretty good considering that cervix wasn’t really planning on showing up that day!

The action plan was to continue as they were, and she got a hall pass.  So after a bit of a walk, they went to the onsite hotel where she had some rest.

She was feeling some cramps like she did before all this started, but there was no pattern. They did some release techniques to be proactive.  

Suddenly she was sure her waters had broken! And the cramping felt more like contractions. But the medical staff thought it was just her plug loosening.  Either way, it felt like something was happening!

Time for a Doula visit, just in case this was the start of something. They had been mostly in triage for 26 hours and they were still in a good mental space; excited to be on their way to meeting this baby. We spent 4 more hours in triage.  She was assessed again, no real change was found but the cervidil tab was gone, so a new one was inserted and she was monitored. Her Doctor encouraged them to go back to the hotel to get a real rest, but she felt nervous about how she was going to get there, and what if there is a sudden change?  How would she get back quickly? By this time her left hip was causing her a lot of discomfort. Everyone was telling her it would be okay, but she felt anxious about this plan. So what did he do? He somehow found a wheelchair in the middle of the night in a building he didn’t know, and brought it to her! Brilliant.

Now they could go and her mind was at peace that she had a way back.  So great.

We all got some rest, she actually slept.  Not a lot, but some! And so they headed back to triage. They had been gone for eight hours. Her cervix was now dilated to 2 cm and was 75% effaced. The new action plan was to use a foley catheter to help soften and open the cervix that little bit more.

While the Doctor was putting the foley catheter in, this inquisitive birther was asking all the ‘what if’ questions. What if my waters break while this is in?  

Half an hour later she felt, and he heard an audible pop! Was it her waters?   

Yes, yes it was! And the foley bulb itself burst too, which everyone told us is something that rarely happens.  

Oh, so it’s going to be like this.

So now we were waiting for a room to start the next phase of this journey to birth.  But it is busy, all the babies want to be born. So they waited for 13 hours for that room! Yes 13.

54 hours after entering the hospital, they finally had a room.

It takes four attempts, (4!) to get an IV going to run the synthetic oxytocin, and then we waited.

2 ½ hours later she started to feel something more than before. Another 90 minutes and we get an update:

“Getting real!”  

It’s time for Doula support. Now the contractions were consistent and increasing in power. She breathed through it, kept that positive attitude, hung on to him. After a couple of hours of this she decided to try the laughing gas. Of course the unit we got didn’t work.  Finally a Nurse got it working. It helped a bit. Took her further. I tried to do an abdominal lift but it caused too much discomfort, so instead she went into a hands and knees position with some release techniques being used to help reduce muscle tension.

Four hours later she was breathing hard through each wave, with great determination.  This is hard.

An assessment puts her at 2 cm dilated now. Even though it had only been a short time in active labour, it had been a long time being 1-2 cm. She felt ready for relief from this. An hour after she got some relief, and only six hours after the ‘it’s getting real’ update, she was feeling so much pressure and intensity that an assessment was done.  She was dilated to between 8 & 9 cm! Wow. That was a rewarding number to hear!

55 minutes later and she was feeling a whole new kind of pressure!  

Now she was fully dilated to 10 cm and baby was in plus 1 station in the pelvis. We could see her instinctively bearing down with contractions as her uterus tried to shift and move the baby down and out. She was changing positions, trying to find one less uncomfortable for her hip pain but still useful for moving her baby. Certain positions were manageable, others were not.  Not for her or the baby. Usually the concern with a baby’s heart rate is that it often dips low during the final stage of birth, this baby was of course the opposite of that. The heart rate had been higher for a while and then was becoming hard to track, so a more direct monitor was suggested and used to track this heart rate. Suddenly the room is full of medical staff trying to figure out what is going on with the baby’s heart rate, and how to manage the now out of control hip pain that she is experiencing.  One Nurse is advocating for just delivering the baby, which would obviously have solved all the problems, but it is all too much. Feeling anxious about your baby is pretty normal, add a whole lot of noise and commotion without clarity and that anxiety is going to skyrocket. And it did. How was she going to birth this baby in this state? We ask for help addressing this and our primary Nurse is right on it! Everyone brought it down a notch and she was able to stop actively bearing down.

We pause. It was what she needed.

One of the Resident Doctors comes in and does an exam to assess the baby’s position, and thinks the baby is low enough for a vaginal delivery but will need instrument help.  Another Resident Doctor is consulted and he thinks baby is well positioned. He asks her to show him a push and is impressed with how well she moves the baby.

They decide it will be better to deliver in the case room, and so we all get suited up and move over.

At this point there was more back and forth between the two Doctors about the baby’s position, one Doctor decides to do an ultrasound to determine the baby’s position.  

Meanwhile she was working so hard and bearing down uncontrollably with each contraction, suddenly we could see the head!  No extra help needed thanks!

Only 14 hours after the synthetic oxytocin was started, 10 hours after she started to ‘feel’ it, and with less than an hour of focused bearing down, this superstar Mama and her rock solid partner were holding their son in their arms.  

There were tears and smiles and relief and amazement.

This part of the journey was over, we got there!

 

I loved watching them meet this new person. When she was able she sat up and lay him down in front of her, unwrapped him and looked him all over. 

It was beautiful. 

The wait was over, a new journey was beginning.

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