Sunday, April 17, 2011

Veronica's Birth Story - Part 2

I am writing this as quickly as possible so that A'Dell can read it before she goes through HER second labour.

Part 1

Once I finally wrapped my head around the fact I was in labour -- and I' m usually not that dense, I swear! -- we settled in to the L&D room. I was delivering at a different hospital than the one at which I delivered Teddy, as the midwives had gained privileges at more hospitals around the city. The L&D rooms at Montfort, the primarily francophone hospital where I had Teddy - were very nice, but the ones at the Civic Hospital were not bad either. The Civic has a Level 2 NICU and is used to seeing sicker infants. As such, the staff don't panic when there are complications. We will ultimately discover how important this tendency is.

I once again had a cheering section and I attribute my ability to have two pain-med free deliveries to this support. In the room this time were Dave, midwife Jackie, primary doula Zoia, second midwife Amanda, and doula student Mary. Most pregnant friends express surprise at the number of people in the room, wondering if I was embarrassed. I have no problem telling them that by this point, you don't care who sees you, especially if it's people you trust. And having that many people to give you ice, to smooth back your hair, to cheer you on through the rough parts...I am tearing up just thinking about the amazing support I have received both times.

When I delivered Teddy, I had some crazy bleeding near the end. It was likely due to my anterior placenta and my totally exhausted uterus -- I ended up having to push Teddy out AFTER my tired uterus had stopped contracting. I needed to have pitocin to deliver the placenta, and I had to get an IV placed while Teddy was crowning. NOT fun, let me tell you. This time, we decided that I'd probably need pitocin again to help with the placenta. We got the IV placed while I was between contractions.

With the IV in place, I lamented to fact that I couldn't labour in the tub. When Jackie overheard me, she quickly set me straight - I could totally use the tub and we'd just work around the IV. She made me promise that I'd have to get out of the tub if my water broke and/or I had the urge to push. And once again, the tub was amazing. I was only in it for about 15 minutes, but it just like last time it made that last bit of transition a bit easier to bear. But I kept getting the urge to push, so back to the bed I went. It was just after 8 a.m.

I started to push, but the fact that my water hadn't broken combined with an anterior cervical lip (again) made progress painful. This stage was just awful. With Teddy, pushing was great - I was finally able to DO something with the pain from the contractions. But this time, I couldn't stop shaking, I was overheating, I thought I would throw up - it was just wretched. It came on so quickly this time. I had a minute or so of "I can't do this!!" moaning and groaning, but the cheering section kept cool clothes on my head and neck and kept encouraging me. My water hadn't yet broken, though, and it was impeding my pushing. Finally and with my permission, Jackie used an amnio hook broke my water and started a bit of pitocin for the eventual delivery of placenta. And that's when things started going a bit pear-shaped.

There was meconium in the amniotic fluid, which the midwives told us immediately. That meant that I'd need to have continuous monitoring from the bed for the remainder of the delivery rather than the intermittent doppler monitoring I'd had up to that point. It also meant that once she was born, an on-call pediatrician and crew would have to take her over to the warming table and clear her airway to prevent meconium aspiration. Jackie put the call in to the team, and I was dimly aware of a few people coming in to the room.

I pushed through the anterior lip with Jackie's help - she had to hold it down, just like Ann did the last time - and harnessed the contractions to push, push, push the baby down the birth canal. It was painful, but I knew that the sooner I got her out, the sooner we'd be able to deal with the meconium issue.

I pushed for 10 or 15 minutes, and this time I could feel how close she was to being delivered. And then, she was crowning. Jackie coached me through, pushing and panting at appropriate points. And then her head was out. I could hear her making some noise, but the midwives couldn't encourage it because they were worried about her aspirating the meconium.

But just like last time, things stalled. Amanda had been monitoring the baby's position the entire time. She'd come in to my pelvis on the left, but had down a corkscrew through my pelvis and came out on the right. In doing the corkscrew, she'd opened up her shoulders and come untucked. And she was stuck. Shoulder dystocia one again; I must have some pelvic craziness. And the crazy corkscrewing took its toll. Poor Veronica's entire face was bruised, and all of the blood vessels in her eyes burst. The whites of her eyes were red for three weeks.

Once the baby's head is out, you have 4 minutes to get the body out before you have to do an emergency c-section; sometimes they'll break the baby's arm to prevent this. They call in an OB team in this sort of potential emergency situation. With Teddy, we got him out after just over a minute. With Veronica, it was closer to 2.5. I pushed, Amanda pressed down into my abdomen to force the baby's shoulder to tuck, and Jackie reached in was finally able to haul her out, all 8 lbs and 15 oz of her. It was 8:46 a.m.

Poor Dave had a front row seat to all of this, but the worst part was that she had an APGAR of 3. She came out totally gray; Dave was petrified that she wouldn't make it. She was immediately whisked away to the cart to be in the care of the pediatrician and his team. They had to intubate her 3 times and do chest compressions in order to get her breathing steadily. But her second Apgar was 7, so she rebounded right away. And to their immense credit, the midwives and doulas reassured him right away that everything was going to be fine.

The pitocin really worked, because I delivered the placenta less than 2 minutes later. That's right - LESS THAN SIX HOURS from first contraction to delivery of placenta.

A lot of this time was a blur, as it happened so fast. But a few moments stand out. These include:

- the fact that everyone was so focused on the baby's breathing that the didn't pay attention to sex. The team kept saying "he'll be fine. He's fine." Finally, I called out "HE?!?". But the doulas and Dave assured me that it was, in fact, a girl.

- Jackie's astonished tone of voice when she pronounced "Your perineum is intact!" Frankly, with such a big baby and so much yanking down there, it's a minor miracle.

- Jackie and Amanda saying in a kind but serious way: "Sarah, promise us that you'll never attempt a home birth!"

After her 2nd APGAR, they brought her over to me. Her breathing had a bit of a hitch to it, and she wasn't terribly interested in nursing, but I snuggled with her while they cleaned me up.

More on the aftermath - my blood pressure spike, her initial nursing trouble - in the next installment.

Wednesday, April 13, 2011

Veronica's Birth Story - Part 1

This is only 8 months late {hangs head sheepishly}. Better late than never, right.

My irritable uterus had me leave work in the middle of July, and I spent the remainder of that month and all of August taking it easy to prevent contractions. And boy, by my midwife appointment on Monday the 23rd, I was tired of being pregnant. I was at 39 weeks, 3 days when I met with my secondary midwife Jackie. The first thing we discussed? Was our mutual belief that she'd be delivering the baby rather than my primary midwife, Claudia. But I'd really clicked with Jackie so that was no problem at all. In fact, Teddy had been delivered by my secondary midwife with whom I'd also clicked.

During the appointment, had a lengthy discussion about shoulder dystocia (when the baby's shoulder gets stuck during delivery) as I'd had it with Teddy. We reviewed all the techniques that midwives can do if it occurs. She measured the baby, who was measuring almost 41 cm. Though the baby was left occiput anterior, Jackie had trouble finding the head, so asked if she could do an internal to see if the baby's head was in my pelvis. I agreed, and asked her to check my cervix to see if anything was going in. Baby's head was as predicted, and my cervix showed no dilation. "You need a few good contractions to get things moving," Jackie told me.

I'd been suffering from pregnancy-related insomnia for much of the third trimester. Late that evening, I headed over to Isha's house to pick up some cloth diaper stuff, and I caught sight of myself in their mirrored closet. "UH!" I thought. "I look so bloated and awful." But I was convinced that it would be a while; I told Ish that much as I departed around 11. I came home, said goodnight to Dave (who'd been sleeping in the guest room to give me the whole bed) and was able to fall asleep around 2 am.

Imagine my surprise when I woke up at 3 am to very strong contractions.

I should give you some context. In the days before having Teddy, I'd have contractions overnight, but they'd fade in the morning. I was in passive, then active labour with Teddy for 28 hours, with three hours of pushing, and my contractions NEVER got closer than 6 minutes apart. NEVER. It was a labour that confounded my doulas (one of whom - Zoia - was coming along for the ride this time, too).

So, when intense contractions started, I thought "Ok. These will help my cervix ripen. No big deal." As with Teddy, the most comfortable position for me was standing and swaying through the contractions. I didn't want to wake Dave until I had to, in case this was a false alarm. So I breathed and swayed and glanced at the alarm clock. "Odd", I thought. "These contractions are less than 5 minutes apart. I wonder when they'll slow down?"

Just before five, the contractions became so intense that I had to moan through them. They woke Dave, and he joined me and began timing. He was totally taken aback as the contractions were between 2 and 3 minutes apart, lasting at least a minute. He suggested that we call the midwife and the doula, just to alert them. "It's too early - I don't want to disturb them," I implored him. "Let's wait until 6". We made it to 5:30.

We called Zoia first. "It might be nothing," Dave said, as I was breathing through another contraction and couldn't stop to talk. "We'll check back in within a half hour if things don't slow down". Zoia, no fool, grabbed her stuff and started loading the car. We paged the midwife. We called my parents, letting them know that they'd need to come in to look after Teddy. Jackie called back, and spoke to Dave as I was once again breathing through the contraction. She heard the story and listened to my protests that "it might be a false alarm."

"Sarah," she interrupted me, "If you water breaks, call an ambulance. Meet me at the hospital as soon as you can."

Dave called Zoia back. She was already en route to our house. She arrived just after 6, and for the second time in my life, witnessed me losing my sh*t in our ensuite bathroom. "Zoia, I am not handling this well. I am not sure I can do it!!" I kept saying. She helped me breathe through the worst of it, and when I was coping better, suggested that she head to the hospital. We'd meet her there as soon as my parents arrived.

My Mom and Dad got here at about 6:40. My Mom thought that Dave had said the contractions were 4 minutes apart. "Let's go to Tim Horton's", she suggested to my protesting Dad. They got here, I said a distracted goodbye to Teddy, and off to the hospital we went...right when traffic was picking up.

Mercifully, my contractions slowed down a bit while en route to the hospital. I had to breathe through a few, but they were bearable. This lead me to believe that it was a false alarm. Yeah - I'm super swift.

Zoia was waiting at the hospital entrance, so Dave dropped me off. We headed up to L&D around 7, as the new shift was starting. I stopped three or four times to get through contractions on my way up. Jackie was waiting for us. "It might still be a false alarm." I kept saying. "You are going to have this baby very soon," she told me. We skipped the exam room and headed right into a L&D room, where I changed. Jackie checked me and proclaimed: "You're 10 centimetres dilated and the amniotic sac is bulging."

"Um, ok. Not a false alarm, then," was my witty reply. I looked at the clock. It was 7:20 a.m.

Thursday, April 7, 2011

Fair warning: off-colour humour ahead.

As the title says - fair warning.

Last week, I gave Beth the gift that just keeps on giving. That's right. I gave my best friend herpes and gonorrhea. I got an email with the subject "YOU GAVE ME THE CLAP!".

Beth has a number of stuffed giant microbes from a company called Giant Microbes. When I discovered that they made these, I could not resist sending her some. Come on. The jokes just make themselves.

The MAIN reason I sent them, though, was because I wanted to support the store that sells them. Mortimer Snodgrass, an adorable and wonderful store in the heart of historic Old Montreal, is owned an operated by the lovely Virginia of Mortimer's Mom (a blog I miss!). In an INFURIATING turn of events, a CITY-OWNED building next to the store has collapsed and the municipal government (notoriously ineffective) seems uninterested in the damage it is inflicting on hardworking local small business owners. The repairs might take months to complete, right in the middle of peak a tourist season. It is totally safe to get to the store, but with the only signage in French, many shoppers are avoiding the area entirely.

It makes my blood boil that this charming little store is struggling because of the ineptitude of the city government, a government who'd been warned that this building was in danger of collapsing. I am a civil servant, and this sort of behaviour makes me ashamed. I can't do much to help, but I can do some shopping. Yes - Mortimer Snodgrass has an amazing online store with the BEST customer service I've ever encountered. With so many pregnant friends, I need lots of gifts! Plus, they ship worldwide.

Look at some of the great stuff they have, you guys! Check out the matching shirts that Teddy and Veronica will be sporting this summer. The staff recommended this storage caddy/tote and I love it so much that I'm buying more as gifts. These bibs are adorable and huge hits in our house. There are water bottles, ice molds, books, umbrellas, bags, many fun things.

If you are looking for something fun, I cannot recommend them enough. Don't let the dumb bureaucracy win, people. Shop Mortimer Snodgrass. You will be so glad that you did!