Monday, January 26, 2009
Lake's Birth Story
Wednesday Dec 10th Claudia came over around 4 and did a HUGE stretch and sweep. The first real successful S & S. Deah wasn't too impressed but it clearly worked as within an hour she was crampy and within 2 hours having mild contractions. I put Tym to bed at her regular time and ran out to do some groceries. Deah sent me to bed around 10 to try and get some rest as she was sure "this was it". I fitfully slept as I could hear her moan through the contractions. By 2:30am I was awake and at her side to try and offer some comfort measures. Pressure at the low back seemed to work the best. I made sure she was hydrated and ate. By 4am we called Denise the midwife then on-call. The contractions were coming every 5-6 min. and lasting 45-60 sec. We agreed that we were ok at home and she would call back in about an hour. By 4:30am we called Christa & Abby over for help. They were an immense relief getting us both food and water and helping Deah though the contractions that were coming closer and closer. Denise checked back in at 5:00 and again we agreed to wait another hour. By 6:30-ish it was clear we couldn't really stay at the house with Tym waking up soon and Deah feeling a little anxious. Denise said to meet her at the Montfort and we were there by 7:30 thanks to Christa's awesome driving and luck with traffic even with a transit strike. We met Denise at triage and she examined Deah saying that she was about 3-4 cm and fully effaced. We hung out for a bit while Denise made sure the OB that was on-call was one that worked well with midwives. By 9:30am Deah was admitted. At 11:00am we agreed to an OB consult strictly due to how large Deah's belly was. Following protocol more than anything to keep us in the hospitals "good books". The OB Dr. Lucier was at first cordial and polite. He recommended a section right away because Lake was so large and he assumed Deah had gestational diabetes (we never did the test and her urine always showed up fine). We declined the section at that time but were open to it if it was clear labouring wasn't going to get us anywhere. The OB's demeanour changed right away and he seemed upset and a bit stand-offish. He proceeded to tell us that last year he had a woman do the exact same thing and he ended up delivering her dead baby after a uterine rupture and he was lucky to save the woman's life. I know he did this as a last "warning" to us but it scared the shit out of me and made me re-think everything. It made me doubt Deah. Not a good head space to be in to help her through contractions. Denise gave us more details that Lucier left out such as the fact that the woman was not even admitted into the hospital yet, didn't have an IV lock on, and had no blood work sent into the labs yet. Apparently these things all played into the delay in getting her baby out in time. Why I don't know but it helped re-assure me abit. Deah laboured hard for the next 2 hours and Denise checked her at 1:30pm. She had gone to 6 cm but Lake's head was still "bobbing" in her pelvis. Which meant he wasn't fully descending properly. We talked things over and all agreed that we would do another check at 3:30 as long as the contractions didn't intensify. Christa and I grabbed quick naps and Deah got in the tub followed by walks around and around the hallways. At 3:30 she was still 6cm and +4 - time to really look hard at a c-section. Denise talked with us and in her professional opinion it was safer and better for all if we called it. We quickly discussed our strategy for dealing with "the big baby" since we were calling in an OB. There is some concern that if the mother has gestational diabetes (which Deah didn't) that the baby could "crash" from the rapid blood sugar dropping after birth. We agreed that as long as Lake was doing well with clinical observations than there wouldn't be a need to call in a paediatrician. She said if she had any doubts that she would let us know ASAP and call for the ped than. We trust her clinical skills so it was no big deal to us to proceed that way. We called for the OB and he came in to discuss the section with us. He mentioned we would need to discuss a vertical incision vs. a repeat horizontal one since Deah had huge infection with the horizontal incision. He then left to go check on an OR wait time. He came back 15 minutes later and said we could get an O.R around 7pm. Deah got back in the tub and I helped as much as I could to get her through the increasing painfully contractions. Clearly starting to head into transition type contractions. The head nurse came in shortly after 6pm and rushed Deah out of the tub saying the porter was here and we had to head to the OR NOW. Deah in her state trying to rush out of the bath while having minute long contractions every 2-3 minutes with a nurse rushing her because the porters won't wait. Not cool! I'm starting to get a little pissed at how things are going since we are being rushed to the OR and the OB has yet to come back in to discuss the type of incision. Deah's whisked off in a wheelchair, Christa's gathered all our stuff and has set off to our new room to set it up for us and wait for Tym and Abby to show up. I head out with Denise to the scrub room to change clothes. Shaking the entire time and trying my damndest to hide it. We change and head into the "waiting" area of the surgical suits. I can see into the room where Deah is sitting on a table, her back to me with some stranger barely holding her shoulders as she moans through more and more intense contractions. As I watch, nobody talks to her, offers her any type of comfort, NOTHING! I start to get really upset and angry and yet feel helpless to do anything . The last thing I want to do is piss off the wrong person by saying something and then get barred from the OR. There are 2 other doctor's outside the O.R chatting away and Denise recognizes one of them. They say hello and ask each other what they are respectfully doing here. Denise says she's here as the midwife for the patient in there. The Dr. says he was brought in for a gestational diabetic prego and subsequent large baby. Denise asks if he means Deah and he says yes that Lucier brought him in. Denise looks confused and comes over to me whispering how weird and strange this is that Lucier would do that without consulting her let alone us. Denise and us had agreed that due to Lake's size we would be watching him closely clinically for signs of decrease in sugar. Lucier went ahead and made a decision that was never his to make. The ped dr. than goes into the OR and introduces himself to Deah who has had her spinal now and is lying flat on the table not really coherent as she's so tired. Ped Dr. tells Deah his name and that he is here to take a look at Lake. Deah just nods and says ok not really sure what's going on but assumes Denise and I have handled it. Deah saying "Ok" was taken as consent for Lake to be transferred to the ped Dr.'s care for the next 12 or so hours. This no one knew until after the birth. As I am still pacing and waiting outside the O.R room, the head nurse comes out of the scrub room, looks me up and down and grills me about my shoe coverings. The same blue sterile coverings she is wearing. She demands to know where I got them, who put them on, and did I have permission for them. I am so thoroughly exhausted, nervous and out of my element I nearly break into tears. I mumble some sort of answers that I guess were competent enough for her as she than enters the O.R. The OB's resident than comes up to me outside the O.R. She has kind eyes and is obviously trying to help me feel a little less nervous. As she is tying her mask on she meets me eyes and says "in 10 years does it really matter if you get to say I had a natural birth or I have a healthy safe child?" In one sense I know immediately that she thinks she is saying something to make me feel better - to help me know this is best for everyone. I already knew that at that time. I knew that as I paced waiting to be let in. I tried to remind myself of that as I listened with tears in my eyes as Deah moaned through a contraction with no help. I know the med student was "just trying to help" in her way, but at that time I just wanted to punch her. I felt chastised all over again for not agreeing to the section at 11am. I am led into the OR after an eternity and go right to Deah's head. We make chit-chat trying to ignore where we are. I eventually ask Deah how it feels this time and she says it feels different. Like it's an up and down incision. My eyes bugged out of my head and the realization of what a vertical and horizontal scar on the uterus means hits both us. I ask if she is sure and she says pretty sure. I lean in close to her and quietly tell her about the ped and Denise's encounter outside the OR. Neither one of us are really sure at that time what any of it means. But it's enough for both of us to agree to try and get out of the hospital and home as soon as we can. Denise comes around the curtain and says "so it's a vertical incision..." and we inform Denise that Deah never consented to it. That there was no previous discussion. Denise says "Oh My God!" and her eyes bug out of her head. She asks 2 or 3 times "he never asked you? He never came over and talked to you?" Again the realization of what this means is apparent. She quickly goes back to the warmer and Lake is born screaming his perfect little lungs out at 8pm. He is a giant! Too many hands are on him at the warmer as I watch Denise do her best to get control and also get me over there quickly. With Tym's birth Sarah (our midwife) was the only one at the warmer as the head nurse simply looked on. This time there's Denise, the head nurse, the ped. Dr., and some other nurse all touching him. It's not at all what I wanted for my son. Denise calmly informs me there was a little mecomium which is why Lake is being succtioned so much. Over-all though he seems fine from it. The ped guy then tells me that for the next 12 hours Lake is under his care to monitor his sugars through a heel prick every 2 hours. I ask why and he tells me that large babies can crash quickly from a change in sugar from a diabetic womb. I look to Denise and she nods her head ok. I assume that they've talked it over; she is under the assumption that Deah and I have talked it over. All assumptions are wrong at this point! I finally bring Lake over to Deah for her to see him. Denise then takes me and Lake to the infant nursery to go the preliminary check. There's a slight heart murmur on the left but that is normal for infants though she'll listen for it just in case at each subsequant check. I than bring Lake to meet Tym, Christa and Abby. While in the room Denise, Paula (another midwife who happens to be there) and I discuss what happened in the OR. I agree immeidaely that a lack of ethics was followed in the incision and the ped being called in. I agree that a letter will be written and some sort of complaint filed. After 60 minutes I am able to bring Lake down to Deah in the recovery room. Seeing them together helped take some of the immediate anger. confusion and helplessness away. Watching my son latch perfectly right away was a pure blessing.