Expect the Unexpected

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Their first baby took his time coming; they were prepared to wait.  In fact they were so ready for this baby to arrive a week or more after his 40 week date, she missed the early signs of labour. 18 days before his ‘due date’ her Doctor told her that her waters had ruptured and those cramps she was feeling were early labour! He sent her home to hopefully get into more active labour and so they could organize themselves to come back in a few hours.  7 hours later she was in a triage bed waiting for a plan, she was still cramping but there had been no increase in the intensity. No one seemed able to agree on her dilation and the on call Doctor wanted confirmation of the amniotic sac being ruptured. It was also very busy in triage. They rested, as much as they could, and we waited. 90 minutes later another Doctor did another assessment and said she was dilated to 3 cm and the cervix was soft and effaced to 75%.  We went for a walk to encourage the labour, and because there was no room for her on the ward yet. The walk definitely helped to ramp up the intensity. Back in triage she was moving into different gravity favourable positions, and then on her side having the classic shakes that usually accompany increased labour activity. Two and a half hours after the last assessment and 4 hours after we arrived, another assessment was done. This time the Doctor said he couldn’t tell the dilation but felt things were softer.  This felt confusing. We were still waiting for the on call Doctor to be available to form a plan of action. The triage nurses were being stretched thin and at points there was only one Nurse in triage. At one point she was working on getting an IV inserted and had to drop everything and run because another woman came in and was clearly having her baby! Finally an IV was put in, and almost 7 hours after arriving, we were admitted to a room on the labour and delivery ward! The labour definitely felt more intense at this point and there was a conversation about pain management and best options.  Another exam and more conflicting information. This time the assessment was that the cervix had moved forward and was fully effaced, but only dilated as much as a fingertip? So confusing! So the synthetic oxytocin was started intravenously at this time. And then there was the morning shift change, and her primary Doctor came on call! He came to say Hi and everyone was excited to see each other. Meanwhile this labour was really showing up. She was moving into all the positions and breathing through the contractions. We were doing what we could to help her work her way through this.

The contractions were coming fast and furious and she appeared to be shifting into another phase. Enough so that the Nurse suggests another cervix exam.  Because the exams had not only been uncomfortable but also confusing up to this point, I asked if it was at all possible that the primary Doctor do the exam since he was most familiar with her body and her history.  The nurse thought this was a great idea and thanked me for suggesting it.

12 hours after we arrived, another exam revealed that not only was she just dilated to 2 cm, there was thick scar tissue on the cervix that was making it impossible to dilate! The labour did not match the dilation because the cervix couldn’t!  What made the most sense at this point was to break up that scar tissue, which would feel as hard as it sounds. In order to get through that procedure, the most reasonable choice was an epidural with a boost for extra numbing. And that is what she chose. Once the epidural was working effectively, the Doctor came back to do the scar tissue release and immediately she was dilated to 5 cm! That seemed more fitting to the labour we had been seeing.

She was comfortable and felt relieved to know that now she could progress.  That happy relief was short lived though!

Only 30 minutes later she was getting those intensity shakes again and feeling SO MUCH pressure!

A quick assessment told us that she was now fully dilated.  

Yup, 5 cm to 10 in 30 minutes. And bearing down instinctively.  Nothing could stop her now. The Nurses were busy getting the room ready and feeling they might be catching this baby as he was coming so fast!  Meanwhile she was staying focused and centred, breathing when she could and allowing her body to take over to bring her baby down. She was on her side, and then right before he was born, the Doctor swooped into the room and we helped her go on to her back so that she could help lift her baby to her chest. He was here! Full of vernix, and perfectly happy to be curled into his mother’s arms.

 

 

 

 

 

 

 

An amazing path filled with unusual road blocks that they navigated thoughtfully and successfully. The strength of the birthing body is unparalleled.

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