Sunday, June 17, 2012

The labour and delivery process

I just want to start off by saying that this was my experience with the process, the hospital and the staff that I worked with. I would also like to remind others that I am a nurse, and while I do not work in the maternity/pregnancy field I am educated in it.

So it all started Monday June 4th, my due date. I had a doctors appointment for that day. It was for 330 and we got in pretty quickly. My Doctor decided to do a membrane sweep and then “accidently” broke my water… I truly think she did this by accident she said it was the first time in 12 years that someone's water broke in clinic. So after that we got sent up to the Early Labour Assessment Unit. They put me on the monitor to see what baby was doing and if I was having any contractions… baby was fine and there were no contractions so we got sent home to either wait for the labour to start on its own or we would be back in 24 hours and induced. At that point I was dilated almost 3 cm.

So we went home to wait, we ordered pizza for supper and by about 6:30 I was having the first signs of regular contractions, nothing too painful or anything just some tightening in my abdomen and back. We tried to chill, watching TV and stuff and I managed pretty good. Then we decided to try and get some sleep… for me that never happened. Dean napped for about an hour while I laid awake and got more and more uncomfortable. Finally around 1230 Dean got up and showered and got ready for the long haul. I also got in the shower, I figure around then my contractions were about 5 minuets apart and lasting 20 – 30 seconds. After the shower I was very uncomfortable with more and more pain in my back. Dean made me eat something and we settled in to monitor my contractions, we monitored them for about an hour and they were about 4.5 minuets apart lasting about 45 seconds. We had been told in prenatal classes that contractions should be 4 minuets apart, lasting a minute for at least an hour, however papers they had sent home with us said 5 minuets apart was when we should go in. I was really uncomfortable and getting a little anxious by then so I called the Labour and Delivery unit. The charge nurse said I should probably come in, so we got ready and headed into the hospital… that was around 3:30 in the morning.

Once at the IWK and back to the early labour assessment unit I was again put on the monitor, and let me tell you laying there for at least an hour was difficult. Baby didn’t like one of my contractions which made me have to stay on the monitor longer. Not to mention the nurse we had wasn’t particularly friendly or helpful. After looking at the monitor for a bit she mentioned that ideally my contractions would have been 3 minuets apart before coming in, talk about mixed messages! Afterword's she said there wasn’t really much to do, there were currently no Labour rooms available… so why did they tell me to come in?? Anyway she told us to walk around for about an hour, this was at about 530, so basically until the end of her shift?? So we paced the IWK halls, mostly the link building as there were very few people around. At that point I was holding on to Dean for most of my contractions and my back was just miserable. After pacing for a while we went back, the nurse could tell I was in pain so was able to get me in line for the next clean labour room with the hopes that the bath tub would help. At this point when explaining where all my pain was she had stated that it didn’t seem like real “back labour” (more on that later). She also checked me at that point and I was 3 cm dilated… in all that time I had only reached 3cm!

I was put on the monitor for shift change and then had a nurse who actually seemed to care, she was the same nurse that did my assessment the previous afternoon, which to me still seemed like the same day. We still had to wait for our room but once we were in it was much more comfortable. While we were in the Labour and Delivery unit we were still not technically admitted so we kept the nurse we had until I was admitted. We found the radio and got some tunes on which helped both Dean and I relax a bit more and I ran a nice warm tub. While IWK doesn't do water births and their tubs are just normal size tubs it was nice to climb in. I definitely needed Deans help and I still wanted him around for my contractions but I felt alot more in control and relaxed. Our nurse was in a few times to check on baby and I eventually got a bit chilled and got out. We had noticed that in the tub my contractions had lessened to about 4 – 5 min apart. But when I got out of the tub I guess gravity took over and they sped back  up again and felt stronger.

Somewhere between 10 and 11 we called my Dad and let him know there would be a baby on the way, we also called my Aunt to come as she was going to be my other support person. Around that time I also began to freak myself out. The pain was getting really bad and I wasn’t finding any relief in any position. After spending so much time with just Dean and I, I began to get scared. I didn’t really know what to do so I began crying and we rang for the nurse. A nurse helping out came in and was able to calm me down a bit, she  helped me realize I was ok, and it was all normal. Again the pain in my back was crazy, which I just didn’t expect. She went and my regular nurse came back and checked me, I was only 3 – 4 cm dilated! We talked about our options and decided to try some morphine/gravol and get back in the tub.

This is where my first thing I would change happened. I wouldn’t have taken the morphine. Not that it caused any harm at all in my labour process or in Abby’s health, but truthfully had I just climbed back in the tub I probably would have been ok. It may have take some of the edge off, but not enough to really help, I think the tub helped more. And by then my aunt had shown up and brought some lunch for Dean and some muffins and stuff for me. I stayed in the tub a bit longer this time and finally I was admitted! That meant a switch in nurses but the one I ended up with was just as good.

Shortly after that I was back out of the tub and sure enough my contractions picked up again and I decided I wanted the epidural. I was entering the “transition” period where contractions are pretty much one on top of the other and I was not a happy camper, this is where women yell and scream at the world and how it’s their partners fault they ended up this way. My nurse noticed where I was and I was in total panic I couldn’t focus and I was screaming, I was holding onto Dean for dear life with my aunt massaging my hips/back because it was where all the pain was. While I was wailing away the nurse was trying to get an IV started in my arm and get blood work, we tried the nitrous gas which is meant to help but it didn’t, probably because I couldn’t/wouldn’t take deep breaths. It took Dean, my aunt and the nurse to keep me calm/still enough for the epidural to go in, I don’t really remember their being any pain with that as I was having too much pain everywhere else. But what I do remember was that once it was in I felt relief almost right away.

It was a huge emotional ride for all of us during that (I am guessing) hour. I said things I didn’t think I would say, Dean was upset, I missed my mom terribly. And once I was comfortable and calm I balled like a baby for a few minutes. We had some visitors at that point (my uncle and cousin) and I was able to nod off a bit and get some sleep. I don’t think Dean slept at all even though we told him too. We were lucky he went to get our bags. I made it through till shift change and was checked and at 7-8 cm! We had some progress and were almost there! My legs were numb and turning was difficult without help but I was almost there!

At shift change (7:00 in the evening, 24 hrs after labour began) a whole whack of people entered my room. One was the nurse who was reliving mine, and there were 4 doctors, some students and some residents. The only two I remember are the attending and who I refer to as Dr. Dude. He was the one who did all the talking to me, and who actually delivered Abby. He was great and supportive. I was feeling pressure to push at that time, but the nurse said until it was unbearable I should wait it out, it meant baby was moving down on her own. I was checked again at some point and was 10cm! I made it all the way! We were still waiting to push and we had decided around 10 we would start, however I spiked a fever around 8:30 – 9:00 and was given antibiotics and Tylenol. I remember shivering like a leaf and having warm flannels on me. At 9:30 my temperature was crawling back up and I had the urge to push so the nurse decided it was time to start. It took a few tries but I learned how to do it. With the epidural it was harder to feel when and what to do, but I got in the swing of it. Dr Dude was in a few times to check on me and the nurse was down there doing her thing. I had Dean and my aunt on either side helping me with my legs, which were pretty dead and numb.

Dr. Dude came to check the progress and discovered that little Miss Abby was in the posterior positioning, meaning the baby was facing my front or face up. This was what caused all my back pain! He tried to flip her, and succeeded, but she flipped back, so we just left it and it meant I would either labour longer or may need a C-section.  Very shortly after that,  while I was pushing a nurse came to relive mine to go for a break. I am not sure if it was the change in nurse, the news that baby was the “wrong way” or that I was having what I think where muscle spasms in my upper thigh/buttock.

I shut down at that point and stopped pushing, so we tried to make me more comfortable, they gave me more epidural drugs and I flipped from side to side. It is at that point that I think baby flipped because I was moving around so much. The pain while not completely going away lessened and when my nurse came back she got me pushing again. The doctors were in off and on and I wanted to know if I was going to have the baby before midnight, Dr. Dude thought so but my nurse didn’t. Very close to midnight Dr. Dude was in and spoke to me about using a vacuum, baby wasn’t doing as well and my fever was still an issue. However after mentioning the vacuum I pushed harder and better. I really didn’t want anymore interventions than I had. The rest is sort of a blur, I was pushing almost all the time, the doctor did end up using the vacuum for one contraction to get her out but I don’t remember it really, I remember everyone telling me to push when I didn’t think I had any push left, and a feeling that is truly indescribable. I remember hearing “Does Dad want to cut the cord” and something about it being a girl, I looked for Dean for confirmation that it was a girl, and after him saying it was I was waling. I was so happy! We had both wanted a girl and I had really thought we wouldn’t get out wish. I heard her cry and they brought her to us. She was perfect!


I ended up needing some stitches “down there” but barely even knew what they were doing. I help baby for a while and tried to breastfeed, she wouldn’t latch which was ok. They cleaned me up a bit and my aunt and Dean made the important phone calls. I was beat but had my baby girl. I am not sure where time went but Abby was born at 1207 at night, and between then and 3:00 I had a bath and was sent up to the Family Newborn Unit… which will be another post all together.

My experience through the Labour and Delivery was a positive one. I has mostly good nurses and the job got done. I found early labour was rough and got mixed messages about when to actually go into the hospital. Dr. Dude used the vacuum which I would rather of not had needed, and didn’t exactly consent to but it was for one contraction and Abby only had a small bruise that lasted a few days. Definitely a positive experience for those 2 days of labour!

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