All at Once

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It was only four days past her ‘due date’, but it had been a long pregnancy and she was ready. She woke up sad that she wasn’t in labour and then as soon as she got up and walked to the kitchen, her waters broke!  All dramatic Hollywood style. We were excited and ready, time to meet this baby. But also cautious and hoping the labour would start on its own, unlike the last one. After 10 hours of cramping, just like she had been for days, she started to feel contractions. Within half an hour they were 5 minutes apart and feeling stronger and stronger.  We were relieved. We met at the Birth Centre for an assessment and got the thumbs up that things were moving along but there was still time to labour more at home. At home we did all the positions and tried all the tricks and she started feeling more pressure and needed to breathe through these now stronger more powerful contractions. Back at the Birth Centre she was walking and lunging and moving. The labour kept coming.

A few hours in and she found herself in the shower getting some relief, then back to changing positions and moving around to help baby navigate the way down and out.  About 3 hours after we got there she needed to rest but didn’t stay down for long. Up and moving around again, there she goes. Surrounded by love and support, her spirit stayed strong. Another hour of this and she tried to rest again as the contractions slowed down a little; a natural break. We did a series of positions to give the baby room to shift and to give her a chance to rest and restore her energy.

It had been five and a half hours since we got there and almost 24 since her waters broke, this cervix check revealed no change in dilation.  Not what we wanted to hear. There was no question the labour was more, but the baby was still high up and had some navigating to do. The labour had quieted down to almost disappearing with this check and a discussion about moving our team to the hospital for augmentation.  We went for a walk while processing this change of events. She had one strong contraction, almost in protest or defiance, and then nothing. It was time to change things up, so we packed up and headed to St. Boniface General Hospital. She had her husband, her mom, her doula, her strength and her positive energy.  She was focused on meeting her baby.

We arrived just before a shift change and were delighted to find our Nurse for the day was one of ‘those’  nurses. She is all about supportive care, position changes and teamwork! We’ve got this.

The labour had basically faded away and so 24 hours after the waters ruptured, augmentation began.  After napping for an hour she started to feel that labour again. Here we go again. She was up and moving with her body, trying to flow and release. The baby was hard to monitor, so everyone agreed to rupturing the new bulge of waters in the forefront and using a direct monitoring clip for the baby. This all led to a huge shift in the labour, the intensity sky rocketed and she starts to think she is going to need some extra help to manage this.  Another cervix check is done because this Nurse heard us when we told her how fast things changed in the last labour, in just 45 minutes she had jumped in dilation for the first time in ten hours! She is now dilated to between 6-7 cm. I remembered the last time when she went from 4 to holding her baby is two and a half hours. I kept telling everyone this! That cervix wasn’t telling the truth. The labour looks hard, she is feeling done; certain she needs an epidural, positive she can’t do any more of this.  Before this could happen the staff needed blood work and a weigh in for the anesthesiologist, which meant a wheelchair ride back to triage! Not even a little bit fun, but our Nurse was excellent and made this as smooth as possible, and this warrior did what she needed to do. We got back to the room and she went onto her hands and knees, things were intense, the baby was not happy when she was sitting up, but she liked the all fours position so that worked. The labour feels swift now. Her sister arrived and infused the space with so much love and positive energy, it took this birther a little further.  We were all doing our best to keep her focused and calm. It was all happening so fast. Her sounds and moves look like late stage labour, so even though it had only been 2 hours since the last check I urged her to get another cervix check before the anesthesiologist arrived. We had a temporary nurse covering our primary Nurse’s lunch break, so she did the assessment. A solid 7 cm dilated she said. It sure didn’t look like that. And the labour looked like it was changing again, she looks like she is starting to bring the baby down. It was 45 minutes before the anesthesiologist arrived to administer the epidural, she had worked her way through all that intense labour and was so done that we didn’t want to push for another check…

I stayed in the room with her, and her mom and sister were just in the hallway, her husband was grabbing a quick lunch. There she was sitting up, curled over trying to stay still and keep her shoulders dropped and she had a strong contraction, clearly bearing down. I look her in the eye and say “are you bearing down?”, she replies “I can’t stop it!” The epidural catheter was in but not hooked up, she had another big contraction and was absolutely pushing. She laid down to be checked but there was no need because we could see the head! Mom and sister come flying back into the room with the obvious sounds of delivery. Dad is running back as fast as he can, and that baby is being born! 13 minutes after she sat up for the epidural she was holding her son!

Amazing, intense and raw.  This is birth.

 

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