The birth of Ruby

Hey everyone;
sorry I've fallen off the map a bit. Ruby and I went through a crazy ride. I'll spill the details here now for everyone. Warning, it is detailed and I have included even the smaller details. If you have a light stomach, perhaps you shouldn't read this...

I was in an appointment a block away from Matt's work when my water broke on May 4th at ten to two. Contractions started soon afterwards approximately 20 minutes apart and so Matt and I went to the hospital, got checked out and were told it was safe to go home. Due to me being positive for a very common bacteria, I had to go back to the hospital every 8 hours for and IV of antibiotics. The process was tiresome. The contractions were not regular, some were 20 minutes apart, and others were 3 minutes apart... but because I wasn't progressing/dilating, there was little to do but wait. At the 24hour mark, I went in to the hospital for another IV and they decided to keep me in hospital; reason being, the risk for infection goes very high for both mom and baby when the water breaks and goes past the 24 hour mark. So at 2:30pm on the 5th I was admitted to the hospital and kept. Th doctor informed us that the maternity ward was unusually busy and that the three maternity nurses they usually have on staff are not adequate. In fact when I was first checked on the 4th, they had to do so in the surgical unit since there were no spare nurses in maternity to be found. The Doctor told me they would like to start me on pitocin (induction) since my labour was not regular yet and I'd only dilated one centimetre since the day before (For a total of two centimetres.... you need to dilate ten in order to being delivery)

Problem: When inducing a labour, a nurse is required to sit with you until the delivery once pitocin is administered-they couldn't spare a nurse to sit around. So, the doctor told me that if they had to induce me, they would fly me out to either Prince George or Vancouver where they had better resources to handle the inductions and where they had more staff available. I had until 2 am to get regular contractions and begin progressing or they were flying me out. That was the latest the doctor could book a medivac and it would be 36 hours after my water broke. At 48 hours, the baby had to come out or one or both of us would have an infection or begin complications that may be irreversible.

By 2 am, my contractions were 3 minutes apart and I was 7 centimetres dilated! Yay, no medivac! However, after being in labour for 36 hours I was beginning to get very tired and sore. I had had no sleep due to the constant returns to the hospital and the odd contractions... The contractions were so acute that no position besides standing was comfortable. Sitting, laying down, labour balls, nothing was helping ease the pain. So I tried the shower. The heat from the shower and the 36 hours of labour (mostly on my feet) led to very swollen ankles that were painful. Once the contractions were a minute apart I wasn't getting any rest and asked about pain medication. The nurse recommended morphine which is mixed with gravol. She said it allows the mother to rest between contractions; since i was in labour for so long, I could no longer force my body to relax and that was part of what was making it so painful. So I got the shot of morphine and for a couple of hours I was able to lay down between contractions, but still had to stand during. Contractions were also getting very long, lasting sometimes over two minutes and only two to three minutes apart. The morphine did slow the progression of the labour, but not by much. Once the first dose of morphine wore off, I still had to wait an hour before I could have the next dose since the drug had to be completely out of my system before the next dose could be administered. I was checked, and I had progressed to eight centimetres.

So, the second dose of morphine was administered (Still with a second dose of gravol) and it failed to work. The contractions were extremely painful and the morphine had no effect. Problem was, I am very sensitive to gravol and having had a second dose of gravol without any pain relief, I was passing out between contractions on my feet. Matt was there and kept an eye on me so that I wasn't falling. But my body remained tense through each break even though I couldn't stand. I was barely able to walk a single step between contractions due to the lethargy and the contractions were intense enough that I was bracing myself of equipment and rails and lifting myself off my feet with the strength of them. Groaning really helped relieve the pain since it relaxed my lower abdomen and left only the contractions to focus on rather than the natural clenching of ab muscles that came with each contraction and would actually make the pain worse.

For obvious reasons the nurse and doc had to wait a full hour to ensure that the morphine wasn't in fact working before administering any other pain medication... First we tried laughing gas, and it tasted bad and made no difference. The only other option at this point was an epidural.

The anaesthesiologist was called in. I had asked for an epidural around 5:00am on the 6th, the doctor- knowing I had originally wanted a drug-free birth, could no longer speak with me. The contractions were 30 seconds to one minute apart and lasted for two minutes or so each. Still I was only 8 centimetres dilated. Still not enough. The doctor turned to Matt and asked him what he thought and whether he would be okay assisting in holding me down. The epidural required that I sit on the bed (making my contractions worse) and that I hold entirely still during the procedure since a large needle is inserted into the spinal column. He was asked also if he preferred to leave since the procedure can be very intimidating and painful to watch. Matt said no. Matt stayed with me and held my shoulders down over the table. He kept eye contact with me while the local anaesthesia was inserted into my back. His support and understanding were beyond compare.

The procedure took ten minutes in total, during which I experienced three long contractions, hunched over with Matt holding my shoulders and a nurse on one side and the doctor on the other. Matt was whispering words of comfort and assurance, praising my strength and assuring me that I wasn't "Giving in" to the procedure. A small sense of loss accompanied the epidural, like I had failed... but Matt was there, holding my hand and giving me kisses and telling me that I'd gone over 40 hours and needed the rest. He told me I was indeed tough and didn't need to prove anything. Matt made all of the labour easier, every part of it. Without him, I would have been lost.

As the new drugs began to work, and the gravol was still present, I began losing consciousness. I slept for two hours and when I woke up it was time to push. Fully dilated (ten centimetres, and at plus one -which means the head and cervix have already begun descent) the doctor told me I could begin pushing. Now, for people who are uncertain: although the epidural makes you "numb" from the waist down- you can still feel contractions. They feel like any other muscle contraction, but there is no pain. So, feeling when they came I was able to push.

When the nurse checked and felt something amiss, the doctor took a look-see. My cervix, although completely dilated had left a very thin layer on both top and bottom and was cupping Ruby's head. Ruby's head was unable to pass through the birth canal because she was caught. From 11am to 2pm I was allowed to push. At 2:00pm, it was officially 48 hours past the breaking of my waters and the doctor and nurse decided to speak with me and Matt, they brought along the obstetrician (read: surgeon). The two options: Vacuum extraction and/or cesarean. The vacuum extraction, because it is very hard on the baby, is only tried three times. If it fails three times then we are to go to cesarean. However, the baby was now at plus two descent past my pelvis, which means the cesarean would be very risky because they would have to pull the baby back out of the pelvis and in combination with the pulling on baby, it can be very risky for mom.

The doctor, not confidant using a vacuum at plus two (usually only reserved for crowning which is called plus four), told me she wanted the obstetrician to be present since he was comfortable using a vacuum at plus two and had more experience doing so. I just nodded. Once everything was settled, another problem arose... The epidural was failing to work. The contractions were back with a vengeance, and the doctors were all stumped. The epidural was still delivering the drug, and I was effectively laying down... why wasn't it working?

The doctor and Obstetrician, were both uncomfortable using a vacuum on someone without pain medication and so the anaesthesiologist was called upon but we had to wait for him to exit surgery. Once he arrived it was three pm. He changed the drug being administered to a more potent drug. When I asked him which one, he said it was the drug he usually reserved for cesarean sections.

Once the drug took full affect, I could no longer feel anything. This posed another problem because I couldn't feel my contractions any more. The doctors tried to use a regular vacuum but it was took big, and it was pinching cervical skin... this was not good. Now the doctors had to scramble to find a smaller vacuum and get the baby out ASAP. I was developing a fever, and my blood pressure was dipping... (When it was usually high)

At three thirty they found the vacuum, and began preparing. The first attempt ended with Matt being sprayed with gunk. His whole face had been splattered with blood when the vacuum let go. Matt was a soldier, wiped his face, spat on the floor and then continued to hold my leg. Taking turns watching the birth and comforting me. On the second attempt, the doctors effectively communicated to me when a contraction was coming and raised the suction pressure.

Baby Ruby came out on the second attempt at 4:21pm. Her vitals hadn't changed at all and she suffered no stress during any portion of labour. She weighed in at 6 pounds 9 ounces and the doctors noticed something strange: First, her umbilical cord had a knot in it... something that could have killed her at anytime during either pregnancy or labour. Second, she had her arm up beside her head when delivered, which might have been causing the inability for her to exit the cervix. (She still sleeps like that!)

After delivery, I suffered a postpartum hemorrhage which should have required a transfusion, but the doctor was very busy stitching up the tears within my vaginal walls and stopping the hemorrhage that by the time she was done, I was still conscious and she decided to give me a prescription of iron instead. My hemoglobin levels came back at 75, normal levels are 110.

My hospital stay was six days, and we were released on Monday the tenth. The doctor only felt okay releasing me if I felt okay going home.

So far, home has been a welcome place with the help of my mom and dad (Grandma and Grandpa!), and Matt's now gone back to work as of Wednesday.

I want to thank everyone who prayed for us, things could have gone worse- but they didn't. I appreciate it and I love each of you for being with us in mind or spirit.

Me at 22 weeks, last week. December 26th, 2009.

While I'm on the subject...

I was looking around at previous websites I used to visit and found that I had this blog. I totally forgot about it! But ah well, I'm back now! At the moment I am 23 weeks along and the pregnancy is healthy as can be.

I went jogging for the first time yesterday since the summer/conception. It was hard but I made it 1.5 KM on my first try here at the track in our local gym. I got a few odd looks, mostly from men. They saw the belly and then they saw the lady go jogging by with this belly.

Right now I am reading a book called the 90-minute Baby Sleep Program. It's a great resource for pre-labour information about proper sleep habits for infants and even toddlers. The book is written by a Doctor who specializes in sleep and it's important role in maintaining good heath.

What really stuck out to me was the following part: "We are Cavalier about our own sleep needs, and some of us may even brag about how little sleep we get at night. In this way, we are poor role models for out children." Page 12; Moore, Polly.

It's so crucial. I can tell in my own life that everything starts to fall apart when I don't sleep well. I do poorly at work, I can't handle the stresses on a daily basis. At home I'm not only picking fights but I can't emotionally handle the fights and that leads to missing out on sleep too. In all, I'm a pretty good example of how sleep affects not only our social interactions but also how it affects our overall productivity! It wasn't until I started working shift/relief work that my university grades fell below my normal average. When I switched to a more regular job my grades returned to their normal range.

All in all, the book encourages parents to put children to bed when they demonstrate the sleepy symptoms and to encourage them to sleep as often as they need. She sites countless articles and studies that have already demonstrated that learning does not remain permanent or learned until a good night's rest. Learning and our ability (and a baby's ability) to apply what we've learned to consequent experiences is based on the quality of sleep we have after the learning! Amazing!

Anyhoo, that's that. It's great and even my husband looked excited about the book when he opened it from the box my parents sent us for Christmas.

I'll be posting a pic of me at 22 weeks (last week) so that we have a few things to monitor progress with.

New!

So, they say it's therapeutic for mom's to be to put their thoughts and worries in writing... so here I am. I also hope to put things on here for when I need them. Since I am moving way up north and I won't get the chance to see a Baby's R Us anytime soon, I will be putting my wish list on here too!

Thanks for checking out my page, and take care!
Amanda