The best laid plans.
This was the refrain Paul and I kept coming back to as we navigated the moments leading up to the birth of our son. The events of the day were already shaping us as parents and putting into practice what we knew would be required on this journey – an understanding that we can plan and prepare, but ultimately, this new adventure would require us to be flexible.
So what was the plan?
Whenever anybody asked me where I was giving birth my answer was always, that my intention was to go to the Toronto Birth Centre (TBC), but if we needed to go to a hospital it would be St. Michael’s (as this is where our midwives had privileges). While I knew a hospital birth was always a possibility, I didn’t really believe that I’d be delivering there so I just put this idea in the back of my mind as an unlikely outcome. While I had initially been very hesitant about an intervention-free birth (i.e.: no epidural), after touring the Birth Centre I knew this was precisely the environment that I wanted for this experience. The entire space has been set up to support labour and delivery – from birthing balls and slings to a giant tub and an in-room sound system so you can put on whatever calming playlist or meditations you need. As a result, Paul and I spent a lot of time preparing for precisely this kind of delivery – we took a course on having an empowering birth, did a lot of reading, committed to a regular meditation practice and had lots of conversations about how to have a positive experience with each other, our midwives and our doula. I felt ready for a long, slow-building labour. Heck, we even created a list of movies to watch during those early stages of labour, made a playlist of familiar, calming music for when the time came (you can check out my “Labour of Love” playlist here) and routinely visualized our drive and experience at the Birth Centre.
So how did it all begin?
On Friday, January 18th, 2019 around 6:20am I woke up as Paul was getting ready to go to Crossfit (admittedly I was a little sad that I wasn’t joining him due to some joint pain I’d started experiencing earlier in the week). I got up to pee and then something felt… different.
When I stood up I saw the first sign that things were already off plan. I called Paul in and told him I thought my water broke, which was quickly followed by a phone call with our midwife to confirm what we suspected – there was was thick meconium in the fluid. The Birth Centre was no longer an option*; we needed to go to the hospital and soon.
*TBC doesn’t do continuous fetal monitoring and meconium could be a sign that the baby is in distress, which means continuous fetal monitoring is required.
We tried hard not to focus on the disappointment and fear that was mounting in us and instead jumped into action. After a quick shower we grabbed our bags and headed to the hospital. As we drove along a route not dissimilar to our early morning commute we were unusually quiet for the two of us, full of anticipation and some nervous energy for what was to come… so naturally we put on some rap music and tried to soothe our nerves to the sounds of Saba and Kendrick Lamar😂.
Once we got to the hospital I was so glad that we took a tour (more on that and other ways we prepared for birth to come) – the endless maze of hallways and lines drawn out on the floor, mixed with that distinct hospital smell seemed overwhelming and we did know where we were going and what to do – without that information we would have felt so lost (literally and figuratively). I’ll be honest, our first interaction with the hospital staff did not impress me and had me longing for the soothing voices and serene ambiance of the Birth Centre. When we arrived at the nursing station in the maternity ward the nurse asked me a question that I did not hear, so I turned to Paul with a look I’d given him many times over the years – what? – and he turned and answered for me. Then the nurse, in her sassiest voice, looked at him and said, “she can speak for herself can’t she?” We were both completely taken aback. Somehow Paul mustered a calm, but firm, voice as he replied, “yes, but she’s hard of hearing so if you’d like her to answer your question you need to speak up.” I just stood there hoping this wasn’t a glimpse into the kind of treatment we’d be getting during the day (spoiler: it was a less sassy but kind of edgy staff – I suppose working in a downtown emergency centre you must see some things that impact your bedside manner).
We beat our midwife there so we headed to the waiting room, which was pretty much a small glassed-in box plopped in a hallway as an afterthought, with chairs lining the edges of the cramped room. We were there with two other women and their partners – both were delivering twins via c section that day. I kept thinking how weird it must feel to know the exact date you’re going to become a mother, but I thought it was lovely that they could relate to one another in ways that most people can’t – my first glimpse into the amazing ways that motherhood can bond you instantly with a total stranger.
When our midwife arrived she ended up having a minor altercation with the same nurse – they asked us to step aside so they could “talk”. It was an interesting lesson I hadn’t intended to learn but apparently there can be a bit of tension between midwives and nurses (which came up a few times throughout the day). However, it was in that moment that I became so grateful to have our midwife on our team – I had full faith that she would advocate for me to the ends of the earth if she needed to, and she did. The nurse didn’t seem to believe Paul and I when we told her there was thick meconium when my water broke and my midwife was adamant that I needed to be checked in and assessed. In fairness to the nurse, she was dealing with an incredibly busy time, along with planned births of multiples.
Our midwife eventually sorted things out (while Paul and I awkwardly watched from a distance) and took us to a room to assess the situation and set up monitoring for both the baby and myself.
A slow start
At this point we could see that I was having minor contractions, but I wasn’t feeling any of them. Once my midwife examined me my body told a similar story – I wasn’t entirely effaced and was 0cm dilated. We could also see that the baby’s heart rate was decelerating occasionally. She explained that I would probably need to be induced as the baby seemed to be in distress, but we’d wait for a resident to come and check me as well.
As we waited, I decided to call our doula in. I was worried about bringing her in too early because – and I know how ridiculous this sounds now – I didn’t want to WASTE HER TIME (🙄 right? I had this conversation with Paul in the hospital too and he also pointed out I was being ridiculous). A quick side bar – always call in your support people when it feels right for you. That’s what they are there for. I’m so incredibly glad she arrived when she did.
Shortly afterwards a resident came in to do an exam and confirmed everything my midwife told me. She also used the exam to stretch my cervix to about 1cm in the hopes that it would send the signal to my body to start the process (yes it was about as much fun as it sounds). It was decided – I needed to be induced, which would happen through an IV drip of Pitocin. This meant we were already starting off both in a place and with an intervention that I was hoping to avoid. I reminded myself that the majority of birth plans do not go exactly according to plan and hoped these were the only surprises (I mean, at least I was getting them all out of the way early, right?).
There were a few other complicating factors here – an induction is an automatic transfer of care from your midwife to the hospital. That said, if you are able to deliver vaginally, once the time comes care transfers back to your midwife and they can deliver your baby. However, our primary midwife was scheduled to be off for the weekend – because we called her before she was technically “off” we were able to have her set us up at the hospital, but once the induction started she would not only be relieved of care, but also officially off until Monday. Luckily the midwifery model is such that we knew our back-up midwife well, but we would have to wait until active labour to call her and have care transfer back.
The birthing wing was extremely busy and short-staffed that morning, so a nurse had to be called in on her day off. The time we spent waiting for the nurse was actually one of the most enjoyable parts of the day for me – our doula joined us, we ate some breakfast and watched the Food Network (aka the best go-to daytime programming). I was able to walk around (still not feeling any of the contractions that were happening) as we spent a few hours monitoring the baby’s heart rate (still seeing decelerations) and sharing stories about our lives as a group. It was a full morning of laughs, funny coincidences and generally calm energy – exactly what I had been hoping for when I visualized this stage of labour.
Eventually our nurse arrived and it was time for our midwife to leave – in that moment I was SO grateful I had called our doula in. Knowing that we had someone there who we had purposefully chosen to be on our team, who knew our hopes and our fears surrounding the day, made the moments while the nursing staff were executing a flurry of orders, or outside monitoring us, feel less isolating and helped me stay grounded. When we hired our doula we had a number of reasons we wanted this support – but we had never considered that there would be a scenario where our midwife would not be with us throughout the day. As informed as we were on the birthing process and interventions we still found ourselves facing these moments with questions and uncertainty – were we making the right decisions? Did we have a say at all? Our doula helped us through these questions and tough moments throughout the day, explaining what was going on, while reassuring us that what was happening was in fact, exactly what needed to happen.
Once the Pitocin was hooked up we all watched as our hopes for a smooth labour that would soon get started drip down from a clear bag of fluid into my veins.
Whoa. It did not take long for those contractions to ramp up. They start off with a low dose and gradually increase it over time, which brought me some relief as I was admittedly a little scared about the induction. The attending nurse also knew about my hopes for as few interventions as possible and was very committed to helping us get labour moving forward, so she came in at regular intervals to turn the Pitocin up. She was lovely, but also very skeptical of my intervention-free plans and told me several times throughout the day that Pitocin is a very intense drug and I’d probably want an epidural. While I appreciated her candor in general, I did not love the skepticism and worried that I would prove her right… and what would that say about me? In the moments after she first made these comments I was incredibly grateful for both Paul and our doula, both of whom reminded me that I had prepared for this and if I really felt I needed an epidural that was also okay.
Time really went out the window for us when we got to the hospital – we kept commenting that we could have been there for 12 minutes or 12 hours and really wouldn’t have known the difference and this remained true as the Pitocin worked it’s way through my body. During the next seven hours we did one of our pregnancy mediations on Headspace and I tried to find different positions to help me through each contraction – from walking to bouncing on a birthing ball. However, every time I tried something new the baby’s heart rate would decelerate, which they were very worried about as it’s a sign that the baby is in distress. Eventually the nurse told me that I need to lay in bed on my left side as that was the only position he was tolerating well.
Naturally, this was the most uncomfortable position for me. As the intensity continued to build and the contractions came closer and closer together my doula could see that I was incredibly uncomfortable in this position but trying to muster all my strength to power through it, so she made a simple suggestion – why don’t we try standing? I know it seems counter-intuitive but it was so much better than laying down and thankfully one of the few positions that wasn’t putting the baby into distress.
At some point in the early afternoon I had been checked by the resident and hadn’t dilated further, but had become more effaced. The busyness of the day kept her from coming back too quickly to make a decision about how to move forward, ultimately giving me more time for things to progress. However, sometime in the late afternoon I was getting strong contractions every minute and began to ask when I’d be seeing the resident next – I needed to know how things were progressing so I could make a decision about what to do next. The contractions got the point that even the nurse felt they were too strong and decided to turn the Pitocin drip down.
Eventually, recognizing that I likely had several more hours of labour to go and that my body was quickly becoming exhausted after hours of standing and labouring I made the call – I needed to rest if I was going to do this much longer and an epidural would help me get there. The usual anesthesiologists were in the emergency room because a stabbing had taken place (there’s always something when you ask for an epidural isn’t there?); while the nurse thought this would mean a long wait for another anesthesiologist to become available, an experienced resident appeared in my room not too long after I made the decision🙌🏻. And in a strange twist of fate, he and I eventually figured out that the reason we looked so familiar to one another is because we went to university together (seriously so many coincidences like this throughout the day)!
This is also where my timelines get a little murky – at some point while my epidural was being set up the resident came back to check on me before her shift ended and delivered the same news I’d been hearing all day – I was still only 1cm dilated. As disappointing as this was for me, it was also an incredibly powerful reminder of the importance of listening to your own body; I had made the right call on the epidural. Because of the shift change she went to consult the OB GYN coming on, as my epidural was being administered.
I had read that the most painful part of the epidural process was actually the freezing they use before they administer the drug – admittedly, I was skeptical of this information. However, that and hoping I wouldn’t have a contraction while they inserted the needle into my spine, were the most difficult parts of the entire experience.
I then laid back and waited for the medication to bring me some relief, with the hopes that I’d be able to take a short nap and build up the strength to labour through the night and bring Eli into the world.
Come back on Wednesday for part two of Eli’s birth story! And share your own stories in the comments below👇🏻