Tuesday, 18 June 2013

They don't call it labour for nothing!

A few people have asked about my labour & delivery story.  For me, it was an incredible experience: the most challenging and rewarding thing I've ever done.  I am not shy, so I am happy to share the story.  I've kept the story on the light side, but if you are at all squeamish about medical stuff, you might find it to be TMI (too much information!)  That said, if you want to know the details of Finley's arrival, read on....

As you know, Finley was born 12 days after his due date.   He takes after his mother, who is regrettably always late.   In the week leading up to delivery, I did everything I could think of to get labour started: long walks, acupuncture, raspberry leaf tea, a traditional Chinese medicine endorsed diet... Nothing seemed to get the ball rolling.  He was quite determined to hang out in his swimming pool as long as he could.

Ok baby, you've kept us waiting long enough!

Trying to shake Rufus out with a hike at Alice Lake

Monitoring Rufus after the due date... Looking pretty happy in there!

He was served with an eviction notice on May 27 at Lion's Gate Hospital.   We started with a cervidil induction.  This is a small tampon-like insert that releases a hormone that is supposed to soften the cervix & get contractions started.  May 27th was a long & painful day, but unfortunately, little progress was made.  The next day we got serious & moved on to more persuasive measures - oxytocin induction.  This is a more powerful synthetic hormone given by IV to get the uterus to start contracting.  May 28th was an even longer & more painful day!  Despite increasing the dose to its maximum, we were not making much progress.  From 9am til early afternoon (time is a blur) I'd gone from 2-3cm to 4-5cm.  It was very discouraging.   At one point I could see that my doctor & nurse were laying the ground-work for a C-section, just to get me primed for the idea.  I was really hoping for a natural delivery, so I was not crazy about the thought of surgery.   My contractions were painful, and knowing that my progress was slow made them more difficult to cope with.   In addition to the pain, terrible nausea & vomiting added to my experience. It was not pretty!!

Either this is a delirious smile or my epidural is working!
My original birth plan was to avoid pain medications, but when I heard what slow progress I was making knew I would have to reconsider.   The nitrous oxide helped a little, but not for long.   Likewise with the fentanyl.   Ultimately I got an epidural, which was put in very quickly and slickly by the anesthetist on-call.  My epidural was slightly lopsided, but with some tweaking it got me good relief.  I fell asleep for about three hours and woke up shivering madly.   The nurse checked my progress and I'd gone from 4-5 cm to fully dilated.  Yay - time to push!  Yay?!?  Yes, I thought "yay" at the time, as I'd often heard that the pushing was so satisfying, that the pain was not a bother as you had something to focus on etc.  Plus I thought "I'm pretty strong, I should be able to get this kiddo out in a few pushes".  

I actually fell asleep in the 2-3 mins between contractions.  Sound asleep!

Nope, it just another hurdle we had to jump!   My epidural was starting to wear off, so the contraction pains were back with a vengance.   I never did get that powerful urge to push; but with the coaching and help of Derek and my nurse, I pushed my little heart out.  I can honestly say I have never worked so hard at anything in my life!  Again there were moments of discouragement. Everyone was telling me that I was making progress, but I couldn't feel any differences or any sense that we are closer to delivery.  At about the three hour mark I was running out of steam. I didn't think I could push any harder or longer. I could see my doctor at the end of the bed watching the situation with a slight shake of her head.  I suggested to her that if there was anything she could do to help the situation that I would be open to that; I was thinking maybe we ought to create a bit more room for baby, if you know what I mean.  Derek told me later that she already had the equipment open and ready at that point.  With the procedure I was able to deliver the head.   But then the shoulders got jammed.  Shoulder dystocia is the term we use to describe a situation where the shoulders get hung up on the pubic bone and baby is stuck.   It can be an obstetrical emergency, but luckily there are a number of maneuvers that can dislodge the shoulders.  For those of us doctors that do deliveries, we know how to do these maneuvers inside and out.  When I could see that I was having shoulder dystocia, I momentarily found myself thinking on the other side of the bed.  Instead of thinking like a patient, I found myself thinking like a doctor!  I kept thinking "somebody do McRoberts maneuver, somebody do a Woods corkscrew!"  I temporarily forgot that my job was actually to be pushing!  Luckily my doctor was doing all the right maneuvers and I still had some good pushes in me.  Both of us were sweating from the effort, but we got those shoulders out and the rest of the body followed with more effort!  I think we actually had torso dystocia and bum dystocia too!   And no wonder he was so hard to deliver - he tipped the scale at a whopping 9 lbs 10 oz!  I almost fell over when they told me!  How did such a big baby fit inside me??  More to the point, how did such a big baby fit out?!?!

First screams:  Lungs are working no problem!

Big Fella!!

Exhausted, relieved & happy!

By the time Finley was born, my labour had become a spectator sport.   In the last hour of labour we started to have some signs of stress to the baby; I had a fever, there was meconium in the amniotic fluid, and the fetal heart rate was elevated.  So we had the whole pediatric team in the room to look after Finley.   With the shoulder dystocia, we had also gathered a big obstetrical team: my doctor, two nurses, a med student and the obstetrician.   It was a full house.   It didn't bother me though; I was totally in my own zone, just trying to get through one contraction at a time.

When Finley arrived he went straight to the pediatrician.   I heard him let out a good loud scream, a most reassuring sound to a worried mama!   The pediatrician was an amazing doc who I knew well from numerous phone consultations we'd had on shared patients.  As she looked after Finley she called out to me:  "Heart rate is good, colour is good, etc", so I knew he was ok.   I didn't know if baby was a girl or boy yet, til I heard someone say: "What a big boy!"  Finley!

Finley had a fever when he was born, and was white as a ghost.   Given the few complications at the end of the labour, the pediatrician decided to run a few tests on him.   She was concerned that he might have an infection, so she recommended antibiotics and admission to the special care nursery.   He was stable though, so they let me hold and cuddle him before he had to go to the nursery.

Seeing and holding Finley for the first time was unforgettable.   I was surprised when I saw him:  So big!  So fair!   So blond!  He was perfect!   He snuggled right up on my chest and it felt like we'd always known each other.  It was so powerful and wonderful to have my little guy on my chest and my amazing hubby at my side. I've never been so much in love.
Words can't describe

Finley only had to stay in the nursery for two days and then he came to our room.  He did super well and has been a strong eater from the start.

In total we were in the hospital for five days. There are so many people that we want to thank for that excellent care we got.  All of the doctors that saw me through my induction and the nurses were amazing. Particularly our nurse Pam, who was with us through the delivery.  She was an unbelievable coach and an awesome support.  Thanks also to all the nurses in the special care nursery who looked after Finley in his first couple days.  Once he moved over to the ward and we faced our first fussy night with Finley, the nurses there were also amazing at helping us through.

My biggest thanks of all goes to Derek. He was absolutely unflappable, amazing and supportive through my labour.  I can't imagine being looked after better than that.

Visiting 1 day old Finley in the nursery

Say hello to Daddy!

 Daddy gets a cuddle

We both need a nap after that hard labour!

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