Digging Deep

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This birthing duo had some unusual decisions to make long before we got to the birth.  Living in a rural city that doesn’t have a birthing facility meant they had to choose between a highway drive to a neighbouring city while in labour or relocating to a bigger centre to wait for the baby to arrive.   After much consideration they decided to temporarily move in with family living in Winnipeg, create a cozy environment for themselves and wait to meet their baby. She settled in at 38 weeks of gestation and he joined her at 39 weeks. They had a little less than a week of waiting together and then the next phase of their journey began.

It started with irregular contractions on her due date. All day her body warmed up to the idea of releasing this baby, looking for its rhythm. Finally overnight we knew the contractions were making changes because the mucus plug came out. And the contractions became stronger, longer and more noticeable.  She could still talk through them, and tried to rest.

By the early morning she was starting to feel hot and cold and generally not good.  She got into the shower to take the edge off. When I arrived both her partner and her Mom were supporting her in a side-lying position, applying counter pressure for the back pain she was feeling.  We helped her try some different positions, always using counter pressure to help ease the back pain that intensified during the now regular contractions. She was breathing and pacing and rocking her pelvis and letting us support her with releasing and softening techniques, again and again.  The labour kept changing, intensifying, and after 5 hours of this she needed something to change, so we went outside. It was a beautiful day, and she stood in the sun surrounded by her circle of support and it felt like something shifted, suddenly she was feeling more pressure. We decided to go to the hospital to see where she was at, with a plan to come back if it was too soon.

Triage was so full we were asked to wait in a crowded waiting room before being seen. We decided to walk the halls instead. It was an hour before there was an exam room available. The assessment did not give us the news we were hoping for. The cervix was only a little bit dilated, although mostly effaced. After an hour of monitoring and then walking around a bit, they decided it would be better to be back in their quiet space.  They were discharged, gathered themselves and went home to try and rest. We all did.

Six and a half hours later that pressure feeling was so intense that she was feeling nervous and wanted to go back to triage.  So we met there. We got in much quicker this time for assessment and found out that her cervix had opened up another centimeter.  But we could see that these contractions were really intense, she needed to work really hard to get through them. She didn’t want to move, she was cold and tired and this felt like too much, but she dug deeper than she had ever had to dig, and made herself get up and move around, moving her frame to give this baby the chance to move itself. Another 3 hours passed and she had dilated another centimeter and the membrane sack was now bulging. Things were changing.

We were finally given a private labouring room. She tried all the positions, we kept using counter pressure and touch to help alleviate that back pain, helping her to breathe. She used the nitrous oxide gas which really helped her to catch up to the labour. There was a lot of pressure on this couple to do something to speed up the labour.

He was always right beside her, holding her up, telling her how amazing she was. 

Another check and there had been no change in the cervix.  It had been 8 hours, and now people were telling her she was only half way done, she had so much more to do, and so almost 12 hours after we arrived, the second time, and after declining the first offer, they agreed to use the synthetic oxytocin to augment this labour. This wasn’t what they had hoped for, but it didn’t feel like they had a choice.  She felt exhausted by this time. How could she do more? So she got some more serious, and effective pain management help and a plan was made for augmentation.

Before the augmentation could be put in place another check told us that she was progressing!

Great news that her body was doing its thing, slowly but surely.

We found a position that she could rest in, and that the baby seemed to favour, and the synthetic oxytocin was finally started. She got a bit of rest. And then another check which said nothing had change. Her waters had ruptured at some point and it seemed the baby had its head tilted which was likely the reason for the slower progress at that point. And so we waited. She was switching sides and trying to rest.  

Then she was feeling more pressure and discomfort, and then the baby’s heart rate dropped.  Always scary. But after turning side to side a few times, she found the side this baby liked best and everything settled down.  Another check and more progress! And so more waiting. Every time she changed positions this baby would show its unhappiness with heart rate decelerations, and we would help her get back onto her right hand side. At one point the synthetic oxytocin was even turned down to give the baby a rest.  And then she was suddenly really uncomfortable and needing to breathe through the contractions. It seems so unfair when labour ‘comes back’, but this happens so often when we are getting close to the end.

A cervix check said nothing had changed, so they agreed to a water sac rupture of the new pocket of bulging membranes. This led to even more discomfort and intensity. She was getting no relief now and we were all applying counter pressure and breathing with her through every single contraction.

After more than 5 hours of zero change to her cervix she went from 5 cm to barely any cervix in the space of 2 hours! Big changes all at once. Clearly not following the typical labour progress, but getting the work done in her own way!

And we could see it, and she could feel it. And again, she pulled up what she needed and powered through.  The strength found as we transition into the next phase of this journey is unlike any other.

Less than an hour later she was dilated to the magical ten centimeters.  All that hard work had paid off! She got a surge of intentional energy and was moving into positions that felt right, letting that pressure build up, and then finally bearing down with the demand of her body.  

And then at long last, he was here. And despite all the waiting and all the work, she was still surprised to be holding him, and he was overwhelmed to be meeting his son. He was really, really here.

And he is everything.

 

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